Category Archives: Reviews

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).


The Freestyle Libre (part 1)

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.

You might have noticed a lot of talk about the Freestyle Libre gaining approval by the U.S. Food and Drug Administration a couple of months back. That means that we here in the United States now have access to a device that has been a hit in Europe for a couple of years now.
Since I was given the receiver and a couple of sensors to try, I am happy to share my experiences using the Freestyle Libre. The setup was easy and completed without even checking the enclosed user manual and other material (more on that in a minute).
The initial two things I have to say about it fall under the Bad Thing/Good Thing heading.
Bad Thing: all of the documentation I received is in Spanish. The user manual and quick start guide are all en espanol. I can read and comprehend some Spanish, but not enough to feel confident using a medical device.
But… Good Thing: The online tutorials were terrific, and all I needed to get started.
Bad Thing: The Freestyle Libre calibration process takes 12 hours.
Good Thing: It’s true… this CGM does not require a fingerstick to calibrate.
I think that’s enough to start with. If you want to see what others have to say about the Freestyle Libre, just look around a bit… you’ll find plenty of information and opinion. Then come back here, as I will likely have more to tell as the next 20 days or so pass.
One more thing: I am thrilled that there is another tool for People With Diabetes to choose from to help them manage their misbehaving pancreases. As a community, I hope we can continue to encourage and empower choice and access for everyone.

Review: The Accu-Chek Guide.

Full disclosure: I was sent a new Accu-Chek Guide by Roche so I could try it out. I was not asked to write about it. All opinions, good and bad, are my own. Read on for my thoughts.

I’ll be honest… I’ve been a fan of the Accu-Chek glucose meters going back to the Accu-Chek Nano (which I still have two of and still use), and I’m about to tell you why. In fact, there are three reasons why I’ve liked these meters for years.

1. Accuracy. Since my first Accu-Chek Nano, the readings I’ve received have been something I could rely on. Even after beginning on my Dexcom continuous glucose monitor, I’ve noticed that my results are almost always within 10 mg/dL of my Dexcom readings. Actually, they’ve been nearly always within 5 mg/dL of my Dexcom readings. Hard to get more accurate than that.

2. Consistency. Those accurate readings have remained, no matter how long I’ve used a meter. It’s really great when you have a feeling that your meter will give you result that you can count on, even if it’s high or low.

3. Improvement. Even though my Nano was pretty good four years ago, my Aviva Connect meter, which I received just about a year ago, has been great too. It’s also been something that’s been able to be synced with mySugr and Tidepool accounts, and believe it or not, there aren’t a lot of meters that are doing that, or doing it with Bluetooth technology.

While I can’t say I know a lot about the company, I can say that I’ve been happy with what they’ve produced for a number of years. So… how does this new Accu-Chek Guide measure up? Here are the pros and cons… since I like happy endings, I’ll give you the cons first.

Cons: Actually, the only con I can think of (feel free to add your own in the Comments section, if you have one) is the marketing of the new container for strips. It’s true that when you open a brand new container, the strips are neatly lined up and easy to access, and they don’t spill if you turn the container upside down. Once you’re about halfway through though, it’s easier to knock one or two (or a few) out of place and then they’re much more likely to fall out when you don’t want them to. Still, it’s not like the previous containers were that great. They went for an improvement, and I think it is an improvement, just not as good an improvement as they’re touting.

Pros: See my notes above about accuracy, consistency, and improvement. In addition, probably the biggest thing that makes me a fan of this meter are the strips themselves. The strips have a flat surface, meaning that instead of having to get blood on a narrow part of the strip to get a proper reading, you can actually get the blood on any part of the strip to get a proper reading.

Check this out (video courtesy of me):

When I saw that for the first time, I was hooked.

Now, let’s talk about price. Not the meter price, because you know glucose meter makers will make their meters extremely inexpensive in order to get you to buy the strips, which is where the real money is made. Roche, makers of the Accu-Chek Guide, is doing something different when it comes to pricing on strips. For people who have trouble affording the expense of strips, they’re implementing something called the Simple Pay Savings Program.

Here’s how it works:
You can get a savings card from your doctor, or from Roche. With the savings card, the first vial of strips would cost $19.99. Each additional vial after that, for the same prescription, is an additional $10.00. That means that two vials (100 strips) would cost $29.99, three would cost $39.99, and so on. You can use the savings care to get up to 12 vials, or 600 strips, per prescription.

All in all, I find this meter another compelling offering from a maker I trust. You might have noticed that I’ve almost entirely stopped reviewing products here, mostly because I get more offers to review things than I have time to write, and also because I want to only endorse things I truly believe in. Take this with a grain of salt if you must, but I really like the Guide.

Please remember that other than the meter and 50 strips, I’m not getting anything for this review. If you have a different experience with the Accu-Chek Guide or other meters from Roche, let me know in the comments below. As always, your experience may be different, which is just one of the reasons why we should communicate with one another.

I should also mention that Diabetes Mine did a fabulous and more detailed review of this meter last week. CLICK HERE to check it out.

Finding diabetes devices you can rely on is a tall order sometimes. Personally, I’m glad to have another meter I can count on.

Liquid Splenda? A little goes a long way.

I was contacted recently regarding by a PR person asking if I’d like to try a sample of a new Splenda product: Splenda® Zero™ Liquid Sweetener.
This is liquid Splenda. In case you didn’t know, I’m a Splenda fan, and when approached, I thought it would be fun to try this out. The idea is that this is Splenda’s formula, just in liquid form.

To set the table (no pun intended), Splenda is sucralose. It’s what goes into Coke Zero, which I really like. Another popular artificial sweetener is aspartame, which is what’s used in Diet Coke. And there’s your difference.

Up to now, we’ve only seen Splenda in granular form in the marketplace, and that’s been okay, because it still works in my morning coffee. How does liquid Splenda perform?

Very well, and very sweet (no pun intended). I mean, a little of this stuff goes a long, long way.

When I received my sample in the mail, I was surprised at how small the bottle was (1.68 fluid ounces), and I reached out to my contact at the PR firm that arranged the review and I asked whether the size I received was the actual retail size, or if it would be bigger. The answer was yes, what I received is the retail size, and it will sell for around $4.99 US.

Tasting it in my coffee, I understand why the bottle is so small. It packs quite the sweet punch. Ordinarily, a semi-heaping teaspoon of granular Splenda is what I’ll use in a typical cup of coffee. Or two packs of the stuff you see in a restaurant. In liquid form, that equates to one squirt of the bottle. More than that, and you really get extra sweetness.

I’m told that the new Splenda will go well in recipes, and I can’t wait to try it in my next batch of cornbread. I know, sweet cornbread. I’m one of those people. It’s the little something extra I go for when I’m enjoying barbeque, especially. Anyway, personal tastes aside, I can see this as something I might have in my cupboard for cooking. Not to replace sugar in things like pies, necessarily, but in things where I just need a little bump of sweetness, without the high glycemic boost that sugar brings. I suspect if you’re used to carrying a purse around every day, you could pack this little thing away and have instant artificial sweetness as close as your handbag.

If I were a thumbs-up or thumbs-down guy, I’d give this a thumbs up. Easy to figure out, still sugar free, the price isn’t crazy high. I hear it should be in your local store soon. Splenda® Zero™ Liquid Sweetener.

I was given a free sample of Splenda® Zero™ Liquid Sweetener to try at home. I not compensated in any way for my take on it, which is absolutely my view and cannot be bought with a little bottle of liquid sweetener. All opinions are my own.

Customer service woes? Dexcom’s working on it.

If you’re a User of the most popular CGM on the planet; and if you’ve needed help from Dexcom’s customer support lately; you may have had a less than stellar experience.

I got a chance to speak with Kevin Sayer about that yesterday. Kevin is Chief Executive Officer at Dexcom. He gave me a rundown of how Dexcom is working on solving some of the issues their customers have been facing.

I asked Kevin if the latest customer service initiatives are a function of Dexcom sales growing faster than their customer service function, or if they’re just looking at things with a fresh set of eyes. The answer is yes to both of those. According to Dexcom’s quarterly report released this week, revenues are up 60 percent over this time last year. That’s a lot. He explained it by saying that it’s one thing when Dexcom was growing from 2,500 to 5,000 customers. But Dexcom is still growing fast, and they now have greater than 150,000 customers. That means when you have problems, they become a lot bigger a lot faster than they used to be. So they were forced to take another look at customer service.

As a result, Dexcom has introduced some initiatives designed to reduce the burden on patients who really could use less burden in their lives.

To begin with, they’re rolling out a phone system upgrade. The idea is to reduce wait times and queues. They’ve introduced a new feature where, when phone lines are busy, a customer can opt to have Dexcom call them back without the customer losing their place in the queue. So hopefully, people won’t be on hold forever anymore.

They’re also adding additional customer service reps. Those hires should continue through the month of May.

In addition, Dexcom has made some website upgrades. There are new self service options, and there have been improvements to the online store. Kevin put it this way: “If you’re ordering supplies at 11 o’clock at night, which is what I’d be doing, we want it to work well.”

Finally, there are training and video updates. More descriptive videos, easier access to videos, and the rollout of something brand new for Dexcom: live webinars.

One of the challenges Mr. Sayer relayed to me is the idea that with the Dexcom G5 system, they were no longer answering questions about sensors and receivers. Receivers that Dexcom designed and manufactured. They were now getting inquiries about sensors and phones. Phones that they didn’t design and don’t manufacture. So that slows up customer service a bit, though he feels they’re getting better at it.

At the end of our conversation, we talked about Dexcom at ten years old. How does he feel about shepherding the company into its second decade?

Kevin admitted that there aren’t a lot of examples to go by in the diabetes device world, because so many have gone out of business before reaching the ten year mark. So in a way, Dexcom is blazing its own trail, while still growing its customer base in a big way. And he told me something that I would expect every CEO to say: Dexcom’s patients are the most important part of their business.

Let’s hope that the phone system upgrades, website improvements, and customer service hires help Dexcom come through for their patients for many more years to come.

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