Freestyle Libre Blood Glucose Monitor

[UncleWede]

Originally Posted by vreihen16

The breathable aftermarket "donut" bandages they sell on Amazon to help hold the Libre sensors on work fine for me as additional insurance.....

I bought some early on, when I was still able to swim and go to the gym (sweat) Man, they get DIRTY, even now. But the ones I had covered the entire Libre, and I had to get my nurse son to apply, I could never reach the back of my arm (especially right side) properly.

I keep a special solution of vinegar/Dawn along with the scrub brush in the shower to remove "the ring" every other Friday.

[vreihen16]

Originally Posted by UncleWede

I keep a special solution of vinegar/Dawn along with the scrub brush in the shower to remove "the ring" every other Friday.

I have a lifetime supply of medical adhesive remover wipes left over from my IV infusion pump days. A home nurse had to visit weekly and change the central IV port dressing, clean off the glue residue, etc.

I also have a lifetime supply of leftover surgical tape, alcohol wipes, and medical-grade C-cell batteries that were used to power the pump.

My DW gladly installs the donut sensor bandages every two weeks. She used to change my IV bag every other day, so sticking a glorified band-aid on is not a problem.....

[Esteban]

Blood sugar doesn't work too well with wine. Oh well, lol

[Esteban]

Anybody have their injection cause the skin to bubble? I hate it when that happens. It's even on a new area, never used before. Don't what I'm doing wrong.

[UncleWede]

Originally Posted by Esteban

Anybody have their injection cause the skin to bubble? I hate it when that happens. It's even on a new area, never used before. Don't what I'm doing wrong.

Insulin injection?

The first couple Libre I had some slight allergic reaction (I think) to the adhesive. Body seems to shrug that off now

EverSense emailed me today, they want me back

[Esteban]

Originally Posted by UncleWede

Insulin injection?

The first couple Libre I had some slight allergic reaction (I think) to the adhesive. Body seems to shrug that off now

EverSense emailed me today, they want me back

Yes, insulin injection. Been a type 2 diabetic for 20 years. Been taking insulin for about 10 years.

Used to take it in my stomach. Moved to the haunches in my sides. Not much there but I'm trying to make the most of it.

Lantus Solostar. Not the best but cheap. $1100.00 without insurance, free with my insurance, til my wife quits working part time. Then Medicare. We'll see how much that'll be.

[UncleWede]

Originally Posted by Esteban

Yes, insulin injection. Been a type 2 diabetic for 20 years. Been taking insulin for about 10 years.

Used to take it in my stomach. Moved to the haunches in my sides. Not much there but I'm trying to make the most of it.

Lantus Solostar. Not the best but cheap. $1100.00 without insurance, free with my insurance, til my wife quits working part time. Then Medicare. We'll see how much that'll be.

Get off my lawn but way back in the bottle/syringe days, I was taught to put the needle in, pull the plunger back a bit before injecting. There was just something unusual sometime. If I did inject, I'd get a bubble. The insulin didn't make it sub-q. You may need a longer needle if it continues to bubble. It's probably not being absorbed properly then

[Esteban]

Originally Posted by UncleWede

Get off my lawn but way back in the bottle/syringe days, I was taught to put the needle in, pull the plunger back a bit before injecting. There was just something unusual sometime. If I did inject, I'd get a bubble. The insulin didn't make it sub-q. You may need a longer needle if it continues to bubble. It's probably not being absorbed properly then

Have you seen the needles they use these days? They are tiny. Do you think that could be the problem? They, so far, are not offering me another option. I think I am getting off not having to use a regular size needle. Help!

[UncleWede]

Originally Posted by Esteban

Have you seen the needles they use these days? They are tiny. Do you think that could be the problem? They, so far, are not offering me another option. I think I am getting off not having to use a regular size needle. Help!

It's not the thickness it's the length there are longer options

Yes, I know exactly what I typed

[Esteban]

Originally Posted by UncleWede

It's not the thickness it's the length there are longer options

Yes, I know exactly what I typed

I'm not saying you don't know what you typed, just wondering if I should ask my doctor for something different than I'm using. 4mm x 32g needles. This is what they're using these days. What are you using?

[UncleWede]

Originally Posted by Esteban

I'm not saying you don't know what you typed, just wondering if I should ask my doctor for something different than I'm using. 4mm x 32g needles. This is what their using these days. What are you using?

There are 2 33guage options here. IIRC, 5/32 and 3/16. I asked for the longer ones because sun/leather covering my fat

I just looked and I have 5/16 (8mm)

[Esteban]

Originally Posted by UncleWede

There are 2 33guage options here. IIRC, 5/32 and 3/16. I asked for the longer ones because sun/leather covering my fat

I just looked and I have 5/16 (8mm)

Are you type 1? Don't know if it matters.

[UncleWede]

Originally Posted by Esteban

Are you type 1? Don't know if it matters.

I am

Tresiba is the better long acting insulin. I don't know the price, all my insulin is $300/3 month supply

[vreihen16]

Originally Posted by vreihen16

FWIW, the Freestyle Libre 2 (CGM!) was recently approved for sale in the USA. The iPhone app has apparently not been approved yet by the FDA, or I'd have that on my arm right now to see how it works.....

Following up on this, the FDA finally approved the Freestyle Libre 2 (FL2) iPhone app for use in the USA back in late August. I've been using the FL2 for a few days now, and thought that I should provide some feedback.

Most importantly is that because it is classified as a CGM, the FL2 sensors are 100% free on my health insurance plan! I was self-funding the original 10-day and 14-day first-generation sensors, so this alone is enough to make me use them more.

The FL2 sensors are the same size as the first-gen ones, and my third-party donut bandages fit the new sensors the same as the old ones.

The biggest gotcha coming from the FL to the FL2 is the phone app use. On the original FL, you could scan a newly-installed sensor with the meter, and also link it to the phone if you scanned it within a few minutes of linking the meter. With the FL2, it is one or the other for a newly-installed sensor...but not both. When I was seeing an endocrinologist, his staff only wanted to see a meter and not the phone. I would scan with the meter for the doctor, and scan with the phone for myself. That isn't an option with the FL2.

Under the covers, I suspect that the FL2 sensors use NFC like the originals but also have Bluetooth/BLE radios in them. The new FL2 iPhone app asked for security permission to use Bluetooth when I installed it. If you read the reviews in the App Store, there are a lot of complaints about sensor range for receiving CGM alerts. Reading between the lines, it looks like the consensus there is that the FL2 meter seems to have much better Bluetooth range. I can tell you that my phone was about 6' away from my pillow through one sheetrock wall, and lost contact with my sensor twice while I slept last night. It seems like you have to manually scan the sensor via NFC to re-establish the Bluetooth CGM link and download the missed/stored data.

Speaking of alarms, that is also a popular gripe in the App Store reviews. The app uses the iOS emergency notification bypass to send high/low/signal loss alerts. This means that do not disturb and the slider mute/vibrate switch on the iPhone are not honored, so it could be fun if you are in a meeting/conference/theater where it makes you the doofus who has the ringing/beeping phone. They appear to have added optional toggles to honor/bypass the silent modes for each alert in the current app release. I left them all bypassing for now, since having a CGM that cannot alert seems silly. Just pointing this out because it was the reason why I knew my phone lost contact with the sensor twice last night. It sounded the alert on both my phone and Apple Watch, waking me up twice.

Just like with the original first-gen stuff, you apparently still need to buy the FL2 meter even if you never intend to take it out of the box. I vaguely recall reading that part of the FDA approval process was having a strip meter integrated into the unit, for use as a backup or when the sensor was reading implausibly. The first-gen meter and app used to both request finger sticks on occasion. The new FL2 app hasn't asked me yet in the few days of use so far. I haven't even broken the seal on my FL2 meter's box yet, but am considering at least putting a charge into the batteries just in case.

The iPhone app needs to be left running (minimized) 24/7 in order to use the CGM function. If you try to close the app, it will throw an emergency alert that doing so is a bad idea. I did notice that the app started dogging out and taking 10+ seconds to perform a manual scan after a day of continuous running, and suspect that it has a memory or task leak bug of some sort. If I see it happening regularly, I'll make it a habit to close/restart the app a few times per day to clear things up.

If anyone has questions, feel free to ask. In the mean time, we can all wait for the FL3 to get FDA approval for the USA, which has a much smaller sensor than the original FL and FL2.....

[UncleWede]

Originally Posted by vreihen16

Following up on this, the FDA finally approved the Freestyle Libre 2 (FL2) iPhone app for use in the USA back in late August. I've been using the FL2 for a few days now, and thought that I should provide some feedback.

Most importantly is that because it is classified as a CGM, the FL2 sensors are 100% free on my health insurance plan! I was self-funding the original 10-day and 14-day first-generation sensors, so this alone is enough to make me use them more.

The FL2 sensors are the same size as the first-gen ones, and my third-party donut bandages fit the new sensors the same as the old ones.

The biggest gotcha coming from the FL to the FL2 is the phone app use. On the original FL, you could scan a newly-installed sensor with the meter, and also link it to the phone if you scanned it within a few minutes of linking the meter. With the FL2, it is one or the other for a newly-installed sensor...but not both. When I was seeing an endocrinologist, his staff only wanted to see a meter and not the phone. I would scan with the meter for the doctor, and scan with the phone for myself. That isn't an option with the FL2.

Under the covers, I suspect that the FL2 sensors use NFC like the originals but also have Bluetooth/BLE radios in them. The new FL2 iPhone app asked for security permission to use Bluetooth when I installed it. If you read the reviews in the App Store, there are a lot of complaints about sensor range for receiving CGM alerts. Reading between the lines, it looks like the consensus there is that the FL2 meter seems to have much better Bluetooth range. I can tell you that my phone was about 6' away from my pillow through one sheetrock wall, and lost contact with my sensor twice while I slept last night. It seems like you have to manually scan the sensor via NFC to re-establish the Bluetooth CGM link and download the missed/stored data.

Speaking of alarms, that is also a popular gripe in the App Store reviews. The app uses the iOS emergency notification bypass to send high/low/signal loss alerts. This means that do not disturb and the slider mute/vibrate switch on the iPhone are not honored, so it could be fun if you are in a meeting/conference/theater where it makes you the doofus who has the ringing/beeping phone. They appear to have added optional toggles to honor/bypass the silent modes for each alert in the current app release. I left them all bypassing for now, since having a CGM that cannot alert seems silly. Just pointing this out because it was the reason why I knew my phone lost contact with the sensor twice last night. It sounded the alert on both my phone and Apple Watch, waking me up twice.

Just like with the original first-gen stuff, you apparently still need to buy the FL2 meter even if you never intend to take it out of the box. I vaguely recall reading that part of the FDA approval process was having a strip meter integrated into the unit, for use as a backup or when the sensor was reading implausibly. The first-gen meter and app used to both request finger sticks on occasion. The new FL2 app hasn't asked me yet in the few days of use so far. I haven't even broken the seal on my FL2 meter's box yet, but am considering at least putting a charge into the batteries just in case.

The iPhone app needs to be left running (minimized) 24/7 in order to use the CGM function. If you try to close the app, it will throw an emergency alert that doing so is a bad idea. I did notice that the app started dogging out and taking 10+ seconds to perform a manual scan after a day of continuous running, and suspect that it has a memory or task leak bug of some sort. If I see it happening regularly, I'll make it a habit to close/restart the app a few times per day to clear things up.

If anyone has questions, feel free to ask. In the mean time, we can all wait for the FL3 to get FDA approval for the USA, which has a much smaller sensor than the original FL and FL2.....

Thanks! I hadn't heard yet.

I'd LOVE for the alert to go off during some of my meetings

For the alerts, does it repeat every x time period until you get back into range? I could see that being an issue, at least for highs for me. Although possibly I wouldn't get to 457 if I knew I was crossing 250 an hour ago. . .

My insurance STILL doesn't have Libre on it's formulary, but I am still paying the formulary price from 2 years ago, and have new script from the Dr.

I don't leave ANY app running on my iPhone. This will be a difficult transition.

Long ago I registered my Dr. in the app. They get the reports directly, I don't have to show them my phone (or the meter that I never used) When I talk to the Dr. she has those reports to go over with me. It's better when she has the web page up on her tablet, but she sometimes comes in with printed graphs. From those it's difficult to read comments and treatment reports (carbs, exercise, insulin)

Going to call the Dr. in a few minutes!

[vreihen16]

Originally Posted by UncleWede

For the alerts, does it repeat every x time period until you get back into range?

Only one alert. The alert says going high or going low, and advises you to check it. I didn't read the instructions to see if they meant to do a manual scan or a finger stick. I believe that it also gives the measurement at the time of the alert, but am too impatient to read the alert before I clear it.

I don't leave ANY app running on my iPhone. This will be a difficult transition.

It bugs my OCD, but I already have to leave the Verizon call-blocker app open.

Long ago I registered my Dr. in the app. They get the reports directly, I don't have to show them my phone (or the meter that I never used) When I talk to the Dr. she has those reports to go over with me.

I would rather *not* have my doctor see every single moment, just curated averages and patterns. What doctors don't know won't hurt me, if you know what I mean.

I'm curious if your insurance will cover the FL2 as a CGM.....

[vreihen16]

Another thing that I just noticed is that the phone app only seems to be logging/graphing data when I manually scan the FL2 sensor like the first-gen ones. I suspect that the CGM function only sends high/low alarms from the tag to the app, not the full per-minute sensor live data stream. This is probably an engineering choice, due to battery draw over the sensor's 14-day life not permitting running a Bluetooth radio for more than sending occasional alerts to the phone app. Long story short, it appears that you will lose data if you don't scan the sensor every ~8 hours, just like the original Libre 10-day and 14-day sensors.....

[vreihen16]

Confirmation that the included meter also only receives alarms via Bluetooth and not a full data stream of per-minute readings:

.

[vreihen16]

By the same person above. I like how he equates the FL2 to iPhone "S" models. From my experience so far, that is a great analogy.

Being in Europe, he already has access to the new FL3. He said that it is a true CGM via Bluetooth, and the package does not have a meter at all. It's smartphone app or nothing. The new FL3 sensor is the size of two stacked pennies. When it will be approved for sale in the USA and if the FDA will even approve it without a bundled meter and integrated backup strip tester is anyone's guess.....

.

[T-Dubbs]

I'm sure the Libre sensor thing works well, but the costs need to come down or the insurance companies need to cover them...

I tried it for a month (type 1 diabetic) and it works well just cant pay out of pocket each month for $100 sensors that lasts 14 days each.

I just wish that my insurance covered them

[vreihen16]

Uh, oh! The FL2 started throwing a scan error this morning:




Restarting the app and rebooting the phone did not fix it, and both the NFC (scans) and Bluetooth (alerts) interfaces were offline. It recovered after an hour or so, and immediately sent an alert that my glucose was high.

From a web search of a few UK diabetic forums, it appears that the FL and FL2 have a built-in error prevention routine. If it detects an implausible reading such as a rapid rise or fall, it shuts down the interfaces for a while until the measurements stabilize. Better to report nothing than report flawed/dangerous information.

Long story short, it went offline in the 170's and climbing, and came back online in the high 200's and falling. It must have been a huge spike right after breakfast that triggered the error. There was a gap in the graph from the times that the sensor was offline.

I never saw this happen with the original 10-day or 14-day FL sensors, and will be keeping a closer eye on the FL2 to see if it goes offline again when I'm not looking.....

[UncleWede]

Originally Posted by vreihen16

Uh, oh! The FL2 started throwing a scan error this morning:

Attachment 2752621


Restarting the app and rebooting the phone did not fix it, and both the NFC (scans) and Bluetooth (alerts) interfaces were offline. It recovered after an hour or so, and immediately sent an alert that my glucose was high.

From a web search of a few UK diabetic forums, it appears that the FL and FL2 have a built-in error prevention routine. If it detects an implausible reading such as a rapid rise or fall, it shuts down the interfaces for a while until the measurements stabilize. Better to report nothing than report flawed/dangerous information.

Long story short, it went offline in the 170's and climbing, and came back online in the high 200's and falling. It must have been a huge spike right after breakfast that triggered the error. There was a gap in the graph from the times that the sensor was offline.

I never saw this happen with the original 10-day or 14-day FL sensors, and will be keeping a closer eye on the FL2 to see if it goes offline again when I'm not looking.....

Dang, conspiracy theory now. 3:47 try again in 10 minutes. I'll be back asleep in ten minutes. Pee, try again, same message

7:05 scan, replace sensor. Checked manual and at 279.