FreeStyle Libre Flash Glucose Monitoring System from Abbott

FreeStyle Libre Flash Glucose Monitoring System from Abbott

This is my personal view from a short trial with the FreeStyle Libre.

FreeStyle Libre box contents
Exciting! My FreeStyle Libre box contents!

The FreeStyle Libre also be used as a regular blood glucose and ketone meter, using test strips prescribed through your GP.

The Libre is different from everything else on the market at present (Jan 2015)  It’s not a CGM (Continuous Glucose Monitor)  If used constantly it enables you to see a full picture of your daily levels which helps you analyse your insulin and carbs and make adjustments to your diabetes management.

It is more economical than available CGM, however it is not yet available on the NHS.  The cost savings are mostly due to the 3 year warranty (when registered) with the scanner.  If using a Dexcom CGM, the transmitter has a minimum 6 month warranty, and the Medtronic Enlight transmitter has a 1 year warranty.  If you do not have a pump with integrated CGM then you have to factor in the cost of a receiver also.  These parts to the other systems add considerably to overall cost.  Some clinics have trials and others have purchased the Libre for some patients, so it is always worth asking your clinic about it and letting them know you are interested.

Like CGM, The FreeStyle Libre reads from interstitial fluid, this is not blood but the fluid below the skin.  You cannot make a direct comparison to any BG meter or other CGM as results will always vary, but be rest assured the Libre has a good record or accuracy.

FreeStyle Libre sensor
FreeStyle Libre sensor on my arm

Insertion was simple, and completely painless.  It stuck well for the full 14 days, although everyone is different so I would always use extra tape in the future.  It would be expensive if it was knocked it off! Although it’s thin and lightweight, (approx the size of a 2p coin) I did bump it a few times and catch it with my bag strap in the first few days, it still stuck well and I got more used to it being quickly.

If you are hoping to improve diabetes management, and/or want to encourage more testing, the FreeStyle Libre is a low start up cost option, without having to purchase more expensive CGM.  It is very user friendly and kids love it!

Pros

Cost – in comparison to CGM (very low start up cost)

Size of the water resistant sensor

Discrete

Size and portability of reader

Ease of swipe to read BG – it’s addictive!

Reduction in daily finger pricks

Very user friendly – easy set up, and no calibration required

Cons

Finger prick testing still required for driving, fast changing BG levels, before corrections and if the Libre gives an unexpected result

Notes and recording insulin doses could be improved

Cost!

I have heard healthcare professional say this is a fad, that Abbott are using clever marketing techniques to build up interest in the product, but I disagree entirely. I have not used the Libre long enough to see if it had any baring on my HbA1c, but as many others have been wearing it full time since its launch and are getting positive HbA1c results inline with expectations from the Libre, I do believe the proof is in the pudding and it is very hard to see any negatives about the Libre apart from financial ones in comparison to blood glucose testing.

If you can afford it, give it a go and let me know what you think.  You can talk to others who use the Libre in the iPAG, CWD (for parents) or Type 1 Diabetes in Scotland Groups on Facebook.

Costs

Starter Pack – Reader plus two sensors: £133.29 +VAT

FreeStyle Libre Reader: £48.29 +VAT (in VAT £57.95)

FreeStyle Libre Sensor: £48.29 +VAT (inc VAT £57.95)

Sensors last up to 14 days

(VAT may be wavered as this is for medical use)

For VAT Exemption notes see here

Check www.freestylelibre.co.uk for more information


Results of the IMPACT Trial (FreeStyle Libre)

The IMPACT clinical trial is a randomized, controlled six-month trial to evaluate the effectiveness of the FreeStyle Libre system in improving glycemic control for the self-management of type 1 diabetes as compared to self-monitoring of blood glucose (SMBG). The primary endpoint was a difference in number of hours per day in hypoglycemia (<70 mg/dl or <3.9 mmol/l) between the group using the FreeStyle Libre system and the group using traditional finger sticks (SMBG) from days 194-208. Two hundred and fifty-two (252) patients over the age of 18 participated in the trial, which took place across 23 sites in Austria, the Netherlands, Spain, Sweden and Germany.

Key findings from the study include (FreeStyle Libre users versus traditional Self Monitoring of Blood Glucose):

  • 38 percent reduction in time spent in hypoglycemia (<70 mg/dl) (<3.9 mmol/l)
  • 40 percent reduction in time spent in nocturnal hypoglycemia at night (11 pm to 6 am)
  • 50 percent reduction in serious hypoglycemia (<55 mg/dl) (<3.0 mmol/l)
  • No increase in HbA1c at six months
  • Glucose monitoring increased to an average of 15 scans per day
  • Routine finger sticks were nearly eliminated—reduced by 91 percent

Full trial information here

A good presentation by Dr Fiona Campbell about the FreeStyle Libre