Libre 2 Trial

[CivicFreak]

Hi all,

Sorry if there's already been a thread about the Libre sensors (I'm sure there will be many) so if this is better fitting in another thread mods please do move it.

I'm currently trialling the Libre 2 after a period of struggling to get my BG's under control. So yesterday I visited my DSN, she ran through the whole process, helped me apply the sensor and set my phone up. So far so good. Got a couple of scans and it seems pretty much in line with my finger prick results, so was happy with this.

Unfortunately when I went to get a shower (I made sure to be VERY careful around it) it came loose and fell off. Two whole hours it lasted. Been in touch with Abbott and they're going to send me another one, so will continue the trial but I have to admit that this doesn't give a good first impression, especially when you consider how expensive they are.

I know a lot of people love them - I can see that from this forum, but I just wonder, is it common that they don't actually manage to last the 2 weeks? I do wonder about their reliability in that sense, and I would guess that there will always be a need for finger pricks as a back up in case they do fall off.

Would be keen to know other people's experience of the Libre sensors 🙂

 

[Kaylz]

There are a number of ways to try and stop this happening, you could try skin tac before applying the sensor, you could wear a strap over it after applying, a clear film patch such as Cutiderm or Tegaderm, vet wrap, micropore etc

A lot find they stick like a limpet and have trouble removing them I however don't trust them without something to help after losing a few in hotter weather xx

 

[helli]

Sensors do fall off but they are rare.
I find the important thing to remember when attaching a new sensor are
- that my skin is clean dry and grease free. I apply my sensors straight out of the shower before I apply any moisturiser.
- that I apply my sensor to a flat part of my arm. It may seem obvious that something solid cannot bend around a muscle but it still took me a while to realise the reason why some sensors started to peel off was because my arms are not soft and pliable but they are muscularish, solid and "bumpy".

I am lucky that when I follow these rules, my sensors stick like limpets. Unfortunately, some people have less sticky skin and need to apply a patch over their sensors (such as Tegaderm) or have purchased a strap from ebay.

As you say, Libre are common as are the thread on the topic. It would be useful for you to review the other threads - use the Search function on the top of every page to find the threads.

You also mention the need to do finger pricks as a "back up" - the need is greater than that. Libre and other CGMs are great but they are calibrated for "normal" levels. If Libre tells you need to correct a high or a low, ALWAYS check wit a finger prick.

 

[DaveB]

I'm lucky that mine have always stuck like limpets. Yes, make sure you use the flat fleshy part of the arm. Wash that area, shave if needed and wipe with an alcohol wipe. May be your skin just isn't a good match.

 

[CivicFreak]

Hi all, thanks for the replies! Good to know that it's a rare event, and maybe I was just unlucky. My arm was cleaned properly and the nurse herself applied it so it should have been done properly.

I may try a strap, or a patch - definitely worth a go. I would, however, like to try to see if I have better luck when my replacement arrives, but at the same time I don't want to run the risk of it falling off again as that is just a waste of resources and money, and I know they're not cheap (even though I'm not paying).

Again, thanks for the feedback, it's given me some good guidance 🙂

One more question - does anyone have any recommendations for a good strap? I'll definitely look into the Tegaderm patch as well!

 

[grovesy]

Two summers running during a heatwave, I have had one fail to least till the staring phase, luckily they were replaced. I am clumsy and have lost the odd one through banging on door frame.

 

[CivicFreak]

Two summers running during a heatwave, I have had one fail to least till the staring phase, luckily they were replaced. I am clumsy and have lost the odd one through banging on door frame.

Easily done I guess. I was a bit taken aback when I saw the size of the needle what gets inserted into your arm but then was pleasantly surprised that you don't feel a thing, and as such I guess it's quite easy to forget it's even there, and easy to catch.

 

[rebrascora]

I use a strap and find it well worth the investment. I got mine off ebay and it is a plastic 3D printed watch face affair with an adjustable elastic strap. Lots of colour combinations available. I have twanged it a few times on clothing etc but the strap takes the hit and the sensor has remained unharmed. I wouldn't be without it now.
I generally apply a sensor at night after a shower as the lack of much movement and the warmth overnight allows the adhesive to really bond with my skin especially with the strap applying a gentle pressure to it. I usually apply it the night before I need to use it. My changeover day is currently a Friday afternoon, so I apply it Thurs night and let it bed in and then activate it when the previous one runs out. This bedding in time also helps it to be more accurate from the start as any reaction in the tissue around the filament at having a foreign body fire into it has time to settle down before I take my first reading. Sometimes the 60 min warm up period just isn't long enough for this to settle down. It doesn't affect the lifespan applying it early like this.
My strap also acts as a visual reminder in the shower because once you start alternating arms you can easily forget which one it is on and accidentally scrub it with a skin exfoliator or towel and cause an edge to lift. Did that a few times before I got the strap. No problems at all since.

 

[nonethewiser]

Hi all,

Sorry if there's already been a thread about the Libre sensors (I'm sure there will be many) so if this is better fitting in another thread mods please do move it.

I'm currently trialling the Libre 2 after a period of struggling to get my BG's under control. So yesterday I visited my DSN, she ran through the whole process, helped me apply the sensor and set my phone up. So far so good. Got a couple of scans and it seems pretty much in line with my finger prick results, so was happy with this.

Unfortunately when I went to get a shower (I made sure to be VERY careful around it) it came loose and fell off. Two whole hours it lasted. Been in touch with Abbott and they're going to send me another one, so will continue the trial but I have to admit that this doesn't give a good first impression, especially when you consider how expensive they are.

I know a lot of people love them - I can see that from this forum, but I just wonder, is it common that they don't actually manage to last the 2 weeks? I do wonder about their reliability in that sense, and I would guess that there will always be a need for finger pricks as a back up in case they do fall off.

Would be keen to know other people's experience of the Libre sensors 🙂

Here what I do, clean skin first with alcohol wipe then wait to dry then apply sensor, did use to use tubular bandage & vetwrap to hold in place but not done so for while now, find adhesion very good lately.

Regards accuracy, sensor expired yesterday after 14 days, it was near enough accurate from start to finish, much more so than libre 1.

 

[trophywench]

My last one which 'died' a couple of hours ago was accurate throughout and the first one I've ever remembered to try applying early. (Couldn't apply new one yesterday as whole day away from home at a very very sad family funeral seeing family members we've not been able to visit for 2+ years and our 2 adult daughters not having seen or had contact with for longer than that, due to all having lives which never crossed. Long day.)

 

[CivicFreak]

Thanks all for your suggestions and advice!

I got my replacement sensor from Abbott a few days ago and decided to order a 3D printed band from Amazon, which has helped massively. Been wearing the sensor since Tuesday and with the band it is staying put.

Liking it so far, it's definitely less intrusive than finger pricking, although I am finding it difficult to "trust" the readings I get from it. Like others, I have generally found it to be accurate when sugar levels are "normal", but I have also seen big differences between the readings I get from the libre and my BG meter but for the most part it does seem close enough, and the that is available in the LibreLink app is really comprehensive. I've got another 10 days before the sensor runs out and my trial ends, but that should give me plenty of time to experiment and see if it really is for me. Right now I'm on the fence. It definitely has benefits, but it needs to gain my trust a little more 🙂

 

[CivicFreak]

I use a strap and find it well worth the investment. I got mine off ebay and it is a plastic 3D printed watch face affair with an adjustable elastic strap. Lots of colour combinations available. I have twanged it a few times on clothing etc but the strap takes the hit and the sensor has remained unharmed. I wouldn't be without it now.
I generally apply a sensor at night after a shower as the lack of much movement and the warmth overnight allows the adhesive to really bond with my skin especially with the strap applying a gentle pressure to it. I usually apply it the night before I need to use it. My changeover day is currently a Friday afternoon, so I apply it Thurs night and let it bed in and then activate it when the previous one runs out. This bedding in time also helps it to be more accurate from the start as any reaction in the tissue around the filament at having a foreign body fire into it has time to settle down before I take my first reading. Sometimes the 60 min warm up period just isn't long enough for this to settle down. It doesn't affect the lifespan applying it early like this.
My strap also acts as a visual reminder in the shower because once you start alternating arms you can easily forget which one it is on and accidentally scrub it with a skin exfoliator or towel and cause an edge to lift. Did that a few times before I got the strap. No problems at all since.

When I applied my replacement sensor I followed your method and did so after a shower. When my DSN applied my first one she only used an alcohol wipe and didn't give my arm a proper clean, so I can only suspect that this may be why it fell off so soon, perhaps there were residual oils on my skin.

I applied my replacement after a shower, making sure to use soap and water, dried and then used an alcohol wipe, and allowed that to dry before applying the sensor. I then put the band on. I wear the band pretty much all the time, leaving it on while in the shower so that there is less chance the sensor itself gets affected by the hot water in the shower. I have been only taking the band off after shower for a few hours to let it dry and give my skin a rest. Seems to be working so far and the sensor is showing no signs of loosening 🙂

Your point on the "bedding in" time is also interesting, as I did expect to have some kind of reaction or soreness for a while after application, due to the needle being inserted into my arm. So far nothing, which has surprised me somewhat. Also interesting is that I just can't feel the needle at all, and the only sign that something is on my arm is the band itself, I feel absolutely nothing from the sensor.

 

[everydayupsanddowns]

Glad you are getting on well with it @CivicFreak

I tend to find that the adhesive on all these bits of diabetes gubbins (infusion sets… CGM sensors… libre…) tends to need about 12-24 hours to come up to full strength.

An over-enthusiastic stretch, or accidental minor knock in the initial hours after application can lead to be feeling a ‘ping’, and the glue is never quite the same again.

But generally I have found the adhesive to be usually well capable of lasting the full 14 days of wear with Libre with no need for additional stuff over the top.

Be a little cautious if you are using anything that applies downward pressure to the sensor - it might give rise to a form of ‘compression low’, where the flow of interstitial fluid around the filament is restricted and the sensor can’t read accurately. The same sort of thing can happen overnight if you sleep on your sensor arm, and it can look like you had a hypo, but it was only caused by leaning on the sensor.

 

[CivicFreak]

Glad you are getting on well with it @CivicFreak

I tend to find that the adhesive on all these bits of diabetes gubbins (infusion sets… CGM sensors… libre…) tends to need about 12-24 hours to come up to full strength.

An over-enthusiastic stretch, or accidental minor knock in the initial hours after application can lead to be feeling a ‘ping’, and the glue is never quite the same again.

But generally I have found the adhesive to be usually well capable of lasting the full 14 days of wear with Libre with no need for additional stuff over the top.

Be a little cautious if you are using anything that applies downward pressure to the sensor - it might give rise to a form of ‘compression low’, where the flow of interstitial fluid around the filament is restricted and the sensor can’t read accurately. The same sort of thing can happen overnight if you sleep on your sensor arm, and it can look like you had a hypo, but it was only caused by leaning on the sensor.

Oh that's interesting, I've never heard of compression lows! I was mindful of how tight I had the band, so I keep it tight enough that it stays in place throughout the day, but loose enough not to put pressure on the sensor itself - essentially because I didn't want to put undue pressure on the needle itself in case it caused some pain or pressure in my arm. Have to admit I'd rather not wear it if I could help it, and maybe in a day or 2 I'll be brave and try to keep it off as long as possible, and only wear it in the shower or bed. The reluctance to let my sensor go free is that I appreciate how expensive they are, and want to ensure it stays on for the full duration of the trial, and I want to give it the best possible chance of that. I know if it fell off that Abbott would replace it again, but I just see that as a needless waste of money, so I will assist it to stay put - however I am intrigued as to how long it can fare on its own. I'm conflicted, as you may be able to tell 🙂

At the moment I'm not sleeping on my sensor arm. I'm left handed but sleep on my right side so I have the sensor in my left arm. I am aware that if I decide to continue with it, I will have to alternate my arms, and therefore I will eventually need to apply it to my right arm - something I'm not looking forward to. I have a few tattoos so I know how to avoid sleeping on sensitive areas, so might be a good idea to treat my sensor as a tattoo, so that I avoid putting too much pressure on it 🙂

 

[everydayupsanddowns]

but loose enough not to put pressure on the sensor itself - essentially because I didn't want to put undue pressure on the needle itself in case it caused some pain or pressure in my arm.

The needle that inserts the sensor is withdrawn during the application process. The part of the sensor that goes under your skin is a flexible filament, and you shouldn’t be able to feel it at all during wear, even if you lean on it 🙂

 

[CivicFreak]

The needle that inserts the sensor is withdrawn during the application process. The part of the sensor that goes under your skin is a flexible filament, and you shouldn’t be able to feel it at all during wear, even if you lean on it 🙂

Blimey, I know so little 🙂

 

[everydayupsanddowns]

Blimey, I know so little 🙂

Not at all! It makes perfect sense to think as you did, because you’d have felt the needle during insertion.

But once you’ve used a few more you will notice when removing them that the filament is bendy and flexible rather than stiff 🙂

 

[Proud to be erratic]

Oh that's interesting, I've never heard of compression lows! I was mindful of how tight I had the band, so I keep it tight enough that it stays in place throughout the day, but loose enough not to put pressure on the sensor itself - essentially because I didn't want to put undue pressure on the needle itself in case it caused some pain or pressure in my arm. Have to admit I'd rather not wear it if I could help it, and maybe in a day or 2 I'll be brave and try to keep it off as long as possible, and only wear it in the shower or bed. The reluctance to let my sensor go free is that I appreciate how expensive they are, and want to ensure it stays on for the full duration of the trial, and I want to give it the best possible chance of that. I know if it fell off that Abbott would replace it again, but I just see that as a needless waste of money, so I will assist it to stay put - however I am intrigued as to how long it can fare on its own. I'm conflicted, as you may be able to tell 🙂

At the moment I'm not sleeping on my sensor arm. I'm left handed but sleep on my right side so I have the sensor in my left arm. I am aware that if I decide to continue with it, I will have to alternate my arms, and therefore I will eventually need to apply it to my right arm - something I'm not looking forward to. I have a few tattoos so I know how to avoid sleeping on sensitive areas, so might be a good idea to treat my sensor as a tattoo, so that I avoid putting too much pressure on it 🙂

At the moment you are correctly and wisely guarding the precious sensor and thus be sure to get the most out of your trial. For cross-reference, in over 12 months I've not had a single sensor fall off and I don't do much 'special' before fitting! So I think it is luck of the draw whether your skin is suitable.

I also sleep on my right and I fitted my sensor repeatedly on my left arm, using a low, middle and upper positioning. For a while during one of the lockdown periods I wore my sensor on my chest above my nipple and that worked fine. The main drawback to not putting it on an arm is that the DVLA rules mean that the Libre is not valid while driving. But at that time I wasn't going anywhere so it didn't matter and I could fall back on finger pricking anyway.

It's fair enough to be conflicted at this time. I can only say that despite some limitations with the Libre 2 - overall it is a big improvement on just depending on finger pricking. Spot check readings from finger pricks can not give you the trends that flash scanning a sensor can; and it is the trends that is the strength of this system, rather than being totally dependent on getting an accurate reading to within a decimal point. If Libre was giving me readings between 5 and 9 I just used that information for bolus dosing.

 

[CivicFreak]

Well my 2 week trial is up. After a bit of fence sitting and not fully trusting it I have really come around to the idea and actually can see a lot of benefit in the data I was getting, so decided I would like to continue it. I guess I still have trust issues with the readings, and still tend to back them up with finger prick tests, but I'm trying to only do that when necessary i.e. when my readings are very high or low. Talked to my DSN and they are putting me on a 6 month trial, as over the last couple of weeks I couldn't see the impact exercise was having on my levels due to me visiting an osteopath to help fix a neck injury I've been carrying for a couple of years, but now I'm ready to start regular exercise again so am really looking forward to seeing the results through the Libre, and the impact exercise has.

 

[Proud to be erratic]

Well my 2 week trial is up. After a bit of fence sitting and not fully trusting it I have really come around to the idea and actually can see a lot of benefit in the data I was getting, so decided I would like to continue it. I guess I still have trust issues with the readings, and still tend to back them up with finger prick tests, but I'm trying to only do that when necessary i.e. when my readings are very high or low. Talked to my DSN and they are putting me on a 6 month trial, as over the last couple of weeks I couldn't see the impact exercise was having on my levels due to me visiting an osteopath to help fix a neck injury I've been carrying for a couple of years, but now I'm ready to start regular exercise again so am really looking forward to seeing the results through the Libre, and the impact exercise has.

I'm delighted for you that your 2 weeks trial gave you an awareness of the benefit and that your DSN is extending your trial for a further 6 months.

There are some limitations with Libre and I deliberately didn't push these to you previously, but given your forthcoming 6 months with Libre you may find the detail below informative and useful.

I captured these from @helli on 23 Dec 21 (who replied to you at #3 in this thread) and I just added a couple of nuances/comments from that capture:

"My advice would be to be fully aware of the limitations of libre.

- it may be less accurate for the first couple of days. Many of us insert it 48 hours before activating.
- it is calibrated to be accurate for “normal“ readings (between 4 and 10mmol/l). Therefore, always check with a finger prick test before correcting treating a hypo or correcting a high.
- Libre does not read blood sugars, which finger pricking does. It reads interstitial fluid which is behind blood sugars: claimed by Abbott as 2.1 mins for children and 2.4 mins for adults, more usually c.5mins and up to 15 mins. Libre 2 extrapolates the current trend to predict the last 15 minutes. This is fantastic most of the time. However, if the trend changes, it can over shoot. This is especially important when treating a hypo - always check your hypo has finished with a finger prick and treat again if still low; Libre will lag and could undershoot, saying you are still low even when recovery is happening - so trust your finger prick result.
- sometimes a rapid change confuses the sensor algorithm and it stalls, giving a Sensor Error message code 373; try again in 10 mins.
- some Libre sensors are faulty. If you have a sensor which is always off by a couple of mmol/l or reports a fault, report it to Abbott by phone (or e-mail). They will probably replace it and may ask you to return the faulty sensor so don’t throw it away.
- if your sensor falls off, Abbott have been known to replace the sensor if the adhesive is poor for your skin. There are several suggestions in this forum for improving adhesion or protecting the sensor.

Once you have got used to Libre, you can look to do things like:
- look for trends which suggest you need to pre-bolus earlier or later.
- look for trends which may suggest your basal isn't lasting between doses.
- see what happens overnight (do you experience Dawn Phenomenon or Foot on the Floor syndrome?).
- see what happens with exercise and general activity.
- you can use the phone app of LibreLink; or register and go to the LibreView website for more detailed analysis and reports.

If you are tech minded, you may want to consider converting Libre 2 to a CGM so you don’t need to scan it. There are a number of options for this depending upon your phone, whether your diabetes team are checking your readings online and how techy you are. But they are not official and written by techies for techies." NB Diabox is written by a diabetic techie for diabetics.

Good luck.