Posted by on Monday, 15 September 2014

Abbott Freestyle Libre review - BG monitoring goes all flash

In recent weeks the mentions, rumours and tidbits about Abbott's shiny new gadget have been reaching fever pitch. If you are of a Twittery persuasion and follow more than about two UK-based-diabetes-type tweeters you cannot fail to have noticed this. Abbott's 'Freestyle Libre' has it's official European launch at EASD today (EASD is a massive professional conference for all things European and pancreas-challenged). I was thrilled to be invited to meet with some folks from Abbott on Friday last week along with a select group of bloggy and tweety types with borderline legendary status for a sneaky peek before the official launch. Quite how I managed to swing an invite remains something of a mystery. We gathered in an upper room in a trendy Soho establishment, were treated to a tasty breakfast and we were sworn to secrecy until 1pm today. Much to my surprise it transpired that we were not just going to be able to handle the technology on the day, but were actually going to be given a chance to experience the Libre ourselves for 28 days, being supplied with a reader and two sensors to take home. It was suggested that we might want to consider writing a post or perhaps tweeting a few characters about our experience, but this was by no means mandatory. Nor did we even have to try the Libre at all if we didn't fancy it.

What on earth are you on about?
In the unlikely event that you have never heard of the Libre, or Flash monitoring, here's a brief overview: It's not quite a CGM. It's not quite a Blood Glucose monitor.

Too brief? Oh, OK... here's a bit more detail: The Abbott Freestyle Libre is a new kind of blood glucose monitoring technology that sits somewhere between existing CGM options and traditional SMBG (fingerstick) monitors. It measures interstitial glucose levels using what Matt (Abbott's techical bod) described as 'wired enzyme technology' and Fiona (communications lead) referred to as 'special sauce'. If you've not looked into CGM before, interstitial glucose is not quite the same as blood glucose. It is measured in the fluid that surrounds the cells in tissue rather than from the blood itself. Typically these levels lag slightly behind BG by up to 10-15 minutes, but Abbott are using an algorithm to adjust readings which they claim reduces this lag to 5 minutes or less on the Libre. The measurement is performed with a tiny, flexible filament inserted under the skin and attached to a small, flat, circular sensor, roughly the size of a £2 coin. Abbott recommends that the sensor is worn on the back of the upper arm which seems to give optimum results and is less likely to be knocked off by doorframes. If you are writing a blog post, you will also notice that this location is virtually un-photographable one-handed - see below. The Libre's sensor measures glucose levels once every minute and stores 8 hour's worth of data. One of the main differences between the Libre and traditional CGM is that the data are not sent via transmitter/receiver continually. To access the information you simply wave the reader (or is it 'flash'? or perhaps 'swipe'?) over the sensor and you will be given a glucose concentration reading taken at that moment along with a graph of data from the previous 8 hours. Data points on the graph are created every 15 minutes averaged from the readings taken at 1 minute intervals. You also get the 'trend arrows' which will be familiar to CGM users and give an indication of which direction, and how fast glucose concentrations are changing. The near-field communication works anywhere between 1cm and 4cm and will happily ready through clothing, even as much as a skiing jacket they said. I've already smiled to myself as I walked down a street and checked my levels by swiping my reader over the arm over my coat.

Sensor shenanigans
I was hugely impressed with how easy it was to insert the sensor. It was also absolutely painless, significantly less 'stabby' than a set insertion for Artoo. Everyone around the table inserted their sensors at the same time, and noone seemed to feel a thing. The sensor came in two parts that needed to be pushed together which seemed to 'prime' the self-serter. Then you chose the back-of-arm location you fancied and applied gentle pressure to the composite gizmo which gave a reassuring click. Interestingly Abbott mentioned that an awful lot of care, attention and engineering boffinry had gone into the seemingly simple process. Including the 'click' which happens only as the inserting spring/needle withdraws. As a result you don't tense up on insertion, because by the time you hear the click - it's all over. Dave (@sowerbee) did ask whether much of the resulting plastic was recyclable, but it seems that almost none of it is - to keep the process as simple, reliable and precise as possible the idea of a reusable inserter seems to have been dropped quite early on. Long term Libre users will probably also need to get a bigger sharps bin - much like the self-serting Mio sets for the Veo, most of the plastic leftovers need to head for incineration. Once you have inserted the sensor the handset begins a 60 minute countdown before the first reading is available. The sensors are being described by Abbott as 'factory calibrated'. While traditional CGM sensors have required occasional BG/fingerstick calibration throughout their life, Libre sensors are manufactured in such a way that this is not necessary. I did ask what would happen if you had forked out your own hard-earned for a sensor only to find that it was stubbornly and continually miles out from your BG monitor and it was suggested that this would be a 'contact customer services' moment. I got the impression that if you could demonstrate that a sensor was massively misbehaving through no fault of your own they may well send a replacement.

Sensor life is 14 days.

From what I can tell there is no way to extend or restart sensors. Each is electronically paired to the handset and begins to count down 14 days from the initial 60 minute 'Start New Sensor' countdown. Smart cookie Chris (@grumpy_pumper) asked what might happen if your reader developed a fault at some inconvenient time - say 5.45pm on the Thursday before Easter. It would be days before a replacement receiver could be sent, so even if the new reader could be paired with the old sensor (and thinking about it now, I'm not even sure it could) several days of 'sensor life' would be lost. Without promising anything concrete, again Abbott seemed to suggest that they would try to behave fairly. Certainly in a market where they must anticipate a significant number of customers will be self-funding they are aware of the need to be seen to be fair if any problems occur. Abbott's research data suggest that sensor accuracy is likely to be slightly further out from BG meter readings during the first 24 hours after insertion, and then more accurate through days 2-14. Early days for me, but this certainly seems to have been my pattern with the first sensor. It is remaining very comfortable after the first few days. I'm currently on day 3 and on the whole I would not know it was there. If I had my insertion time again I might attempt to make sure it was just higher up my arm than my t-shirt sleeve line, but the sensor is very discreet and if anything just looks like a nicotine patch to everyone else so it's not particularly problematic if it is on show. It certainly doesn't scream 'medical device'.


The reader
The reader looks very like a normal BG monitor. It has a single button and then uses a decently responsive touch screen to navigate between various functions, displays and data handling options. Nice clear colour screen too. It was really easy and straightforward to set up and is very intuitive to use. No real need to go digging around in the handbook so far. The reader stores 90 days of data, and provided that you swipe your arm at least 3 times a day at the right moments you get a full 24 hour picture of changes in glucose levels. So far I have been swiping with such frantic, gleeful regularity that I can't actually tell you what happens to graphs where you've run over the 8 hour sensor storage limit, but I suspect you would just see a gap. Along with the 8-hour graph that you can see each time you swipe you can also dig back through a logbook of recent swipes, which you may have tagged with references to insulin, food, medication, exercise etc or view daily graphs 24-hours to a screen or check a variety of analytical screens.

The handset will also function as both a standard blood glucose monitor or blood ketone monitor (using the appropriate Freestyle Optium strips). Somewhat inevitably, the Abbott bumpf suggests that you check your BG level with a fingerstick meter if your levels are changing rapidly (where the potential difference due to lag between interstitial readings and blood glucose readings could be more marked) or if the result on the Libre doesn't match how you are feeling. It's nice to know then, that with a few strips and a fingerpricker in your pocket the Libre reader gives you access to fingerstick checks without the need to carry a whole extra bag of kit. On the whole though, the marketing claim is that you could use results from the Libre in place of almost all your normal fingerstick tests. I'm really interested to see whether I would have the confidence to do this so I'm currently testing at my usual SMBG schedule alongside Libre swipes to see what sort of differences I find. Those of us with more than a few years T1 mileage will already be aware that BG meters themselves are not exactly the most consistent performers, meter-to-meter or even strip-to-strip on the same meter.

The reader can also function as a bolus wizard in a similar way to the Insulinx or Accu-Chek Expert, though you need the support of a healthcare professional to get this set up and access this functionality. Like most meters the reader has an operating temperature range of 10-45C so while you can apparently scan through a ski jacket, you would probably need to keep the reader toasty in an inside pocket to avoid it grumbling about being a bit chilly. Battery-wise the sensors are unpowered and the reader is recharged via USB. A full charge is expected to last around 7 days of normal use.

Alarming
As has been mentioned, one of the main differences between the Freestyle Libre and conventional CGM is that the data is not pushed by transmitter to the receiver. This means that the Libre cannot alert you with beeping/buzzing noises if your levels are soaring or crashing. This may be a significant concern for some, particularly when it comes to night-time, but part of me is quite glad. I always had a sneaking concern over how I would respond to a CGM repeatedly wittering and warbling to remind me that I'd made an almighty hash of estimating yet another buffet meal and that my glucose levels were still stubbornly stuck in orbit. The fact that the checking on the Libre is always initiated by me and can occur as often as I want it to is, if anything, something of a relief.

Data crunching
The handset offers a number of nifty, inbuilt analytical functions which can really help you to get your head around this avalanche of new data. I think I'm going to leave a detailed description of these for a separate post as I suspect many of you are losing the will to live by now. Briefly though, you can view results for 7, 14 30 and 90 days for Average Glucose, Time in Target, number of Low Glucose Events (where levels have stayed below 3.9mmol/L for over 15 minutes) or view a Daily Patterns graph, provided you have more than 5 days of glucose data stored. You can also export data via USB cable to be compiled into PDF reports and which can use something intriguingly called AGP (ambulatory glucose profiling). More on that later when I've got more data stored, but it looks really interesting. Helpfully several of the views display results grouped/averaged by time period so, for example, you can easily spot which time of day I've been having most fun with in the past 3 days.

What does it cost?
Abbott are offering a Starter Pack for £133.29 which includes a reader and two sensors. Otherwise the reader (on its own) costs £48.29 and sensors £48.29 each. These prices are ex-VAT so people would need to fill in the paperwork to get their VAT exemption on medical grounds. At those prices a full year's sensor coverage runs to just over £1,250 which is certainly not cheap, but when comparing with existing CGM options it is probably worth bearing in mind the significantly greater cost of handsets/receivers and transmitters for those options. Especially where transmitters are only guaranteed to last 6 months.

Freestyle Libre sensors/receivers will be available to purchase from Abbott's online shop from the end of September/beginning of October 2014 and once you have a receiver you could choose to buy sensors to cover as much or as little of the year as your budget allowed.

What has it been like so far?
In a word, amazing.

I have never had access to any kind of continuous data before, so I guess it was always going to be an eye opener, but I have been really impressed with the similarity between my standard fingerstick readings and results on the Libre. In a follow-up post once this first sensor has run its course I intend to do a little compare-and-contrast number crunching of the results, but already I am wondering what it might be like to more or less 'fly solo' with the Libre for the second sensor and only cross-check with SMBG if things felt wrong.

For the first time ever I have a full picture of what has been going on overnight every single morning. And if I wake up blearily overnight I am FAR more likely to swipe the Libre for an instant check than I am to get up, go downstairs and test. Not only that... but swiping the Libre does not involve turning any lights on or faffuing about with strips and finger-squeezing so there is far less chance of disturbing Jane in the rare event that my BG meter happened to be upstairs. I've already caught one sneaky overnight low that I am 100% sure I would have simply ignored/not checked via SMBG. Much comment has been made about the Libre for under 18s. Currently it is only licensed/available for adults but it was made very clear on Friday that Abbott are leaping through the regulatory hoops for a paediatric license as fast as they can. The phrases used were 'actively pursuing' and 'great need'. Sadly Abbott cannot predict the timeline, but certainly gave the impression that this was something they are already working towards as a priority. I can imagine that swipe-the-lump-under-the-duvet monitoring would hugely appeal to parents of children with diabetes who choose to test during the nighttime.

One of the other things I have already noticed is that the Libre makes glucose monitoring so effortless that I am inclined to check more frequently rather than less. Certainly in these early 'novelty' days. Part of this, I know is my own foolishness. I have been carefully logging and recording my BG levels, food, exercise and all manner of other details for several years now. It was one of the changes that made a massive difference to my own management and understanding of how my diabetes behaves and really helps me spot patterns and fix things. I made an agreement with myself early on that I would stick to a regular testing schedule and add in extras if things needed checking, but (importantly) that I would log every BG check I made to ensure I wasn't kidding myself by only writing down the good ones. Perhaps it's just me, but as noble as that set-up is I still find that there are occasions where I suspect I might be a tiny bit higher or lower than I'd like but don't want to mess up a good week's worth of results with another red flag so I'm tempted to make a small correction on instinct and hope to solve an imagined problem by the time I next test. This can be particularly the case if I'm having a week where I've had frustrating red flags peppering my results because results are 0.1 mmol/L past the cut-off rather than being real, proper, decent mess-ups. Yes it is silly. I know it's silly. But I do it anyway. And sometimes I end up treating a hypo-that-never-was and sending myself sky high in the process. Jane says it's because I am too much of a perfectionist. Too competitive with myself. And she's right. Again.

But with the Libre I am released from this - at least in part. If I want to check how a correction is going I don't need to wait until I think I'll be out of red flag territory. The curve on the graph will be there whether I check or not, so I might as well actually know. This, for me I think is going to be something of a Big Thing. Less double guessing and more data-driven responses. I may never play Uncertainty Tennis again while I have a sensor in my arm.

I am very interested to see how things progress over the next few weeks and will transfer some results into Excel (manually unfortunately as there is no direct .csv export from the Libre software) to try to understand how close or otherwise the results have been between fingerstick SMBG and Freestyle Libre. Unsurprisingly though, the trend arrows and graphs are already winning me over.

Does it replace fingersticks? My first few days certainly look really promising. Abbott themselves concede that there will always be at least some continuing requirement for good old fashioned punctured fingers. I'll write an update in a few more days with some of my own n=1 observations about numbers.

Left-right: Me, Dave, Jen, Laura, Chris and Sue
Brucie bonus
Aside from meeting the fab folks from Abbott and PR gurus WeberShandwick who laid on a really interesting and engaging event, one of the very best parts of the morning for me was getting the chance to meet face to face with some amazing folks from the #DOC. Jen (@missjengrieves), Laura (@ninjabetic1), Sue (@desangsue), Dave (@sowerbee) and Chris (@grumpy_pumper) are every bit as lovely as you would imagine. I look forward to reading their thoughts on the Libre later on.

Try these other posts too:
Laura (@ninjabetic1): FreeStyle Libre - Flash Glucose Technology
Laura (@ninjabetic1): FreeStyle Libre downloaded data
Jen (@missjengrieves): Freestyle Libre Review – a gamechanger for diabetes management?
Dave (@sowerbee): New Kit! - Freestyle Libre Review: Part 1
Dave (@sowerbee): Libre FGM v Enlite
Sue (@desangsue): New Freestyle Libre Sensor System


UPDATE: Abbott Freestyle Libre vs BG meter


Disclaimer. Abbott kindly paid my train fare, treated me to breakfast and allowed me a trial 'starter pack' of the Freestyle Libre which I am allowed to keep. They encouraged me writing a blog post about my experience, but said they would have been quite happy if I hadn't bothered. They certainly didn't insist that I only said nice things - if at this point I'd thought the product was rubbish I would have said so. I've not been paid to write this post or publicise the product in any way.

60 comments:

  1. Thanks for such a thorough write up - I'm looking forward to seeing what people think of it after all the buzz.

    I'm really curious, though, how they're justifying the "end of fingerpricks" statements - even ignoring the advice to check by pricking if you're changing rapidly etc (and I assume before doing things like driving?) All the other cgms are very specific about not using them to bolus/treat. I appreciate it's not a cgm, but it's still testing interstitial fluid, so I'm not sure where the increased confidence comes from (and I will totally hold my hands up and say that I have bolused and treated hypos on the basis of my cgm on several occasions, bad diabetic that I am ;) ) Has there been any feedback from HCPs on this?

    I have to say that, for me, the cost comparison between the Flash and my dexcom/vibe is pretty much the same, as I get about 4 weeks out of each sensor and so it come to about the same yearly cost as the Flash, but I love that the upfront cost is so much lower on this - it seems like it will be much more affordable for people who just want to pick one up every so often, which is much more expensive with the other cgms.

    I'm glad to see you're getting such a benefit from it, and I'm looking forward to reading your number crunching analysis (I'm such a geek about these things!) ;)

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  2. It looks great - thanks Mike for the great write up. We now have to wait until it licensed for under 18s.

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  3. Thank you very much for such a lot of informations! We all are looking forward to the end of fingerpricks! Many greetings from Germany!

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  4. Thanks for the comments folks! Angie - in answer to your question, I confess I'm not entirely sure. The language Abbott are using seems quite carefully phrased to me and they are certainly being very clear about a range of circumstances when the Libre's results may differ from SMBG. I'll be interested to see what I get after 14 days, but aside from a few readings where things have been rising/falling rapidly I have been very impressed. Certainly not much more variation than I would expect between, say, two different brands of BG meter testing the same drop of blood.

    I had a quick skim-read of the manual to see whether the Bolus Calculator in the Libre would accept swiped readings for dose calculations - that would be quite telling. I'd need to check with Customer Services and/or dig a little deeper, but it looked initially as though you would need fingersticks to calculate doses.

    As I said in the review, I am almost tempted to use my second sensor to 'fly solo'. Not something I think Abbott would officially advocate, but most of my swipes today for example have been only a few decimal points away from SMBG readings taken at the same time. After all it's not as if BG monitor results themselves are exactly flawless!

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  5. Bolus calculator is said to require a bg using integrated meter. You need optium strips. Unlock code is the same of insulinx

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  6. Hi
    My three years old daughter was diagnosed about three weeks later. Her BG is still not very controllable and we struggle to cope with finger pricking especillay when she is sleep.I amm considering freestyle libre but have to concerns. First whether the sensor is going to fit her tiny arm or not? the second is that he might remove the sensor, What do you think friends??

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    1. Yes, I was on the trial and it is not completley reliable. The sensor comes off if your hot & sweaty, the machine does not always match my results with my normal machine. I personally think three is a little young. This sensor still has to be pricked on which she may find distressing, but if this machine is eventually fine tuned its will be fantastic.

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  7. Hi anonymous. You won't be able to use the Libre, certainly not yet. It is currently for over 18s only. Abbott are trying to get a paediatric license, but can't say how long that might take.

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  8. Hi Mike, thanks for the detail behind your experience of the Libre. Considering the pricing, I'm just wondering if there was any discussion on availability on NHS? Vish

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  9. Hi Vish, As far as I am aware NICE have not yet given any CGM technology a formal 'Technology Appraisal'. My guess would be that the Libre would more or less fall into CGM territory for the NHS. I know Abbott have been keen to engage HCPs, but from what I can see you would still need a sort of 'special circumstances' type funding arrangement to get the sensors funded by the NHS. Certainly worth asking the question though!

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  10. Thanks for the great review. I'm from Brazil and I will be in Paris in the middle of October. I hope to be able to buy the starter kit while I'm there. Do you know if Abbott has plans to do an Android app, so people with smartphones with NFC capabibilities would be able to make the readings without the need of carrying the meter?

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  11. Thanks 'unknown' :)

    I didn't hear any mention of NFC/smartphone option being anywhere in the pipeline (though that doesn't mean it won't happen at some point). I suspect it's a bit of a long shot though, because of the regulatory approval needed for medical devices, which I believe would cover an app on a smartphone in that situation. My guess would be that the Libre-using-Android-owning overlap would be pretty small too, so I think it's a bit of a niche market.

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  12. Sorry for the double post. In both of them, I used the option to post using my Google account, so I wonder why it didnt use my name instead of anonymous or unknown Btw, the first try I clicked in the preview (not publish) button and the comment disappeared. I wrote everything again and this time clciked the publish. Seems that comments using Google account has some defects.

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  13. I get that Abbott are saying it is not licensed for children, but how exactly can they stop parents from purchasing this under their own name and putting it on their kid? After all, interstitial fluid doesn't exist only in adults, right? I know if my kid had diabetes, i'd be buying one tomorrow - even if it is unlicensed!

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  14. Well, I suppose, they can't. And neither could they prevent an adult from inserting a sensor in other locations than the back of the arm (the only currently licensed location). I seem to remember much hoohah about delays in the licensing of Dexcom sensors for paediatric use too. But the regulatory process is what it is, and it is there for good reason.

    Medical history is littered with unfortunate, unforeseen outcomes that no-one could have predicted from the use of phamaceuticals and devices. Most of the disaster/horror/apocalypse/zombie takeover movies I have ever seen revolve around a medical breakthrough that goes horribly wrong - though to be fair I doubt the Libre has the potential to zombify anyone.

    Would the Libre safe, effective and reliable in use for people under 18? Seems likely to my uneducated eye, but actually I have no way of knowing. And nor do Abbott. And nor do any parents.

    I did try to ask if Abbott had any concerns/expectations over acquiring the license for paedatric use and/or the possibility that some parents in desperation might go 'off label', but I could not manage to phrase the question in such a way that Abbott could legally offer an answer.

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  15. Do you think the sticky bit is sticky enough that it will last 14 days?

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    1. No its not. I used four sensors in a week whilst on the trial. I recommend that people are aware once they lose their stickyness it cannot be reattached, costly even more money. Until this becomes free under NHS it is too costly for an average person.

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    2. Sorry you've had adhesion issues Anonymous - not something I have had an issue with in the years I have used sensors. I think perhaps it has to do with skin type? Might be worth considering Skin-Tac or another similar preparation if this is an issue for you? Personally I have to gently ease them off at the end of sensor life as they are still very-much stuck fast for me.

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  16. It's that arrow that I've been looking for ever since diagnosis! - surely worth a try for the initial pack?
    The cost looks very comparable to using the number of test strips that I do, we must be able to convince NICE/NHS? And if we all stop using test strips, the other meter suppliers will get on with developments, hopefully with reduced costs too.
    Really looking forward to your next post on this, also read the others you recommended, thanks. I am definitely in the maket for this!

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  17. looking forward to purchasing this - anyone got an idea of a release date?

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  18. Hi Anon - yes the sticky for both of my sensors stayed well and truly stuck for the 14 days. I have seen reports from some on Twitter who had sensors come loose and needed re-sticking with opsite or similar. I guess they are a bit like infusion sets in that regard... some of my sets seem to 'give' if I get hot/sweaty/bend/stretch in the first half day or so. After 24 hours though the sticky seems to kind of 'set' and I am much more confident of them staying put after that. If I'm in doubt I stick some opsite flexifix over the top :)

    Anon #2 - I think the initial release date of early-mid October may have been put back very slightly, but I can't imagine it will be long now. Might be worth congaing Abbott or checking the Libre website

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  19. hello, just wondering if it only shows you the numbers that you've flashed when displaying the previous 8 hours or if its all readings that the sensor picked up (like a regular cgm)?

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  20. Hi, would be good to have an update on how the trial is going, would you still say it is an 'amazing' piece of kit and do you know when we can all have one?

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  21. Hi Anon

    I've never used a CGM, so I'm not entirely sure I understand war you mean by 'all of its readings' You certainly get to see the trace which you can use to estimate glucose levels at any point - the 8 hour trace is very useful for this, though the on-screen 24hour is a bit on the small side. There are also a number of very useful PDF reports you can generate if you choose to download the meter to your Mac or PC.

    Ceri - Yes I'm still convinced by it. I have a blog post I am desperate to write (frustrations of time!) which compares the readings I have with the fingerstick BGs I took at the same time. In my case they make pretty compelling readings and while some are considerably out (2mmol/L) many are within a few decimal places. The average difference was +/-0.8mmol/L. My second sensor did not quite live up to the first but there was apparently a manufacturing glitch in some of the very early sensors which has now been fixed. My second sensor ran out on Friday lunchtime and I have missed the reassurance of 'check anytime' massively.

    I am intending to purchase some sensors when they become available, which I *think* is due to be late October/early November.

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  22. (Not sure if my first post posted…) Thanks for a great review. This technology looks compelling - did Abbott give any indication on timeline for introduction in the U.S.? Many thanks - Jessica

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  23. Thanks Jessica.

    I guess that would partly be down to the FDA - though I'd imagine the US is a market that Abbott are keen to access as soon as they can. Fingers crossed the approval comes through soon.

    Diabetes Mine seem to be keeping an eye on it from the US perspective: http://www.diabetesmine.com/2014/09/new-freestyle-libre-hybrid-glucose-monitor-approved-in-europe.html

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  24. Thanks for the posting. Can you go swimming with the sensor on the arm? I understand that it's water resistant, so we can still take shower. I am not sure about swimming or bath. Do you havean aanswer by a chance? TIA

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  25. HI Anon

    The sensors are rated IPX7 which means they are fine for immersion (including swimming on the surface) for up to 30 minutes. I have seen reports of people swimming for 45 minutes without problems - I'm not sure if they added a little overprotection such as opsite flexifix though.

    Mike

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  26. hello everyone , please tell where can i find the checker?? i really need it .
    is there anyone try it?? thank you for helping me

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  27. Hi Vivi

    To see if the Libre is available in your country, check www.FreeStyleLibre.com

    M

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  28. My diabetes nurse tells me that this will probably be available in Canada in the New Year. I don't have a cgm as yet because I have only recently started the Omnipod after 45 years of injections. I decided to hold out for the Libre after my nurse explained it to me. He went to a seminar and I believe it was demonstrated there. I would dearly love to be able to check my bg while I am out and about - I think it would give me far more confidence.

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  29. Are Abbott considerring the Free Style Libre for an Australian release yet or at all ?

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  30. Hi Jenny

    Your best bet is to check www.freestylelibre.com for availability/regulatory approval in Australia.

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  31. Hi ! Congrats for the post, you have no idea on how helpful and inspiring it was to me ! I'm a brazilian and i am planning to travel to uk or spain just to buy one of this. I have two doubts: 1) How you remove the sensor and is it painful ? 2) I wonder if i can freely go to a pharmacy and buy it, or i have to present a prescription ?

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    1. I can only advise that it is not painful & you can only buy this online.

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  32. Hi Anonymous, The sensors peel off after 14 days. No more painful to remove than an infusion set or sticking plaster. Libre are not for sale in a retail environment like a pharmacy or chemists - you can only buy them via the Freestyle Libre website. You can check the .com version to see about availability in your country.

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  33. Seems like Abbott is on backorder across all countries in Europe for this, so no option to buy it since January first. Very disappointed, as they do not even respond/communicate when it will be available next and where...

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  34. How much does this meter and the sensors cost? I use sticks and using the dafne rules go through numerous sticks a day. I have been a type one diabetic for 37 years and I am sick of the daily scourge of finger pricking. I am from the UK.

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  35. Hi Anon

    See 'What does it cost' above. Starter pack or reader and 2 sensors would be just over £130. Currently demand exceeds supply and Abbott stopped taking new customers in the Autumn, and still haven't re-opened the gates - which annoys me intensely as I missed the boat for signing up! You can sign-up on www.freestylelibre.co.uk and they promise to let you know when you can place an order again.

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  36. I just wrote the longest comment but it didn't get published... damn that commenting system of yours... :)
    Whats your email?

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  37. Sorry about that - didn't receive it (they are all screened before publishing).

    In answer to your question - check 'about the blog' page :)

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  38. Hi Mike,

    Do you know if the sensors are safe to go in an MR scanner?

    I'm a Radiology Nurse and often have to go in these scanners, and wouldn't want the magnet to pull the sensor out of my arm if there is any metal in it.

    Thanks

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  39. Hi Stacey

    I couldn't find anything specific on the freestylelibre.co.uk site but this one (http://in.abbott-diabetescare.com/in/products/detail/freestyle-libre-pro-system_947) which I think is for India, contains the following in FAQs:

    "Do patients have to remove the sensor during MRI/CT scan?

    Yes. The sensor should be removed prior to exposing it to strong magnetic or electromagnetic radiation, for example an X-ray, MRI (Magnetic Resonance Imaging), or CT (Computed tomography) scan. The effect of these types of procedures on the performance of the system has not been evaluated."

    If in any doubt, I'd suggest calling Abbott's helpline. They will know for sure. Thanks!

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  40. hello, I am currently living in Houston, Texas and I would like to know where and if I can find FreeStyle Libre Flash Glucose Monitoring System here in Houston. Many thanks in advance Donatella

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  41. Hello Donatella

    Abbott are actively pursuing FDA approval for the Libre in the US. If I hear any more information about that I'll post an update. From what I can gather it is very hard to estimate how long the approval process might take.

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  42. can we from the Us purchase it and have it mailed here?

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  43. Hi Anon

    No. As far as I know, the libre will only be available in the U.S. After FDA approval.

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  44. Hi Mike. Thanks for all the work on the Libre. I just received a starter pack here in Canada from a German friend and am having trouble with the German (40 years since I last worked in the language). Would anyone have an English manual in pdf? Just to make sure I don't press the wrong button. Thanks.

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  45. Buna seara,
    Întmplator am ajuns pe acest blog , cu sperata si bucurie ca poate ma puteti ajuta sa achizitionez un astfel de aparat pentru fetita mea de 3 ani......De doi ani de când a fost depistata nu pot sa-i fac glicemia si sa nu plâng, când ma uit la degetelele ei mici si eu trebuie sa le presez sa iasa un strop de sânge .....simt ca înebunesc de durere.Va rog cu disperare sa ma ajutati.Merci

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  46. Good evening ,
    I arrived on this blog with joy and hope that maybe you can help me to buy such a device .We did not accept and still crying when I make her blood sugar levels and put them degatelele for a speck of blood.I am desperate please help me I can buy the device, Thanks

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  47. Hello Anon

    Google Translate suggests your initial post was in Romanian - unfortunately, as far as I know the Libre is still only available in the initial launch countries of UK, France, Germany, Italy, the Netherlands, Spain, and Sweden. Libre readers and sensors can only be sent to those countries at the moment. Hope it launches more widely across Europe for you soon.

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  48. In Spain we cannot buy the Libre. We have contacted Abbot subsidiary in May and they told us they run out. We are on a waiting list since then and nothing.:-(. Even friends who bough it on Nov´14 don´t have the sensors.

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  49. Hello
    it is my first day usage for the freestyle, i have problem with the readings
    this morning it reads 2.8 but on the finger testing it reads 4.2

    second Q, Why it is allowed for over 18 years only ? Why i couldn't use for my 10 years old daughter ?

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  50. Hi Anon

    Q1. Abbott say sensor accuracy is likely to be less reliable on Day 1 (but still often within reasonable limits). Many users seem to find that the first 24 hours is likely to contain more differences between blood and sensor. Some have even taking to inserting the sensor slightly early and then waiting before activating it, though this is not advised by Abbott. My experience is that when a sensor reads very differently in the first 24 hours it may well settle after 36-48 hours. If it runs very different to BG for much longer than that contact Abbott and they can check the setup and may replace it free of charge. However keep careful notes, because more than once I have *thought* that a sensor was really misbehaving when actually the differences were more down to the inevitable variations between BG and interstitial glucose (e.g. when BG is moving rapidly, if dehydrated, pressure on sensor).

    2. Abbott got the approval for adults first, but they need separate research results and approval for under 18s. I don't think they are expecting any problems with under 18 approval, but the process takes a long time to complete. It is certainly something they are actively pursuing. I have seen some parents on Facebook who are already using Libre with their children as they cannot bear to wait.

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  51. Hi Mike
    I tried the Libre system back in April this year. After 3 days I visited my local Supermarket and the security gates killed the sensor dead. I am about to try the system again and wonder if you or any other users have been able to visit Supermarkets without this happening. Abbott's Technical Support suggest that some gates are set to a higher power than necessary. They will replace any sensors damaged in this way but that will still prevent me visiting the same shop without it happening again. I think Abbott's should have sorted out this problem before launching the product.

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  52. Hello Anon

    Sorry to hear your experience - I've not heard of people having trouble with supermarkets (I wore a sensor over the last few weeks and went in and out of shops/supermarkets without bother) though I have heard problems with Libraries. Perhaps it depends on the system?

    I would phone Abbott and explain what happened - they may replace the sensor and ask you to return the old one to them.

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  53. This all sounds wonderful after 4.5 years of pricking my 5 year old daughter. It is now licenced for children so will be ordering a kit tonight. Can't wait not to find the toes in the middle of the night! Thank you!

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  54. hi

    Very interesting reading yor comments thank you all. I am on week 3 and loving it and hoping sometime soon it will come down in cost . Does anyone know if it is affected when it gets very hot as I sat today in a pub with the sun streaming through the window and my arm got very hot and I wondered if it would affect the sensor? Also does airport security scanners affect the sensors too?

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  55. Hi Janeyxxxxx

    I've not had any problems with airport scanners, but have heard of some concerns over library scanners. I've also not had any problems with sensors getting warm, but have heard worries where people get dehydrated, I guess if in warm places it pays to stay well hydrated :)

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  56. my husband just had a free 2 weeks trail. it was excellent. does anyone know where i can get some funding or help to buy some more sensors as we live on benefits

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