The Freestyle Libre (part 2): Final Analysis.

Disclosure first: I was given the Freestyle Libre continuous glucose monitor to try at home. Abbott is covering the cost of the device and two sensors. I am not being compensated in any other way. All opinions on my brief experience with this device are my own, as always.

My trial run of the Freestyle Libre CGM was pretty smooth sailing.

There are a number of things I should cover, so let me give you the rundown of what I’ve observed:
 
 
– First of all, as I mentioned earlier, the sensor warmup period is a lengthy 12 hours. It’s great that there are no finger sticks involved, but there certainly are when you have to wait 12 hours for your first CGM reading. You still have to know what’s happening with your blood sugar over the course of 12 hours. So even though I’m not using them to calibrate (the Libre is self-calibrating), I’m doing a fair amount of fingersticks during that 12 hour warmup period.

It’s been mentioned elsewhere that the warm up time in other countries is significantly less than 12 hours, so here’s hoping that gets ironed out soon (also, more on the “careful” versus “full gusto” submission processes with FDA below).
 
 
– Unlike what I’ve been reading from others who have been doing the same trial, the numbers I saw from the Freestyle Libre were almost always higher than what I saw from my Dexcom or my Accu-Chek Guide meter. When my numbers were lower, they were pretty much in sync, single digits separating the numbers on the screens. When the number got over, say, 140 mg/dL, the numbers on the Libre were higher.

In these situations, the Dexcom always showed the lower number, and the Libre the higher number. The number from my glucose meter was somewhere in the middle. Like this:

Obviously, I don’t know this for sure, but to me, this would indicate not a failure, but a difference in how the glucose data is being interpreted by each individual CGM. As many will tell you, it’s not usually the number, but the trend that’s important. Plus, if glucose is being interpreted a specific way on a regular basis, it’s easy to account for that, or at least understand when to do a BG meter check to make sure.
 
 
– The size of the sensor is very small compared to any other CGM sensor on the market (for those of us in the USA, about the size of a half dollar). Insertion was easy (don’t forget, my user guide was in Spanish, so I did my insertion based on online tutorials). The comfort level wearing this on my upper arm is without compare. And it stayed on, without the need for extra adhesion.

This might be a factor to keep track of down the road… If they get enough competition, I can foresee Dexcom breaking the mold, so to speak, and speeding up work on a smaller sensor and transmitter option.
 
 
– There is certainly a convenience factor in being able to take the reader, scan it over the sensor on your arm, and see a new reading instantly. Even less than a minute apart. For the record, Dexcom gives you a new reading every five minutes.

This is not a big deal to me, but I have to admit that sometimes, I found it easier to have the reader next to me when I slept, and instead of reaching for my phone and getting the number in the middle of the night, I just scanned and saw the number on the Libre reader.
 
 
– That said, I have my phone with me throughout the entirety of my waking hours. To roll out a medical device in this day and age, and not have a Bluetooth/Mobile option of some kind attached to it is a real shortcoming. Especially considering the reader options are significantly limited. There is a mobile app for Freestyle Libre available in other countries (known as LibreLink), but not yet in the USA.

I get it… Abbott either wanted to make sure they got the Freestyle Libre approved as a standalone without having to get the mobile app approved at the same time, or they couldn’t get it approved right away and went instead for just the sensor and reader. They’re probably working feverishly to get the mobile app okayed as soon as possible. I’m only speaking for myself here, but that’s a dealbreaker. Double dealbreaker if the mobile app eventually comes out only on an Apple platform (LibreLink is available in other countries on Android, so yay).

You might wonder why, in this case, I seem to be holding Abbott to a higher standard than maybe I held Dexcom a few years back. Why? Because it’s 2018. In case you haven’t noticed, we’re in a digital, mobile-manipulated world, and yes, I’m expecting industry to keep up with the times. Is that asking too much?
 
 
– One additional item: There have been rumblings about the lack of alarms with the Freestyle Libre. That’s true in a sense, because alarms are not part of this package, unless you’re actually scanning the sensor. You, as an individual user, will have to figure out whether that’s important to you or not. I’ve also heard a lot about alarm fatigue from the Dexcom, so I will leave it up to you to decide what is best for you.
 
 
Overall, I think the Freestyle Libre is a good option for People With Diabetes. The cost is less than the Dexcom, the readings are accurate enough for this cowboy, and you can’t beat the size and comfort of the sensor. I also think this might be a super option for some (if they can get it approved by insurance), because of the longer sensor life (10 days versus 7 days for Dex), and the fact that finger sticks are not required (other than sensor calibration, finger sticks are not required for Dexcom either).

Bottom line: For now, I’m not moving away from my Dexcom. If there’s a mobile app that allows me to see the reading on my phone, and helps me share data? Then I’ll be happy to take a second look.

Again, and I don’t think I can say this enough, it is wonderful to have an additional CGM option, and one that isn’t forced to be linked with a specific insulin pump. There are plenty of reasons to like the Freestyle Libre, and only a couple of reasons for me to hold off on a full throated endorsement (for now).

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Comments

  • Rick Phillips  On January 16, 2018 at 10:16 pm

    Any new CGM option is important. I get to use a Libre in a month of so. I cannot wait to try it out. The one thing I continue to say is that the Libre seems more like a glucometer than a CGM.

    Liked by 1 person

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