Flash Glucose Sensing (Libre)

Flash Glucose Sensing(FGS) has its own page because it is not CGM but is more than blood glucose testing. Abbott describe their FreeStyle Libre as a replacement for routine fingerstick blood glucose measurements but in the diabetes community Libre is being talked about as a potentially cheaper alternative to CGM. Both measure the glucose in interstitial fluid but the Libre sensor cannot transmit and therefore will not alert you to low or high glucose levels until you ‘flash’ the sensor.

Libre reader following a 'flash'

Libre reader following a ‘flash’

The Libre system includes a sensor which is worn for up to 14 days, and a handset which the user scans over the sensor to obtain a reading. The reading also shows a trace for the last 8 hours and usually a direction arrow showing whether the glucose reading is stable, rising, rising fast, falling or falling fast. The handset includes a smart FreeStyle Optium blood glucose meter and blood ketone meter.

Abbott markets Libre as a replacement for fingerstick blood glucose monitoring, but note that the Abbott FreeStyle Libre UK website says:

“A finger prick test using a blood glucose meter is required

  • during times of rapidly changing glucose levels when interstitial fluid glucose levels may not accurately reflect blood glucose levels or
  • if hypoglycaemia or impending hypoglycaemia is reported by the System or
  • when symptoms do not match the System readings.”
    (INPUT’s highlighting)

Please note: you will still need to do fingerstick blood tests prior to and during driving to meet DVLA requirements. 

Emma, 20’s, said “It has reignited my interest in my blood sugars. I’ve always been frustrated by finger prick tests because you don’t actually know what the reading means. Am I stable? Going up? Plummeting down? Now I know 😀 I already can’t imagine life without it.”

NICE Medtech Innovation Briefing (MIB) published July 2017 – link

MIBs are Objective information on device and diagnostic technologies to aid local decision-making by clinicians, managers and procurement professionals. The information provided includes a description of the technology, how it’s used and its potential role in the treatment pathway. This is not the same as NICE guidance, and does not have to be acted on by clinicians, managers or commissioners.

See our Research page for research and articles about Libre.

Abbott are currently marketing Libre to be purchased directly by users. There is no NHS funding route available for it at present. However, Abbott are keen for it to be available on the NHS and are working on studies to show the costs vs. benefits.

On 12 January 2015 Abbott posted this message on Facebook and their website:

“We are incredibly grateful for the positive feedback and support we have received since launching the FreeStyle Libre System. A number of people living with diabetes, as well as patient groups and healthcare professionals have asked us about the issue of reimbursement. It is Abbott’s intention to collaborate with the relevant authorities to pursue reimbursement for FreeStyle Libre and we are actively working to achieve this.

In March 2014, we announced that we had commenced clinical trials in three EU countries, including the UK, in order to generate patient data to support reimbursement. We are particularly proud that the first patient to enter the EU trial was from Ipswich. These trials have now been extended to nine countries and we expect to see results this year.

When we have patient and outcomes data from these trials, we will be working with regulatory authorities on reimbursement. Thank-you for your on going support.”

Latest update on 23 August 2016

“The FreeStyle Libre System is manufactured by Abbott in Witney, Oxfordshire, UK. As manufacturing is scaled up to meet UK and global demand, increased investment and jobs are being created on the site in the UK.

“Abbott has invested in and completed two large clinical trials in Type 1 and Type 2 patients who intensively use insulin to demonstrate value to payers that patients and physicians are experiencing with the FreeStyle Libre system.

“We are actively pursuing reimbursement and Abbott have submitted to the NHS Business Service Authority to have FreeStyle Libre flash glucose monitoring system sensor assessed for listing in the NHS England and Wales Drug Tariff for multiple daily injectors of insulin (MDIs) and available on prescription in the community (FP10), which was acknowledged by them in June 2016. The NHS Business Service Authority will be following the procedures agreed between the Department of Health and the Drug Tariff Part IX Forum and the submission is being processed according to the date order in which it was received. Additionally, we are also pursuing reimbursement in Scotland and Northern Ireland with the appropriate bodies.”

Libre website & webshop (be sure to tick the VAT exemption box)

To join the chat about Libre, have a look at the Facebook group

 

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