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Freestyle Libre 3

Discussion in 'Ask A Question' started by DavidDK, Mar 1, 2022.

  1. DavidDK

    DavidDK Type 1 · Well-Known Member

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    Good morning

    I see the manufacturer has now uploaded a number of videos on You Tube about using the Freestyle Libre 3 which appear to be directed at prospective users in the UK and Ireland.

    Does anyone have any intel on:

    1. Who will be able to use the Libre 3 in the UK?

    2. Whether the Libre 3 will be available on prescription?

    My current understanding is that GPs won't be able to prescribe it as they can Libre 1 and 2. Libre 3 will only be available through patients' diabetes consultants/DSNs. This seems to me an inefficient way of accessing the product and unsustainable in the medium/longterm.

    At present, I can get two Libre 2s on prescription every month using the GP electronic repeat prescription system. Assuming I even qualify for a Libre 3 I don't particularly want to have to visit my consultant or DSN each month to get hold of the product.

    3. Will the Libre 3 ever be available to buy in the UK for those who aren't eligible on prescription?

    4. Have the issues identified by some users with the Libre 2 (significant failure rates during warm up or within hours/days after initiation; tendency of the Libre 2 to read significantly under or over compared to a finger stick reading when sugars are changing and not within target range) been resolved with the Libre 3?
     
  2. KevinBell

    KevinBell · Newbie

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    According to the health minister, the libre freestyle is / will only be available to type 1 diabetic which is only 10% overall the 90% of Type 2 will have to continue to prick our finger, the cheapest I have found here in the UK is £45 a fortnight
     
  3. DavidDK

    DavidDK Type 1 · Well-Known Member

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    Thanks Kevin Bell.

    I understand the differences between Type 1 and Type 2, but I have never understood the attitude of successive governments concerning why Type 1s are more deserving if getting technology to manage their diabetes and Type 2s are somehow less deserving, because if a delusional perception Type 2s have brought diabetes on themselves.

    HM government's main aim
     
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  4. In Response

    In Response Type 1 · Well-Known Member

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    Currently, GPs can only add Libre 1 and 2 to our prescriptions upon advice from consultants so I had assumed this would continue with Libre 3.
    However, my pump supplies come from the hospital - they are not on prescription from my GP and I only have to have a consultant appointment once a year. I do not have to return when my pump supplies run out. The same approach could be taken with Libre 3.
    Anyone know what happens with NHS funded Dexcom?
     
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  5. In Response

    In Response Type 1 · Well-Known Member

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    What percentage of type 2 pick their finger? I appreciate there are many of this forum who do but that is a small subset of people with type 2 in the UK.
    AND, Libre does not replace finger pricks.
     
  6. DavidDK

    DavidDK Type 1 · Well-Known Member

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    HM government's (or rather HM Treasury) main aim will be to save money. But denying this game changing new technology to all diabetics is a stupid and false economy. You don't have to be a maths genius to work out it will cost the state far more to deal with the many complications that can occur if diabetes (Type 1 or Type 2) is poorly controlled than to give all diabetics the tools we need to lead healthier lives.

    Alas government is always penny wise and pound foolish, short termist and concerned only with a four/five year electoral cycle.
     
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  7. DavidDK

    DavidDK Type 1 · Well-Known Member

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    Thanks In Response. I had no idea how pump supplies are dealt with. That gives me hope accessing the Libre 3 won't be as inefficient as I feared.
     
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  8. Hopeful34

    Hopeful34 Type 1 · Well-Known Member

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    When I first got Libre 1 prescribed from the hospital I emailed the DNS to ask her to prescribe them, and a week later picked 6 up from the hospital pharmacy. When I had 2 left I repeated the process. It worked like a dream for about 18 months, and meant if I had a faulty one I never ran out of them. Far better for me, than getting 2 a month.
     
  9. DavidDK

    DavidDK Type 1 · Well-Known Member

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    Thanks Hopeful34.

    I agree, the way things are done in the health authority in which you live seems better than mine.

    Alas. I am constrained by whatever process has been dictated by the local clinical commissioning group (no matter how illogical/counterintuitive/unhelpful to working diabetics).

    At least I can reorder online without having to drop into my GP surgery every month. I only need to pick up my prescription at my local pharmacy as soon as it's ready.
     
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  10. Daibell

    Daibell LADA · Master

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    I'm surprised so many appear to have problems with Libre 2 both with reading accuracy and failures. I've only had 1 failure in 6 months and virtually all show good readings after the first hour.
     
  11. DavidDK

    DavidDK Type 1 · Well-Known Member

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    Yes Daibell I was quite surprised also.

    With the Libre 1 I think I had literally at most two sensors fail over the course of just over a year. Unfortunately the number of Libre 2s I've had fail is in double figures.

    As for accuracy issues, clearly the manufacturer has changed the algorithm used in Libre 2 to the one used in Libre 1. For some people the Libre 2 algorithm works absolutely fine, but for others it doesn't (even if the sensor is inserted 24/48 hours before it is started).

    And the manufacturer has made a conscious decision to make the Libre a closed system, so - unlike Dexcom - users can't self-calibrate sensors to make readings closer to a fingerstick test.

    In theory at least the Libre 3 may be a better proposition as it is supposed to send readings to your phone every minute and there is no need to scan the sensor to get a reading.
     
  12. Hopeful34

    Hopeful34 Type 1 · Well-Known Member

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    Sorry I should have added that after 18 months I had to order them from my gp at 2 a month as you do. Order online and items delivered by the chemist.
     
  13. sgm14

    sgm14 · Well-Known Member

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    My understanding is that Libre3 on the NHS was only going to be for those who were thought to require a true CGM solution, eg those on an insulin Pump and that the Libre2 is still the default.

    I don't really understand why, unless they just want to move slower to see how well the Libre3 works.
     
  14. counsellorneil

    counsellorneil Type 1 · Newbie

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    I’m also confused if there’s a reluctance to put the Libre 3 on prescription. As far as I understand the cost will be the same. I’m hoping it will be as easy for me to switch to the 3, as it was to go from 1 to 2. Just a request to my GP. As well as doing readings every minute, compared to 5 minutes, it’s also smaller in size, plus the new app has a couple of extra options, though not really groundbreaking.
     
  15. DavidDK

    DavidDK Type 1 · Well-Known Member

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    Thanks sgm14 and counsellorneil.

    I believe a statement should be issued imminently by the NHS about eligibility because I think access to the Libre 3 is supposed to start from 1 April 2022.

    From the information leaked on the internet so far, yes it seems that the NHS want to integrate use of the Libre 3 with use of pumps.

    And that is absolutely fine, provided patients want that.

    I'm not ready yet to have to have to wear a pump. I just want what our brother and sister diabetics in Germany have had for the last year: access to a continuous glucose monitor proper with a sensor that is significantly smaller than the current Libre 1 and Libre 2 sensors, with a significantly better failure rate than the Libre 2 and significantly more accurate than the Libre 2 (being able to self-calibrate would be nice!), which provides readings directly to a smartphone or smartwatch every minute, allowing me to make treatment decisions.

    My understanding (which may be incorrect) when the Libre 3 was put out into the world as a concept was that it would be "future proofed" to some extent. So going forward users would be able to access new functions, such as being able to connect the Libre 3 to a pump so insulin can be delivered; or being able to get readings sent directly to a smartwatch (which interests me); or the Libre 3 having the ability to communicate with smart insulin pens to keep a record of how much insulin a user has taken, how much insulin a user currently has left "on board" and perhaps dosing suggestions.

    However, because the Freestyle Libre is a "closed system," unlocking such features (assuming they exist at all) is dependent entirely on the manufacturer (working with other commercial partners as necessary).

    If access (via the NHS) to a Libre 3 is going to be conditional on wearing an insulin pump that would be overly restrictive in my opinion.

    I'm hoping access won't be that restrictive.
     
  16. sgm14

    sgm14 · Well-Known Member

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    I don't have any insight into the internal decisions made by the NHS, but one possibility may simply be, that this is temporary and is related to bureaucracy and tenders and contracts. For example a search for NHS Glucose Monitoring tenders thows up this link which talks about CGMs. Now the Libre2 is not normally consider a CGM and hence may not covered by that tender.

    So it also possible that the NHS have a tender to cover insulin pumps and related accessories which is separate from the tender that covers flash monitoring devices (I am thinking that CGM's may, in general, be more expensive than Flash monitoring, hence it makes sense to separate them).

    So, they must have an existing contract with Abbott to supply sensors and that contract may actually specify that the sensors should be Libre 2s and hence it can not be changed to Libre 3s until the contract has expired and the tender renewed. (The contract in the link is for two years, so it is possible they Libre2 contract is also for two years, which means there is probably another year to go)

    Of course, all this is total speculation on my part.
     
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  17. DavidDK

    DavidDK Type 1 · Well-Known Member

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    Thanks sgm14.

    Yes, I suspect you are onto something there.

    The Libre 2 is definitely a flash glucose monitor and not a CGM because the Libre 2 has to be scanned to obtain a glucose reading.

    CGMs have been more expensive historically than flash glucose monitors.

    I note that some of our German brother and sister diabetics using the Libre 3 have confirmed the price of the product under their health care system is exactly the same price as the Libre 1 and Libre 2.

    And keeping the same unit price as Libre 1 and 2 was what was teased when the Libre 3 was first mentioned two years ago.

    So I would hope the NHS has negotiated a good deal. Particularly as the Libre 3 won't come with an optional standalone reader.

    We shall see.
     
  18. sunspots

    sunspots Type 2 · Well-Known Member

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    I suspect, once GlucoRx have fixed some of the problems with their cgm Aidex, it might become the NHS choice as it is significantly cheaper than the competition. My current sensor is working well and the app glitches have settled. It can also be recalibrated.
     
  19. DavidDK

    DavidDK Type 1 · Well-Known Member

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    Thanks sunspots.

    I hope with every fibre of my being the NHS won't do as you suspect they might. I remember having my trusty blood glucose monitor being taken away from me and it being replaced by a blood glucose monitor made by the same manufacturer you mentioned because the test straps were "cheaper" than what I was using at the time.

    Of course I preferred my old blood glucose monitor, but I never found the replacement blood glucose monitor to be as useful helping me make treatment decisions as my original meter.

    As a taxpayer it really would annoy me intensely if the NHS (or more accurately in reality HM Treasury) were to do that a second time.
     
  20. PaulAshby

    PaulAshby Type 1 · Well-Known Member

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    I've had my first two Libre 2 sensors and they have both had to be returned, not an impressive start.
     
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