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Going To Have A Moan About Libre

  • Thread starter Thread starter Knikki
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Knikki

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A Little Moan About Libre

First off I really do like Libre.

Over the last 6 months I have this tech on me, it has certainly helped with managing T1D. I am now more aggressively managing it than I have ever done in the past.

I’m also aware of the “15 min” delay between the Libre Reader and finger pricks, which is fine.

I’m also aware of the issues people have with incomparability with their bodies and the sticky carp that it uses to attach to the skin.

I know there have been some threads questioning the accuracy of the sensor but to my mind I don’t think that anything that is currently available over the counter could be classed as “100% accurate” and if you want that then you would need your own lab. Which, if you think about it is not very portable.

I’m also aware that really low or high readings the accuracy is certainly questionable but that is the same with virtually all the meters.

Me, I use it as tool because I find its ability to detect/show trends far more valuable to me than 100% accuracy.

Saying that, there are a few things that make me laugh about it.

The Reader: This is the one you get as a kit or with the sensor produced by Abbott. I use this because it is the one that the DSN will use to see how your doing but I find it too restrictive because if you scan you can’t go back later and change any of the insulin units or carbs, if you want to. The Ginger Bread man is useful.

The Mobile App: This I find a more useful bit of kit, gives you ability to be more flexible with inputting data and it will give you an “estimated Hb1Ac”

So this morning, sensor has still 5 days to run do a scan and get:



Now I know that there are people on here who seeing that will be going PANIC!!!!!

BUT….

Is this right?

I use mine connected to a MiaoMiao and use xDrip+ which turns this in to a continuous CGM and taken only a couple of seconds after the above:



And after all that the Bloods were closer to one above at 4.8

Had I relied on the Libre I would have been stuffing my face and ended up over correcting which is not what I wanted.

The other great thing about xDrip+ is you can recalibrate by adding in a blood reading, making it far more useful than the Libre app or reader. I think, the one BIG thing missing from the Abbott toys.

The upshot of all this.........Have you managed to stay awake to the end?

Any newbies out there getting Libre just beware that what the Reader App tells you it might not be always be correct and always ,always, always, always if you'r in doubt check with a finger blood test.

Yes I know that there are those out there who will come along and say "mine is within half a point of the bloods" or "mine reads the same as bloods"......yep been there got the t-shirt and have the season ticket.

You can also get Glimp (have downloaded but not played with) for Android
Spike I think is the one for IoS but don't have a phone from the shiny fruit stall so no idea whats it like.

It is a great tool but has its limitations.
 
Hi @Knikki

You’ve made some good points. I don’t use xdrip or Gimp to calibrate my Libre:

1. I don’t have an Android phone/device
2. The gap between my Libre and my blood glucose sensor (Contour Next One) is often inconsistent during the same day i.e. my Libre can be 0.5 to almost 2mmol below the Contour (even when my BG is fairly stable), so I wouldn’t know what to set the xdrip to.

Therefore, I don’t trust the Libre if it shows a hypo value or that I need extra insulin to make a correction. However, for day-to-day Diabetes management, I find it invaluable and tend to only use my Contour when I apply a new sensor and if I need to drive of course. The big bonus is that is the lack of stress knowing what my BG (technically my interstitial glucose) is at at any time and whether it’s trending up/down.
 
Am laughing at your ramblings. Have had exactly the same goings on with mine this morning. Though I’m on my hols so relaxed about it. I only use the reader, as I have an old I phone, and can’t afford the other equipment. My parents are actually funding the Libre for me for a year. It is then back to finger pricks. The last sensor was unnervingly accurate. This one less so. Having said that I NEVER adjust to a sensor, only a blood test. I am also very aware of my own body and usually know I’m going low. However, I know this is not the same for everyone..
In other news I am one of the many who reacts badly to the adhesive. Am managing with Cavilon at the mo thankfully. There is a long way to go with the accuracy and sustainability of this product. I for one do not think the NHS should have taken it on board until a lot of these were ironed out. I feel it has let Abbot off the hook when they have this enormous contract.
 
All fair points, @Knikki .

I get the same comparing reader scans against xdrip+. It's like the algorithm on the reader exaggerates lows and then just sticks there, whereas xdrip just reports the numbers.

Just speculation on my part, but I wonder whether Abbott, knowing they would have to get libre approved by authorities in many countries, decided to be very cautious with it, so that the exaggeration forces people into testing just to be sure when they're approaching hypo land.

One of the conditions here in NHS Lothian for us getting libre on script was that we should share results with the hospital. That's fair enough, but it does mean we need to be careful to point out to them that a lot of the lows it reports should be taken with a pinch of salt. I've taken a few photos of the reader and meter to show them just to drive the point home.

In practice, they've not actually bothered asking to see the results, I'll generally just wave the xdrip 90 day agp graph at them, tell them I'm doing ok, see you 6 months, next patient please.

One of libre's selling points was the factory calibration so that us punters wouldn't need to calibrate. Hmm, not worked out so well in the real world. This is where glimp, xdrip have really improved that aspect. Without having to get FDA approval (or, as a dietician once told me, "illegally"!).

I'm curious about the xdrip graph. I can see that the yellow and green dots are the trace, but what's the story with the blue dots, which seem to mimic the trace - what do they do? I don't get those with my xdrip set up through blucon. Are they maybe the raw number which libre/mm sends before xdrip interprets it as a bg number?
 
There is a long way to go with the accuracy and sustainability of this product.

I have an occasional look at some American T1 sites. Dexcom seems to be used much more widely there than here, presumably because of insurance schemes.

The surprising thing is just how similar views are over there on dexcom accuracy as the views are here on libre.

Some love dexcom, it's the most accurate cgm evaah, others hate it, they can't trust a single thing it says.

I suspect the latter might be down to two things: one, cgm just doesn't seem to work that well with some folks, maybe their body chemistry makes them more prone to "biofouling", I don't know, or, two, they've maybe calibrated it incorrectly when not stable, it can really throw it out if it's calibrated when moving rapidly.

I read a really useful book a while back, on kindle, Beyond Fingersticks, by William Lee Dubois. It's quite old now, so a bit dated, but he makes the point that the art of using cgm involves knowing when to trust it, but also being able to identify when not to trust it.

I regularly bolus from it, but, 2 yrs in, I've picked up a few "tells", which make me say, meh, gonna have to stab here to be sure.

Sure, it's not perfect, but the filament is doing a difficult job in a hostile environment, so I'm ok playing with the uncertain swings and roundabouts it sends me, as I've always got my old one touch verio as a backup in sketchy situations.

It's unfortunate that it just doesn't seem to work for some. I honestly don't know why that is.
 

I'm aware of the hoops that the drug companies have to jump in order to get approval to be released in various territories, which could be the reason that Abbott have not built their stuff to do calibrations, still as the tech evolves it may happen.

As for the "blue lines" at the moment I have no idea, at a guess it is what the program is picking up where as the other colours are what it is reading after the recalibration???

The build I am on is from 6th September which I think is newer version than the one your running.

Will have to have a look round Git Hub I think they have a forum but not found it yet.
 
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@becca59 I think your right, from what I can find out pre launch two trials were done and from what I can find from a quick look there were 300 patients involved, plus from what I can see the roll out of the technology is still in a "trial stage" lasting till 2021- thats if I have read it right?

Considering how many people now use, it is not surprising that there are reactions to the sticky stuff or that peoples bodies don't get on with it, Abbott simply did not have a large enough pool to test with and being rolled out means they get a much larger test bed and hopefully feedback to improve things.
 
The build I am on is from 6th September which I think is newer version than the one your running.

Yeah, could be that. I'm often tempted to update my year old version but it's working so don't want to risk updating to a duff version.

I've recently switched the Motion Tracking option on. It does things like raising low alerts levels when it reckons I'm driving which could certainly be useful, but I'm more interested in how it paints the purple area in different shades when I'm moving or still - with a bit of walking and resting, I could create my own personalised kilt patterns...
 
I didn't notice this thread the other day when I had my own little moan about this in the Type 1 thread @Knikki but I am also experiencing similar. I'm around 10 days into this sensor and both this and the last one have drifted off reading low. I got the last one replaced as I had no way to recalibrate with my Blucon not up and running previously. It feels like a real oversight that they didn't allow for recalibrating the sensor even just once a day on the official Libre apps.

This morning isn't the best example but I am running around 2.5mmol higher than the sensor is showing consistently. According to Librelink I've been in range overnight into this morning but so far I've had two excursions above my target range!




Edited to add: I also don't get the extra dots with Blucon @Scott-C so it must be a MiaoMiao thing (my xDrip is up to date as of last week). I've fiddled with the display settings turning things off and on and I've not seen them.
 
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Don't any of you get "warnings" if you are too low or high ? If my Libre says that I am low but I don't feel low then I accept that my bloods are below what they should be but not so low as to bring on a hypo. Same if it show too high. I can tell when I am too low or too high, I don't need a machine or a blood test to acknowledge this. I use the Libre as a guidance and a very useful one it is. Can't remember the last time I had a hypo and my bloods have never been more controlled and in range.
 
Yes I get warnings usually as I head into the low 4s. I'm very cautious and have a target range of 5-8 instead of the more traditional 4-7 for driving purposes. Not as quick with hypers but the symptoms do come after a short time. Libre with Blucon/xDrip is giving me peace of mind and at a glance the current state of play, direction I'm heading and a safety net in case I need it. That on top of the useful information throughout the day and the ability to spot patterns and trends in the data I couldn't see before.
 
Had I relied on the Libre I would have been stuffing my face and ended up over correcting which is not what I wanted.
To be fair though, I'd hope that anyone seeing a line like that on any CGM would check their blood. Especially when using a Libre which is notoriously bad at low numbers.
 
To be fair though, I'd hope that anyone seeing a line like that on any CGM would check their blood. Especially when using a Libre which is notoriously bad at low numbers.

The tale was more a "one of caution" because I some do rely on it more than they should, but that is a guess.

Saying that this morning was fun xDrip was not playing ball so scanned with usual apps Libre said 6.1, OK but something felt amiss so check bloods which said 13.9 was not expecting that
 
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I tend to get warnings when high, like the post above, but lows not so good at catching these days but I can still function when, sometimes stupidly low if I'm not doing anything that requires to much concentration.
 
I am hypo unaware. Get zero symptoms until I am around the 2ish mark. I know when my bloods start getting above 12.
I am going to be purchasing the MiaoMiao for the purpose of setting alarms when Lo. Pretty valuable for me and my situation
 
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