Ditching Libre for fingerprick

[spoon363]

Hi, so I was newly diagnosed with Type 1 in January and have had a libre freestyle for the past couple of months. Must sat that I thought it was great at first, but have found problems with the sensors not activating twice, dropping off twice after a week, or like today it just said it was ended after a week.

Also I've noticed in the second week the sensors seem to get less accurate. For example last week the sensor was saying I had 5 hypos in a day, however on fingerpricks I was well over 5 mmols.

I've got to the point I don't trust it entirely when it says I'm going low.

Anyone else ditched them?

 

[Lucyr]

I've got to the point I don't trust it entirely when it says I'm going low.

You’re not supposed to trust it when it says you’re going low, you’re supposed to fingerprick to check whether you’re low. Sounds like the problem is you haven’t understood when to use fingerpricks. Have you done any of the online libre training?

 

[spoon363]

You’re not supposed to trust it when it says you’re going low, you’re supposed to fingerprick to check whether you’re low. Sounds like the problem is you haven’t understood when to use fingerpricks. Have you done any of the online libre training?

Not yet. I was told by the DSN that this replaced the finger pricks. However the sensor is telling me I'm 3.7 for example and I do a finger price and I'm 5.8. That's quite regular recently. Making me wonder as one hand its telling me I'm having a hypo and the finger prick is saying I'm fine to drive?

 

[Leadinglights]

Not yet. I was told by the DSN that this replaced the finger pricks. However the sensor is telling me I'm 3.7 for example and I do a finger price and I'm 5.8. That's quite regular recently. Making me wonder as one hand its telling me I'm having a hypo and the finger prick is saying I'm fine to drive?

There are quite a few threads discussing the limitations of the Libre system so it may be worth looking at those before deciding whether to ditch it.
Many do find it useful despite some issues. Your DNS was probably not correct in saying it completely replaces finger pricks, it is knowing when they should be used that is important.

 

[rebrascora]

I think it is important to understand the limitations of Libre and other CGM and if you don't, then you may become disenchanted.
I also think that applying the sensor in the best circumstances is helpful. Generally I apply mine in the evening when it is cooler and I am less likely to sweat. I also use an arm strap the keep the sensor secure for the first couple of days, particularly in this heat and I use a hair drier to ensure my arm is absolutely dry before I apply the sensor and I hold the applicator in place for at least 60 seconds before i wriggle it free.... as it never seems to lift off cleanly and any tugging on the sensor when it has just been applied will risk displacing the filament.
Many of us also find that applying the new sensor 24 hours before activating it helps for our body to react and then settle to a foreign body being fired into it, so we get more accurate results when we start the sensor a day or so after applying it.
These are all little tips that we have found work for us as individuals and help Libre to be more effective for us. I also put my arm strap back on when I get a shower as I tend to forget which arm it is on and end up giving it a good scrub, which under hot water makes it vulnerable as the heat softens the adhesive. The arm strap acts as a visual reminder to be careful when I wash that arm.
Libre and other CGM are also prone to compression lows where, if you lie on them the tissue where the filament is sampling your levels gets compressed and it will record a false low. I seem to have learned over time not to sleep on my sensor although I mostly prefer to sleep on my back anyway. There are other issues with the algorithm which Libre uses to convert the interstitial fluid reading to Blood Glucose my extrapolating the previous readings to predict what the next reading will be 15 mins from now..... because interstitial fluid lags BG buy about 15 mins. This is fine when your levels are reasonable stable but when they are changing quickly and the rate of change is changing, then it will be less accurate and it is even more of an issue when levels are changing direction.... ie dropping low and you eat carbs and it will take Libre 30 mins to cotton on to a change of direction whereas a BG fingerprick will show your levels have recovered after 15 mins.

Once yea understand all these quirks, find an application technique and perhaps armstrap or overtape which works well for you, then Libre is great, but there are some people who find that it doesn't agree with their body chemistry and a different system may suit their body better.

 

[Bloden]

Sorry to hear you’re finding the Libre so frustrating @spoon363. I use mine mostly for checking which way my bg’s trending. I prick my finger if I need a more accurate reading, eg before meals and if I’m going low. 🙂

 

[rebrascora]

I also meant to add that if the sensor has not bedded properly or been disturbed after initial application then it seems to be more likely to read low and eventually fail, so making the application as effective as possible may well improve performance.

I was initially self funding and at £50 a shot that I could ill afford, I was really worried that I might botch it, so I was very particular about everything I did to ensure that it had the best chance possible of good adhesion and I think that has probably stood me in good stead for the success I currently have with it. At day 14 I still need to grimace with discomfort as I prise it off my arm.

 

[Tdm]

I was finding my libre was giving me up to 10 false low alerts a night. My dsn moved me over to dexcom g6 and its blooming brilliant. I can trust it for treatment decisions. I do fingerpricks before meals and it tends to be spot on.

Ask to try dexcom

 

[spoon363]

I also meant to add that if the sensor has not bedded properly or been disturbed after initial application then it seems to be more likely to read low and eventually fail, so making the application as effective as possible may well improve performance.

I was initially self funding and at £50 a shot that I could ill afford, I was really worried that I might botch it, so I was very particular about everything I did to ensure that it had the best chance possible of good adhesion and I think that has probably stood me in good stead for the success I currently have with it. At day 14 I still need to grimace with discomfort as I prise it off my arm.

Thank you for your advice. I've just applied one and hope it starts up/ stays on/ doesn't give dodgy readings. My prescription is for 4 at a time to last for 2 months. I'm aware I'm costing the NHS a lot of money so getting frustrated at the problems

 

[spoon363]

I was finding my libre was giving me up to 10 false low alerts a night. My dsn moved me over to dexcom g6 and its blooming brilliant. I can trust it for treatment decisions. I do fingerpricks before meals and it tends to be spot on.

Ask to try dexcom

Thank you. It's something to consider.

 

[Leadinglights]

Thank you for your advice. I've just applied one and hope it starts up/ stays on/ doesn't give dodgy readings. My prescription is for 4 at a time to last for 2 months. I'm aware I'm costing the NHS a lot of money so getting frustrated at the problems

If you are getting failures or substantial discrepancy with finger pricks then they should be reported to Abbott and a replacement FOC be requested. The NHS shouldn't be paying for faulty sensors.

 

[Tdm]

What i did was buy a dexcom myself (i was getting desperate) and ran it beside libre, and presented the data to the nurse. They had to apply for the funding. I have no hypo awareness which probably helped.
Despite dexcom being bulkier, it doesn't give compression lows (possibly as less comfy to sleep on) and you can wear on tummy as well as arm. G6 also has different settings for day time alerts and night time, so you can run lower at night when you have no fast acting insulin. Also, choice of alarm noises (inc crying baby)

 

[Amity Island]

Hi, so I was newly diagnosed with Type 1 in January and have had a libre freestyle for the past couple of months. Must sat that I thought it was great at first, but have found problems with the sensors not activating twice, dropping off twice after a week, or like today it just said it was ended after a week.

Also I've noticed in the second week the sensors seem to get less accurate. For example last week the sensor was saying I had 5 hypos in a day, however on fingerpricks I was well over 5 mmols.

I've got to the point I don't trust it entirely when it says I'm going low.

Anyone else ditched them?

Do you use the freestyle reader or a mobile phone?

 

[BenjaminRWT]

Just want to get in on this thread a moment...

Not yet. I was told by the DSN that this replaced the finger pricks. However the sensor is telling me I'm 3.7 for example and I do a finger price and I'm 5.8. That's quite regular recently. Making me wonder as one hand its telling me I'm having a hypo and the finger prick is saying I'm fine to drive?

I don't drive, but I'm having similar issues with mine, Put a new sensor in yesterday evening, alarm on my phone kept going off all night telling me I was at 3.8 or lower. Fingerprick tests saying I was 5.5 or thereabouts.

Weirdly it was fine all day for me in work. Did a reading from my libre just before lunch, telling me 4.7, decided to do a fingerprick test as well to be sure and that was 4.8. Close enough.

Then I get home from work and the alarm went off again. Same thing. 3.8, fingerprick says 5.5.

I haven't felt as though I was having a hypo with any of these. No symptoms that I could identify. First time it happened I did down a small carton of orange juice and a couple of biscuits just to be on the safe side, though.

On a side note, last week while meeting a couple of friends after work, I started to feel a bit iffy. Bit light-headed, which I normally don't. Libre was saying 4.8, within range. I had some juice cartons in my work bag so I had one of them, again, just in case that was the beginnings of a hypo. Felt fine a a little while later.

Could these weird readings because I "switched arms" for this one? I noticed when I took the old one off yesterday, under the patch I was using for a little bit more protection the skin was a bit reddish and bumpy. I put the new sensor in my other arm just in case.

Either that, I somehow messed up putting it in, or a dodgy sensor. I put in my repeat prescription for my next lot of sensor yesterday evening so it'll be a week before I will need to pick them up. I'm tempted to remove this one and just fingerprick for a week until I get them.

 

[Inka]

It’s best to use alternate arms @BenjaminRWT The Libre tends to be a bit inaccurate for the first couple of days. I also found I had a run of really inaccurate ones. If you’ve just put one on, I’d keep it on but finger-prick when needed.if it’s very inaccurate, contact Abbot.

 

[Inka]

What i did was buy a dexcom myself (i was getting desperate) and ran it beside libre, and presented the data to the nurse. They had to apply for the funding. I have no hypo awareness which probably helped.
Despite dexcom being bulkier, it doesn't give compression lows (possibly as less comfy to sleep on) and you can wear on tummy as well as arm. G6 also has different settings for day time alerts and night time, so you can run lower at night when you have no fast acting insulin. Also, choice of alarm noises (inc crying baby)

The G7 isn’t bulkier. I find it less obtrusive than the Libre 2. It’s small and has a low profile. It’s also more comfortable to insert - actually painless. It’s also extremely accurate.

 

[Wotisname]

Hi, so I was newly diagnosed with Type 1 in January and have had a libre freestyle for the past couple of months. Must sat that I thought it was great at first, but have found problems with the sensors not activating twice, dropping off twice after a week, or like today it just said it was ended after a week.

Also I've noticed in the second week the sensors seem to get less accurate. For example last week the sensor was saying I had 5 hypos in a day, however on fingerpricks I was well over 5 mmols.

I've got to the point I don't trust it entirely when it says I'm going low.

Anyone else ditched them?

Haven't ditched them but over a week ago mine failed on day 12 wouldn't give a reading when I scanned it , tried again ten minutes later , same message try again in ten minutes , eventually message read, sensor has stopped working attach another one. Fitted a new one on other arm within two minutes sensor lifted off my arm due to loss of blood lifting the adhesive patch ( WHY DON'T THEY MAKE THE ADHESIVE PATCH BIGGER ) Spent the next seven days without one due to delay from Abbott sending replacement / and next prescription from GP not due. I don't seem to have a problem in the colder months ,but in the summer I have to wear an elasticated arm strap , with a plastic disc that fits snugly over the sensor to stop them lifting of my arm, but this seems to affect the accuracy of the sensor when i sleep on my arm .Does anyone else find that the replacements Abbott send out don't work for the full fourteen days.

 

[everydayupsanddowns]

Thank you. It's something to consider.

Different sensors certainly suit different people - Dex One (which is the cost-equivalent to Libre could be worth trying). Though the G6 does allow calibration which can be helpful.

 

[BenjaminRWT]

It’s best to use alternate arms @BenjaminRWT The Libre tends to be a bit inaccurate for the first couple of days. I also found I had a run of really inaccurate ones. If you’ve just put one on, I’d keep it on but finger-prick when needed.if it’s very inaccurate, contact Abbot.

Sorry to bump this thread, but seems to be a pattern with new sensors for me.

For example, I put a new one in yesterday evening. If anything my BS was a bit high for a while, even post-meal for me. Not overly so, like reading 10.1 when a blood test was more like 9.2 or something.

Just a while ago, I checked my libre (when it's accurate, the new real-time update on the app is actually handy), and I'm reading 5.3. That's low for this time of day, in work. Did an finger-prick test, 7.8. Which is about normal for me.

In fact, as I'm typing this, an alarm just went off claiming I'm 3.7 mmol/L. Another finger-prick test says 6.5.

This happened a few times in the early hours of this morning, too, and as I was starting work this morning. That one was a 3.8, fingerprick test said 4.0. No symptoms but had a carton of orange juice to be on the safe side. So it is close enough at times, but then other times like this it's off to the point I'm getting woken up in the middle of the night with it.

I'm off to London for a few days on Sunday. I'm hoping it will have settled by then and be more consistent. I'm taking my blood testing kit with me as well, and a spare libre sensor just in case this gets knocked off or anything.

 

[Amity Island]

Hi, so I was newly diagnosed with Type 1 in January and have had a libre freestyle for the past couple of months. Must sat that I thought it was great at first, but have found problems with the sensors not activating twice, dropping off twice after a week, or like today it just said it was ended after a week.

Also I've noticed in the second week the sensors seem to get less accurate. For example last week the sensor was saying I had 5 hypos in a day, however on fingerpricks I was well over 5 mmols.

I've got to the point I don't trust it entirely when it says I'm going low.

Anyone else ditched them?

Hi Spoon363,

This is worth a read. Explains the discprepancy between ISF and BG. From my understanding, if your blood glucose begins to head in the lower direction, then any glucose in the interstial areas will naturally drop quicker as a result, hence why the libre may say below 4, but finger prick says above 4. Correct me if I am wrong but basically, I think the body draws in or stops any extra glucose going to non-essential areas ISF (which the libre reads), when it needs to.

"For decades, the major source of information used to make therapeutic decisions by patients with diabetes has been glucose measurements using capillary blood samples. Knowledge gained from clinical studies, for example, on the impact of metabolic control on diabetes-related complications, is based on such measurements. Different to traditional blood glucose measurement systems, systems for continuous glucose monitoring (CGM) measure glucose in interstitial fluid (ISF). The assumption is that glucose levels in blood and ISF are practically the same and that the information provided can be used interchangeably. Thus, therapeutic decisions, that is, the selection of insulin doses, are based on CGM system results interpreted as though they were blood glucose values."

Discrepancies Between Blood Glucose and Interstitial Glucose—Technological Artifacts or Physiology: Implications for Selection of the Appropriate Therapeutic Target

For decades, the major source of information used to make therapeutic decisions by patients with diabetes has been glucose measurements using capillary blood samples. Knowledge gained from clinical studies, for example, on the impact of metabolic control ...

www.ncbi.nlm.nih.gov