Should The Freestyle Libre Be used to check blood sugars before driving?

Should The Freestyle Libre Be used to check blood sugars before driving? It’s been a hot topic recently, but the DVLA have now updated their guidelines to include the Libre, under Flash Glucose Monitoring (FGM) in general. Is that the right call though?

I have been a long term advocate of the Libre. I purchased my first sensor when they were released in 2014 and have continued to self-fund it on and off since then, when finances allowed. In the last 2 weeks I have been issued a Libre on prescription so that I can go ahead with full time use. I appreciate that I am very lucky to have access to this technology over the 6 years since I was diagnosed.

While I appreciate the patterns that the Libre provides me with, I have yet to have a sensor so reliable that it can be used to replace finger pricks completely. A Freestyle Libre measures interstitial fluid, rather than blood, and so it would be fairly unreasonable to assume that the results would correspond at all times. I am sure to do a finger prick before my main meals, first thing in the morning, last thing before bed and before driving. On the whole, that has me still checking 4-8 times a day.

The DVLA guidelines for driving with insulin treated diabetes state that:

“Group 1 drivers may now use finger prick glucose testing and continuous glucose monitoring systems (FGM and RT-CGM) for the purposes of driving”

Which means that you could eliminate the finger prick before getting behind the wheel and replace it with a swipe from the Libre – but that leaves me with so many concerns. Personally, I think FGM is a great tool to use along side finger pricks, not as a replacement.

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If I were to prick my finger and see a 5.2 mmol/l then that is deemed safe to drive, however if I match it with a Libre reading showing a downward arrow then that would indicate the need to take action before getting behind the wheel.

I usually find my Libre reads lower than my blood glucose level by around 1mmol/l, but it has been known to be as much as 3 or 4mmol/l in the first 48 hours. That would of course show that the Libre would be a conservative check for me, but that is not the case for everyone. Each sensor is different, as is each persons response to a sensor. Although FGM has been available for nearly 5 years in the UK it is still not completely reliable I don’t think this was a good decision by the DVLA.

My original question was Should The Freestyle Libre Be used to check blood sugars before driving? I know that I won’t be  before driving without doing a finger prick too.

WHAT NEXT?

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