Freestyle Libre

FreeStyle Libre: First Observations!

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With the life of my FreeStyle Libre sensor coming to an end in a few days, I thought I’d better write some observations while they are fresh in my mind.

I first put my Libre sensor on during Diabetes Exchange in Sydney (disclosures are at the bottom of this post). We were advised that the best place to wear the sensor was on the underside of the upper arm. In similar fashion to an insulin pump infusion site, the sensor came packaged in what looked like an insertion device. It simply “clicked” into place on the arm.

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I’m the kind of person who easily gets annoyed by things. I fiddle with my watch, my medic alert bracelet presses too hard on my skin, and I am always picking at scabs. So I was pleasantly surprised that I have hardly noticed the Libre sensor. So far, the sensor has held nicely on my arm. I had one bath where the sensor was submerged in water for some of the time. I’ve had showers and changed my clothes every day, where the sensor is inevitably subject to some bumps and friction. The sensor is starting to look a little grubby around the edges, though, as it heads towards the end of its life.

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Being Winter, my sensor often sits under warm clothes and I notice it less. It is likely exposed to lesser impact and outdoor activity compared to the warmer months of the year. I’m also not sure how comfortable I’d feel wearing this $95 sensor to the beach under some rough waves.

Some of the other bloggers raised the issue of the Libre not having alarms to alert them of high and low blood glucose readings, which is a very valid point. I am not particularly concerned by this. Just as with finger pricks, I check often enough to be able to catch any impending highs or lows. I’m all for something simple, and that minimises the diabetes junk that I have to carry around with me. The Libre fits the bill nicely. As with anything, more features will mean an even higher price tag.

A great deal of my Libre use has been checking my glucose levels after meals. This has given me an insight into where my levels are heading after I eat, and in evaluating the need to readjust settings and ratios on my new insulin pump. We were told that data may be less accurate than a finger prick when glucose levels are rapidly changing, so please bear this in mind around my observations. 

My Libre reader has typically run around 1-2 mmol higher than the reading on my meter. I have also noticed a more significant difference where my Libre presents a reading greater than 15mmol. I have found greater accuracy where my levels are in single digits, and where there is no active meal bolus in my system.

That being said, the Libre has been super convenient to have while I’m transitioning to the insulin pump. It’s been a huge relief on my fingers at a time where I would likely be using test strips like water. Every morning, I plug it into the computer and upload the data to Diasend. It gives me access to detailed graphs that have tracked the movement of my levels through the night, which is extremely helpful in making decisions around my overnight basal insulin rate.

I walked around without my meter and test strips while I was in Sydney quite comfortably, too. The reader was quite easy to carry around, and fitted nicely into a t-shirt or jeans pocket. It was a really convenient tool to evaluate my blood sugar levels after some big Sydney meals, and a reliable indicator of glucose trends. I would definitely consider buying a sensor next time I plan on travelling.

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After a week and a half with my sensor, I am also feeling extremely challenged not to micromanage data. It’s extremely challenging to look at those annoying trend arrows after meals and not respond to them. It’s for the same reason that I’m not particularly interested in using a Continuous Glucose Monitor (not to mention the price!). I will definitely miss the convenience and the detail of my Libre data when my sensor shuts down on Thursday, but I am also very much looking forward to a break.

You can find out more about the upcoming Australian launch of the FreeStyle Libre at freestylelibre.com.au.

Disclosure: Abbott paid for my travel and accommodation expenses to and from Sydney. I received a FreeStyle Libre reader and 2 sensors free of charge. There was no expectation that I would blog about the Libre. All opinions expressed here remain my own.

DX2 Sydney

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Two weeks ago, I had the privilege of attending Abbott’s Diabetes Exchange event in Sydney (see below for disclosures). I went into this event excited about trialling the FreeStyle Libre, and meeting some of the other Australian bloggers in person. Having only communicated with PR ladies Hannah and Laura prior to the event, I was surprised to learn that there was an Australian based Abbott team. I was also pleasantly surprised that they were such a core part of our proceedings over the two days.

Peter, Bruce, Michael, Pamela and Jen were with us throughout the whole two days worth of proceedings. They each presented in front of us, but they were also very much with us in a social context, too. They dined with us on Thursday evening, they sat next to us during the formal proceedings, and they also put their cooking skills to the test with us on Friday afternoon at the Sydney Fish Market.

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Going into this event, I honestly wouldn’t have thought I’d have anything in common with these guys. They were there to sell us a product, after all. However, I had some really great conversations with most of them. Although not all of them had diabetes themselves, I could see how genuinely passionate they were in the work they did. I could see how genuinely interested they were in us. Not just about the diabetes, either. I recall speaking with Jen, in particular, for at least an hour at dinner on Thursday.

One of the highlights of the event was hearing from Udo Hoss, who talked us through the “science” of the FreeStyle Libre.

We learned about how the Libre sensors were clinically proven to produce accurate and consistent results across their whole 14 day life. I learned about the term Mean Absolute Relative Distance (MARD) from regular blood glucose checking. From memory, the MARD must be below 15% in order to be a reliable indicator of glucose levels. The Libre system achieved a MARD of 11.4% across its 14 day sensor life, making it accurate enough to make insulin dosing decisions from. For this reason, Abbott are pitching the Libre as a replacement for finger pricks.

Given that the MARD is slightly higher during the first 24 hours, I cheekily put my hand up and suggested that we should receive an extra day’s worth of sensor life to compensate. There was a lot of laughter in the room, but sadly no leeway!

There were also three conditions where we were told to confirm a Libre scan with a finger prick.

  1. When glucose levels were low.
  2. When symptoms don’t match glucose readings. (Corrected)
  3. When glucose levels are rapidly changing.

We raised the question of how we would be able to push the sensor life beyond it’s 14 days. Unfortunately they automatically shut down, as Abbott cannot guarantee their accuracy or safety beyond the 14 day life.

We were also told that the data lagged by about 6 minutes.

It’s easy to sit behind a computer and complain about something being too expensive, or something else being difficult to access. Trust me, I’m guilty of it. Yes, Abbott are a business, and like any business they are trying to sell us a product. I acknowledge how privileged I am to be able to try this product free of charge. The $95 price tag for each sensor will place it out of reach for many, I’m sure.

That being said, sitting in with the team from Abbott really gave me a greater appreciation for the whole product. I had a much greater appreciation for the whole research and development process, and not just the item that I see on the shelf at the Chemist.

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Thanks again to the team at Abbott for your great hospitality, and for having me at DX2 Sydney.

You can learn more about the Australian launch of the FreeStyle Libre at freestylelibre.com.au.

Disclosure: Abbott paid for my travel expenses to and from Sydney. I received a FreeStyle Libre reader and two sensors free of charge. There was no compensation, or expectation that I would blog about the event. All opinions expressed here are my own.

Hey, Sydney.

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Today, I’m attending my first “official” diabetes event since I started my blog. I’m headed to Abbott’s Diabetes Exchange Program in Sydney, where I’ll learn more about the FreeStyle Libre which is launching in Australia soon.

What is the FreeStyle Libre, you ask? It’s a glucose monitor that measures blood glucose readings by “scanning” a small round sensor worn on the arm, rather than traditional finger pricking. I wrote about it in more detail over here.

I’m just an ordinary guy living with diabetes. While I don’t blog for the perks and the recognition, it’s a huge testament to my writing here that I would be included in such an event. These sorts of things never happen to me, so yeah it’s a big deal.

I’m also really excited for the opportunity to meet some of the folks in the Oz Diabetes Online Community who will also be present. While I love the Diabetes Online Community, these guys mean the most to me out of all of my DOC connections being closer to home. I watch their activity online with great interest and I try to follow their example when writing about diabetes here.

Which brings me to some disclosures. Abbott has paid for my travel and accommodation expenses to and from Sydney. I have been given a FreeStyle Libre reader and 2 sensors free of charge. There is no expectation that I will blog about the Freestyle Libre or anything else discussed at the event. I have not been paid to write anything. Any opinions expressed here and on social media are voluntary and remain my own. I have actually had to take time off work to attend this event.

You can follow along using the hashtag #DX2Sydney on Twitter later today, and keep an eye on my Facebook page, which you can ‘like’ here.

While I’m on the topic of travel, can I just say that Lost has ruined my life forever? I’m obsessing over the diabetes supplies I’m packing, wondering whether they will be enough to last me if I were stranded on a tropical island! Not to mention that stupid ending in the church…

See you soon, Sydney.

“Do You Use a Lot of Test Strips?”

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“Do you use a lot of test strips?” My pharmacist asked me, as I placed a handful on the counter to purchase.

I went silent, lost for words to answer his question.

“Yeah, I do,” I replied.

I was wondering if I was going to have to justify myself. Was this going to be another big dilemma where I would be told that I’m using too much? Was the computer going to tell him that I’d gone over the limits and couldn’t purchase any more?

“Do you see a diabetes educator?” He asked.

He sounded like he wanted to suggest something. That I needed to get help?

“We’ve actually got a little boy who comes in here. He’s got this little sensor that he wears on his arm that measures his fluid. He swipes over it, and it gives him his readings. He doesn’t have to prick his fingers so much. It even gives him a history of his readings.”

I smiled, because I knew exactly what he was talking about. “Yeah, that’s the Freestyle Libre,” I replied.

A little over a year ago, I wouldn’t have even known anything about this. I would have just stood there and politely nodded, but disinterested all the same. I’m so proud of the interest I’ve taken in diabetes over this past year. I love how passionate and how “in the know” I feel around the subject of diabetes. I loved that I was able to hold up that conversation and sound like a bloody expert. The happiness I felt for that little boy and his mother was so real.

I know that he was genuinely being nice, but I still felt I needed to justify myself before walking out.

“Just because I use a lot of test strips, it doesn’t necessarily mean I’m struggling with my diabetes. That’s the common misconception among healthcare professionals. Regular testing is just something I do that helps me to manage my diabetes.”

“And just because I’m buying them, it doesn’t necessarily mean that I’ve run out of them at home. You’ve gotta stock up, right?” I said, thinking fondly of this “Clean It Out” prompt from Diabetes Blog Week last year.

FreeStyle Libre To Hit The Australian Market

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Updated: You can read about the blogger event I attended in Sydney here, and my initial review of the product here.

Okay, well in case you haven’t heard this news already…

Abbott’s FreeStyle Libre Flash Glucose Monitoring System recently received approval from the Therapeutic Goods Administration in Australia, and is expected to be launched in the Australian market in the coming months.

The Glucose Monitoring System consists of a small round sensor that is worn on the back of the upper arm, and a “reader” that looks very similar to a blood glucose meter. Users need only scan the reader over the attached sensor in order to receive a reading, and 8 hours worth of historical data.

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The Libre has a few key differences that sets itself apart from a traditional Continuous Glucose Monitor (CGM). The sensor appears to be much more discrete, approximately the size of two stacked 20 cent coins. Sensors also have a life of 14 days, as opposed to traditional CGMs which last up to 7. Abbott also claims that the Libre eliminates the need for finger pricking, making glucose testing more convenient and discrete. Alternative CGMs need calibrating with finger pricks, and only guarantee glucose trends rather than historical data.

Unlike a CGM, however, the Libre is not a “live” glucose monitoring device. It is up to the user to complete the scan in order to obtain a glucose result and historical data. There are no alarms or indicators to alert the user when they are going high or low. I also don’t believe that there is any “sharing” functionality of data through smartphones, which many CGM users in the DOC place a high value on. It appears that data can be downloaded to a computer and generated in report format, similar to the Insulinx meter I have been using recently.

I know that many folks in the Diabetes Online Community do pay for the convenience, live data, sharing and peace of mind that a CGM offers them. I know that many have come to rely on this standard in their diabetes management, and I wouldn’t expect that the Libre would hold much appeal here.

I have previously expressed reasons for not wanting a CGM myself. I’m quite motivated to do my finger pricks as much as I need to. I’ll be switching to an insulin pump in May, and I can’t say I’m keen on wearing two devices. I can’t say that I could handle seeing “live” data all the time. At $75 for a sensor that lasts only 7 days, I can’t say that I can afford it either.

I believe that this is where the Libre would hold the greatest appeal.

I also know that for many who would like one, a CGM is out of reach. At a time where there is a strong push for greater access to glucose monitoring technology in Australia, the arrival of a new competitor in the Libre is an encouraging sign. I have only heard positive things about the Libre from European folks in the DOC who have tried it after traditional finger pricking.

The biggest factor here is likely to be the cost of the Sensors, which need replacing every 14 days. While Abbott is yet to comment, Seven News speculates a shelf price of $100 per sensor. Given that CGM sensors are not currently subsidised by the National Diabetes Services Scheme (NDSS) in Australia, I would not expect that Libre sensors would be, either.

You can read more about the FreeStyle Libre, and sign up for e-mail updates at freestylelibre.com.au.

Disclosure: Abbott sent me a Press Release regarding this news. I was not asked or paid to write this, and all opinions expressed here are my own.