Freestyle Libre: A Diabetes Educator’s Experience
Reviewed by Dr. kotb and his team
So, last week, I took advantage of the free Freestyle Libre reader and sensor offer for current Dexcom users.
I was so excited to try out the Libre and wear it with the Dexcom G5 to compare the two as a self-management experiment. I was prepared for the two devices to differ as one is a continuous glucose monitor (Dexcom) and the other is a flash glucose monitor (Libre). Here are my thoughts.
Ten Thoughts of a Certified Diabetes Educator
1. Filling the Prescription: Win for the Libre
I was able to get my hands on a Libre within 36 hours of claiming the offer. I contacted my endocrinologist to write me a prescription and almost immediately Walgreens worked on obtaining a Libre system for me. My Walgreens didn’t have the Libre in stock, so they placed an order, and I was able to pick it up the next day. Whenever I try to re-order Dexcom supplies through my third party distributor, it seems to be disastrous, and it takes a week or so to receive my shipment.
Considerations: If you do not have insurance coverage for a CGM, have a high deductible, or cannot afford your out-of-pocket cost with coinsurance, the Libre is a much more affordable option.
However, make sure that your insurance will cover the Libre. If insurance covers the Dexcom (and you have good insurance coverage), but not the Libre, then Dexcom may be a more affordable option.
2. Insertion Process: Win for the Libre
The insertion instructions for the Libre are understandable and easy to follow which differs from the difficult Dexcom insertion process.
Considerations: If you are unfamiliar with diabetes technology, have low dexterity or have vision problems, the insertion process for the Libre may be much smoother than insertion of the Dexcom.
3. Calibration: Win for the Libre
The Libre is factory calibrated, so it does not need to be calibrated after warm up or throughout its ten-day session. The Dexcom requires two calibrations after its two-hour warm up and then one calibration every 12 hours.
At first, I thought this was an absolute win for the Libre. However, I noticed that there were a few instances where my Libre was significantly (60+ numbers off) from my meter reading and Dexcom reading. I understand that the Dexcom will be closer to the meter reading since it uses the meter reading for calibration but I felt scared that I couldn’t tell the Libre it was wrong to re-adjust it. I don’t think I’m fully ready to trust factory calibration yet.
Considerations: The factory calibration is a beautiful feature as it reduces user-burden. All the user has to do is insert the Libre before starting the session. This feature is beneficial for those who cannot or will not check their blood glucose manually throughout the day.
4. Adhesive: Tie
I cleaned off my site area with alcohol before inserting the Libre. I was unsure of the guidelines for using skintac, so I did not use any before insertion.
After two days the Libre began to peel off, and I had to reinforce it with Tegaderm. The Dexcom also does not have great adhesive.
However, I have been using the Dexcom long enough to figure out the best way to make it stick for me (donut-shaped application of liquid skintac before insertion, gifgrips on after insertion, followed by additional liquid skintac on top).
Considerations: Both the Libre and the Dexcom seem to cause allergic reactions in some.
Final Thoughts
Trialing the Libre was an awesome opportunity as it gave me a sense of having patient choice for self-management tools.
However, I am not sure I am mentally ready to use the Libre over the Dexcom. I am used to using my Dexcom G5 CGM and have become somewhat dependent on its benefits for my peace of mind and sense of safety.
There are still many clear clinical benefits to using the Libre, however, and the best fit depends on individual self-management needs.
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