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Freestyle Liberating

So,what's all the fuss about?

Today's graph with two Nutella-covered wraps - no Low Carb here!

The Abbott Freestyle Libre is a paradigm-changing piece of medical equipment.  It has been warmly embraced by many of the diabetic community since its launch almost three years ago (its birthday is on 16th October).  So what's all the fuss about and is it justified?

In my opinion, yes, but with some important caveats, especially with how you use it and interpret the results.  These are my tips for getting the most out of it:

  • Use it for trends - stop thinking you need to compare it to other meters.  The only reason you should continue to test traditionally is to meet requirements of DVLA.  OK, if you are hypo-unaware, I can see logic in checking.  Yes, it can be 'inaccurate' but that's hard to quantify.  If you're far enough into your journey with diabetes, you should have a fair idea of what the scan is going to show.  If it doesn't match what you think, it could be wrong, or you may have miscalculated food or insulin - or it could be down to the random variations that all T1s get.  When you were first given a traditional meter - did you buy another one just to make sure it was 'accurate'?  If so, probably need to keep comparing for your own peace of mind.

  • Don't get down-hearted - there will be 'bad' days, frustrating days and downright confusing days.  T1 doesn't go away and you have many years ahead to cope with the condition.  One day, one week or even one month are almost irrelevant.  Keeping motivated is the most important factor in maintaining long term good health and control and incremental improvement is the most sustainable.  Never compare your target range or your successes/failures with anyone else.  By all means celebrate successes and comiserate failures, but they should be there to motivate you alone.

  • Beware of over-thinking/testing.  I hear stories of people scanning 50...60..100 times a day.  To me that would be concerning - I'd be worried about the person's mental well-being, especially if they sustained that over a long period.  For me, as a former scientist, I only scan if I'm going to do something about it.  If my insulin has finished acting, before a meal and before bed.  That's it.  Seeing as Novorapid has an action lasting up to 5 hours, the most regularly I would need to scan is every five hours.  Additionally, I like my sleep, so unfortunately, the 8 hour gap overnight means I almost always get a gap - I will never test during the night unless a hypo wakes me.  Shame they don't stretch it to 10 hours of data between scans!  Diabetes shouldn't be a worrying condition - are you going to worry for the rest of your life?  That's a sure-fire way towards depression and other associated health conditions.  Yes, some aspects of diabetes can be dangerous and if you don't take control, then it can be extremely serious.  However, for most well-motivated and dia-educated people that risk is greatly reduced.  Worry about motivation and knowledge, not the condition itself.
Finally, a question that we get asked lots on the Libre Facebook page (as well as the free postage code - it's BCCFRD10 in October btw!) is about accuracy.  This is difficult to quantify, but think of the spot result that is given by the Libre as a range.  The table below is what traditional meters have to adhere to and can be applied to Libre.

So, if your Libre is reading 6mmol - your actual level should be between 5.1 and 6.9.  If you then compare with another meter and it reads 8, it's saying your range is 6.8 - 9.2.  As the two ranges overlap, then these two results are compatible with an accurate reading, albeit at the outside edge of allowable range.  As I implied earlier, I don't care enough about raw results to want to check apart from when I have to.

I have many more thoughts about the Libre, but that's enough for today.


Anonymous said…
Remember that 15% table for BGM only applies if the meter is up to specification. In a recent test of a number of brand new meters in the US only 1/3rd of them were found to meet the standard. I’d trust the Libre almost every time over a BGM. Only thing better is your own feelings.
NickC said…
Hello Anonymous,

True...and actually, the Libre doesn't have to meet that standard as it's only for traditional meters. I think the issue with Libre is that it is subject to systemic errors. Where you take a new test strip each time for a BG (albeit the batch may be bad, or compromised in some way), the Libre is using the same 'substrate' for testing each time. This means that the readings are not independent of each other, like they are with a traditional meter. I'm not sure I trust Libre over a BGM...I trust both of them unless it doesn't make sense.
Philip King said…
Sleep envy!

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