Contributors: Yeunju Kim and Erica Wong, PharmD Candidates Class of 2023, PCOM Georgia School of Pharmacy
Sometimes when life deals you lemons, you don’t always get lemonade! Managing your glucose levels is not always the type of daily activity that is easy to do. Bob is a 50 year old male with a past medical history of type 2 diabetes with presence of diabetes related neuropathy along with several other pain related conditions. Bob’s current medication regimen includes both basal bolus insulin regimen, as well as long-term use with opioid-pain medication and steroid injections for the treatment of pain. The increasing stress levels has contributed to a hemoglobin A1c slightly above 9% and average daily glucose ranges from 270 mg/dL to 295 mg/dL, despite his insulin therapy.
For persons with type 2 diabetes and comorbidities that can significantly increase glucose and/or create wide variations in daily glucose levels, find themselves to be at a higher risk of diabetes-induced complications. In such persons, a continuous glucose monitoring system (CGM) is strongly preferred. CGMs, including recently FDA approved Freestyle libre 3, is typically recommended for those who have uncontrolled glucose levels, higher risk for hypoglycemia, variable deviations between discordant A1c, finger-stick readings, or suspected medication non-adherence.1
Abbott’s Tiny Freestyle Libre 3 Cleared in EU. Medgadget. Mar 2020. (https://www.medgadget.com/2020/10/abbotts-tiny-freestyle-libre-3-cleared-in-europe.html)
The Freestyle Libre 3 CGM style, unlike Freestyle Libre 2, is designed to track real time glucose level automatically every minute instead of having to scan every 8 hours. Another benefit of Freestyle Libre 3 compared to other CGMs is that it is the smallest, thinnest, and most accurate 14-day continuous glucose monitoring system currently available in the market. For persons like Bob who require close monitoring of glucose to manage their type 2 diabetes, a commitment to scanning the sensor will not be an issue since Freestyle Libre 3 automatically tracks real time glucose level and shows trends using collected data.
Comparison between Dexcom G6 vs FreeStyle Libre 2 & 3 2,3,4,5
Side note: Dexcom G7 is expected to be FDA approved in 2022.
References:
- Add continuous glucose monitoring to your practice: a step-by-step guide. Aafp.org. Published March 15, 2021. Accessed June 13, 2022. https://www.aafp.org/pubs/fpm/blogs/inpractice/entry/cgm_guide.html
- FreeStyle Libre 3 System. Freestyle.abbott. Accessed June 13, 2022. https://www.freestyle.abbott/us-en/products/freestyle-libre-3.html
- FreeStyle Libre 2 System. Freestyle.abbott. Accessed June 13, 2022. https://www.freestyle.abbott/us-en/products/freestyle-libre-2.html
- Dexcom. Dexcom. Accessed June 13, 2022. https://www.dexcom.com/
- Abbott’s FreeStyle® libre 3 system receives CE Mark – features world’s smallest, thinnest sensor with best-in-class performance at the same low cost for people with diabetes. Abbott MediaRoom. Accessed June 13, 2022. https://abbott.mediaroom.com/2020-09-28-Abbotts-FreeStyle-R-Libre-3-System-Receives-CE-Mark-Features-Worlds-Smallest-Thinnest-Sensor-with-Best-in-Class-Performance-at-the-Same-Low-Cost-for-People-with-Diabetes