EDITED 16.7.27 to provide more accurate information about Dexcom since using it. Also, changed my neologism of FPT to fingerstick test to avoid confusion.
I heard about the Freestyle Libre just after I was diagnosed with type 1 diabetes in September 2016. After the initial few months of wild highs and lows, I decided to make the investment.
How much does it cost?
The starter kit costs £133.29 excluding VAT (you can tick a box to claim VAT relief if you have type 1) – this includes the reader and two sensors. The sensors are supposed to last 14 days each, so this should last you… 28 days (take that, maths teachers who put me in set 7/8! Side note: I think that having type 1 should automatically entitle you to a maths genius certificate).
I have heard of a lot of NHS trusts offering this starter pack for free, so it’s well worth asking your DSN about it, as you may be able to trial it for free. In most cases, you get to keep the reader after your trial, so you then only need to purchase sensors – which cost about £48.29 each after VAT relief . So, if the sensor lasts the full 14 days, the Libre costs about £3.45 per day, setting aside the cost of the reader, which should last indefinitely. I would say that’s a pretty reasonable cost IF it works for you, but more on that later.
How does it work?
Like a continuous glucose monitor (CGM; e.g. Dexcom) the Libre measures the level of glucose in your interstitial fluid, which is a thin layer of fluid that surrounds your cells and contains, among other things, glucose. However, the level of glucose in interstitial fluid is a little behind the level of glucose in your blood – specifically about ten minutes behind. Therefore in time-sensitive situations, namely hypoglycaemia, a system like the Libre just won’t cut it, and a fingerstick test will be necessary.
What did I like?
I really really really wanted to love the Libre.
- In theory, the Libre should give you a much better understanding of your BG levels – and, in turn, a better handle on said levels. Testing with fingersticks alone only provides a glimpse into how your levels are doing that day. Even though I test on average sixteen times a day (largely due to being hypo-unaware) I don’t have a full picture of how my levels are. Using the Libre, you can see exactly when you spike and fall, and therefore address the root cause.
- It has handy directional arrows that show which direction your BG is heading. You can see if your BG is dropping rapidly when you see a vertical downward arrow, and hopefully treat it before it becomes a hypo.
- Applying the sensor is not pain-free, but it hurts about as much as a fingerstick test on a freshly-healed site. So, I’d say that inserting a sensor is about a on the pain scale. I am a very weak human so I did require a little help inserting the sensor, as you need to give it a fair push to get it to insert. However, I know of nobody else who had this problem, so I’d chalk that up to my being a weakling! It hurts about the same amount as inserting the Dexcom sensor (updated since using Dexcom).
- If the Libre gives you accurate readings (more on that in the next point) it should give your fingertips a well-deserved break from being prodded. The Libre doesn’t need to be calibrated with an fingerstick test a minimum of twice daily like Dexcom, but I would definitely recommend checking against an fingerstick test before making dosing decisions with insulin or treating hypos. Still, even this amount of fingerstick tests should make for less sore fingertips.
What did I dislike?
- The reason why I don’t use the Libre any more is simply because it was not accurate for me. As I mentioned above, there is a ten minute lag in BGs because of where the Libre takes your BG reading from, but this wasn’t a ten minute lag. It would read as high when I was low, and vice versa. I had six sensors in total and not a single one of them was accurate for a majority of the time. One had me reading as ‘LO’ (less than 2.2 mmol/l) for a whole day upon insertion. On a side note, some users of the Libre accept that it isn’t massively accurate for the first 24 hours. However, Abbott don’t factor in that 24 hours, so you’re really only getting a maximum of 13 days out of a sensor in that case. I can only speak to my experience, but I do know others who found the Libre to similarly inaccurate. Once I was aware of the issue with inaccuracy, I found myself using a fingerstick test to confirm every single reading, which defeated the point of using the Libre to give my finger tips a break.
- The Libre sensors don’t always last the full 14 days. Though, to Abbott’s credit, they always refunded those sensors that didn’t last. Some of them just stopped working, some started giving very inaccurate readings, and I know of some that just fell off. I didn’t have the last problem, but I did have a few sensors that felt very loose towards the end. You can buy plenty of things that keep sensors in place for longer, but that’s an extra cost that you have to be willing to pay.
- The Libre will continue to take readings without needing to scan for 8 hours. I don’t know about you, but I sometimes like to sleep for more than 8 hours! I found it a little inconvenient to set an alarm to scan. I also found the Libre was particularly inaccurate at reading nighttime hypos, especially if you slept on the arm the sensor was inserted into, it would exaggerate a hypo so that upon waking you appeared to have been hypo for hours. I definitely think Abbott need to do more to address the Libre’s incompatibility with sleep.
- I’ll preface this last point by admitting that this isn’t a very fair criticism! The Libre doesn’t have the ability to set alarms to alert you to lows and highs like the Dexcom. This isn’t fair, because quite simply it isn’t a Dexcom. However, I do hope that Abbott are able to add this feature in a future version of the Libre. Furthermore, despite the initial costs of the Dexcom (see Dexcom review for pricing) being more expensive than the Libre, the sensors cost about the same per day (about £3.66 for the Dexcom), so it would be worth considering the Dexcom if, like me, you’re hypo unaware.
What about Abbott’s customer service?
I did eventually manage to get a refund of all of my sensors and even my reader, but that took a lot of effort on my part. For the most part, the customer service representatives I spoke to were curt and unwilling to help. However, the last person I spoke to, Tanya, was incredibly helpful.
Abbott have a freephone number and they answer the phone very quickly, so they get points for that. However, their general attitude towards customer service was one of disinterest. They were prepared to do only the bare minimum and you really need to hold your ground to get what you want. Overall though, I did get my money back, so I have to give them credit where credit is due. My advice would be to persevere!
Would I personally recommend the Libre?
In short, no. If you’re given the opportunity to trial it for free, I would take that opportunity – it’s a no brainer. But, I wouldn’t recommend paying out of your own pocket for it. It was just so inaccurate that it was pointless having it. I know lots of people get on really well with it, so I’m inclined to believe that it might be more accurate for some people, but I would want to know how often they checked a Libre reading against an fingerstick test reading! Overall though, I had enough sensors over a long enough period of time to know that it wasn’t a problem with a particular sensor or batch, but rather a problem indicative of an inherent flaw with the way Libre sensors work with particular people, i.e. they just don’t!