An increasing number of people living with insulin-treated diabetes use or want to use continuous glucose monitoring systems. One of these systems, the FreeStyle Libre, has been covered under the RAMQ in Quebec since July 2019 under certain conditions, allowing more people to have access to this technology.
The FreeStyle Libre is a Flash glucose monitoring system. It works with a sensor that users place on their arms and scan to view their blood sugar level. The sensor wire is inserted under the skin for 14 days. Capillary blood sugar measurements aren’t necessary, unless the user wants to confirm a blood sugar reading, for example in the case of hypoglycemia. Unlike other continuous glucose monitoring systems (Medtronic, Dexcom), the Freestyle Libre doesn’t have high or low blood sugar alerts.
Among the many studies that examined these new systems and the FreeStyle Libre specifically, a Dutch study (involving 1,000 participants) and a Belgian study (involving 2,000 participants) analyzed the impact of the Freestyle Libre on usual life conditions.
Improved hemoglobin A1c (A1c)
The Belgian study, with 77% of participants living with type 1 diabetes, showed an improvement of hemoglobin A1c—from 8.0% to 7.6% in six months—which was maintained after 12 months of using the system.
The Dutch study found that the number of hospital stays linked to diabetes and hemoglobin A1c (A1c) was reduced.
Reduced number of hypoglycemic episodes and workplace absenteeism
Both studies observed that the number of people who experienced hypoglycemic episodes as well as the time spent in hypoglycemia had decreased.
Workplace absenteeism was also shown to be reduced in both studies.
Improved quality of life
Study participants generally noted a better quality of life in relation to the following factors:
- Little to no capillary blood sugar measurements (finger pricks)
- Easier blood sugar readings (around strangers, in low-light conditions, before driving, etc.) and facilitated decision-making
- Better ability to do physical activity
- Better understanding of blood sugar variation
- Reduced severity and frequency of hypoglycemic episodes
- Easier blood sugar and insulin dose management at mealtimes
- More regular adjustment of insulin doses
- Friends and relatives (family, roommates) less worried about their diabetes
Some negative experiences have also been noted, for example:
- Sensor falling off
- Accuracy issues
But overall, the many benefits that the FreeStyle Libre brings to people with diabetes outweigh these drawbacks.
A new generation of FreeStyle Libre (FreeStyle Libre 2) with Bluetooth connection is now available in Europe, but not yet in Canada. This model has low and high blood sugar alerts, which will further improve blood sugar management and quality of life.
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References:
- Tucker, M. FreeStyle Libre: ‘Convenient, Valuable Addition’ to Glucose Monitoring; Medscape, January 2, 2020. Accessed January 14, 2020.
- Fokkert, M., van Dijk, P., Edens, M., et al. (2019). Improved Well-Being and Decreased Disease Burden After 1-Year Use of Flash Glucose Monitoring (FLARE-NL4); BMJ Open Diabetes Research and Care;7:e000809. doi: 10.1136/bmjdrc-2019-000809
- Charleer, S., De Block, C., Van Huffel, L., et al. (2019). Quality of Life and Glucose Control After 1 Year of Nationwide Reimbursement of Intermittently Scanned Continuous Glucose Monitoring in Adults Living With Type 1 Diabetes (FUTURE): A Prospective Observational Real-World Cohort Study. Diabetes Care, 43(2):389–397. doi: 10.2337/dc19-1610.
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