FreeStyle Libre Flash Glucose Monitoring System

@KC12 I had a blind testing like this here a couple of times. I wore a sensor for 3 days, and logged everything I ate, the times of each meal/snack including carb intake, time and insulin dosage, BG levels, activity, and so on. I think it was just a way for doctors to look at a typical day for me and cross data, without me changing my behavior due to seeing the results in real time.

I heard somewhere that Abbott is only planning on releasing the FreeStyle Libre in the US for this kind of use only. I hope itā€™s not true as that would be devastating for me. :disappointed:

@Paulchalmers I am in Canada also and had written to Abbot about availability of the FSL here. They just said intention is to ā€œmake it available globally and timing depends on regulatory restrictions of specific countriesā€. But my pharmacist who is also a diabetes educator indicated to me in December that the FSL should arrive in Canada in about six monthsā€™ time.

Someone from India posted here that that was the plan for the Libre in India. I would never use a blood glucose device that was blind to me. It makes no sense.

Hi, I live in Europe and have been using Libre since it came out, i.e. for about 1Ā½ years. My experience is very positive compared to finger pricking, especially the fact that the sensor keeps up to I think 12 hours of readings in memory until next scanning. The reader is pretty simple, touch based and works through thick clothes, e.g. winter jackets. I is also quite solid - i have dropped mine at least 20 times and it is still working.
The provided software is good, I usually print some reports and take to my doctor when going for a control. The Hba1c estimation is more or less identical to the blood value.
Pros:
-Small and thin sensor, practically size of a 2 EUR coin, if that is telling you anything. Not attracting any attention.
-The patch on the sensor attaches well, no matter if you are hairy like I am or not
-It can handle swimming pool, even though I sometimes put a Tegaderm over it if it is close to expiry, as the glue starts to release when approaching days 12-13

  • Price - a sensor costs approx 60 EUR, lasts 2 weeks
  • Reliable, I have had only one sensor dying on me because the ā€œthreadā€ got pulled out by accident
    -Easy and discreet to use everywhere - at work, in the car, on a plane, at the beachā€¦ anywhere.

Cons:

  • Limited supply until now, now it is possible to order up to 6 sensors every 2 weeks
  • The patch/glue does not hold (as) well in summer when the skin gets a bit sweatier
  • I have had one delivery of 2 sensors showing inacurate values, differing 2-3 mmol/l (36-54 mg/dl). Fixed with a new batch of sensors
  • Not a CGM - it will not warn you of highs/lows unless you are scanning. That is the reason why I am currently testing the Dexcom G5 mobile. I have had nights when I would wake up with highs or mornings when the saved readings would show that I had been low most of the night.

If you have any questions feel free to ask. I could also help out if anybody is interesting in ordering a starter pack from here.

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Here is my ā€œjailbreakā€ experience with the Libre for all of two hours so far. (Yes, I am that excited, I had to share immediately!)

CONTEXT: I am a T1D using a pump and synced CGM, fairly tech-savvy, very hands-on in my management and always looking to learn more. I first heard about Abbottā€™s Freestyle Libre about two years ago, but figured that since I live in the US, Iā€™d have to wait until it becomes available here. Luckily, my best friend lives in Sweden and, after hearing me complain about the wait, recently discovered that one does not need a prescription to buy it there. So I got two sensors and NO reader (which is what I requested). I had already found out that with the help of an app which works on Android phones one could manage without an extra reader piece. (I use a Google Nexus; while I am not 100% sure, I believe that what allows these apps to by-pass the need for an Abbott reader is the specific NFC technology that Android phones use and so this reader-less set up is probably not possible on another type of cell phone.)

INSERTION: I only had the instructions in Swedish (which I do not read), but the pictures were clear enough and it seemed easier than inserting my pump site or regular CGM. The ā€œinserter deviceā€ is incorporated into each ā€œpodā€ (inserter+site) you get, so there is no extra piece you need for that. I saw for sure there is a needle that introduces the sensor inside your skin, but the pricking feeling was so negligible that, if I hadnā€™t seen, I would have wondered how exactly the insertion happened. Totally quick and painless.

APPS (in lieu of the Abbott reader): In preparation of this experiment, I had already downloaded and familiarized myself with Glimp. (An unnecessarily busy app that allows you to record all kinds of food- and insulin-related details which I have no interest in doing, but which ā€“ critically ā€“ uses the mentioned NFC (near-field communication) technology to ā€œhearā€ the sensor when you put the back of the phone, with the app open, near it.) It vibrated in recognition of the sensor when I first tried to get a reading, but it did not produce one. I looked it up again online and discovered that the sensor must be initialized first, which this app cannot do.

It turned out one needs another app for that (or an Abbott reader, which was not something I am planning to get). Thankfully the same developer, CTAPP Software, had figured out that their users might be up to the same plan as me and have created another little app, Glimp S, which does NOTHING BUT new Libre sensor initializing. A little inefficient, but nonetheless ā€“ yey! I hadnā€™t just wasted $165 (that was the cost out of pocket for the two pods and delivery within Sweden). Or so I thoughtā€¦

I downloaded it quickly but the first attempt to use it on the sensor gave me an error (impossible to understand in meaning since the developer is based in Italy and their use of English is a littleā€¦ not idiomatic enough and as a result, hard to follow). I was starting to despair, thinking that Abbott had outsmarted me after all, butā€¦ I decided to try the first / last resort of anyone who has worked in IT: reboot the machine. And it worked!!!

Upon restarting my phone, and trying again to get the sensor to ā€œflashā€ to its back with Glimp S open, I got the message that my sensor was already initialized. Phew, good news. Then, in Glimp, I finally was able to produce the first value from it. And have been ā€œflashingā€ ever sinceā€¦

ACCURACY: With so few values so far, it is obviously hard to tell, but the current levels of the Glimp readings, my Medtronic CGM and my Bayer Contour Next meter all seem to be tracking each other incredibly closely.

GETTING A FULL SET OF VALUES: Many people on various forums complain that they are not interested in using something like the Freestyle Libre if they are not getting the ā€œcontinuous valuesā€ out of it. Well, while it is important to understand that this is NOT a continuous glucose monitor (and so will not alert you when crossing any threshold values), you CAN in fact see the values and resulting trend lines on the Glimp directly + download all the once-a-minute values the sensor captures for further analysis.

To do that, you need to use the Options > Remote glucose monitoring > Connect to Dropbox (or Nightscout, but I donā€™t use that so canā€™t speak to it) and allow your Dropbox account to create a folder for Glimp where a bunch of CSV files will be automatically created. Then, each time you flash-read, the relevant files will be re-written and if you open the only one you really care about, GlicemiaMisurazioni.csv, you will see the ā€œinternalā€ readings for every minute of the sensorā€™s life. Itā€™s not the most user-friendly presentation, but then you can upload those values in whatever BG management system you prefer and see your pretty trend lines, averages, etc. there.

Remember what I said about the Glimp app being overly dense, with entry fields for meter values, which part of which finger you pricked, weight, food, activity, calories, lancets, needles, strips, whether you bled, other notes and injections (spot and amount)? These are the sorts of things that would be written into the other files created on Dropbox if you enter them in the app on the phone. I do not see myself using any of that extra junk, especially considering that 1) most of it is rather irrelevant for a pump user and 2) I have various other apps that record the small portion of these things I do care about.

So there, this is my immediate experience and while I do not think itā€™s necessarily something a lot of people would do the same way I describe, I imagine it might be interesting and educational for at least some of you.

Off to do another flash-read! :slight_smile:

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Thanks for the detailed report.

Thank you for replying. This is apparently the case. It is in India now and if I wanted to get it I could very easily apply to my Doc. I will have to pay about 100 bucks US per two weeks when I go in for a reading. At least that is what I was told. I will ask for more information on my next visit.

It appears to be a very good system but if it is out of my hands I will not avail myself of it for sure.

Thank you for your reply.

I will check again with my Doc on the next visit for more information.

However, such a ā€˜patient blindā€™ situation may be for my benefit for short term monitoring however, as the industry video suggests, it is a long term process.

My reaction to such as system may be construed as paranoia, however I feel somewhat insulted that I am considered incompetent to use such a system - because it is assumed that I live in a 2nd world country so I must beā€¦ or even more sinisterā€¦ that it is a tie up with Pharma and the Diabetic Medical Profession for profitā€¦

Anyway pricking myself 4 times a day while not that bad in the long run having personal access to this new system or any such system would be a blessing for sufferers of Diabetesā€¦

KC

Hi there,
I recently got my LIbre from a friend in Italy (who shipped it to me in the States) but when I plug it into my computer NOTHING happens, which means all of my data is locked on my reader. Iā€™ve had my first sensor on for about 10 days, and I love it, except this is a major problemā€¦I need my data in a shareable format.

Does anyone have any ideas or experience with this, or suggestions of what to do?

Thank you!

Are you using the Libre software? To get data off the Libre using the Abbott software, you need to get this off the Abbott UK site. (I am in Canada and use the UK version).

Also you could try using Diasend which will pull Libre data off the reader and into the web based Diasend app. You need an account and the Diasend uploader installed on your computer.

If you canā€™t get the Abbott software to work, the diasend approach will validate that the data can be pulled off the device and eliminate a Hardware or Cable problem

Thank you for sending this info. I am US based and locked out of getting anywhere on the freestylelibre uk site, so I do not have the software. Others in the US have told me that it just launched automatically when they plugged in their USB cable to their computer, but that hasnā€™t been the case for me.

I will try the Diasend route, I was not aware of it.

Alternately, if someone can send me the software? perhaps via dropbox?

Thank you!

I extracted the official link of the Libre software from their website Perhaps another user needs these as well:

Windows
https://freestyleserver.com/distribution/fxaa20.aspx?product=fslibre&version=1.0&os=win&region=ous&language=xx_yy

Mac
https://freestyleserver.com/distribution/fxaa20.aspx?product=fslibre&version=1.0&os=mac&region=ous&language=xx_yy

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I passed along your website URL to the Close Concerns/Diatribe people so they could include a link to it on their freestyle libre page. Since youā€™re Germany based itā€™s okay for you to have these links up on your site.

Thank you again for all of your help.

@holger when I click on either of those links, it says access is denied, forbidden. is this because it can tell Iā€™m in the US? and @Larissa3, did you try clicking on those links?

Interesting. I already helped Larissa with a PM.

Just an idea: could you open the link and when you see the access denied then edit the link in the browser as follows: change region=ous to region=us
Perhaps ā€œousā€ in the link stands for outside US and ā€œusā€ will be accepted for someone inside US?

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I havenā€™t looked at this thread in a while, but wanted to share my major disappointment when I just read this (see last paragraph in particular): http://diatribe.org/freestyle-libre-shines-type-1-diabetes-study-decrease-74-minutes-day-spent-hypoglycemia.

Long story short, the patient version of the Freestyle Libre has not even been submitted for FDA consideration in the US yet! Personally, I keep using sensors sent to me from Sweden, but I was really (mistakenly) hopeful the product might become available here by the end of this year. Now I understand there is no chance for that. :frowning:

NOOOO!

Is there anything we can do? Iā€™m so desperate for a CGM.
Iā€™m in tears over this. Iā€™ve been trying to get a CGM for so long (very high deductibles making it completely out of my reach) and finally saw a glimpse of hope in the Libre, just for it to be taken away.

It is important to understand the process. The Libre Pro and the Libre are fundamentally the same. The application for the Libre Pro was submitted a year ago and approval is anticipated in not too long. Once the Pro is approved I would expect Abbott to submit the Libre for approval. And like with glucose meters, if you have a meter that uses the same fundamental guts and sensors the approval will be expedited. Approval in Europe with the CE mark is fundamentally different than FDA approval in the US. The FDA is much more stringent in assuring accuracy.

I understand the process and am not complaining that the FDA tries to do its job. My complaint is that Abbott hasnā€™t even submitted the application for the patient version of their amazing product that so many of us in the USA are eagerly awaiting.

Even if the devices are essentially the same, which is true, the non-pro version wonā€™t make it to market until it gets its formal approval. So we will have to wait longer than I at least originally thought.

(And my implicit criticism is that these choices are often done by these companies for strategic business reasons ā€“ e.g., have two different quarters during which they can come out with the announcement ā€œProduct X approved by the FDAā€. So, yeah, itā€™s my very understanding of the process that has me so upset.)

Hi! I am considering ordering Freestyle Libre for my 5-year-old daughter. Just wanted to check if the readings can be seen in mg/l instead of mmol. Also, my daughter is extremely skinny; I wonder if the sensor will fit her arm well. If it does not, can the sensor be used on other parts of the body?