So Friday was a fun day.
When the invite to the launch of the Abbott Freestyle Libre popped into my inbox (lucky thing), I regretfully had to decline due to work commitments. My disappointment at missing out on a new bit of kit that’s got the diabetes world talking (and a free breakfast) was entirely compounded when I realised that long-standing members of Diabetes Online Community Royalty would be in attendance. @sowerbee, @everydayupsdwns, @ninjabetic1 and @grumpy_pumper?! All in one place? These are people I’ve been speaking to (and learning from) for years. I subsequently arranged to say a brief real life hello after the launch, on my lunch break. As I pottered down to Soho, Mike of @everydayupsdwns fame told me they were running late. I thought I’d try my luck and muscle in to the members-only venue, and suddenly there I was, arriving in a whirlwind and gate-crashing the tail end of a talk they’d been having for the entire morning. I’d only gone in to say hi, but within minutes I was bestowed with two yellow boxes by the lovely people at Abbott. The Freestyle Libre was upon me. Oooooh.
What Is It?
The Freestyle Libre is the latest blood glucose monitoring system from Abbott, and it’s had the diabetes online community in an eagerly anticipated spin for a little while. The last meter I test ran as an alternative to my simple but uber trusted One Touch Ultra Easy was the iBg Star, which had all the chat, but seemingly couldn’t quite handle its actual job of measuring blood sugars accurately. To the back of the cupboard it went, my trusted meter was restored and we’ve been living happily ever since, with our multiple finger pricks each and every day, and hardened black fingertips as a result.
The excitable buzz in the room as Laura, Mike, Dave, Chris and Sue (@desangsue) played with their new toys and chatted to the Abbott team got me more than a little eager to rip the packaging open and step into this brave new contactless world.
The Freestyle Libre works in my mind like a medical Oyster Card. You very easily, very speedily, and very painlessly insert a small sensor under your arm which pushes a little flexible filament into your skin and stays there for 14 days. You switch on the accompanying reader with one press of a button, swipe (or ‘flash) it under your arm and bingo, it takes a reading. In one second. No blood, no finger pricking, no waiting, no messing. I felt like I’d unlocked the Matrix.
Now, pricking your fingers and testing your blood isn’t difficult – and in comparison to where we’ve been in recent history, it’s incredible in its own right. But there are many reasons why as diabetics we only test a handful of times a day (if that, at certain periods of our lives… ahem). Test strip allocation, time, convenience, defiance, perceived social awkwardness among other things mean we type 1s generally stick to meal times, exercise and ‘feeling funny’. The Libre quite aptly liberates you of all of these barriers. I must have tested 40 times on the first day, just because I could. The benefit here is it becomes akin to a CGM, or continuous glucose monitor, the holy grail of diabetes control that is yours for a very costly sum. The Libre isn’t the same as a CGM, but instead is marketed as the latest in ‘flash glucose’ technology. Instead of measuring the sugar in your blood, it measures sugar from cell tissue. Yep, it goes over my head too. But it’s freaking cool. Well, as cool as autoimmune disease can get…
I’ve now had this bad boy for 72 hours. My initial bewilderment at being able to test in one second, through my clothes, on the move, has not wavered. It’s incredible. The data graph is mesmerising – watching my sugars react to food, exercise, stress – for instance, I went up .5 mmol/l in a minute after rushing for the bus – is outrageously entertaining. I’m geeking out like never before – normally I leave the numbers to other, entirely more capable bloggers. The sensor takes a reading every minute, and every 15 minutes plots the average on a daily graph, which is downloadable in 90 day stints. The sensor stores the readings for eight hours, so even if you don’t swipe yourself for a while, you’re able to fill in the gaps when you do. The trending pattern arrows and daily graph have offered me insight I’ve never ever, in my 18 years sans pancreas, been privy to. Awake, asleep and everything in between – it’s all there in my hand. The danger there is becoming a slave to said graph, and the attempts to never venture outside the self-imposed target range could become quite the mission. Mission impossible of course. But seeing as the graph will fill in the gaps anyway, whether you test 40 times a day or four, I’ve found my thinking to be that I might as well clock it myself and nab the up or downward spikes in glucose levels before they’re fully unleashed. Having that kind of detailed data in front of me is not only allowing me to take control, but it’s persuading me to do so.
Look and Feel
The sensor isn’t big or bulky – it’s about the size and thickness of a £2 coin. On insertion, I decided to tuck it way under my arm. This was what I like to call ‘valid vanity’ – it’s my brother’s wedding next week and I didn’t want to be conscious throughout of the (albeit small) white disc showing through the beads on my rather beautiful dress. Placing it so far round means I don’t have to worry at all about what I’m wearing each day – the average passer by just won’t see it. After the first night I had completely forgotten there was anything at all stuck to my body until I was fiddling with my hair in the bathroom mirror and spotted it, just lying there. I cannot feel it; I cannot see it under clothes. Insertion took a minute at most, and it wasn’t in any way painful. The stickiness seems to be holding up just fine, and even I’ve managed not to knock it on anything, despite my constantly bruised limbs (case in point – as a few of us walked back to the tube post Libre, I managed to catch my handbag on a parked bike and send myself flying backwards. A PARKED BIKE). The only disadvantage to having it so tucked away is that I look like I’m conducting some weird test on the odour levels emitting from my armpits every time I swipe. Currently the back of the arm is the only place the sensor is allowed, but hopefully as time goes on Abbott will test more areas of the body, to enable the sensor to be rotated in accordance with the season’s latest looks. Ha.
The Science Bits
The Freestyle Libre will be available to buy within the next month from freestylelibre.co.uk.
The reader is £48.29 + VAT
A 14 day sensor is £48.29 + VAT
(We are exempt from VAT on medical grounds, but there’s paperwork attached to this)
Or you can purchase a started bundle of a reader and two sensors for £133.29 + VAT.
Obviously we’d all want this to be available on the NHS. The Libre team are currently making their way around hospitals in the UK and beyond, and clinical trials are very much under way. Hopefully after some user testing the Libre will be more widely available –even part funding by hospitals would make this more accessible for those who, like me, can’t stretch to £100 a month for two sensors.
Another hurdle to overcome by the Abbott masterminds is gaining a paediatric licence – something we were told in no uncertain terms they’re ‘actively pursuing’. Currently if you’re under 18, you can’t play Libre. To me this is entirely vital – it really could irrevocably change the way type 1 diabetes is monitored in the young. The parent of a young diabetic would no longer have to wake them to check their blood sugars in the night – peace of mind I’m sure that money can’t buy. And I can’t imagine this sensor not becoming part of pump therapy at some point down the road, so instead of imminently becoming the bionic woman with a sensor on my arm and an Omnipod on my back (soon!), it’s all rolled into one device. If anyone asks, that was my idea ok?
The most important bit in my mind. YOU HAD ONE JOB, iBg Star…
My very first reading matched my One Touch to the 0.1mmol/l. So far, so accurate. Then throughout that first day, as I periodically cross-checked the readings, there were a couple of spikes that were a little bit out. However this seems to have dissipated with each day – my last reading was out by just 0.2, which I’ll happily take. Abbott recommend you still carry a meter with you for back up, and the Libre reader actually has a port for test strips which is pretty handy if you’re in a spot of bother with the sensor for any reason.
To me, this thing is marvellous. And not just because I’ve been privileged enough to have been given the kit to trial. There are some cons, as with anything brand new – you can only log doses in whole units for example (unless you have a code that unlocks the area of the Libre deemed suitable only for healthcare professionals – the fact that this exists left a slightly unpleasant taste in the mouth), but with trials and time and testing I can’t see monitoring systems like this disappearing as suddenly as they’ve arrived. I can understand why I’m more dazzled by this than the more diligent bloggers, who have carefully and responsibly experimented with lots of fantastic kit while I run around town leaving my injection on the tube. But for me this is exactly why it wins – the key to getting people to take care of their illness lies in the ease and discreetness with which it can be managed. People are busy and distracted, and many people don’t like to make a song and dance about this thing (she says, waving her reader about like a light sabre across the office). My One Touch stays in my bag until I consciously decide to test. The Libre lives on my desk, much like my phone, so if I see it, I’ll likely swipe because I don’t have to stop what I’m doing to do so. For me, to be able to roll over when my alarm goes off in the morning and test within a second without even opening my eyes properly, or to pull it out on the tube and test without balancing four different components of kit on my handbag whilst inevitably dripping blood onto my white shirt, or to test in the gym after a workout to find out how and when my levels have spiked over the past hour, or to test and see that although I’m running a little high, things are on the way down so WOAH THERE LADY don’t panic and overcorrect so soon… sign me up*.
*As soon as it’s available on the NHS.
In February 2016, Abbott announced they had obtained the CE Mark for the Libre for children and teens with diabetes aged 4-17 years old. Great news!