Abbott′s FreeStyle Libre system changes how people with diabetes measure their glucose levels and ultimately achieves better health and wellbeing. Since April 2018, the Freestyle Libre is available to children and young people aged 4-21years, based on clinical need. The unfortunate upper age limit means that many adults, who might benefit from the system, cannot get access to it despite their diabetes team believing it would support tightening control and prevent future diabetes complications.
Dr Ronan Canavan has made many applications over the last year with very limited success. Earlier this year he made an application for 22 year old William D’Arcy which was refused and then again refused on appeal. Dr. Canavan stated, “We have this young person who based on my clinical judgement needs a Freestyle Libre as his current level of control is very worrying. He has a strong real fear of having low glucose levels that inhibit his ability to manage his diabetes. I recommend that he test his blood glucose level at least 10 times a day but he cannot commit due to the finger pricking required. The Freestyle Libre would relieve him of that”.
Dr. Anna Clarke of Diabetes Ireland states “There are many cases like this one – the diabetes team believe the Freestyle Libre would benefit a person’s diabetes management but the age barrier means they can’t get it”. She also continued “the HSE state they are committed to reviewing who can access this technology but in April 2018, they stated a year and here we are 15 months later with no review”.
William D’Arcy, the young person with Type 1 diabetes states “if I was a year younger, I could get the system but because I am over 21 years, my application is denied. I can’t believe we are the only country who has an age barrier. I want to work with Dr Canavan’s team to protect my health and manage my diabetes better but I can’t commit to pricking my finger 10 times every day. I believe the Freestyle Libre would give me better quality of life immediately and help me protect my health and wellbeing going forward”.
Diabetes control is measured by a HbA1c blood test which reflects average blood glucose over the preceding 3 months and should be in the 50’s for best health outcomes in the long term. A raised HbA1c level reflects poor or bad diabetes control and increases the risk of health problems such as heart attack, stroke, blindness or amputation. Dr Canavan is concerned for Williams’s future health and states “this young man’s continued current HbA1c levels means he is more likely to progress to advanced complications with 5 years which will prove much more costly to the State”.
Diabetes Ireland is seeking the HSE Health Technology Review of the Libre Freestyle system that was promised for April 2019 to be undertaken promptly with due recognition on quality of life improvement for the individual, improved health outcomes and not just based it on cost savings resulting from the reduction in blood glucose strip usage. The future health of our people with Type 1 diabetes must be the priority as this will improve their quality of life and limit future health expenditure.