Par Marine Dumeny
Published on 28 Jul 22 at 18:12
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- A glucose sensor on a diabetic patient. (©Marine Dumény / Lorraine Actu)
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The story begins in Australia, but here it is in France for a few weeks and now in Nancy : influencers have praised the use of glucose sensors (medical device used by diabetics) to… lose weight.
Lorraine News contacted witnesses to this misuse, including a diabetic person, the University Hospital of Nancy, the Order of Pharmacists and the leading company in the market for these sensors to explain to you what is going on in this controversy…
Seen in box
Samir and Sasha (first names changed) are in a nursing training institute (IFSI). They are 22 and 23 years old, and are familiar with the blood glucose sensors (readers) used by people with diabetes. Indeed, Imane, one of their friends, has been wearing one since 2018.
The three of them were, on a Thursday evening, in a posh club in Nancy where a few well-known heads from the Nancy Tiktok-sphere were also present.
They were in a corner of the establishment, in a group, all very connected to “well-being” or sports on the networks. We already knew about the phenomenon via TikTok and a debunking done by coco_and_podie, a diabetic Instagrammer who popularizes the disease. Imane quickly understood that despite the sensor, round and white so easily visible in a box on a bare arm, the people present were not diabetics. The problem for us is not a few people who abuse it… It’s that our friend, on a daily basis, really suffers! It’s not a fashion accessory!
Same story with her friends, who both recall that patients with diabetes do not wear this device for pleasure.
Imane, suffering from type 1 diabetes, is insulin-dependent: “Without this medical device, my life would be much more complex. Injecting yourself in public, thinking about it regularly enough to compensate for excessive variations in blood sugar and having this constant pressure to risk discomfort or a coma… People don’t realize it.
Useless, even dangerous
Think controlling your blood sugar can help you lose weight?
Bruno Guerci, head of endocrinology, diabetes and nutrition, explains why this is not possible:
First of all, a healthy person has no blood sugar spikes, except outside of mealtimes but within acceptable limits, and especially no hypoglycemia. Only people with diabetes (or suffering from another pathology affecting blood sugar, or a treatment lowering the level of circulating glucose) are subject to it. In addition, whether you gain or lose 3 kg, the blood sugar level remains extremely stable.
” Steady “. That is to say that the normal value of blood sugar in a fasting person is between 0.7 and 1.1 g/l (of blood). It can rise to 1.8g/l during the day (with meals) without this being a problem.
Learn more about blood sugar
We begin to suspect diabetes if the fasting blood sugar is higher than 1.26g/l. Hyperglycemia – always fasting – can also be a sign of:
– damage to the pancreas, such as inflammation or cancer;
– hyperthyroidism (the thyroid gland in this case secretes too much thyroid hormone);
– or stress, caused by trauma, stroke or post surgery.
On the contrary, too low blood sugar, we then speak of hypoglycemia, can be a sign of:
– malnutrition;
– significant weight loss;
– excessive alcohol consumption;
– adrenal or pituitary insufficiency;
– hypothyroidism (the thyroid gland in this case secretes too little thyroid hormone).
Note that hypoglycaemia or hyperglycaemia can cause discomfort or even a coma.
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On sale by prescription, only in pharmacies
All of the Nancy pharmacies that agreed to answer our questions (i.e. six pharmacies) affirmed that the sale was not made without a prescription near them.
Several sensors are popular with people with diabetes (FreeStyle Libre (Abbott), Guardian (Medtronic) and Dexcom G6 (Dexcom)). The one at the center of the controversy, round, white, the size of a two-euro coin, is the FreeStyle 2marketed by Abbott.
The company answered our questions by email:
The glucose sensor is a medical device for people living with diabetes. It has been reimbursed by social security on specialist medical prescription since 2017 for people with diabetes treated with intensified insulin therapy. Abbott has been working closely with patient associations, diabetologists and health authorities since the sensor was brought to market.
Nevertheless, the “FreeStyle” – one of the most popular devices due to its 14-day lifespan – is in free sale on the website of the company that markets it.
Over-the-counter sale and use of medical devices
It is therefore easy to obtain it in this way, however, for 59.90 euros, plus delivery. Reseller sites on the net, including the giant Amazon, also offer glucose sensors, or readers, at higher prices.
For these two cases, no proof or prescription. This is over the counter, we also have simulated a purchase to make sure.
Another device exists, also over the counter, also involving the sensor developed by this brand: the “Supersapiens”. It is a “training program” developed for athletes.
The brand also confirms its commercialisation : “There is a version of the LibreSense sensor intended for high-level athletes for training. It is for sale on the site.
The influencers concerned by the controversy ensured (on the networks) for the most part to supply themselves with sensors via this last bias. Cost: from 150 euros monthly for two sensors to 700 euros for nine pieces, with -in addition- a “Supersapiens” smartphone application, and an explanatory booklet on blood sugar sent by email.
Possible prescription traffic?
In addition to the possibility of self-service, Lorraine News wondered about other possible ways to obtain the device at a lower cost.
Prescription traffic, identity theft, reuse of sensors or misappropriation of a loved one’s equipment…
Regarding prescription traffic, we are very vigilant, we deal with it regularly for drugs. Here, it is a medical device and the pharmacy is not the only source of supply. It is still necessary to alert and redouble our vigilance since this behavior [des influenceurs] could put patients in difficulty. We will work to strengthen our strategy to avoid this drift, as well as the use of the prescription of a relative. A few simple questions from the pharmacist are generally sufficient, as well as follow-up of diabetic patients or even a quick call to the prescriber.
As for the reuse of old sensors, “there is no “deposit” system, even if recycling is offered [ndlr : via le site d’Abbott ou en pharmacie] “explains Bruno Maleine, president of the Central Council of licensed pharmacists (a body of theorder of pharmacists).
What about the risk of out of stock?
Abbott responds on this point to Lorraine News “We don’t meet currently no stock issues for patients”.
As for pharmacies in Nancy, we do not have the same echoes. According to them, ” supply tensions, occur per period. They can actually temporarily penalize patients”.
Tensions confirmed by Bruno Maleine: “Since the marketing of the sensors, we are often in supply tension with Abbott. We even had a quota on the FreeStyle sensors”.
Between legislation around medical devices and interests
On the side of Abbott, the answer given concerning the over-the-counter sale is as follows: “The regulations of this device authorize the sale without a prescription to people with diabetes who are not eligible for the indications for reimbursement in pharmacies or on [notre] site. »
And, legally, we checked it on the ANM website (National Medicines Agency), that’s right.
Nevertheless, the phenomenon encouraged by influencers is worrying, because of its possible dissemination to a large audience:
If the phenomenon grows, we will have to consider discussions with Abbott. The status of medical device, in this case, implies that the sensors do not belong to the monopoly of pharmacists. We dispense with them, but we are not the only ones. However, within the Order of Pharmacists, we have various bodies and councils to represent our professions, including the industrial section. In this case, they are our relays to discuss the problem with the companies that manufacture the devices in question.
It is to be wondered if the misuse made of this device, which now stirs the public debate around medical devices, would not be likely to move the lines in terms of management and legislation.
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