Ask the Pharmacist

Q: I have been hearing a lot about the new blood glucose meter that does not require strips. What can you tell me about it?

A: The first easily-accessible (there have been other monitors available already aimed only at the insulin-pump crowd), non-finger-prick blood glucose monitor, known as the Freestyle Libre, is being heavily-promoted, and has caught the attention of many of our customers who are weary of sticking their fingers time and again.

While this technology may well be the way of the future, at this point in time, it may not be an ideal solution for many of our diabetics for several reasons that we will discuss.

This technology is known as continuous glucose monitoring (CGM) and involves essentially three parts. There is a sensor with a fine needle that you stick into your arm and wear for 14 days before replacing it with a new one. The needle reads the glucose levels in your interstitial fluids (this is the thin layer of fluid which surrounds the body’s cells) as opposed to reading from blood as normal meters do.

The sensor, which you wear continuously, is about the size of a toonie and it measures your glucose every minute or so and retains the reading within it for 15 minutes. It can be worn in water (up to a depth of three feet and not for longer than 30 minutes) and can go through a metal detector at airports but must be removed for full body scans, x-rays and MRIs.

The next two parts are the transmitter which is part of the sensor, and the reader that looks much like a normal glucose monitor. When the reader is moved to within four centimetres of the sensor, the transmitter sends the measurement to the reader and your blood glucose level appears on the screen within a second.

The signal can go through some clothing (up to four millimetres of thickness) so you should be able to get a reading through a shirt or blouse; whereas, a jacket is possibly going to block the signal.

With every scan, you get your current reading, which way your sugars are heading (i.e. up or down), and the last eight hours of glucose data is transmitted to your reader. The reader can store readings for up to 90 days. Despite having a needle, the sensor is supposed to be relatively painless with 90 per cent of people indicating they hardly know it’s there.

So, given the simplicity of use and the lack of pain, why isn’t it a great option for all diabetics? Well for one reason, it’s really expensive. The starter kit costs $227 (Canadian) and the sensor that needs to be replaced every two weeks costs about $50. The government is currently not paying for it, but some private plans are.

However, at that cost to your insurance benefits, is it worth using them up on a convenience, as insurance companies and employers struggle to find ways to afford covering the latest new drugs which frequently cost hundreds to thousands of dollars per month.

Secondly, checking interstitial fluid is not as accurate as checking your blood sugars since it runs about five to 10 minutes behind what’s actually going on within your body. For most readings, this time lag will be irrelevant but in times of rapidly-changing glucose levels, such as when some of our diabetics are heading toward a hypoglycemic (or low-blood sugar) event, a finger prick test with a traditional strip will still be necessary to get a more accurate up-to-the-second reading in order to know how to intervene.

Another potential negative is that you are going to have to order new sensors on-line as they are not sold in any pharmacies. As such, you’re going to have to be organized about re-ordering them well ahead of time so that you don’t run out and deal with the potential hassles of screwed up orders and closed highways that may leave you without proper monitoring for a few days.

There also seem to be some challenges for a few people with the sensors falling off, necessitating holding them in place with some medical tape. Given that the sensors can’t be put back on and must be replaced, this can be a costly hassle for those who find adhesives don’t stick well to their skin.

Patients taking high levels of Vitamin C or Aspirin can find they get inaccurate results as well.

Lastly, in reading some user reviews (hardly a scientific basis, we realize), there seemed to be a more negative sentiment than we had expected for a variety of reasons.

All that being said, the Freestyle Libre can be really handy for some Type 1 (insulin-dependent) diabetics and our guess is that as this technology is fine-tuned (one of the other meter companies we spoke with mentioned it will have one as well, it is just waiting until it can make a “better” one), this will likely be the way of the future for testing blood sugars.

For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination. Also check the website at www.gordon-pharmasave.com/ and the Facebook page at www.facebook.com/GordonPharmasave/?fref=ts