Abbot Libre system

I get mine on prescription at the moment. The NHS pays £33 for them.

Shecat said:

My main question is I went to buy sensors, they cost £47 each after VAT exemption, each! I bought one thinking there would be 2 in the box so this seems pretty expensive.

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Yep, it was like getting a 100quid pay rise a month when I finally got them on prescription (I self funded for about 2 years, some did so for longer)

Shecat said:

I did see on the website that apparently I can claim a reimbursement from the NHS for the sensors. Has anyone ever done this and what do I do?

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I haven't seen that claim anywhere (mind you I haven't looked), but for most of us who get them on prescription it was never the doctor who decided whether you could get them or not, it was a consultant who decided whether they could be funded or not (some CCG's have stricter rules than others), so if (and that's a big 'if') you can claim some of it back I suspect it'd have to go through your consultant, but I'm guessing here and I've never seen anyone mention it. Might be useful if you could link where you saw it.

I'm fairly certain that you'll need a prescription and in order to obtain one you'll have to be prescribed by secondary care, either by a DSN or Consultant who would then contact your GP who would write the scrips. As has been said CCGs have different rules governing entitlement.

I remembered asking an Abbott rep two years ago about reimbursement and she said no. Have you spoken with your diabetes nurse or consultant to ask about it? Some of us get it on prescription.

Shecat said:

I on average prick my finger 140+ times every 14 days whereas this sensor is one prick into my arm for 14 days unlimited readings.

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Be aware that the readings are not always accurate and can be 1.5 mmol/L out or more.
The sensors are good for trends.
So you would still have to finger prick at times, especially when readings were very low or high, or changing rapidly.
The readings tend to be 15-20 minutes behind your real BG level anyway so caution is advised.

LittleGreyCat said:

Be aware that the readings are not always accurate and can be 1.5 mmol/L out or more.
The sensors are good for trends.
So you would still have to finger prick at times, especially when readings were very low or high, or changing rapidly.
The readings tend to be 15-20 minutes behind your real BG level anyway so caution is advised.

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Hi,

I would agree. But apps like xDrip or Glimp can be calibrated to the BG meter, chopping a little more sense into the interpreted data..

EllieM said:

Isn't one of the criteria for libre prescriptions that you test more than 7 or 8 (can't remember the number but definitely less than 10) times a day? @Shecat should ask at their next hospital clinic appointment.

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In my local NHS area in Scotland the primary criterion is that you inject 4 or more times a day but you must also undertake to test at least 6 times a day.

I recommend ringing your diabetes centre and they should be able to tell your their criteria. I thought I was doing enough by testing 7/8 times a day then I went and they said it had to be solidly over 8 tests a day (to make the cost of the sensor cheaper than the cost of the lancets and test strips). Then had to wait 18 months for my next clinic to get referred for libre training and another 6 months for the training itself! A quick phonecall would have been so much easier had I thought!

LittleGreyCat said:

Be aware that the readings are not always accurate and can be 1.5 mmol/L out or more.
The sensors are good for trends.
So you would still have to finger prick at times, especially when readings were very low or high, or changing rapidly.
The readings tend to be 15-20 minutes behind your real BG level anyway so caution is advised.

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I agree that Libre sensors are good for trends, and any anomalous readings should be double checked. Certainly you get a more instant read from blood than you do interstitial fluid.

But it's a bit misleading to say that readings are not always accurate and can be 1.5mmol/L out or more. This is true for any meter, which are basically only required to be 15-20% accurate according to FDA/ISO standards. So if your BG is around 10mmol/L then any reading from 8mmol to 12mmol is considered "accurate" for *any* kind of meter, not just the Libre. They're all supposed to follow the same standards, yet you can find tons of articles about well-known finger-prick readers that don't meet the 15% accuracy 95% of the time/20% accuracy 99% of the time criteria. So who is to say your finger-prick reader is right and your libre isn't?

If you really want to know how your meter skews, then take a reading when you next go for labs, and compare your lab BG to your meter or libre BG.

Twisticles said:

I agree that Libre sensors are good for trends, and any anomalous readings should be double checked. Certainly you get a more instant read from blood than you do interstitial fluid.

But it's a bit misleading to say that readings are not always accurate and can be 1.5mmol/L out or more. This is true for any meter, which are basically only required to be 15-20% accurate according to FDA/ISO standards. So if your BG is around 10mmol/L then any reading from 8mmol to 12mmol is considered "accurate" for *any* kind of meter, not just the Libre. They're all supposed to follow the same standards, yet you can find tons of articles about well-known finger-prick readers that don't meet the 15% accuracy 95% of the time/20% accuracy 99% of the time criteria. So who is to say your finger-prick reader is right and your libre isn't?

If you really want to know how your meter skews, then take a reading when you next go for labs, and compare your lab BG to your meter or libre BG.

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Labs don't test BG they test HbA1c - at least in my part of the UK.
My current Libre is reading consistently 1 to 1.5 mmol/L low compared to my finger prick test.
Not sometimes the same, sometimes higher, sometimes lower (as if it was reading the same actual value to an accuracy of +/-15%) but consistently lower.

Anything is possible but I think the odds are against the Libre being more accurate using interstitial fluid to estimate BG than a finger prick using real blood.

LittleGreyCat said:

Labs don't test BG they test HbA1c - at least in my part of the UK.

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The NICE guidelines for diagnosis of T2 point to the WHO guidelines amended in 2015.
Am I to understand that your diagnosis was done without any venous Fasting Plasma Glucose test? You probably want to chat with your Dr about NICE and WHO guidelines!

LittleGreyCat said:

My current Libre is reading consistently 1 to 1.5 mmol/L low compared to my finger prick test.
Not sometimes the same, sometimes higher, sometimes lower (as if it was reading the same actual value to an accuracy of +/-15%) but consistently lower.

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Happy your libre is consistent at least! As mentioned, great for spotting trends. Even better, the Libre can tell you whether you're going up or down, whereas a fingerprick is only a moment in time.

LittleGreyCat said:

Anything is possible but I think the odds are against the Libre being more accurate using interstitial fluid to estimate BG than a finger prick using real blood.

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Also as mentioned, with a 15-20% tolerance on any kind of home measurement, why is it that you immediately assume the Libre is reading low, instead of your finger-prick meter running high? According to the standards they've been certified to, both are equally likely. You've never had a venous fasting plasma glucose test to identify your lab-certified fasting levels, so why assume the Libre is under and not that your meter isn't reading high? After all the gold standard for glucose levels is testing venous blood plasma, not capillary blood.

I'm genuinely trying to sift the anecdotal from the scientific - the science on the Libre is proven and certified so I don't understand why the "odds are against" it? It's certainly slower than a finger-prick to detect rapidly changing BG, but by less than 5mins.

Interesting independent report on the Libre accuracy is here

Twisticles said:

The NICE guidelines for diagnosis of T2 point to the WHO guidelines amended in 2015.
"The current WHO diagnostic criteria for diabetes should be maintained – fasting plasma glucose ≥ 7.0mmol/l (126mg/dl) or 2–h plasma glucose ≥ 11.1mmol/l (200mg/dl)."Am I to understand that your diagnosis was done without any venous Fasting Plasma Glucose test? You probably want to chat with your Dr about NICE and WHO guidelines!

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You were apparently talking about checking a BG meter against "Labs" which I took to mean the regular blood tests T2 Diabetics have. Although not often referred to as "Labs" in the UK.
What has this to do with venous fasting blood tests at first diagnosis (when most if not all T2s wouldn't even have a BG meter or know what one was).
First diagnosis usually includes a venous fasting BG test.
Regular checks thereafter do not, because long term monitoring relies on HbA1c to show average BG levels.

You seem strangely in love with the Libre sensor.

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LittleGreyCat said:

Labs don't test BG they test HbA1c - at least in my part of the UK.
My current Libre is reading consistently 1 to 1.5 mmol/L low compared to my finger prick test.
Not sometimes the same, sometimes higher, sometimes lower (as if it was reading the same actual value to an accuracy of +/-15%) but consistently lower.

Anything is possible but I think the odds are against the Libre being more accurate using interstitial fluid to estimate BG than a finger prick using real blood.

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Hi there, I've had my libre for a week and love it for a number of reasons. It is around 10/15 minutes 'behind' of course so in the first few days (to test it all), I did a libre check, then a blood test 15 minutes later and they were practically the same. I also checked with finger pricks on 3 of my old meters and again, roughly the same. I sometimes use the libre itself to do its own blood test and again that comes up as similar to the libre reader. It was trial & error at first and the biggest surprise to me was how much glucose levels fluctuate minute to minute. In the space of 15 minutes, mine can be anything between 4 and 5, or it can show a 7 following exercise then 10 minutes later be down to a 5. I would have known none of this on the old finger prick method so as you say it is fab for trends, and yes, I am happy to use it and accept its readings before driving and insulin dosage. Let's face it, we have had to calculate insulin dosage on a random single test before this so the libre in my opinion is a massive step up. x

LittleGreyCat said:

You were apparently talking about checking a BG meter against "Labs" which I took to mean the regular blood tests T2 Diabetics have. Although not often referred to as "Labs" in the UK.
What has this to do with venous fasting blood tests at first diagnosis (when most if not all T2s wouldn't even have a BG meter or know what one was).
First diagnosis usually includes a venous fasting BG test.
Regular checks thereafter do not, because long term monitoring relies on HbA1c to show average BG levels.

You seem strangely in love with the Libre sensor.

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Well I'm in love with it, nothing strange about that. It may have its 'issues' as does ANY means of checking glucose levels (even the hb1ac), but it doesn't half make things easier when compared to finger pricking. Once you get to understand how it compares to everything else in my opinion it is fab. I love knowing if I'm falling or rising, I can do loads of checks whenever I want within a second, no more sore fingers, it makes me feel a bit more normal.

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The Libre combined with the Miaomiao is really good. The MM allows you to calibrate the Libre readings with a finger prick test. I happily puit these readings into my pump and bolus with them

My Libres almost always read 1-1.2mmol/l lower than my glucometer readings, and my HbA1cs.
It is very consistent.
So I agree that there is a clear disparity between blood testing results by fingerprick and interstitial fluid results by Libre.
This may be down to the individual person's body. My results are far too consistent to blame manufacturing variations for the sensors.

Having said that, I have bought a miaomiao in order to calibrate the Libre readings, and feel that people who rely on the sensor to guide them on insulin doses, especially for low readings, should bear these potential inaccuracies strongly in mind.

As for the claim that there is
a 15-20% tolerance on any kind of home measurement
I am afraid the situation is much more complicated than that.
This link explains things in more detail
https://www.diabetes.co.uk/blood-glucose-meters/iso-accuracy-standards.html
and it is important to bear in mind that the ISO accuracy standards apply to blood glucose meters.
They do not apply to interstitial fluid meters.
If anyone has the equivalent standards published for interstitial fluid meters/sensors I would love to read them, so please post a link. Thank you in advance.

This is the info that Abbott have on their international website about accuracy
https://provider.myfreestyle.com/freestyle-libre-clinical-evidence.html
I have to say that my experiences and my body to not align with their statements, although the miaomiao helps a great deal.

@Brunneria if my readings are high or low then I do a finger prick test anyway. Even then the readings are favorable to my finger prick tests. I am one of the lucky ones who gets accurate readings 90% of the time

porl69 said:

The Libre combined with the Miaomiao is really good. The MM allows you to calibrate the Libre readings with a finger prick test. I happily puit these readings into my pump and bolus with them

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Though on MDI. Same here realy. Certainly fills in those gaps twix the tests prior to bolusing. The direction from previous 5min reading intervals helps a little with "forecasting" too.

Tha whole debate about BG readings being different on oposite sides of the body? Lol, I tend to calibrate a meter reading from the same side the sensor is.. Whether that matters. I find it pretty close considering lag & what not.
Hypo treatment? Don't know about you @porl69 , The meter always finishes first on the ascent..

But any irregularities high or low are always checked out with the meter.

Certainly adds a new dimension with the wearable monitor. Been dreaming about this Captain Kirk stuff since I were a kid!