Thanks so much for your feedback…it is very helpful and very much
appreciated!
The Dexcom states that their CGM measures interstitial fluid and therefore must be calibrated against a fingerstick.
Is the FreeStyle Libre measuring the REAL blood glucose? or is it measuring interstitial fluid?
Do you still do fingersticks? Do you have to calibrate the FreeStyle Libre with a fingerstick/ meter with test strip?
Dexcom states that one should not dose insulin according to Dexcom readings because it is not measuring blood glucose levels directly.
Is the FreeStyle Libre a substitute for fingersticks? Is it measuring blood glucose? or is the idea that if your BG is not changing rapidly, the FreeStyle Libre is sufficiently accurate?
Thank you so much for clarifying.
- Libre is not measuring blood
- Fingersticks for checking the accuracy, not for calibration.
- No calibration of Libre possible.
- I have tested both and according to my comparisons, Dexcom CAN be used for dosing insulin, while Libre should not be taken litteraly, even though it gives you a good idea about the direction. Here in Europe Libre is used as a replacement for blood tests and I have used it in that way as well - you simply accept the readings even though you know that they may be up to 36mg/dl (2mmol/l) off.
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Actually the FDA advisory committee voted to recommend that the FDA approve insulin dosing based on the Dexcom. I don’t believe the FDA has approved it yet. Despite that, I started making dosing decisions based on my Dexcom. I think anyone who has used their Dexcom has enough observational data to have confidence in the readings.
[quote=“Brian_BSC, post:75, topic:50313, full:true”]
Actually the FDA advisory committee voted to recommend that the FDA approve insulin dosing based on the Dexcom. I don’t believe the FDA has approved it yet. Despite that, I started making dosing decisions based on my Dexcom. I think anyone who has used their Dexcom has enough observational data to have confidence in the readings.
[/quote]This is almost becoming one of those government jokes, as far as I’m concerned.
I’ve been dosing based on my Dexcom pretty much since shortly after I got it, and compiled enough real-world experience to reach the confidence you cite above. Over 2 years now.
I know way too many other diabetics who also laugh at this heavy precaution over using Dexcom data from dosing decisions. I agree that its a bad idea for anyone not engaged enough to understand the accuracy behavior of the system, what it takes to keep it accurate, and how these matters are “custom” to each person.
HOWEVER. If you are engaged, the Dexcom can provide more than acceptable data for making treatment decisions – which is, of course, why it has been recommended, and the FDA is considering.
Really, the problem is the lazy diabetic that doesn’t want to “be on top” of an accurate CGM. People like that – no disparagement meant at all, honestly – shouldn’t dose based on a CGM. They should always do a fingerstick.
But then, maybe its just me… I find that to be MORE work, hassle, etc. than simply calibrating the G5 once or twice a day, and staying more or less aware of how long I’ve been wearing the sensor. With the occasional exception, that’s what it takes to “stay on top” of it.
The Libre is as good as the Dexcom in my opinion. The difference is marginal. You just can not take some blood glucose test and deviate its precision from that. I have used the Libre for one year now. I do only test for verification after switching to a new sensor (the Libre does not rely on calibrations). For the next 13 days I rarely test with glucose stripes. My last A1c was 5.8 and this shows that the Libre can be relied on 24/7 - even for sharp shooters like me. You just have to be aware of the time lag.
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Hi everyone, just a quick update.
I’m spending a month with family abroad and decided to contact the local FreeStyle Libre distributor here and pay a fraction of the price for a 14 day trial of the sensor and reader.
I’m currently on day 4. The first day was useless as all I got was LO (when the reading is under 40 mg/dl) even though none of my BG readings were that low.
When I began getting actual readings, they were consistently lower than my finger prick ones. Since then there were only a couple of times when the readings have been only less than 10 point difference (BG meter always reading higher).
I also have 2 meters on me by different brands and while there are differences in the meter readings themselves, the gap between them and the Libre is still huge.
I’m also on a very LC diet and so don’t have large BG swings so I don’t believe this to be the reason for the large gaps.
I’m just very disappointed so far. Has anyone else experienced this before? I will call the the distributor tomorrow. Could be a faulty sensor?
It could be a bad sensor - I’ve had a couple that were way off and one that died prematurely. The last few have been close to my meter though, although usually the meter is a little higher. The trends on the libre have always been consistent with my meter so it’s always at least been good enough to tell me if my BG is going high or low.
I also got better luck sticking them in the fattiest areas and waiting longer before activating them (usually I’ll let it sit overnight).
It will always show approx 1 mmol/l (18 mg/dl) lower reading, as the Libre is not showing the real time situation, but has a lag. Anyways, always count with being 15-20 mg/dl higher and you know where you are.
I’ve just purchased a set of free-style libre (and sensor) and will use it on my daughter (waiting both the unit and her doctor’s inputs), to see if we can see why her hba1c is higher than it should be (yet undiagnosed).
I am going to be following this thread with interest.
I was just looking online to see if the Freestlye Libre had been approved (I know the pro has been and my endo office has been visited by a rep). But I couldn’t find any info about timeframe. Any one on this thread have any knowledge about if or when they expect FDA approval?
The pro version was submitted for FDA review sometime in the summer of 2015 and was approved in September 2016. Abbott’s same press release said the consumer version is under review by the FDA, but it is not clear when it was submitted in 2016 (sometime after March). If the consumer version follows a similar timeline it would be late 2017. One would think the review could be faster given the already-approved pro version…
Thanks! Let’s hope it is sooner- my son won’t use a dex so I would love to try this.
I actually suspect that the approval of the Dexcom for dosing may have caused Abbott to revise their filing. If they can’t come to market with a version of the Libre that is approved for dosing they may at a more significant disadvantage compared to the Dexcom.
I absolutely love my Libre sensors and meter. I have fiddled about with Medtronic CGMS previously and hated it. It was inaccurate and alarmist, and I very quickly developed sensitivity to the sensor (not the Enlite, but the original). I had better luck with the Enlites, but I still hated the constant nagging of my pump (and that was with all alarms off!!).
I love that the Libre allows me to decide when to check, and whether it’s worth a fingerstick to double check things. But my readings have been so close to fingersticks I have really stopped fingersticking altogether. I get good readings almost immediately, don’t have to wait longer than an hour to start up, and no real itching. The only downside I have found is occasional copious bleeding just after insertion. Some shirts have been stained as I didn’t notice in time. I bleed and bruise freely at the best of times, so this isn’t entirely surprising.
For me, this is the ideal solution. It works with my lifestyle and habits, and is far more accurate than Medtronic CGMS (again, for me).
I think it would be super helpful to be able to trial all 3 products to determine the best fit (I am in Australia and all options are self funded). I also like that one doesn’t have to go through “training” with a DE to get the starter kit. Who has time for that sort of malarkey?
If my 73yo father finally develops type 1 (or 2, but he is skinny and very active with no FHx, but has IGT), I will buy him the Libre sensors. Or maybe give him my leftover Medtronic stuff, lol. He will almost certainly want a pump…
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I wrote a piece about how I got my hands on the Libre in the U.S. and why I love it. I included another TuDiabetes user in the story, thank you Holger! https://asweetlife.org/how-i-got-my-freestyle-libre-flash-glucose-monitor/
Look forward to sharing more.
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6 posts were merged into an existing topic: Why I love the FreeStyle Libre, the almost CGM
In US, so I don’t , and I have a CGM which I wouldn’t trade in for it! As much a I love the idea of no more finger sticks, I simply don’t have any more “real estate” to give to it. Replacing the CGM isn’t helpful to me, because I do like/need the alerts from the CGM. (And yes, I know people have used phones, hacking tech and Xdrip to turn the Libre into a true CGM…)
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Alerts via Nightscout, is that a possibility?