Sunday 31 January 2016

Libre Intentions

This will be quick - I've got to get a munchkin ready for a party in 30 minutes...

My first Freestyle Libre arrived in the post on Friday.  It's currently sat in its partially opened boxes on my sofa.  I'll probably take the plunge this evening - but right now, I'm filled with a sense of apprehension.

Not just because of the intimidating packaging (and thanks to those of you who've reassured me), but more because I'm not sure why I've got one.

There's no doubt it's popular among the online community - I've seen plenty of tweets and blogs about the virtues of it's quasi-CGM ability, and I've met a few people in real life who are incredibly complimentary about it too.

But I know my control is actually pretty good overall.  And I know I have the moderately addictive personality that could mean I can't just use two sensors and revert to conventional testing.  I've held off for so long because I want to make sure I'm going to use if for the right reasons for me.

Regardless of all the basal testing I've done, I know that at some point between 10 and 11am, my BG takes a dip.  Not always a huge one, but something strange happens around then and I'm hoping I can start to visualise what that is.

I also do a lot of exercise, and whilst I've worked hard to be able to manage my diabetes and run as much as I do, I've got a genuine curiosity about what happens to my BG whilst I exercise.  Again, the Libre should help me out there.

Lastly, I'll have some evenings where I eat late, and things don't behave in the way the usually do.  Last night was a prime example, where, despite meticulous carb counting and appropriate insulin delivery, I woke up around 16.5.  Not much cop is it?  Hopefully I can understand how that happens, so I can learn what to do about it in the future.

What I don't want to do is become someone who chases flat lines on a graph with temporary basal rates and huge doses of insulin.  I know from DAFNE that a more patient and informed approach is more likely to give better results and understanding in the longer term.

As you may know, I got to listen in on a few sessions at the Association of Children's Diabetes Clinicians conference on Friday, and two talks there really captured my attention.

Firstly, Dr Peter Adolfsson talk about how, in his native Sweden, patients (particularly paediatric patients) are introduced to continuous glucose monitoring before they start pump therapy.  Indeed it turns out, not all patients want or need pump therapy once they've understood how the glucose reacts to different situations.  This gave me hope I was making the right decision with a Libre.

The second talk was from Prof. Kath Barnard, who spoke brilliantly (and candidly) about the lack of psychosocial support for people using diabetes technology like CGM, and how many that self fund, do so and ignore a lot of the information they receive (e.g. cancelling/ignoring alarms from devices).  This made me feel more cautious with the Libre.

Am I getting myself into something I fully understand that will give me the information I want, without changing my existing attitude and approach to managing diabetes?  In short, I don't know.  But there's probably only one way to find out...

3 comments:

  1. Hi Andy,
    I 100% understand where you're coming from with this blog post. I umm-ed and ahh-ed over the Libre for a long time, wondering if it was something I genuinely needed or just wanted. I've just done a month of Libre, and I've come to the conclusion that, as awesome as it was, it's not something I need to fund full time. But I'm so glad I tried it, and I will get another sensor in the future (probably a couple of weeks before my clinic appointment in March). I hope you end up happy to have given it a go.
    -Vicki.

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    1. Thanks Vicki - that's reassuring. I'm thinking I'll give the first one a go, see what I learn from it and then try and put it into practice with my regular meter. I like the idea of saving one until closer to a clinic appointment! Thanks :-)

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  2. Great post Andy. I've used 6 or 7 over about a year and a half. Sometimes to cover chaotic periods (eg Christmas/holiday) where the extra info is very helpful to try to work around less predictable meals. And at other times where things seem to need a bit of a 'reset'. Equally helpful in both situations I find.

    They have also been very useful during distance runs/training to be able to watch things while pottering along and pre-treat impending dips without over-treating when I would have been fine.

    Hope you get a lot out of it, and try to remain calm if/when the Libre doesn't match your fingersticks which will inevitably happen.

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