{"id":48118,"date":"2017-12-12T09:26:41","date_gmt":"2017-12-12T14:26:41","guid":{"rendered":"https:\/\/asweetlife.org\/?p=48118"},"modified":"2017-12-12T09:37:02","modified_gmt":"2017-12-12T14:37:02","slug":"freestyle-libre-or-cgm-which-one-is-right-for-you","status":"publish","type":"post","link":"https:\/\/asweetlife.org\/?p=48118","title":{"rendered":"Freestyle Libre or CGM, Which One is Right for You?"},"content":{"rendered":"

The good news is that our technology options for diabetes management<\/a> are expanding every day.\u00a0 But the bad (?) news is that now you have to decide which ones work best for you.\u00a0 We take a deep dive into the new Freestyle Libre flash glucose monitoring system to help you make up your mind.\u00a0<\/p>\n

\u00a0<\/strong><\/p>\n

Should You Use a Freestyle Libre system?\u00a0 <\/strong><\/h3>\n

With the Freestyle Libre system approved for use in the United States<\/a>, many stateside PWD are looking at Libre as new tool to improve their diabetes management.\u00a0 But what exactly is the Freestyle Libre system, and how will you know if it\u2019s a good fit for you?\u00a0 We talked with a few seasoned Libre users to get a feel for their experiences with the flash glucose monitor.<\/p>\n

 <\/p>\n

How does the Freestyle Libre work?<\/strong><\/h3>\n

\u00a0<\/strong>The Freestyle Libre is a flash glucose monitoring system that includes a sensor worn on the back of the upper arm and a handheld reader.\u00a0 The sensor uses a thin filament that\u2019s inserted underneath the skin to measure glucose levels every minute.\u00a0 The handheld reader is used to scan the sensor, replacing routine finger sticks.\u00a0 Recently approved for use in the United States, the Libre has been available internationally for several months.<\/p>\n

\"Freestyle
Freestyle Libre Sensors<\/figcaption><\/figure>\n

Key differences between the US version and the international version are that the US version has a 10 day sensor life, a 12 hour queuing up period for the reader, and requires a prescription, while the international version has a 14 day sensor life, a 1 hour warm-up after insertion, and does not require a prescription.\u00a0 Also, the Libre sensors cannot be \u201cre-started,\u201d meaning that it has a hard-stop after 10 or 14 days (depending on which system you\u2019re using), while the Dexcom and Medtronic CGM sensors can be re-started after expiration.<\/p>\n

 <\/p>\n

So what do people actually using the Freestyle Libre think?<\/strong><\/h3>\n

Scully Brown<\/a>, a Canadian PWD diagnosed with type 1 diabetes at the age of 22, has used both the Libre flash glucose monitoring system and both available CGM models (Dexcom and Medtronic).\u00a0 \u201c[The Libre] is super easy to insert, super low profile, and [produced] no adhesive problems for me. Happy that it\u2019s meant to be worn for a full two weeks. It\u2019s very easy to use.\u201d<\/p>\n

Another fellow Canadian agreed: \u201cInsertion is easy-peasy and not intimidating for those new to medical devices, and there\u2019s no need for calibration although of course I do still check my blood sometimes to compare numbers,\u201d said Michelle Sorensen<\/a>, who was diagnosed with type 1 diabetes in 1999 and is also a health care professional.\u00a0 \u201cCost is a huge pro, too.\u00a0 For someone like me paying out of pocket, the start up in Canadian dollars is $50 for the meter and then $89 per two week sensor. Because of this, plans that wouldn\u2019t cover the CGM are covering this flash technology.\u201d\u00a0<\/p>\n

But there are drawbacks, as with any device.\u00a0 \u201cI\u2019m not a fan of carrying around the reader\/meter, and you can\u2019t re-start it,\u201d shared Scully.\u00a0 \u201cAnd only a couple insurance companies are providing coverage, but that\u2019s better than none.\u201d<\/p>\n

Michelle added, \u201cI have heard some people say they don\u2019t want to remember to test, they want alarms to remind them when to worry about diabetes. I see that point of view as being true for a number of people. But for me, it\u2019s not a problem because, for better or worse, I rarely forget about my glucose or diabetes for long so it\u2019s not a problem to grab the meter and quickly flash it across the sensor.\u201d\u00a0<\/p>\n

 <\/p>\n

Is the Freestyle Libre a continuous glucose monitor?<\/strong>\u00a0<\/strong><\/h3>\n

\"FreestyleThis is a tricky question.\u00a0 According to the Freestyle Libre website (US version<\/a>), the Libre is a \u201ccontinuous glucose monitoring (CGM) device indicated for replacing blood glucose testing and detecting trends and tracking patterns aiding in the detection of episodes of hyperglycemia and hypoglycemia, facilitating both acute and long-term therapy adjustments in persons (age 18 and older) with diabetes.\u201d\u00a0 But the Canadian version of their website<\/a> states, \u201cThe FreeStyle Libre flash glucose monitoring system is indicated for measuring interstitial fluid glucose levels in adults aged 18 years and older who have at least 2 years of experience in self-managing their diabetes.\u201d\u00a0 No mention of being a continuous glucose monitor.\u00a0<\/p>\n

Classification matters in terms of insurance coverage, with the Libre covered by insurers outside of the US but coverage within the States still being under review.\u00a0<\/p>\n

The Libre is classified as a \u2018flash glucouse monitoring system,\u2019 which differs from the continuous glucose monitoring system,\u201d shared PWD Alanna Shockley<\/a>, a Canadian with type 1 diabetes who received 100% coverage for her Freestyle Libre system.\u00a0 “Health Canada states that the CGM provides constant monitoring with no extra involvement from the user, where the Libre is user directed monitoring showing a brief history of trends. Since it is not continuous it isn’t classified by this particular insurance company as a CGM and falls under the blood glucose monitoring requirements.”<\/p>\n

\u201cIt\u2019s not a simple matter of classification. It\u2019s really important to understand that the Freestyle Libre system is not a continuous glucose monitor,\u201d said Michael Park, another Canadian PWD. \u00a0\u201cRather, it\u2019s an interstitial fluid glucose monitor that automatically records numbers every minute,\u00a0as well as every time you check in. I understand that many people are addicted to the constant monitoring from the CGM devices, but we need to remember that the vast majority of diabetics don\u2019t have access to that technology, nor the resources to control their sugars at that level of minutia. \u00a0Acknowledging that this is a step up from a glucose meter, it really is an incredible step! \u00a0Comparing 96 test results per day to the recommended four glucose checks by insurance companies, this really is an amazing system.\u201d<\/p>\n

In the US, we\u2019re hopeful that full reimbursement for Libre will be approved, seeing as how the Libre System is marketed as a replacement therapy for finger sticks for making treatment decisions.\u00a0 Only time will tell.<\/p>\n

 <\/p>\n

But what about alarms?<\/strong><\/h3>\n

\u201c<\/strong>I do miss night alarms for peace of mind when my levels are unstable or unpredictable. But the years with my Dexcom helped me gain better control of nights so I am safer now. If I set my alarm for middle of the night, it\u2019s easy to grab my Libre and flash it over my arm and read the meter, which lights up,\u201d shared Michelle.\u00a0 \u00a0<\/p>\n

Scully agreed, stating that the alarms are what keeps her preferring Dexcom.\u00a0 \u201cIt does not alarm or alert [independently] when BG isn\u2019t in range. This is a number one issue for myself, as a person with type 1 diabetes.\u201d\u00a0<\/p>\n

But not everyone found the lack of alarms that alarming.\u00a0 \u201cBeing able to get that amount of information from a device that doesn\u2019t yell at me is a truly loving and helpful innovation in diabetes management,\u201d said Michael Park.<\/p>\n

 <\/p>\n

How do I decide which to use?<\/strong>\u00a0<\/strong><\/h3>\n

There are a lot of points to consider, but for most, insurance coverage is the deciding factor.\u00a0 Outside the US, Libre is fully or partially covered by most insurance companies, while traditional CGMs may not receive coverage at all, leaving patients paying costs out of their pocket.<\/p>\n

But once cost\/payment is secured, people with diabetes have several points to consider.\u00a0 Do you feel that you need a CGM that alarms when you go above or below thresholds?\u00a0 Does ease of insertion and wearability matter most?\u00a0 Are you okay with carrying another device or do you need your devices pared down to the minimum number?\u00a0 Are you negotiating adhesive allergies?\u00a0<\/p>\n

To make a final decision, try and get your hands on these devices.\u00a0 See which one looks most easily integrated into your lifestyle.\u00a0 Consult with the companies to see if you can wear a sample product to test wearability or skin reaction.\u00a0 And check in with people who have worn one, or both, systems.\u00a0 Real life experience and feedback from peers might be exactly the information you need, along with your health care provider’s advice, to make an informed decision.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"

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