An APPE student’s experience with continuous glucose monitoring

Elizabeth Clapper is a final-year PharmD candidate at the Northeast Ohio Medical University College of Pharmacy.

As part of my recent APPE rotation, I got the chance to wear the Freestyle Libre 2 continuous glucose monitor to better understand our patient’s experiences. I asked for the opportunity after hearing patients talk about what they liked about it, how it fell off too soon, and how they commonly asked “does it hurt?” Since I was asked by patients so many times if it hurt, I wanted to be able to provide a more personal answer.

Feeling the concerns of a patient

The Freestyle Libre 2 is a small round disk that a patient applies to the back of their arm for 2 weeks at a time to monitor blood glucose without frequent finger sticks. The sensor must be scanned by a cell phone app or a Freestyle Reader every 8 hours. Although a small needle is used to apply the device, no needle remains in the patient, only a small filament. Each sensor has an adhesive backing that allows it to stay on the patient’s arm.

Honestly, I was slightly nervous about applying the sensor, since this was the first time that I ever poked myself with a needle. Upon applying the sensor to my arm, I felt a small pinch that shortly subsided. If I were asked, I would compare this process to getting my annual flu vaccine, and I felt no discomfort the next day.

Another concern I wanted to better understand was if the sensor would remain on my arm for the promised 14 days. I picked a great time to examine this question, as it was July with temperatures in the 90s. While my sensor stayed on my arm the entire 2 weeks, I did have a few close calls when I was nervous that I knocked it off.

Now I understand better

One important counseling point for the Freestyle Libre 2 is that when it’s scanned, the sensor only reads data from the most recent 8 hours. Due to this obstacle, a patient must continuously scan their sensor throughout the day to properly store the blood glucose data. If a patient does not scan every 8 hours (or more frequently), there may be some gaps in their data.

I did great the first week, which I would attribute to my excitement to learn and understand the experience of the sensor. However, one day I decided to sleep in a little, which led me to have a small 1-hour gap in my blood glucose data. This showed me that even if a patient has good intentions when it comes to their health, some things are not always so practical. To combat this barrier and help patients remember, we counseled patients to scan every morning when awakening, with each meal, and prior to bedtime.

Getting the opportunity to wear the Freestyle Libre 2 gave me a small look at what some of our patients experience every day. I am grateful for the opportunity to empathize with my patients and highly recommend other students explore similar areas to better understand and care for our patients.