Wearable Devices: The Good, The Bad and The Ugly

Wearable glucose monitoring devices are the newest tech. There is the Libre Freestyle Sensor Flash Glucose Monitor and the DexcomG6 Continuous Glucose Monitor to name a couple. There may be others but those two are the ones that ‘everyone’ is talking about. I’m not promoting either product but I am going to talk about my experience and some common themes others are experiencing with the Libre Freestyle Sensor. So far, I like it. Has it changed my self-management long term? I don’t know yet. I have only been using it since the end of January 2019.

What is a continuous glucose monitor (Libre Freestyle sensor)?

It’s a device, actually a sensor, about the size of a toonie (silver dollar). It attaches to your arm by an applicator that comes in the box. Inside the applicator is a needle that is there only to assist with the insertion of a small flexible tube attached to the sensor. The needle does not stay in your arm. The flexible tube stays in the interstitial fluid just below your skin to monitor your blood sugars. You then can use either the glucometer that is specific for the Libre sensor for scanning or you can use your iPhone and their app. They are still working on an app for Android users. You have to scan a minimum of once every 8 hours so that the sensor uploads all the data by bluetooth to the app or the Libre glucometer. If you don’t, you will lose that data. I would say most users are scanning the sensor as often as if they were poking their fingers in 24 hrs. You have to change the sensor every 14 days. Now that you know what the sensor is all about, I’ll offer my thoughts.

The good of continuous glucose monitors

Some of the pros of using continuous glucose monitors, like the freestyle libre, include:

No more finger pokes!

Scanning now replaces that. Mind you, if you are unsure the reading is correct, you should double check by finger poking especially if you’re on insulin. There is a 15-minute delay from the blood poke reading to the interstitial scan reading. There is some expected difference in the readings but they are usually close.

No more finger pokes in the middle of the night!

It’s replaced by a scan. Saves a lot of time and sleep.

Easy to apply, even by yourself

I found if I did it the way the manufacturer suggested with my arm bent across my chest, the adhesive pulled at my skin. If I apply it with my arm at my side, I don’t notice any pulling. I don’t even notice I’m wearing it.

Better self-management

I can see what my sugars are in real time and, boy, does that change behavior.

I can use my iPhone to scan

I chose not to carry my other glucose monitor as a double check after the first month because the readings were very close to each other.

No one notices I’m checking my blood sugars

that’s how quick it works.

I can set a reminder

I set a reminder to let me know it’s been 8 hours since my last scan so I don’t lose the data.

I bought stickers to dress up my sensor

I’m a kid at heart. Mine has a happy face on it. It’s a great conversation starter.

No more bothersome letters from the insurance company

I don't get letters from my insurance company warning me I had reached my yearly limit on test strips.

So as a user, that’s my thoughts on the pros of using a continuous glucose monitor.

The bad (or not so good) of continuous glucose monitors

Some of the not-so-good parts of using continuous glucose monitors, like the freestyle libre, include:

Finding the right spot to attach it

The only place it has been approved for use is on the back of the arm. I put my first sensor on my non-dominant arm thinking that would be best but I sleep on that arm. Those two weeks were a bit challenging. My next two weeks were better with the sensor on the other arm.

Many insurance/drug plans do not cover these newer devices

I can afford to pay for them but I have two really good insurance plans and neither will pay for the sensors because I’m not on insulin.

I can’t get the sensor off easily when it expires at 14 days

I had to buy another product called "Remove" to help get it off.

Warning: things get caught on them!

Things like bra straps or hitting doorways during a clumsy moment can rip the sensor off.

You need a prescription to get one in some countries such as Britain and the USA

Some drug plans require a prescription to have them covered. In Canada, I can buy it over the counter. I would need a prescription if I were on insulin to get it covered. And they don’t cross countries. What works in the USA won’t work in Canada, etc.

Some tests cannot be done with the sensor on

It interferes with the results of MRIs and CTs. The devices have not been tested with professional TENS units.

The ugly of continuous glucose monitors

Some of cons of using continuous glucose monitors, like the freestyle libre, include:

They’re not cheap

In Canada, they range from $89-$140 each every 2 weeks with no drug plan coverage. That’s not affordable long term.

Not covered unless you’re on insulin

Continuous glucose monitors are not covered by most insurance plans but what surprises me is that they haven’t figured out that it’s less expensive than strips and lancing devices. I wonder if it’s because of the recent recommendations for diabetics who are not on insulin to test less?

Many people are developing severe rashes and allergies

Some people are developing allergies and rashes to the medical adhesive used to stick it to your arm. There are Facebook support groups for this. Folks are finding ways to jimmy-rig them so they can still use one. Abbott, in the UK, is working on changing the glue used. They need to work on this quickly. Dexcom is having the same issue.

Dead sensors out of the box

My very first sensor: I got it on, no issue; it was however, dead, it wouldn’t activate. Then I couldn’t get it off. I went to work. Asked a friend (G) to come to the washroom to help me get it off. No luck. Another colleague (A) walked in to use the washroom, glance, ignored, did her business, then asked what we were doing. We all broke into laughter. (A) has long beautiful nails. It took forever to get it off but she got it. After that fiasco I called the manufacturer, they replaced it.

Many people are having trouble getting them to stick

I cannot understand that. I have trouble getting them off at 14 days when they’re expired! No answer to that one.

Technology issues

And last, but not least, when during a routine maintenance update, the app and all things associated with it, crash. Well, that’s tech for you.

I hope the ugly doesn’t happen to me. Other than a few speed bumps, I am very happy with it.