Hello.
Please speak to your internist about the reason why they want to use the Libre so as to understand it better. It isn’t just another means of getting some numbers that are able to be obtained using a glucometer. If it is a cost issue right now, then maybe revisit it, but if you are able to do it, I would highly recommend doing it. I am going to explain the differences, reasons for using a CGM in addition to BG testing and if you want or need any additional info, including graph data, video explanations etc please let me know & I’m happy to share it.
I actually did BG testing for over a year (and still do) and then used the Libre recently to get the information that I was never going to get with BG testing alone. If I could go back in time, I would have used it sooner vs later. The reality is that I just didn’t fully understand its utility and then I allowed the fear of the unknown & how stressful it might be to get the best of me and delayed using it. I actually finally listened to 2 of the leading feline diabetes experts in the US and tried it. I wanted to use the device that would allow me to get and see information that I did not have and simply would never have without it. There are actually even cats that these top feline diabetes specialists thought they had regulated well as per BG curves, but then found out that they weren’t so regulated once they utilized the Libre. Sometimes, you get lucky and it turns out that they are regulated well, but it still is a game changer to be able to actually see and know what is happening vs worrying or guessing. Otherwise, also helpful with dosing-seeing what happens with dosing for a nice blueprint.
Blood glucose is incredibly dynamic vs static meaning it fluctuates quite a bit. The speed of the changes make it difficult at times, actually even impossible at times, to know what came before or after some BG checks and what the speed of the change was. With BG checks, you will read about the importance of data (i.e. get +1 or +2 or +11) & they are absolutely right that you need more data to eventually see the trends more clearly and make the best dosing decisions. The fact is, with BG checks alone you are simply limited with the amount of data you are able to get with a glucometer vs a CGM. Let’s say you get more BG tests.....one an hour for 24 hours. You’ve got 24
static BG checks (and loss of sleep
) that will certainly put some pieces of the puzzle together for you, but a great deal of your puzzle will still be missing. The Libre will collect a measurement every minute, record the data every 15 minutes and you get the actual dynamic trends happening.
So, 24 static BG checks and static info, loss of sleep, probably some anxiety OR 1440 checks which give you the more complete picture AND dynamic vs static trends that are happening.
People try to guess “did they bounce?” “Was it the food” “did they drop overnight”........all questions more easily answered utilizing the Libre. My ability to adjust and try dosing options became child’s play compared to using BG testing alone to do it & I was able to do it very safely not having to stall on a dose change because I actually knew what was going on.
I also want to try to put to rest that the manufacturer has reps talking to vets and that’s the reason why vets are using them more and more every day—-especially when it comes to the internal medicine vets/specialists. The leading experts in feline diabetes who are continuing to work tirelessly to advance research, diagnosis, treatment & management of diabetes are the ones who are influencing the internists and vets to utilize the Libre because of the simple reality of what they have studied and seen now over years and years of utilizing a CGM and seeing and showing how it is able to be helpful, even a game changer, when managing feline & canine diabetes. They are the ones lecturing, publishing papers and book chapters and recommending the use of the CGM.....and this is the reason why it is being recommended and will continue to be recommended to clients...not because Lilly has deployed a group of reps to the vet offices. I actually wish they could go to vet offices and share the info & data from the leading academic universities vet hospitals because it would help a lot of cats and dogs and the pet parents
.
As far as keeping the Libre on goes....one of the feline DM experts who was part of validating its use in cats & has literally applied it to 100s & 100s of cats over years now, applies it to the side of the neck below the ear and then uses the Kitty Kollar to provide some additional protection. Applying the sensor on the back of the cat is more of an issue when it comes to the cat messing with it. Some cats won’t mess with it, but it was less successful as far as keeping it on. The other key is to use less Vetbond glue, as they have discovered it can be more of an irritant as days go on vs the actual CGM adhesive causing the problem. The one other key thing to keep in mind is it does not have to stay on the entire 14 days. With 1440 readings per day, if you get a week or even 5 days—you have a lot of helpful info pertaining to what is happening from a dynamic sense and with respect to speed and direction of highs and lows after onset, meals, nadir, overnight etc., What is the consistency..or lack of consistency, transient highs or lows & speed they happen? You will now not only have a +1 through +12 am/pm cycles but the +1 and every minute in between to that +2 and so on. Bonus—while you sleep, no data lost or brought into question. Simply scan the sensor within 8 hours and you see what happened while you were catching some much needed sleep
!
Do not get rid of the glucometer because if you see a low, you will check the BG. There will continue to be a place for the glucometer even while using the CGM
. However, in the next few years, as the CGMs become much smaller and cheaper, the potential to use them more regularly for pets vs for just a few weeks or month will become more of a reality.
Sorry for the crazy lengthy post! Again, please contact me if you have any questions or want more info now or in the future Re: application, best practices (including getting it OFF
)
. Sometimes we take one step/one thing at a time and the added device right now in this moment may feel overwhelming, but try to keep it in mind for later if you decide to pass on it now. Best
. I had to sort through Addisons, GI & chronic pancreatitis, rule outs of heart and kidney issues & the addition of med changes with the diabetes with my T last Fall & it was a lot 
! I will be thinking about you both & hoping that you get the info you need with the planned testing.