I have been using the Freestyle Libre on and off since its release in the UK in 2014. Initially I funded it myself, almost full time when I was in my old job and then ad hoc when I became self employed, buying the odd sensor to help with difficult periods in my pregnancies. In February of this year I was offered the Libre on the NHS, to use alongside my insulin pump to maximise my diabetes control. Of course, I said yes.
Like everyone, I have had my ups and downs. I am by no means the perfect diabetic, but on the whole I maintain a good level of control. Except for the day I was diagnosed I have not had an hbA1C of over 55 (7.3) and even then that was considered a very poor result for me. It is not easy and a lot of hard work goes in to maintaining that level of control, but having the Libre is meant to make my life just that little bit easier.
It has been almost 2 months of continuous Libre usage. I haven’t had more than 1 hour disconnected from a sensor for the last 8 weeks. Its there when I eat, sleep, shower, play…… everything. That in itself is nothing new as I am accustomed to my pump being attached, but at first the novelty of having the Libre constantly meant I was using it “properly”. More recently though? I get the feeling it is affecting my blood sugar control.
And not in a good way.
I have always found the best way to manage my diabetes is to be proactive. Pre-bolus before all my meals, quite far in advance for high GI meals. Use my pump features like temporary basal rates to help with exercise and alcohol, or square-wave bolus for certain meals. Each blood glucose test meant I was taking some kind of action, anticipating my blood sugars next move and trying to stay ahead with it.
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The beauty of the Freestyle Libre is the ability to check your blood glucose with just a swipe. This means that instead of pricking my finger around 6 times a day and making all my decisions based on that, I am now swiping around 15-20 times a day and reacting to the figure each time.
In recent weeks I have noticed more and more that I am riding quite a rollercoaster of blood sugars. When I am seeing a figure that is close to hypo and with a downward arrow I am having something to eat, without a bolus, instead of just trusting my pump waiting to see if the hypo comes (of course there are times when that would be stupid – like when there are large amounts of active insulin). As a result I am going high, making me react and give a correction, making me go low. And so the cycle continues.
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Insulin stacking is quite hard to do with a pump provided you follow its correction recommendations, which I do, but it’s not impossible. The Libre has a slight lag to a finger prick of around 10 minutes, so when I make a correction based on a figure it gives me I can be over correcting. The moral of the story is of course to finger prick before correcting – and that is the habit I need to get back in to.
I am of course SO thankful for the NHS for providing me with a Libre, an the onus is on me to make sure that it helps me rather than hinders me. But as things stand, I think my hbA1C will have risen over the last few months. I am only maintaining approximately a time in target of around 65%, but my personal target is 75%.
As with all of these things, recognising the issue is half the battle. I know what I have to do going forward, and I hope that the Libre will continue to help me along the way.
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