I have been using the FreeStyle Libre glucose monitoring system (CGM) since December 2018. Here are some questions I had myself before considering the switch from my OneTouch system and some of the answers I came up with or have come to understand using the Libre glucose monitoring system. Hopefully this information will helpful to diabetics like me (read my story) that are considering using this system.
Do I need to still use a finger based glucometer
On occasion, yes. The Libre app will recommend you do a finger based test if your sugars have had a drastic change; are really high; or very low. At most, I would say I have to do a finger test a few times a week.
You will still need to fall back to traditional finger pricks with the FreeStyle Libre system if:
- Your glucose reading indicates a low or going low message; or a high message
- Your trending arrow is rising or falling quickly
- Your sensor cannot provide a reading
- Your readings do not match how you are feeling
The FreeStyle Libre reader can scan both your sensor (fingerless scans) and has the ability to do finger / blood based scans. Personally, I use my iPhone 8 over the Libre reader (although I have both) – after all, we always carry our phones with us, why lug around a glucose monitor as well. However, I fall back to my old OneTouch for finger tests as 1) I had three units (home, office, and roaming) and 2) I had an existing prescription for the test strips.
How often do I need to scan the sensor?
The sensor holds 8 hours worth of data and then starts to overwrite the oldest readings. Personally, I would argue 8 hours is not long enough. However, despite this comment, in reality 8 hours isn’t too bad.
We test our glucose before breakfast; lunch and dinner which is well below 8 hours between the three. I also scan before bed for my long-lasting insulin injection. So – 4 scans a day as a minimum – 24 hr / 4 scans = 6 hrs.
Where I find the sensors 8 hour window fails me is over night. I admit it, I enjoy sleeping in. 8 hours is not long enough as I always seem to have a gap between my bedtime scan and my morning scan for any time over the 8 hours. Is this the end of the world, not really as you would expect a slow and steady downward trend as my long lasting insulin does its work.
The OCD in me hates the missing data.
What do I love the most about my Freestyle Libre?
Not having to finger prick myself several times a day is a total bonus. However, what I love the most about my FreeStyle Libre is the biohacking. How did my body respond to this food or that food. Take the picture on the right as a great example. This picture was pulled from my iPhone Libre App that shows the last 24 hours of continuous glucose monitoring.
For the most part I was behaving that morning and had great number over night. Then hello lunch. A group of us from work decided to go for sushi. Even worse – all you can eat sushi. You know what that means right? GORGE!!!!! Look at that spike (and that was with a dose of insulin – looks like I underestimated the carbohydrate intake with that meal. Needless to say, I know better for next time we decide on Sushi for a work event. It wasn’t until almost 9 PM (9 hours after lunch began that I was able to get my sugars back on tack.
With the Libre system or any continuous glucose monitoring system – pay close attention to your spikes and your gentle waves. How does a protein with your fruits keep your sugars down compared to fruits alone? Do you find you spike more aggressively with one food over another? With knowledge come power or in our case control over our chronic illness.
This will be one question I will be bringing to my diabetes clinic – should I have waited until dinner to try to get my numbers back on tack or was there a more proactive means.
How frequently do I need to change my sensor?
The FreeStyle Libre sensors last exactly 14 days from when it was activated will need to be replaced. Both the iOS and Android phone App and the Libre Reader have a countdown timer in them as as a constant reminder.
My only comment is that when the sensor expires, you lose any data between the last time you scanned the sensor and the expiry. It literally self destructs like a spy movie. Well, without the explosion.
Does the FreeStyle Libre Sensor really last 14 days
I admit, I am only on week 9 (5th sensor) of using the system, however, I have yet to need to remove a sensor before the 14 day mark. That being said, it is winter in Canada and I have a phobia of slipping and falling on ice so my running KM has been limited and the sensor has not been exposed to excessive sweat.
It will be interesting to see how well the sensor holds up in the summer, between sweat, exercise, and just overall life. I do notice that the adhesive does begin to lift away from my skin around the outside of the sensor at about the 10 day mark. There are a few solutions to this:
- Amazon has several pre-manufactured sticky pads that you can place over top. See them at my Amazon Store here where I list some of my favourite Libre Accessories.
- Make your own sticky pad – this is my preferred choice. As an athlete I have tones of Kinesiology Tape. I cut a small piece, and place it over-top of the sensor for the last 3 or 4 days.
- I have summarized the steps that I use to help prevent my FreeStyle Libre from falling off before the 14 day expiry – Tips to help keep your FreeStyle Libre from falling off.
How Well does the Libre App for iOS and Android work
Overall, I have little or no complaints. I do love data – and it is a bit disappointing that the iOS version locks my data away and doesn’t share nicely with other apps.
Remember, the FreeStyle LibreLink app is compatible with NFC enabled phones running Android OS 5.0 or higher and with iPhone 7 (My Libre was a great reason to upgrade my iPhone 6 to an 8) and higher running OS 11 and higher.
Improvements to the IOS version could include:
- Allowing blood glucose readings to be added to Apple Health App. The Health app does not need 100% of the data; I would be happy with the break points of when I have scanned the sensor- similar to what goes into the log book.
- Ability to import older glucose readings from a text / csv file
- Ability to export glucose readings to a text / csv file. This one would not be needed if the data was in the Health App as there are several other applications available to assist in exporting data from the Apple Health App.
- Downloading the last 90 days worth of data from the LibreView website if you ever reinstall the app. Reinstalling the app looses any data stored on your phone, however, your historical data is safely saved on Libre View.
NOTE: As of October 2019 – the Freestyle Libre is now available for both iOS (iPhone) and Android. An exciting time for all phone users!
Does the Freestyle Libre need your phone to be close or always on to capture glucose data?
The Freestyle Libre sensor captures data 24 hours a day without needing your iPhone. Look at the sensor as an independent device – your phone or the Libre glucose meter only needs to be around once every 8 hours to download your stored data. Otherwise they are two independent devices. That being said you can scan the sensor as frequently as you want.
Can I share my Glucose Readings with my family?
One great feature of the App is that you can be held accountable and give a family member access to your results via a small app called Libre LinkUp.
Libre LinkUp allows up to 20 people to monitor your glucose scans. Unfortunately you will not see the 24 hour data, however, the user will have access to your LOGBOOK showing when you scanned your Libre Sensor and the glucose reading.
To send a Libre LinkUp Invitation – look for the SHARE link under the dropdown menu on your App and follow the instructions. The user will receive an email with instructions on how to download the Libre LinkUp app and a special code to connect to your data.
Be warned – they can check in on your levels at any time and scold you. You can also share this data with your healthcare provider; if they have registered with FreeStyle.
Can I print Reports for my Diabetes Clinic or Health Professional?
The best reports for you and your healthcare team are available through the online companion to the Libre System – Libre View
LibreView is a secure, cloud-based diabetes management system that gives healthcare professionals and patients clear, easy-to-understand reports from many popular Abbott glucose monitoring devices.
The report can print summaries on the following:
- Glucose Pattern Insights
- Monthly Summaries
- Daily Log
- Mealtime Patterns
- Weekly Summaries
- Daily Patterns
Is the FreeStyle Libre System covered under private health insurance in Canada
Yes! Almost 100% of the cost of my sensors is covered by my medical / prescription health insurance provided by my employer. What I did notice is that there is a significant range in costs between pharmacies. I have also read in many usergroups that some insurance companies are only covering the Libre System if you use insulin to manage your diabetes. That being said, contact your insurance provider to double check.
Although you are not obligated to use Abbott’s official pharmacy for the FreeStyle Libre system, they do appear to have the best price for both the sensors and the reader.
When I was trying to activate my first prescription, I was advised by them that my doctor needed to send the prescription directly them despite me already having a paper prescription.
As I already had a paper copy, I simply went to my community pharmacy which was able to get both the sensor and reader in for the next morning (I was my pharmacies first patient to give the system a try.).
Where do I get the FreeStyle Libre System in Canada
You can get the FreeStyle Libre from your local pharmacy (mine was able to order in the sensor and the reader) for the next morning.
There is also an official pharmacy for the Free Style Libre that is listed on the FreeStyle Canada website. If you are living outside of Canada, check your local FreeStyle website for pharmacy locations.
Can I use my phone as well as the FreeStyle Libre Reader
YES! Absolutely — I have both an iPhone and the Libre Reader – and they work interchangeably. However, here is what you need to consider:
- When activating a new sensor, first scan the Libre Reader – then scan your phone
- Both scanners work independently – so if you wanted to aim for 100% of data in both devices, you would need to scan both your phone and the Libre Reader regularly.
- As of Summer 2019 – only the iPhone is officially supported here in Canada. See below for some unofficial and unsupported ways to get the Libre to work on Android Devices.
How large is the Freestyle Libre Sensor
The Freestyle Libre sensor is discrete and very comfortable the sensor can easily be worn under the most clothing. The Libre sensor is slightly larger than a quarter and about as thick as two coins.
Freestyle Libre: as small as a quarter
Can I use my Android Phone with Freestyle Libre
As of The end of September 2019 Freestyle Libre is available for both iPhone (iPhone 7 or newer) and Android. A very exciting milestone. Visit your App Store to download.
In addition to the official Android App, many Android users have also had great success using FreeStyle Libre on their Android phone with the following Unofficial apps. As an iPhone user I have not tested them.
GLIMP – An Android app for managing diabetes, compatible with Abbott Freestyle Libre, Libre Pro, MiaoMiao and BluCon sensors.
- Memorize blood glucose levels
- Acquires glucose values from Abbott Freestyle Libre sensor without Abbott reader
- Memorize insulin units, carbohydrates and sport activities
- Remote Glucose Monitoring via Dropbox and Nightscout
- Smartwatch app (requires an NFC-open smartwatch)
Diabetes M – The application tracks almost all aspects of the diabetes treatment and provides you and with detailed reports, charts and statistics. You can send the reports to your supervising physician via email. Diabetes:M also gives you various tools, so you can find the trends in blood glucose levels and allows you to calculate normal and prolonged insulin boluses using its highly effective, top-notch bolus calculator.
- Smart Watch Compatible
- Bolus Calculator
- Food Database
- Analytical Charts
- Reporting and import / export
- Android and iOS Versions
Nightscout xDrip+ – Attempting to ease the burden of diabetes management through automation technology. Providing proof of concept tools to further research goals and inspire the next generation of systems.
- Voice, Keypad or Watch input of Treatments (Insulin/Carbs/Notes)
- Visualization of Insulin and Carb action curves + Undo/Redo
- Improved alerts and predictive low forecasting feature
- Instant data synchronization between phones and tablets
- Support for many different data sources
Do you have more questions about the FreeStyle Libre Glucose reader?
As I come up with more hints and tips about the FreeStyle Libre system I will be sure to add them here. Feel free to leave a comment below with any questions you may have and I will be sure to answer them.