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November 19, 2020
Freestyle Libre vs Freestyle Libre 2 CGM
What's the difference between the FreeStyle Libre 14-Day and the new FreeStyle Libre 2 from Abbott? We'll provide all the differences so you'll know which Continuous Glucose Monitor is right for you.
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“Should I switch to the new FreeStyle Libre 2 CGM System?” Many Freestyle Libre users have asked themselves this question since the release of the FreeStyle Libre 2 earlier this year. Here at US MED, we have been asked all kinds of questions like “What’s the difference?”, “Is it worth it to switch?”, and “Does it warn you of highs and lows like the Dexcom G6?” These are all great questions and to help keep you informed, we’re going to compare and contrast the differences between the Freestyle Libre 14-day system and the FreeStyle Libre 2 system.
Before going any further, we highly recommend that you consult with your physician to determine the best CGM for your specific needs. If you are new to CGMs, check out our article that explains the different types of continuous glucose monitors that are on the market.
FreeStyle Libre CGM Systems – How They Work
The FreeStyle CGM systems are made up of a reader and a sensor. The small sensor is placed on the back of your upper arm, which measures the glucose levels within the interstitial fluid located just underneath your skin. To check your glucose levels, you simply scan your sensor using the Freestyle Libre reader or your smartphone*. Glucose levels are continuously monitored without the need for constant fingersticks. It is important to note that there may be times where fingersticks will be required for treatment decisions. Such times include when you see the “Check Blood Glucose” symbol on your reader, when symptoms do not match system readings, when you suspect readings may be inaccurate, or when you experience symptoms that may be due to high or low blood glucose.
FreeStyle Libre and Libre 2 Similarities
The FreeStyle Libre 2 has many similarities to the FreeStyle Libre 14-Day System. Here’s a list of all the features that both continuous glucose monitoring systems have in common:
- No Fingersticks needed for calibration.
- Measure your glucose every minute, 1,440 readings per day. This is the highest number of daily readings in any CGM currently on the market. That’s five times more glucose readings than competitor brands.
- Thin Small Sensors. Each one is about the size of 2 stacked US quarters. They are the thinnest sensors when compared to competitor brands. Low profile prevents the sensors from interfering with your normal activities.
- Sensors last up to 14 days. Replace sensors less often.
- Sensors maintain a high level of accuracy over 14 days.
- Sensors typically placed on the back of the upper arm.
- Water resistant Sensors which can be worn while swimming, showering, or exercising. (US MED highly recommends using CGM adhesives to ensure sensors don’t fall off).
- Trend arrows show glucose changes, which can be used to prevent going into hypo or hyperglycemia.
- FreeStyle LibreLink App allows you to track and monitor your glucose levels from your cell phone.*
- Built-in glucose finger testing meter to check your CGM reading.
FreeStyle Libre 14-Day and Libre 2 Differences
First, the Freestyle Libre 2 is an integrated Continuous Glucose Monitor (iCGM). The FDA classifies an iCGM as a CGM that can be used as part of an integrated system with other compatible medical devices, software, and electronic interfaces. Examples include automated insulin dosing systems, insulin pumps, blood glucose meters or other electronic devices used for diabetes management. It’s important to note that Abbott states “this system must not be used with an automated insulin dosing system, such as a closed-loop insulin delivery system, and insulin suspend systems.” You’re probably asking yourself, “What does all of this mean?” It means that for now, the Freestyle Libre 2 can integrate with software and other medical electronic interfaces but cannot control delivery of insulin through an insulin pump.
The FreeStyle Libre 2 has a customizable audio alarm which alerts you within a minute if you are too high or too low without having to scan. This feature brings the Freestyle Libre 2 on a level playing field with the Dexcom G6. This alarm is optional, giving you the freedom to turn it on or off. The FreeStyle Libre does not have any alarms and requires you to check your reader to see if you’re approaching hypoglycemia or hyperglycemia.
The FreeStyle Libre 2 system has a combined mean absolute relative difference (MARD) of 9.3% (9.2% for adults and 9.7% for pediatrics), making it the only iCGM sensor sustaining a high level of accuracy over 14 days. For those that are not familiar with MARD, it is a commonly used measurement of performance for continuous glucose monitoring devices. According to the American Diabetes Association, “the mean absolute relative difference (MARD) is currently the most common metric used to assess the performance of CGM systems. MARD is the average of the absolute error between all CGM values and matched reference values. A small percentage indicates that the CGM readings are close to the reference glucose value, whereas a larger MARD percentage indicates greater discrepancies between the CGM and reference glucose values.”
The FreeStyle Libre 14-Day system can only be used by adults 18 years old or older while the FreeStyle Libre 2 has been approved for children ages 4 and up, as well as adults. The FreeStyle Libre 2 also has one-third fewer false alarms in children when compared to competitor CGM brands**.
So Is It Worth It?
All things considered, the FreeStyle Libre 2 has all of the features of the FreeStyle Libre with the added benefits of an alarm to alert you of highs and lows, along with the expanded use by children ages 4 and older. US MED cannot provide medical treatment advice and cannot tell you which device is best for you. However, we have provided enough information for you and your physician to make an informed decision. Consider the features of each CGM system and decide which ones are most important for your healthcare needs. Before making the decision to switch, be sure to check with your insurance provider to see if they will cover the cost of the FreeStyle Libre 2.
Another thing to consider during your decision is that the FreeStyle Libre 3 was recently approved for use in Europe. The FreeStyle Libre 3 has all of the same great features as the FreeStyle Libre 2 and boasts the smallest, thinnest, and most discreet sensors available. The FreeStyle Libre 3 sensor is roughly the size of 2 stacked US pennies. An official release date has not been announced yet, but speculation within the industry are expecting a US launch sometime in mid-to-late 2021. If you are not in a rush to upgrade your continuous glucose monitor, it may be wise to wait for the FreeStyle Libre 3 to be released in the US.
Important safety precautions for both FreeStyle Libre Systems:
- Do not take high doses of vitamin C (more than 500 mg per day), as this may falsely raise your FreeStyle Libre and Libre 2 sensor readings.
- FreeStyle Libre 14-Day sensor readings may be altered when taking high levels of aspirin
*The FreeStyle LibreLink app is only compatible with certain mobile devices and operating systems. Please check their compatibility guide for more information about device compatibility before using the app. Use of the FreeStyle LibreLink app requires registration with LibreView, a service provided by Abbott and Newyu, Inc.
**Among patient-applied, on-body sensors. Date on file, Abbott Diabetes Care.