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I have been meaning to do this post for a while, but I wanted it to be well-researched, well informed and provide you with everything you need to know about the FreeStyle Libre Sensor. I’ve been using the Freestyle Libre for over 2 years now, so I want to tell you everything I know about it and my experience.
Some of you may have already heard of the FreeStyle Libre Sensor, others may not. So, to take an official quote from the Abbot website:
“The FreeStyle Libre flash glucose monitoring system is the first product in the flash glucose monitoring category and is designed to liberate people with diabetes from many of the hassles of glucose monitoring, such as routine finger pricking.”
What this basically means is that the FreeStyle Libre is a system that allows you to “scan” your blood sugar using either a reader or an app on a smartphone. This reduces the need for countless finger pricks and the system can indicate via a graph whether your blood sugar is rising, dropping or heading steadily.
This is all achieved by wearing a sensor on your arm, which is the size of a two pound (UK) coin. (two stacked quarters in the USA) The sensor lasts up to fourteen days. (10 days in the USA).
The FreeStyle Libre System has two main pieces.
Firstly, FreeStyle Libre sensor:
This is the piece you wear on your arm. It’s a small sensor that you wear on the back of your upper arm and it automatically measures your blood glucose level and stores the data for an eight hour period.
Every time you scan the sensor with your reader or smartphone app, the glucose data is transferred from the sensor to your chosen device within one second- pretty quick right!?
Once you are finished with the sensor after the fourteen day period, you simply dispose of it.
The second part of the FreeStyle Libre System is the FreeStyle Libre reader.
This is a handheld reader (as shown below) that shows your glucose readings and can store the data for up to 90 days, which gives you the chance to analyze patterns and trends.
When you move the reader over the sensor, it shows up a current glucose reading and the last eight hours of data as well as a trend arrow.
This trend indicates whether your glucose may rise, go down, or stay steady.
This is useful if it’s been hours since you’ve taken insulin, or you are on a low number and are about to take part in some form of physical activity. It allows you to attempt to “catch” high and low blood sugars before they occur.
Please note, that in the USA, the Freestyle Libre Sensor lasts for a ten-day period, not fourteen.
To gain a glucose reading, you simply perform a quick, 1-second scan of the reader over the sensor. This gives you more data than a finger prick, however, if you are in a hypo, then it’s best to double check with a finger prick. This is because the FreeStyle Libre Sensor is still a piece of technology that isn’t always accurate.
There are occasions it will provide you with false information, especially within the first few hours of using it whilst its adjusting.
All the data that the Freestyle Libre sensor provides you with can be used to gain insights into your routine blood sugars via graphs, averages, and a predicted HBA1C.
This allows you to make adjustments to your diabetic care (alongside the advice of your team) to improve your quality of blood sugars and therefore the quality of life.
Before you can use your sensor it has a “warming up” period. In the USA this warming up period for the libre sensor is 12 twelve hours, in the UK this period is one hour.
The glucose reading comes from the interstitial fluid (ISF), a thin layer of fluid that surrounds the cells of the tissues below your skin. This means it doesn’t come from an actual blood sugar, which can mean there is a 15-minute delay from what the reading on your Freestyle Libre is and the reading from an actual blood sugar prick from a monitor.
So, in cases of hypo, it’s always important to double check your blood sugar via a finger prick test just to be sure, and if you feel like something isn’t right, then test with your finger too.
When it comes to driving with the FreeStyle Libre monitor, it’s important to note that in most countries it’s not approved as an official reading of your blood sugars, so you are still required to do blood prick tests before you drive a car. (This is true of UK law).
So whilst the Freestyle Libre sensor can certainly reduce the number of finger pricks you do, that doesn’t mean you should suddenly throw out your blood glucose meter and solely depend on the Freestyle Libre system.
The cost of the Freestyle Libre Sensor will depend on the area that you live, but the basic prices across the UK, USA, Canada, and Australia are as follows.
FreeStyle Libre in the USA is the least expensive at Walmart, where each 10-day sensor is $35.99, and each reader device (one time purchase) is $69.99.
Other information for purchasing the Freestyle Libre in the USA: If you’re a current Dexcom CGM user, you may be eligible for a FreeStyle Libre system reader and one sensor, free of charge. (While stocks last, you can apply on the website)
If you are covered by Medicare: The FreeStyle Libre System is now covered by Medicare for those who qualify.
The website also has a useful “map” tool where you can enter your ZIP code and search for the nearest Freestyle Libre Sensor supplier to you.
UK: £57.95 including VAT (which you can claim back) For a starter pack including 2 sensors and the reader, it’s a total of £159.95 including VAT (which you can claim back)
Australia: $92.50 for a sensor/ $95.00 for the reader.
Canada: CAD $49.00 for the reader / CAD $89.00 for sensor
CAD $227.00 for The starter pack According to the website, many insurance companies cover the Libre now.
Ireland: Starter pack: €169.90, Sensor: €59.90, Reader: €59.90
The FreeStyle Libre system has been reimbursed, as of the 3rd April 2018, for some patients aged between 4 and 21 years. Please speak with your Diabetes Specialist at your next appointment, to see if you are eligible.
Please note, that the FreeStyle Libre System is proving so popular that Abbot is currently struggling to keep up with demands. I know this is affecting the UK and Ireland, I am not 100% sure how this is affecting the rest of the world. But, this is the official notice off their website for UK purchases.
“Due to a tremendous response to the FreeStyle Libre system, we are closing the webshop to new customers. Please subscribe to our mailing list and we will notify you as soon as the webshop re-opens. For current customers, we are temporarily limiting orders to two sensors per order every 25 days. You will also receive free shipping, which will be applied automatically to your basket. Thank you for your patience and support.”
It’s not waterproof. It’s water resistant for up to one meter (three feet) for around 30 minutes. However, FreeStyle Libre Abbot has stated that “intense activities whereby a user is continually moving or repeatedly in and out of the water, may reduce the sensor wear time”.
What this basically means is, it’s not ideal for jumping in and out of the pool/sea and waterparks aren’t ideal (I can personally vouch for both, having lost 3 Freestyle libres to water).
My only suggestion is that you tape it down extremely well with medical tape, or something similar to try and keep it down.
In the UK, AU, CA and Ireland, you can wear the sensor for up to 14 days. The Freestyle Libre in USA it’s only been approved for 10 days.
Typically, the Freestyle Libre Sensor will last the full 14 days if you are careful. This does, however, depend on your lifestyle. If for example, you are a surfer, or constantly in water, then it’s unlikely it will last the full two weeks, due to the force of water, and the fact it can handle up to 30 mins (which is meant to signify a shower or bath)
The Freestyle Libre Sensor can also rip off on doors, walls, and stupid things. So to help make it stay in place, you should use some form of medical tape to hold it in place. I personally use tegaderm, as it protects it and keeps it clean, but there are more funky, awesome and colourful tapes you can get to protect your libre at stores such as: who sells a variety of tapes for the Freestyle Libre.
Pepmeup Diabetes, who offer beautiful covers for the reader and sensors! And, Rockadex who make some pretty awesome styles too! ((you get a discount with Rockadex when you busy our eBook- and pimpmydiabetes! I have never used any of these before, but they are highly rated amongst the diabetes community, so I am sure they are great.
Comment below if you have used these services, or know of any other great stores ( I know there are others around!)
First, let’s define what exactly a CGM is (continuous glucose monitor). As quoted by Dexcom:
"A CGM is an FDA-approved device that provides continuous insight into glucose levels throughout the day and night. The device displays information about glucose direction and speed providing users additional information to help with their diabetes management."
Now, the million dollar question is, “Is The FreeStyle Libre a CGM?”
Well, according to their USA website, Libre is a...
"continuous glucose monitoring (CGM) device indicated for replacing blood glucose testing and detecting trends and tracking patterns aiding in the detection of episodes of hyperglycemia and hypoglycemia, facilitating both acute and long-term therapy adjustments in persons (age 18 and older) with diabetes.”
...however, on the rest of their global websites, it shows no mention of it being a CGM. And, actually, I don’t think it can be considered one.
The FreeStyle Libre is a flash glucose monitoring system, which works by glucose readings taken from the interstitial fluid (ISF), a thin layer of fluid that surrounds the cells of the tissues below your skin.
The Freestyle Libre System does not provide you with alarms notifying you that you are going low or high, which other CGMS such as Dexcom and Medtronic do. The use of an alarm is different for everyone, but the ability to have an alarm tell you in the night if you are going low could save your life.
The Freestyle Libre sensor can’t be “restarted”, once the time period is up, then it’s finished. Typically Dexcom and Medtronic sensors can be extended if they are still accurate and working.
The flash monitoring system does not integrate with insulin pump devices like some CGM devices can. For example, the Medtronic Enlite sensors can link up to your Medtronic insulin pump and provide you will real-time data trends, bolus advice etc.
This Freestyle Libre sensor cannot do this, or at least not yet! What this means is that if you rely on a bolus wizard to help you work out your insulin dose, you will need to input the blood sugar into your insulin pump manually to calculate the dose. It’s a good idea to test with a finger prick just to be accurate as you don’t want to cause yourself to go high or low, especially within the first 24 hours of using the Freestyle Libre system.
The Freestyle Libre is available worldwide. Currently, it’s available in the USA, UK, Canada, Australia, New Zealand, and Europe. This is the official statement from Abbot.
“FreeStyle Libre system was CE marked for pediatric use in Europe and approved for adult use in Australia, Brazil, China, and Japan.”
The FreeStyle Libre link app is available in the UK, Ireland, and Europe with compatible smartphones. Please let me know if the app is available in other countries and I will add it to the list. The minimum requirements of your phone's system are: NFC enabled phones running Android OS 5.0 or higher and with iPhone 7 and later running iOS 11 and later.
In November 2017, the FreeStyle Libre was approved on the NHS, which means that residents of the UK would no longer need to self-fund. However, so far there has been a bit of a “postcode” lottery with this situation, with some people claiming they were denied the FreeStyle Libre Sensor and others that got it fine.
This is the situation from what I know in Northern Ireland specifically and how I got it on the NHS.
Not everyone is automatically going to receive it. A Criteria has been put in place and this includes external monitoring via your GP and your diabetes specialist on a trial period to prove that you are using it correctly and it will benefit you.
Children can get it automatically.
If you have been self-funding the FreeStyle Libre sensor yourself for over a year, you are automatically entitled to the sensor on the healthcare system in Northern Ireland. The money was released in December.
All you have to do is get a letter from your diabetes specialist send to your GP confirming the prescription and that’s it.
If you are from NI and you have been self-funding and are being denied, please contact me and I will provide you with the number of the health minister in NI dealing with this. He will sort it immediately.
I now get the FreeStyle Libre on the NHS after months of confusion.
I believe in the UK, the situation is similar in that it’s easier for children to get the monitor straight away. If you are new to using it you will be placed on a trial period.
Honestly, the information about this is ridiculous, so it’s best to contact your local health minister for advice.
As of September 2017, the FreeStyle Libre system was approved for use in the USA. As I am not a resident of the USA, I really can’t provide you with too much information, other than what I have mentioned above. But, the good news is, you do have a chance of obtaining it. There is a wonderful article here that details the new of the FreeStyle Libre Flash monitoring system in the USA that you may find useful.
It's just been announced that Abbot are releasing a second Freestyle Libre! This will enable optional alarms thanks to bluetooth. It will offer customizable alarms for low glucose and high glucose, and a technical feature that notifies the user of signal loss.
You will be notified via sound or vibration. You can still continue to be able to scan your new FreeStyle Libre 2 sensor as often as desired to see glucose readings, trends and patterns, and eight-hour history.
This post provides you will more info. I hope to give it a try when it is released. I love the idea of having alarms.
If you haven't heard of the Miao Miao before then let me explain it. It's simply a transmitter that can be attached on top of the Freestyle Libre. It then continuously reads the Freestyle Libre and sends the data to your phone. So it basically transforms the FreestlyeLibre into a CGM.
They sent me a device to try but it didn't arrive in time, so I will use it for my trip to Central America in January. However, they did send me a discount code, so if you'd like to try it (and tell me what it's like) then you can use this referral code to get $10 off your order.
I will give a full review once I have tried it, but it really does look exciting and promising!
The short answer is: YES.
The long answer is this…
I’ve been traveling with the Freestyle Libre for almost two years now and it’s completely transformed my ability to travel the world. I actually don’t know how I could manage without it.
I don’t own a CGM (right now) as they aren’t funded in any way under the NHS and the cost is too high for me. But, the Freestyle Libre has given me a freedom like no other when traveling the world.
Countries my Libre has been with me (so far): Brazil, Argentina, Chile, Bolivia, Colombia, Peru, Thailand, Amsterdam, Vietnam, Laos, Cambodia, Indonesia, Italy, Germany, Austria, Luxembourg, Croatia, Slovenia.
The FreeStyle Libre has transformed the way I travel. It’s super useful for hiking, for skiing with type 1 diabetes, for night’s out, for long days sightseeing, for bus journeys, flying with diabetes, absolutely everything. The ability to just scan my blood sugar when I am in a fast-paced environment is something that reduces stress and helps you feel normal.
It’s also great to gather patterns and information from my blood sugars to see how my body and blood sugars are adjusting to a new time zone, new climate, altitude, foods etc, and by seeing my data on useful graphs, I can make changes quickly to get my blood sugars back to their normal routine.
You will have seen I always have my Libre with me when I am traveling. Sometimes I had breaks because I couldn’t afford them, but now I get them on the NHS, I don’t intend on having many breaks.
I always have better blood sugars when I am travelling. That’s because I am constantly on the move, and I am not stressed, I am in my happy place. There is a reason my HBA1C has been the lowest (6.5) it’s ever been only because of travelling full-time.
If you want to bring the Freestyle Libre Sensor with you on a backpacking adventure, then I suggest you remove the boxes as something you won’t have is a lot of space.
Take your Freestyle Libre out of the boxes and put them in separate little clear bags and they won't take up as much room.
So, yes, my honest answer is that the Freestyle Libre helps make travelling with diabetes not only easier, but safer. You feel like a “normal” person, and everyone thinks your Freestyle Libre is a nicotine patch! :P
I met a couple in Bolivia who spoke no English, (I speak little Spanish), but I managed to work out that she was telling me her son wore a Freestyle Libre!
I was on the back of a moped in Bali and saw the guy in front of us driving had a Freestyle Libre sensor on his arm. My instinct was to chase him and bond! It’s great being able to spot that little device around the world and think, “hey! There is another one of us!”
This is the website that has the contact details of local points of contact to find out about getting the FreeStyle Libre Sensor, it’s availability in your area, and the cost.
I hope that I have provided you with a lot of the information you need about the Freestyle Libre Sensor system and App, and if there is anything you think I have missed out then please just pop a comment below, or message me and I will add it in!
The FreeStyle Libre has both its benefits and drawbacks, but if you are on insulin pens, pumps and just want a nice aid to help you with your care that won’t (hopefully) break the bank, then I think this is a wonderful place to start.
My HBA1C lowered because of the Libre, and I think it can do the same for anyone!
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