Saturday, November 19, 2016

Freestylin' a fortnight with the Freestyle Libre

Just over a fortnight ago I was provided a freestyle libre CGM device. The session as run at Gloucester Royal hospital by a rep from the manufacturer, Abbott. At the end of the session we were each given a monitor and a patch. 

The patch is the size of a £2 coin and is secured to the arm with its own adhesive. To get a glucose reading you pass the monitor over it and bingo! The genius of the patch though is that it stores glucose data, when you scan it not only gives you that snapshot it also shows, on a line graph, the previous glucose levels. It is this that has proven invaluable to me and in a short period seen me make changes to my regimen. 

I was reticent about the patch as the blurb tells you it can be worn for sport, swimming, I'm the shower etc and so on. As a runner I was keen to know how valid this was and then test it myself. I run commute so shower at least twice a day if not more. I also cycle a little and go to the gym. 

In the fortnight I was wearing the patch (that's how long they last) I have probably
Had 34 showers
Run 60 miles
Cycled 40 miles and
Been to the gym 5 or 6 times

The patch has been secure and there has been no hint of it lifting. Not even a small amount. In fact when I went to remove it after it had expired it took some removing. 

Truly impressive adhesive!

As for the change to my regimen, I though I had good control. My hba1c is normally good. Actually I didn't have that good a control. What I had was a blood sugar that went from high to low and back again through the day. Boom and bust with an average in the middle. I also experience a pretty big dawn phenomenon. For example if I wake up and my blood sugar is 9 by the time I get to work around 8'ish having run or cycled my blood sugar will be pushing up towards 14/15. It then takes the remainder of the morning to come down, following breakfast and insulin. 

For the rest of the day I am more balanced. 

This highlighted a need to increase my background insulin, levemir, from 3 units twice daily to 6 units twice daily. Guess what I am now so much more consistently in the healthy band of 4-7mmol and not seeing the prolonged spikes that I was getting previously. This has transformed in a matter of a few days and is giving me so much more confidence in my diabetes control. 

It has been at the expense of a couple of hypos but in the same way as a change like this removed the higher numbers I need to regain that balance at the lower end too. 

The patch is self funded and at £50 for 2 weeks is not a cheap product. I understand that there is work taking place to reduce the price and or get it available via the nhs but no timeframes are available. 

My meter previous was the accuchek expert meter.  A quick google reveals the price to be £28'ish for a box of 50 test strips. This would last me normally between 7-10 days. I estimate 5 tests per day but if I am struggling this may increase to 10 or more. With the Libre I average around 30 tests a day. Extreme? I really don't think so, with that kind of data available so quickly I test between meetings at work, when I go to walk the dog, when I'm out and walking around - I do it because I can and because I care about where I am in that moment and more importantly to know if I need to do anything to address increasing or decreasing blood glucose levels. 

If I were to test that regularly with the accuchek it would be maybe £25 a day! The maths really does stack up for me so I can only imagine there are other issues to resolve. 

Looking longer term if the data the libre provides enables me to make the changes I have to improve things significantly I am a better risk to the NHS going forward. This will also save money. Basically put the better control I have now the less likely complications in the future. 

The libre is fantastic. I really love it and what it provides me and has enabled me to do I a very short space of time. It has become an essential piece of equipment in my diabetes management. For some the costs will make this prohibitive but if you can manage that then this quickly becomes indispensable.