Call for diabetes device to be extended to all

Reduces costs and improves quality of life
  • Deborah Condon

People with type 1 diabetes are calling on the Minister for Health to extend the availability of an innovative device that has been shown to greatly improve the lives of those affected.

The FreeStyle Libre consists of a small round sensor - about the size of a two euro coin - which is worn on the back of the upper arm for up to 14 days. A handheld reader is scanned over the sensor to upload glucose results. This takes less than one second and there is no need to draw blood. As a result, it does away with the need for finger pricking.

The device has been described as a 'game changer' by many, however, the cost can be prohibitive. The starter kit costs €169.90, which includes two 14-day sensors to cover the first month. After that, each 14-day sensor costs €59.90, so almost €120 per month.

There are around 20,000 people with type 1 diabetes in Ireland, including around 2,750 children under the age of 16. Originally, anyone wishing to use the device had to pay privately for it.

In January 2018, the HSE announced that it would be reimbursing the device for children and teenagers, but with some restrictions. Adults would not be reimbursed at all.

This announcement was met with anger by the type 1 diabetes community as these restrictions meant that thousands of people were being denied free access to this technology.

According to Diabetes Ireland, the national diabetes charity, Ireland is currently the only country in the world to put an age restriction on free access to the device.

Following the outcry from the diabetes community last year, the HSE said it would review the cost effectiveness of extending the device to everyone who needs it, but would defer this decision for a year. It said there was a need for further Irish-based data in relation to the device's clinical effectiveness and quality of life.

In response to this, Diabetes Ireland undertook further research on these issues and it has now submitted a report to the Minister for Health, Simon Harris, and the HSE review team.

It undertook an online survey of over 300 users of the Freestyle Libre. Around half of these were funded by the HSE, i.e. they were under 21, while the other half were over 21 and paid privately for the device. The results reflect the views of over 10% of Current freestyle Libre users in Ireland.

The survey found that usage levels were almost as high among those who had to pay privately, which reflects the desire of people of all ages to use this innovative technology.

It also found that 86% of respondents scanned more than eight times every day, with 29% of these scanning more than 17 times daily. This is key because the HSE has proposed that scanning more than eight times every day would be more cost effective than current blood glucose strip costs.

Blood glucose test strips are small disposable strips of plastic, which have a key role to play in diabetes control. A drop of blood is placed on the strip, which is then placed inside a blood glucose meter to test your blood glucose levels. These strips are reimbursed.

The survey found that there was an average reduction of 66% in the use of blood glucose strips, with 48% of respondents reducing their usage by 75%.

Meanwhile, apart from the cost savings, respondents were also asked if the Freestyle Libre had benefitted their daily life. The report on the survey found four main recurring themes in relation to the device:
-It makes life easier
-It improves diabetes control
-It empowers individuals to be more proactive and confident in their diabetes management
-Privacy - this related to the fact that many people with diabetes do not like testing blood glucose levels in public places using the traditional method of finger pricking.

One respondent, Susan Elliott in Galway, said that her diabetes control had 'improved dramatically' after using the device.

"The trends are so useful. I know what different foods do to me. I know what happens while I am sleeping. It is invaluable. I have dreamed of such a device for years. It's the best thing ever and I am lost without it," she commented.

According to Diabetes Ireland's health promotion and research manager, Dr Anna Clarke, this survey clearly shows the many benefits associated with the Freestyle Libre.

"Without doubt, this survey proved that using the Freestyle Libre results in increased frequency of checking glucose levels. Respondents reported decreases in acute high and low blood glucose levels, improvements in proactive diabetes management, and results in improved glucose control and other side-effects of fluctuating glucose levels, such as eyesight disturbances.

"Using the device also results in less sore fingers and greater security at night time, resulting in peace of mind and less anxiety," she noted.

Diabetes Ireland is calling for the extension of the device to all people with type 1 diabetes, based on quality of life improvements and cost savings.

"Libre may be the French for free, but for people with type 1 diabetes, Freestyle Libre means freedom from finger pricking, improved glycaemic control, removal of much of the anxiety about hypoglycaemia events and control over their life with diabetes. That is worth having," Dr Clarke added.

The survey report, Users Experiences of Flash Glucose Monitoring on Daily Life Experiences, can be viewed here. For more information on Diabetes Ireland, click here.


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