Cyborg Times (new BG meter)

February 17, 2016 12:49

novorapidboi26 DAFNE Graduate
NHS Lanarkshire 1,819 posts

Yelekreb said:
I'm 5 days into my first Freestyle Libre sensor. First 18 hours - horribly inaccurate. Now pretty good. Does lag a bit (and measures differently to finger sticking), but really helpful in understanding trends. Its expensive, but very helpful!

This is how I understand the benefit of its use.....it can display patterns of BG at times when you cant or wont test your blood sugar......

good for basal testing and so on.....

the same goes with CGM,, good for basal testing...and yes, good for spotting hypos etc, but most folk can feel the lows coming on....

not something that everyone should have or want really......

im still going to get a libre soon.... Smile

February 17, 2016 19:50

HelenP DAFNE Graduate
Queensland Diabetes Centre, Brisbane, QLD 218 posts

I'm curious! Do you intend to use them continuously or use just to set basal rates etc? Has anyone tested the life of one of a sensor or do they just shut down automatically after two weeks? Any site problems after two weeks? I occasionally have site issues with the pump stuff and would be reluctant to just "replace the sensor" especially as they are as expensive as they are.

Helen

February 17, 2016 20:11

SimonC DAFNE Graduate
NHS Harrow 78 posts

HelenP said:
I'm curious! Do you intend to use them continuously or use just to set basal rates etc? Has anyone tested the life of one of a sensor or do they just shut down automatically after two weeks? Any site problems after two weeks? I occasionally have site issues with the pump stuff and would be reluctant to just "replace the sensor" especially as they are as expensive as they are.

Helen

Helen

They shut down automatically - they clearly have a countdown timer, and really only do last 2 weeks - to the minute.

I am on my second month of using them, and they really are an eye opener as to how the level deviate - for me, have discovered that I need to take my breakfast fast acting much earlier - about 30 mins before I eat - to keep the dawn phenomenon to a minimum, but I can take the fast acting much closer to when I eat during the day.

Because you can see the rise and fall plotted on the graph it paints a much better picture of what is happening than taking a single point in time and trying to guess what is actually going on - is that snapshot on the rise, or on the way down, or is it levelling off - you just can't be sure with the single test - although you can make an educated guess, but with the monitor - you know, you can see.

I have also changed the amounts of my split long acting to also help with this - and whilst still not perfect, it is getting there.

It also helps when driving - yes in the UK we have to do a blood test to comply with the law, but whilst driving, I can quickly scan - this can inform my decisions and thus ensure I know if the levels are dropping close to the UK limit of 5 mmols, before they get there, and so stop or know I am no where near the limit. yes I know there is more to it such as stopping and re blood testing every 2 hours - for the pedants, but you get the picture.

For me, the very first monitor was a bit out of sink with the blood reading for the first hour or two, but since then they have all been pretty much in tune with the blood tests, and now I tend to rely on them and refer to these rather than any blood test.

Apart from all this, it really is very easy to get a reading. The NFC range goes right through any clothing, including my thick motorbike jackets, and at work, I do just pick op the scanner and scan - done in 2 seconds.

I love them.

February 17, 2016 21:17

Warwick DAFNE Graduate
Diabetes Australia-Vic, Melbourne, Victoria 423 posts

Helen,

Although the Libre will be released here in Australia in the next few months, I've been using the Dexcom G4. Still horribly pricey, but when a sensor dies after a week, you can just restart it again. The best I have had lasted 53 days. I don't know of anyone else though getting such long-lasting behaviour though so it does really depend on the individual.

The G5 gets released at the end of the month but I won't be moving to that. The transmitter on a G5 is set to die at 3 months exactly. It is almost the same price as a G4 transmitter but the G4 transmitter is warranted to last at least 6 months, so for me it is a no-brainer to stay with the G4 given that the transmitter costs $540 for a G5 and $580 for a G4.

February 18, 2016 09:17

Yelekreb DAFNE Graduate
Cardiff and Vale University Health Board 11 posts

I've bought mine to cover a ski trip - being able to test through clothes is a huge bonus. I plan to use it intermittently to cover holidays/sport etc. I've stuck some Tegaderm over the top to give a bit more robustness. I think it should be fine without, but bashing the sensor is a possibility skiing. I've already discovered that I can hit a door frame with the back of my arm!

The insight into my BS levels over 24 hours is amazing. The sensor stores 8 hours of readings, + you can 'zap' as many times as you like for an instant read. The reader (which is just a special BS Meter) can hold 90 days data. Abbott are trialling a mobile based version using NFC in Sweden. Android only, but maybe Apple will be enabled sometime.

It's not a perfect system. The reader is a bit plasticky and it would have been nice to have a case. You can use it as a normal BS monitor as well using Abbot Opitum strips. You still have to finger prick, but as opposed to knowing where I am 4-6 times a day, I can now know anytime. It's like driving with your eyes open, rather than every 6 hours!

It is expensive - no doubt. There is good research that shows CGM (or equivalent) combined with good education (DAFNE!) can lead to significant HBA1C reductions. This of course would be an enormous cost saving to the NHS in the long term. But I doubt it will get NHS funding soon. That being said, if Abbott can role out worldwide and economies of scale kick in, we (hopefully) would see unit price reductions. Competition might help here too.

I know of one A&E Doctor (T1) who uses Freestyle at work as finger sticking for him is hazardous due to the bodily fluids he is exposed to. If you work or are exposed to a dirty environment, this could be a real help. I can even 'zap' when running - I'm worried I will miss it!

February 18, 2016 13:26

sarahg DAFNE Graduate
Essex Partnership University Trust (South East) 29 posts

Hi Guys. Hope it works out for you on your ski trip. Having used this system for over 12 months it has been amazing . I missed swimming and iam finding I am now getting a bit on sore arms , so iam going to take a break for a while. The system is a fantastic way to see how your blood glcouse is 24/7. I do find the skin tac wipes really help with ensuring it stays on for the 14 days as I do find getting sweaty at the gym/ gardening reduces length of time the sensor stays on.

February 18, 2016 19:55

SimonC DAFNE Graduate
NHS Harrow 78 posts

It is funny how different we all are - my only bug bear with the libre system is that the glue on the sensor is too strong.

I was away for the weekend with my wife, and I was in the sauna, steam room and hot tub, and the sensor did not peel off - and when I had to remove it a few days later it was still stuck solid, and took quite a lot to pull it off. It leaves a big red mark where it has been which takes about 4 days to go - I alternate arms to give each one a rest.

February 19, 2016 08:42

Frazer DAFNE Graduate
Essex Partnership University NHS FT (St Margaret’s Hospital) 16 posts

I have exactly the same problems as you SimonC. It's quite a relief to know I'm not the only one!
On the earlier comment about a case I keep mine in a very small camera case. It's 13cm by 6cm and the reader fits in perfectly.
I can't remember where I got it but it's made by a company called Lifeventure, just Google it and you'll find it.

February 23, 2016 07:38

Adamkerrnz DAFNE Graduate
Auckland DHB, Auckland 1 post

I'm waiting for the Libre to be released in Australia and hopefully eventually in nz. The exchange rate nz to pounds is pretty horrific so hopefully pricing Is better from Australia. The dexcom is just too expensive for me, but I would love to have this technology available

February 24, 2016 10:08

Garry DAFNE Graduate
North Lincolnshire and Goole NHS Foundation Trust 328 posts

Just a newcomer to this technology. Only on my second sensor.
But I can say that my limited experience wholly reflects earlier posts. Stays on well. Sometimes knocks against door frames...even though applied to the back of the arm. When it died - timed to the minute, I took it off in the shower and thought is this going to unstick? It came off with a big pull OK but as others have mentioned it leaves a red mark. I was a little luckier SimonC, as the mark has almost disappeared within a day, although it is very easy to see where the sensor needle entered. I have used the reader with my usual Abbott test strips for finger bloods as a check and they have all been within 0.3 mmol/L. Compared to my Optium Xceed meter within 0.5 mmol/L...so I'm pleased that I have great confidence in the results.
I've tried it as I have been having problems keeping control during exercise. But this is an ideal aid for that situation. When out on my bike I can stop for a minute, take the reader out of one of the back pockets on my top and get an instant reading through my bike suit. A check during walking is even easier of course.
No case available yet. I would like a very small grippy case as I find the reader difficult to keep hold of when the hands are cold. Fortunately, I have only dropped it in the house onto carpet so far....but!
Like all of us, I'm a bit shocked by the ongoing cost but would like to think that the NHS would eventually do a direct comparison against fortnightly test strip costs. When I last looked, some time ago admittedly, I was averaging 90 strips a fortnight. But I don't know the current strip cost so I'll go and sweetheart my friendly cycling pharmacist for the info.
Need get some more ordered. Lets see how easy that is?
Regards
Garry

February 17, 2016 12:49 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	Yelekreb said: I'm 5 days into my first Freestyle Libre sensor. First 18 hours - horribly inaccurate. Now pretty good. Does lag a bit (and measures differently to finger sticking), but really helpful in understanding trends. Its expensive, but very helpful! This is how I understand the benefit of its use.....it can display patterns of BG at times when you cant or wont test your blood sugar...... good for basal testing and so on..... the same goes with CGM,, good for basal testing...and yes, good for spotting hypos etc, but most folk can feel the lows coming on.... not something that everyone should have or want really...... im still going to get a libre soon....
February 17, 2016 19:50 HelenP DAFNE Graduate Queensland Diabetes Centre, Brisbane, QLD 218 posts	I'm curious! Do you intend to use them continuously or use just to set basal rates etc? Has anyone tested the life of one of a sensor or do they just shut down automatically after two weeks? Any site problems after two weeks? I occasionally have site issues with the pump stuff and would be reluctant to just "replace the sensor" especially as they are as expensive as they are. Helen
February 17, 2016 20:11 SimonC DAFNE Graduate NHS Harrow 78 posts	HelenP said: I'm curious! Do you intend to use them continuously or use just to set basal rates etc? Has anyone tested the life of one of a sensor or do they just shut down automatically after two weeks? Any site problems after two weeks? I occasionally have site issues with the pump stuff and would be reluctant to just "replace the sensor" especially as they are as expensive as they are. Helen Helen They shut down automatically - they clearly have a countdown timer, and really only do last 2 weeks - to the minute. I am on my second month of using them, and they really are an eye opener as to how the level deviate - for me, have discovered that I need to take my breakfast fast acting much earlier - about 30 mins before I eat - to keep the dawn phenomenon to a minimum, but I can take the fast acting much closer to when I eat during the day. Because you can see the rise and fall plotted on the graph it paints a much better picture of what is happening than taking a single point in time and trying to guess what is actually going on - is that snapshot on the rise, or on the way down, or is it levelling off - you just can't be sure with the single test - although you can make an educated guess, but with the monitor - you know, you can see. I have also changed the amounts of my split long acting to also help with this - and whilst still not perfect, it is getting there. It also helps when driving - yes in the UK we have to do a blood test to comply with the law, but whilst driving, I can quickly scan - this can inform my decisions and thus ensure I know if the levels are dropping close to the UK limit of 5 mmols, before they get there, and so stop or know I am no where near the limit. yes I know there is more to it such as stopping and re blood testing every 2 hours - for the pedants, but you get the picture. For me, the very first monitor was a bit out of sink with the blood reading for the first hour or two, but since then they have all been pretty much in tune with the blood tests, and now I tend to rely on them and refer to these rather than any blood test. Apart from all this, it really is very easy to get a reading. The NFC range goes right through any clothing, including my thick motorbike jackets, and at work, I do just pick op the scanner and scan - done in 2 seconds. I love them.
February 17, 2016 21:17 Warwick DAFNE Graduate Diabetes Australia-Vic, Melbourne, Victoria 423 posts	Helen, Although the Libre will be released here in Australia in the next few months, I've been using the Dexcom G4. Still horribly pricey, but when a sensor dies after a week, you can just restart it again. The best I have had lasted 53 days. I don't know of anyone else though getting such long-lasting behaviour though so it does really depend on the individual. The G5 gets released at the end of the month but I won't be moving to that. The transmitter on a G5 is set to die at 3 months exactly. It is almost the same price as a G4 transmitter but the G4 transmitter is warranted to last at least 6 months, so for me it is a no-brainer to stay with the G4 given that the transmitter costs $540 for a G5 and $580 for a G4.
February 18, 2016 09:17 Yelekreb DAFNE Graduate Cardiff and Vale University Health Board 11 posts	I've bought mine to cover a ski trip - being able to test through clothes is a huge bonus. I plan to use it intermittently to cover holidays/sport etc. I've stuck some Tegaderm over the top to give a bit more robustness. I think it should be fine without, but bashing the sensor is a possibility skiing. I've already discovered that I can hit a door frame with the back of my arm! The insight into my BS levels over 24 hours is amazing. The sensor stores 8 hours of readings, + you can 'zap' as many times as you like for an instant read. The reader (which is just a special BS Meter) can hold 90 days data. Abbott are trialling a mobile based version using NFC in Sweden. Android only, but maybe Apple will be enabled sometime. It's not a perfect system. The reader is a bit plasticky and it would have been nice to have a case. You can use it as a normal BS monitor as well using Abbot Opitum strips. You still have to finger prick, but as opposed to knowing where I am 4-6 times a day, I can now know anytime. It's like driving with your eyes open, rather than every 6 hours! It is expensive - no doubt. There is good research that shows CGM (or equivalent) combined with good education (DAFNE!) can lead to significant HBA1C reductions. This of course would be an enormous cost saving to the NHS in the long term. But I doubt it will get NHS funding soon. That being said, if Abbott can role out worldwide and economies of scale kick in, we (hopefully) would see unit price reductions. Competition might help here too. I know of one A&E Doctor (T1) who uses Freestyle at work as finger sticking for him is hazardous due to the bodily fluids he is exposed to. If you work or are exposed to a dirty environment, this could be a real help. I can even 'zap' when running - I'm worried I will miss it!
February 18, 2016 13:26 sarahg DAFNE Graduate Essex Partnership University Trust (South East) 29 posts	Hi Guys. Hope it works out for you on your ski trip. Having used this system for over 12 months it has been amazing . I missed swimming and iam finding I am now getting a bit on sore arms , so iam going to take a break for a while. The system is a fantastic way to see how your blood glcouse is 24/7. I do find the skin tac wipes really help with ensuring it stays on for the 14 days as I do find getting sweaty at the gym/ gardening reduces length of time the sensor stays on.
February 18, 2016 19:55 SimonC DAFNE Graduate NHS Harrow 78 posts	It is funny how different we all are - my only bug bear with the libre system is that the glue on the sensor is too strong. I was away for the weekend with my wife, and I was in the sauna, steam room and hot tub, and the sensor did not peel off - and when I had to remove it a few days later it was still stuck solid, and took quite a lot to pull it off. It leaves a big red mark where it has been which takes about 4 days to go - I alternate arms to give each one a rest.
February 19, 2016 08:42 Frazer DAFNE Graduate Essex Partnership University NHS FT (St Margaret’s Hospital) 16 posts	I have exactly the same problems as you SimonC. It's quite a relief to know I'm not the only one! On the earlier comment about a case I keep mine in a very small camera case. It's 13cm by 6cm and the reader fits in perfectly. I can't remember where I got it but it's made by a company called Lifeventure, just Google it and you'll find it.
February 23, 2016 07:38 Adamkerrnz DAFNE Graduate Auckland DHB, Auckland 1 post	I'm waiting for the Libre to be released in Australia and hopefully eventually in nz. The exchange rate nz to pounds is pretty horrific so hopefully pricing Is better from Australia. The dexcom is just too expensive for me, but I would love to have this technology available
February 24, 2016 10:08 Garry DAFNE Graduate North Lincolnshire and Goole NHS Foundation Trust 328 posts	Just a newcomer to this technology. Only on my second sensor. But I can say that my limited experience wholly reflects earlier posts. Stays on well. Sometimes knocks against door frames...even though applied to the back of the arm. When it died - timed to the minute, I took it off in the shower and thought is this going to unstick? It came off with a big pull OK but as others have mentioned it leaves a red mark. I was a little luckier SimonC, as the mark has almost disappeared within a day, although it is very easy to see where the sensor needle entered. I have used the reader with my usual Abbott test strips for finger bloods as a check and they have all been within 0.3 mmol/L. Compared to my Optium Xceed meter within 0.5 mmol/L...so I'm pleased that I have great confidence in the results. I've tried it as I have been having problems keeping control during exercise. But this is an ideal aid for that situation. When out on my bike I can stop for a minute, take the reader out of one of the back pockets on my top and get an instant reading through my bike suit. A check during walking is even easier of course. No case available yet. I would like a very small grippy case as I find the reader difficult to keep hold of when the hands are cold. Fortunately, I have only dropped it in the house onto carpet so far....but! Like all of us, I'm a bit shocked by the ongoing cost but would like to think that the NHS would eventually do a direct comparison against fortnightly test strip costs. When I last looked, some time ago admittedly, I was averaging 90 strips a fortnight. But I don't know the current strip cost so I'll go and sweetheart my friendly cycling pharmacist for the info. Need get some more ordered. Lets see how easy that is? Regards Garry