I wrote about our second favourite flash glucose monitoring device – Abbott’s Libre – and covered off all the undoubtedly good things about the device. But all is not milk and honey in the land of the Libre and so I’ve jotted down a few of my annoyances for your delectation.
Some of these are practical day-to-day things and some are more esoteric and aren’t really Abbott’s fault but I’m going to lump them all together because no-one ever said life was fair.
There’s no escaping the fact that any flash glucose system is not going to be as accurate as a capillary blood test. Prior to starting with the Libre, I used Bayer’s (sorry, Ascensia Diabetes Care’s) Contour Next Link meter, which I think is the best and most accurate meter I’ve ever used. It’s a great bit of kit and you just get used to reliability and accuracy. Check twice in quick succession with the Contour Next and you’ll get the same result.
Everyone goes into using the Libre with their eyes wide open – we all know that interstitial readings will lag behind capillary. We all know it could be a bit wonky. But, in practice, I want accuracy – I want to know what’s happening with my glucose levels now and I want the results to be accurate, dagnabbit. I’ve compared the Libre’s results to my Contour Next and it’s not uncommon for them to be way apart, even when nothing much is happening blood-glucose wise.
I know I’m asking for the moon on a stick but my Libre / meter is my only source of data for deciding how much insulin I put in. Getting it wrong makes my BG go a bit high or a bit low. Mild inaccuracy is not going to kill me (calloused fingers crossed…) but it’s annoying to have to constantly correct as a result of shoddy data.
All that said, I think seeing general trends develop is far superior to spot checks through the day. So I can put up with this but more accuracy is definitely on the wish-list.
Before I started on the Libre, I was slightly worried about having the sensor stuck to me for 14 days. As a confirmed member of the metropolitan, metrosexual elite who’s never done a proper day’s work of manly hard graft in his life, I have baby-soft sensitive skin. I find a pump infusion set tends to get itchy on the third day and after removal I look like I’ve been attacked by an angry octopus.
I’ve had mixed results so far. Sensor number one was driving me mad with itchiness after about a week; but sensor number two was absolutely fine. Sensor number three has proven to be okay so far but we’re only a few days in. I suspect the “recipe” for the glue will only improve as we go on and I know there are things that can be done to help mitigate the problem. So the jury’s out on this one for the moment.
In terms of wearing the sensor itself, it’s not a problem. It’s very similar to having a pump infusion set in – you sort of notice it but it’s not a big deal.
Equally, I’m not particularly bothered about having the Libre on view when I do things like go swimming. Mainly because I never go swimming. Quite why anyone would want to splosh about in a luke-warm pool of urine-infused chlorinated water is beyond me. But different strokes for different folk and all that.
In any event, now that our very own Prime Minister has been photographed with a Libre then it’s what all the cool kids will be wearing this season; surely making it the latest must-have diabetic accessory!!
Reliability & customer support
Admittedly I’m going on a data sample of only two here but I’ve had a 100% sensor failure rate. Neither sensor I’ve used so far has lasted the full 14 days. They’ve nearly got there but not quite. A day or so before I’m due to change sensor I get a flat-lining graph of “LO” for hours on end – results which hint that I should be dead, rather than bumbling along with a happy 6.0 according to my backup meter.
According to a brief, unscientific survey on twitter my experience seems to be pretty isolated. Maybe it’s just beginner’s bad luck? So we’ll park this one and come back to it in a few months.
However, this neatly leads me onto customer support. The first time a sensor failed I rang Abbott to chat it through with them. I spent 20 minutes on hold (apparently my call is important to them), gave up and emailed them. I then filled out a lengthy diagnostics form and pinged it back to them. Three days later I hadn’t heard anything so I chased them up by email. Five days after that I still hadn’t had a response, so I chased them up via email. I then got the following maddeningly vague response:
Please be informed the life of the sensors are up to 14 days and in your case it seems that the sensor have reached the end of the life and that might have caused this issue.
We are sorry as we won’t be able to proceed any further with a resolution with regards to this issue.
I followed up with a further email to try and clarify their position and was given, essentially, the same reply six days later.
I’m led to believe that Abbott have been slow sending out orders recently and I suspect they’re a bit overwhelmed with customer support requests due to the rapid take up of the Libre. This is fine in the short term but they do need to sort it out.
One of the reasons I quite like Medtronic – your soaraway Shoot Up’s second favourite pump manufacturer – is that I feel that they “have my back” (as our American cousins might say). There was the time I broke my pump (by taking it through an airport body scanner – what an idiot) and Medtronic had a replacement on my doorstep within four hours of me reporting it. I’ve rung them on a few occasions outside UK office hours and have been talked through how to fix a problem quickly, efficiently and effectively via just one phone call.
I know some people have had bad experiences with Medtronic but I’ve been happy with them. Am I as confident with Abbott? Perhaps not. Will Abbott improve? I hope so.
Aside from all that, there are a few minor annoyances, which I’ll rattle through quickly:
I love using the Libre with my phone but if you forget to set it up within an hour of the new sensor’s life (say, you’re doing something more interesting – like not thinking about diabetes all the damned time) then you can’t use it all. You’re locked out for a fortnight. I’ll probably do this only once but it’s an infuriating ‘feature’.
I also hate Abbott’s online sensor tutorials; I’m a big fan of online videos as it’s easier to see how to do something rather than read about it. However, I don’t need to be given the sales message “WHY PRICK WHEN YOU CAN SCAN” every bloody time I watch a video. My kit is funded by the NHS, I don’t have any choice but to use the Libre. I want cold, hard facts not sales guff, dagnabbit.
The online LibreView can sometimes seems a bit wonky. I think it’s great but for some reason when I logged on today there are no results for the last week. Why not? Where has my data gone? Is this a temporary glitch or has something got corrupted on the way up? Again, I need to see if this is a one off or whether their software is a bit goofy.
Despite the unrelenting negativity above, I do think the Libre is a Good Thing. You would have to prise it out of my cold, dead hands to get it from me. But is it perfect? No, of course not. Is it a step forward and useful weapon in the war against wonky blood glucose and control? Emphatically, yes.