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FREESTYLE LIBRE ON SALE!!!!

This is a 'classic' libre overnight graph for me. I started out with higher glucs than usual but that pattern is being repeated night after night just shifted higher or lower depending on where my glucs were when I went to bed.

Getting this information from the Libre has been absolutely fantastic. When I started with it I was dropping into hypo soon after going to sleep, bouncing out, dropping again and then a steep climb from 5:30am to 9mmol or more from dawn phenomena.

I changed that to the graph shape here- wooohoooooo, I get a full nights sleep now - simply by changing medication and insulin timing. Key change was that I now take Levemir, 16u, at 08:00 with a nip of Novorapid for the dawn phenomena and then Levemir again at 24:00. Surprisingly delaying the evening Levemir has had no ill effects but it has timed its action to kick in the **** - dawn - phenomena.

If only I can get rid of that steady drop at the beginning of the night, its taking me into hypo every time if I go to bed lower than 7mmol or more. Something for my diabetes team.

That is the absolute brilliant part of the Libre, it has shown me what has been going on overnight and I've been able to correct it.

Now the bad news. You can see the difference between scans and finger prick values. Bearing in mind I fasted between 23:00 and 11:00 you would have thought them to be a lot closer but they are out 0.8 and 1.4 for no reason. This is pretty much the fasting error range when a sensor has settled in. New sensors have been all over the place in the morning. Given that I'm targeting 4.5mmol with Novorapid that is near 30% error factor,

The moment I eat or add in insulin the differences between scan ad BG becomes unpredictable for a couple of hours. The values shown on the graph are a real problem to me. On a 4.9 I would usually eat a little before going out, certainly before driving. On a 6.3 I would not. If I were to eat I would add 0.5u, maybe 1u, correction on a 6.3. Okay, maybe I run tight control (I have no idea what others do) but that's why I bought a Libre.

So my conclusion is that the Libre simply cannot live up to the Abbot hype about 'doing it without pricking'. It can't. I now have a pretty good grasp as to when the scan is going to go haywire and am sort of compensating, its working as a early 'need to check' alert, but I would never give the scanner to anyone to calculate bolus for me.
 

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Unfortunately my second sensor partially fell off at the gym yeterday which makes a total of two so far. Both had onyl been worn for a few days and were far behind the 14 days of full use.

I rang the Libre team again, and they were again very useful.
  • They confirmed that stock was low, and that they'd stopped all new users from purchasing sensors/readers. All existing customers should be okay for new sensors going into 2015.
  • Replacement orders are limited to every 14 days, so make sure you have your new sensor fitted at a time that wouldn't leave you unable to purchase a replacement and have it recieved in time to seamlessly transition between the old/new. I managed to get around the two sensor limit on my first order by also purchasing the starter kit again. 1 spare reader and 4 sensors to get through Xmas comfortably.
  • I used Skin-tac this time to attach the sensor, it's messy stuff and althogh it seemed to improve the adhesion of the sensor it didn't stop it from mostly coming off at the gym, they explicitly said that even though people sweat differently or have different mounts of skin sebum, the sensor shouldn't fall off. If yours does, report it and the technical team send out a new sensor for free. They need reports of the sensors falling off so they can elevate the issue to management.
  • I've found a cheap place in the UK to purchase Opsite flexifix, which is considered the best thing to use to cover the sensor. Tech support said fine with this, just don't stretch it over too tight as to restrict the flexibility of movement that the sensor already has. Search for Opsite flexifix at: http://www.farmaline.co.uk. It's about 1/4 the price of elsewhere I've looked.
 
The iPro sensor is fairly accurate with the data it picks up... i was quite impressed and compared the readings with 2hr bg readings. Not a great deal of difference
 
igmr said:
The values shown on the graph are a real problem to me. On a 4.9 I would usually eat a little before going out, certainly before driving. On a 6.3 I would not. If I were to eat I would add 0.5u, maybe 1u, correction on a 6.3. Okay, maybe I run tight control (I have no idea what others do) but that's why I bought a Libre.

So my conclusion is that the Libre simply cannot live up to the Abbot hype about 'doing it without pricking'. It can't. I now have a pretty good grasp as to when the scan is going to go haywire and am sort of compensating, its working as a early 'need to check' alert, but I would never give the scanner to anyone to calculate bolus for me.
Click to expand...

I absolutely agree with you, and in a similar vein I'm sad to say I can't use it as a guide during exercise either for the same reasoning. What is encouraging is that the Libre team are doing very well with sales, and that they are upfront about capturing user expereince to improve the accuracy and software further down the line.
 
igmr said:
Now the bad news. You can see the difference between scans and finger prick values. Bearing in mind I fasted between 23:00 and 11:00 you would have thought them to be a lot closer but they are out 0.8 and 1.4 for no reason. This is pretty much the fasting error range when a sensor has settled in. New sensors have been all over the place in the morning. Given that I'm targeting 4.5mmol with Novorapid that is near 30% error factor,

The moment I eat or add in insulin the differences between scan ad BG becomes unpredictable for a couple of hours. The values shown on the graph are a real problem to me. On a 4.9 I would usually eat a little before going out, certainly before driving. On a 6.3 I would not. If I were to eat I would add 0.5u, maybe 1u, correction on a 6.3. Okay, maybe I run tight control (I have no idea what others do) but that's why I bought a Libre.
Click to expand...
You are targetting an incredibly tight level there. I target a range of 4-8mmol/l. I'd say that my use of LCHF and Libre over the last 14 days is allowing me to stay in that range, and if the software is anything to go by, offering up a roughly 6.3% HBa1c. That's good enough for me. Trying to manage myself to 4.5 would mean taking up far too much of my time, and my experience so far is that a combination of diet, exercise and the range I am in has cleared minor retinopathy (that got me discharged as an out patient) and manages my blood pressure well.

I guess it's a toss up as to just how much time you want to spend and how much control you want to achieve. I guess if you are working to a wider range, the readings from the Libre are fine. If you are trying to focus on such a tight (and low) level, then really you don't have a choice but to stick to finger pricking. I'm surprised that you aren't on a pump given the level of control you desire.
 
Sideburnt said:
I absolutely agree with you, and in a similar vein I'm sad to say I can't use it as a guide during exercise either for the same reasoning. What is encouraging is that the Libre team are doing very well with sales, and that they are upfront about capturing user expereince to improve the accuracy and software further down the line.
Click to expand...
tim2000s said:
You are targetting an incredibly tight level there. I target a range of 4-8mmol/l. I'd say that my use of LCHF and Libre over the last 14 days is allowing me to stay in that range, and if the software is anything to go by, offering up a roughly 6.3% HBa1c. That's good enough for me. Trying to manage myself to 4.5 would mean taking up far too much of my time, and my experience so far is that a combination of diet, exercise and the range I am in has cleared minor retinopathy (that got me discharged as an out patient) and manages my blood pressure well.

I guess it's a toss up as to just how much time you want to spend and how much control you want to achieve. I guess if you are working to a wider range, the readings from the Libre are fine. If you are trying to focus on such a tight (and low) level, then really you don't have a choice but to stick to finger pricking. I'm surprised that you aren't on a pump given the level of control you desire.
Click to expand...

You are clearly stating that the Libre is not suitable for those that wish to avoid diabetes complications. Can I quote this to Abbott, "do not buy a Libre if you care for your long term health"?

The scan values from the Libre are not 'fine', they are unpredictably inaccurate and if you want to avoid complications wise up to the need for tight control. PM me and I'll tell you what poor control gets you and what life is like coping with them.
 
tim2000s said:
You are targetting an incredibly tight level there. I target a range of 4-8mmol/l. I'd say that my use of LCHF and Libre over the last 14 days is allowing me to stay in that range, and if the software is anything to go by, offering up a roughly 6.3% HBa1c. That's good enough for me. Trying to manage myself to 4.5 would mean taking up far too much of my time, and my experience so far is that a combination of diet, exercise and the range I am in has cleared minor retinopathy (that got me discharged as an out patient) and manages my blood pressure well.

I guess it's a toss up as to just how much time you want to spend and how much control you want to achieve. I guess if you are working to a wider range, the readings from the Libre are fine. If you are trying to focus on such a tight (and low) level, then really you don't have a choice but to stick to finger pricking. I'm surprised that you aren't on a pump given the level of control you desire.
Click to expand...

Agreed. I target 4.5 - 8 with my pump set to aim for 6 with its corrections. I find that the Libre is great for overnights and general pattern. It's accurate to within 1mmol 90% of the time which is fine by me :)
 
smidge said:
Unfortunately there's no handset so I'll have wait until next Monday when it gets plugged in and the data is downloaded. I have to BG test 4 times a day as well, so it should make a pretty comprehensive comparison between IF and BG as well as between the Libra and the Medtronic CGM.

Smidge
Click to expand...
I thought Medtronic cgm is terribly inaccurate and noone uses them anymore :o
 
igmr said:
You are clearly stating that the Libre is not suitable for those that wish to avoid diabetes complications. Can I quote this to Abbott, "do not buy a Libre if you care for your long term health"?

The scan values from the Libre are not 'fine', they are unpredictably inaccurate and if you want to avoid complications wise up to the need for tight control. PM me and I'll tell you what poor control gets you and what life is like coping with them.
Click to expand...

igmr, I wasn't intending to pass comment that I thought what you were doing was incorrect, simply that your control is, indeed, very tight. I apologise if I have caused offence. I understand that there are many complications that can arise and none of them are pleasant, and in reading all the literature, it's fairly easy to see that:
  1. Complications are very likely and they are extremely unpleasant
  2. When you get them is driven by your blood sugar levels, both fasted and post meal over a long period of time plus other lifestyle factors.
  3. There is plenty of study based evidence that what is considered to be good control for a diabetic will still lead to earlier onset of issues with the kidneys, eyes, cardio vascular system, etc
  4. Continued yo-yoing of glucose levels correlates with adverse effects on the body.
Coming back to the Libre. If it is allowing me to reduce point 4 of the above and maintain a better balance, then it is reducing one of the risks associated with developing complications. I don't need to know my blood sugar levels to improve my balance, purely my trends. It does this admirably, as you have agreed, and was the primary reason that I wanted one.

With regard to your experience of the readings being unpredictably inaccurate. I have seen differences from blood tests, but in general, I haven't experiences wildly incomparable results next to my blood glucose levels. I have also seen differences across different metres. In the absence of proper evidence either way, I'm not clear as to whether this is a failing of the Libre in general or something that relates more specifically to individuals.
 
hale710 said:
Agreed. I target 4.5 - 8 with my pump set to aim for 6 with its corrections. I find that the Libre is great for overnights and general pattern. It's accurate to within 1mmol 90% of the time which is fine by me :)
Click to expand...

I wish I could be as lazy in my control. For many years I used to be but I'm paying for that now. I'd much rather be out and about instead of sitting in my wheelchair moaning about the libre but, hey, I took the p*ss with my control and now I'm paying the price. My own fault.

Hopefully you guys will dodge the bullet of diabetes complications, they are not easy to live with, believe me. Tight control becomes a lot more important as they bite.

Pump would be nice but the NHS here seem to have a zero support policy for us type 2s on insulin. Bare minimum check ups to qualify for funding.

In the mean time I need the Libre to live up to its marketing hype.
 
As a slight aside, when you were diagnosed, how was the information about complications presented to you? One of the first things that was drummed in in our area as a newly type 1 diabetic kid in the late eighties was that if we didn't keep a good level of control, essentially, we'd go blind, probably have to have limbs amputated and also suffer kidney failure. And it was presented in a very matter of fact way that was particularly scary as a thirteen year old.

In addition, I was stabilised as an in-patient on a ward where there were older diabetics having amputations done to them. Altogether, as a starter, it was a pretty strong set of warnings.
 
PaulinaB said:
I thought Medtronic cgm is terribly inaccurate and noone uses them anymore :eek:
Click to expand...

Well, I guess we'll see next week! Maybe CGM, Libre and BG testing will all tell totally different stories and we've all been fooled all along!

Smidge
 
smidge said:
Vertical up arrow - BG rising more than 0.1 mmol per minute
Diagonal up arrow - BG rising between 0.06 and 0.1 mmol per minute
Horizontal arrow - BG changing less than 0.06 mmol per minute
Diagonal down arrow - BG falling between 0.06 and 0.1 mmol per minute
Vertical down arrow - BG falling more than 0.1 mmol per minute
Click to expand...
My arrows are all over the place - they don't know whether their coming or going stupid things :wacky:

6l52InQ.jpg
 
igmr said:
I wish I could be as lazy in my control.
Click to expand...

I actually take great offence to that. I am anything but lazy with my control. I maintain an hba1c in the 6s through consistent exercise, carb counting and monitoring the effects of food. I basal test regularly to ensure my settings are correct. I work hard, I just keep my targets realistic.

It is unfortunate that you've had complications, but until you know full circumstance you can't say keeping my BG below 8 is lazy.
 
image.jpg
Back to being 3 mmol out today. All days it's been between 1 and 3 out.

Not helping my grumpy day. Grumble grumble grumble
 
tim2000s said:
As a slight aside, when you were diagnosed, how was the information about complications presented to you? One of the first things that was drummed in in our area as a newly type 1 diabetic kid in the late eighties was that if we didn't keep a good level of control, essentially, we'd go blind, probably have to have limbs amputated and also suffer kidney failure. And it was presented in a very matter of fact way that was particularly scary as a thirteen year old.

In addition, I was stabilised as an in-patient on a ward where there were older diabetics having amputations done to them. Altogether, as a starter, it was a pretty strong set of warnings.
Click to expand...
I cannot actually recall any of my doctors or DSNs talking about this apart from explaining diabetic neuropathy (diabetics may lose sensation in their feet, so you have to carefully check your feet), although that might in part be due to me strongly pushing to be discharged as fast as possible (after 4 days peeing into a bottle whilst lying down and with two IVs and an aterial line and no change of clothing I really wanted a shower).

You are clearly stating that the Libre is not suitable for those that wish to avoid diabetes complications. Can I quote this to Abbott, "do not buy a Libre if you care for your long term health"?
Click to expand...
No, he is saying that the Libre is not suitable if you insist on arbitrarily picking glucose targets beyond what treatment guidelines recommend and far beyond what is supported by evidence. Yes, diabetics with good control have higher incidence of complications than healthy people BUT that does not automatically mean that aiming for a HbA1c of 4.0 will be better than HbA1c (sure, you have a nice story explaining why you'd expect this to be this way, but sadly reality doesn't always work like that).
Until such a time that you can produce a RTC clearly showing that extremely tight glucose targets are better Abbot will own your rear for slander.
 
tim2000s said:
igmr, I wasn't intending to pass comment that I thought what you were doing was incorrect, simply that your control is, indeed, very tight. I apologise if I have caused offence. I understand that there are many complications that can arise and none of them are pleasant, and in reading all the literature, it's fairly easy to see that:
  1. Complications are very likely and they are extremely unpleasant
  2. When you get them is driven by your blood sugar levels, both fasted and post meal over a long period of time plus other lifestyle factors.
  3. There is plenty of study based evidence that what is considered to be good control for a diabetic will still lead to earlier onset of issues with the kidneys, eyes, cardio vascular system, etc
  4. Continued yo-yoing of glucose levels correlates with adverse effects on the body.
Coming back to the Libre. If it is allowing me to reduce point 4 of the above and maintain a better balance, then it is reducing one of the risks associated with developing complications. I don't need to know my blood sugar levels to improve my balance, purely my trends. It does this admirably, as you have agreed, and was the primary reason that I wanted one.

With regard to your experience of the readings being unpredictably inaccurate. I have seen differences from blood tests, but in general, I haven't experiences wildly incomparable results next to my blood glucose levels. I have also seen differences across different metres. In the absence of proper evidence either way, I'm not clear as to whether this is a failing of the Libre in general or something that relates more specifically to individuals.
Click to expand...

No offense taken at all.

I need tight control, I'd much rather not have the need but there you go. Neuropathy, charcot foot, retinopathy, 29% kidney function, hyper tension you name it I got it - tight control makes things a whole lot easier.

I have nothing but praise for the Libre for resolving the yo-yo'ing, it has proved fantastic for me. Absolutely wonderful, I have never been anything but enthusiastic about how it maps and graphs how my levels are moving.

Accuracy. Within the above I really do not care. As long as the scans are consistent, the graphs will be consistent and I can - have - act on the data.

Now accuracy as of NOW, scan reading. Fasting, no rapid insulin. All 3 sensors that I've used,once settled, pretty much showed 1mmol low and 20 minutes behind a finger prick. I can almost trust this. Unfortunately I do not live fasting and no insulin.

So. When my glucose levels are rising - be it food, high gi or low gi or be if dawn phenomena, the scan lags behind the rise and the differnce between the two increases. Then, as the insulin bites my BG peaks and starts to drop - while the scan is lagging and still rising. They get closer and after 30 or 40 minutes the scan gets to read higher than the BG - they cross and can be identical. It is entirely impossible to know where you are on the two value bell curves to predict what the scan is actually representing. If you are getting consistent differences I would suggest it is more to do with the timing of your testing than anything else.

In straight value terms I have seen a scan 4.5mmol low to a BG and 2.0 higher than a BG . I cannot take action with an error potential greater than my target glucose level. Bluntly. good luck if you think you can.

Knowing all this I can guess what a scan means nut it is safer to finger prick just in case.
 
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