Is there any more iconic symbol for diabetes than a drop of blood on a finger? Throughout my diabetes career––yes, it’s work––piercing my finger with a lancet and placing a drop of blood on a test strip has been the constant reminder that I am tethered to a disease that is much bigger than I am.
In the past, when I’ve read about continuous glucose monitors (CGM), it always sounded bulky and uncomfortable. I wasn’t eager to get one. And today people are touting the bionic pancreas as the answer to all of our dreams, but being bionic doesn’t appeal to me either. I’ve also read about contacts that Google is working on with Novartis. The contacts will use tear fluid to obtain blood sugar readings that will be wirelessly transmitted to a smart phone. When I found out how long it would be before the contacts were released, 5-10 years, I shrugged it off as another sign that my work would continue.
When I first spotted the FreeStyle Libre from Abbott, my initial thought was that it looked tiny––the size of a quarter, and friendly––approachable and simple. I wanted it, but the problem then was that it was only available in Europe. (The Pro version is available in the U.S. and the company is actively working towards FDA approval for the personal version.) I decided I needed to try and get my hands on one.
As I wondered who to ask for help, I read more. The meter and matching sensor aren’t labeled a CGM because you have to scan the sensor to see your numbers, rather than numbers automatically being logged and recorded. Abbott calls its device a Flash Glucose Monitoring system. They do essentially the same thing, so, whatever, I call it a CGM. The Abbott device doesn’t have an alarm. I know that not everyone knows when they’re high or low. Since I do, I knew the Libre would work well for me.
I realized I finally had my in when a close friend moved to Milan. “Can you do this for me?” I inquired about the daunting task of ordering sensors online, waiting for the delivery, repackaging the sensors and mailing it to the U.S. I was asking a lot. “Sure,” she said. It helped that I was visiting her in Italy, and that we made that first online order together. (If you browse to the FreeStyle Libre European site from any IP in the U.S. you will be promptly denied.)
The first batch arrived in April 2016, but not before there were several panic attacks when the Italian post office asked for letters from my doctor describing what was in the box. I imagined an old woman with a cigarette between her thin lips. I said to my friend: “Tell them it’s diabetes material and electronics.” What we were doing was not illegal, but it felt suspicious. I did it with glee, my friend, not so much. I typed up a letter on my computer and emailed it over to her. It worked!
While I’ve seen some other CGMs in development that require you to go to your doctor’s office to have a sensor inserted under the skin (sounds awful), the Abbott FreeStyle Libre can be attached at home, with zero help. It’s foolproof. Each sensor lasts fourteen days, is waterproof and––I work out a lot––sweat proof. The data can be downloaded to your computer whenever you want.
That day when I could finally toss my old glucose monitor out the window (figuratively) was huge. Despite being diligent about taking readings, I never took enough to know where my numbers were trending––up, down, level––information that would require me to test over four times in a single hour. Forget it.
After trying it in a few places, today I proudly flash my FreeStyle Libre on the inside of my bicep. When I wore it on the outside of my arm, I found that it would get caught on backpack straps or a towel when I came out of the shower. Soon there will be an app for my iPhone––there’s already an Android version––but until then I’m using the Abbott monitor. It’s about half the size of a phone. At the beginning, I tested often with my One Touch Ultra to see how accurate it was. Once I was sure it was on target, I stopped toting around the extra monitor. Today I swipe constantly. I love knowing what is going on, seeing exactly when a meal will hit my blood sugar and learning which foods are best—the ones that don’t cause spikes or stay in me for extended time periods. Getting access to 24/7 data on my body was, to be cliché, a game changer, and I couldn’t wait to see my first A1C.
With my newfound passion for continuous data on my blood sugar, I talked to other people that wore the FreeStyle Libre, like 45-year old Holger Schmeken from Germany. Schmeken has type 1 diabetes and is on his 47th sensor. (Yes, he’s counting.) “The reliability of the sensor data is very high. In fact it’s more accurate than any glucose meter I have ever owned in over 25 years. This made it easy for me to make the big step: trusting the Libre for dosage decisions.” Schmeken is also a software developer and created Glucosurfer, a site for people to upload and share medical data. (He may be more passionate than me.)
Speaking of numbers, Abbott recently announced a direct correlation between a higher frequency of monitoring and better blood glucose control. Abbott looked at 50,000 FreeStyle Libre users in Europe and found that “people who scan more frequently using its FreeStyle Libre system spend less time in hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar) while having improved average glucose levels.” I can definitely vouch for that. My AIC has already dropped below 7.0% and I’m looking forward to seeing it hit 6.5% soon.