Everything you need to know about the Freestyle Libre 2* . The 2nd generation Libre sensors now are a step closer to a full CGM by providing alarms in a new experience while in the exact same package and price ! Continue reading for a full comprehensive review on all the new features and differences from the first generation libre. If you prefer watching a video review you can also check out my YouTube video on Freestyle Libre 2 by clicking here or at the end of this article !
// *freestyle libre 2 currently only available in Germany
I had the opportunity to purchase and try the 2nd generation Freestyle Libre 2 system and wanted to share here everything I learned through my experience and research on this flash glucose monitoring device.
Just in case you are not familiar with original Freestyle Libre Device you can quickly check more information on Libre 1 from Abbott >> here <<
The new freestyle libre 2 takes us one step closer to a CGM (continuous glucose monitor) by introducing alarms and a 'low energy' bluetooth connection on top of existing NFC; between the sensor and the Libre 2 Reader.
The new sensors have been introduced in Germany in November last year but were until recently only available on prescription. Starting February 2019 you can also purchase them through their website if you have a German delivery address.
It is expected that the FreeStyle Libre 2 system will be next available throughout Europe followed by other countries in the future; however there are no release dates for either as of yet from Abbott.
The price of the new system, inclusive of the additional features; at its release in Germany remained the same and it should remain the same as the original FreeStyle Libre for following countries. ( eg. UK cost is is currently ~ 48£ for 1st gen libre sensors)
If you want to learn how to transform your FreeStyle Libre 1 sensors into a full CGM with alarms on your phone see my blogpost on >>> LIBRE AS CGM <<< .
Unboxing of the sensor quickly reveals the all too familiar two piece applicator and exactly the same instructions as you found in previous versions of the sensor. The process as well as the sensor are 100% the same except the added bluetooth in the internal part of the sensor which you won't be able to see.
The Libre sensor lifetime is the same 14-days as the previous sensors in Europe.
According to Abbott the new sensors should have better accuracy particularly when comparing the first days of use; my understanding was that this change is based on the use of a new algorithm based on new clinical studies and if my understanding is correct )the difference in the way the sensors are individually calibrated in factory unlike their predecessors which were calibrated in batches.
In my personal experience over the last 2 weeks I found the sensor to be very accurate in normal range and generally keeping up very well with high and low blood sugars also. The only major differences to fingersticks I found were while sugars where changing rapidly as its to be expected. Although not a fair comparison (by my experience of two weeks on Libre 2 versus three years on Libre 1 ) I found this particular sensor to be significantly more accurate than the first generation libre but I cannot say for sure if this will be true on a consistent basis.
For more information and the full report from Abbott on accuracy as well as comparisons to Medtronic Enlite and Dexcom see >> https://freestyle.de/fileadmin/epaper/AccuracyFreeStyleLibre/index.html#14
The new sensors at the time of this review do not work with the LibreLink App* and in order to use them you will need to also purchase the Freestyle Libre 2 Reader.
* UPDATE >> the Libre 2 sensors now also work with Libre Link App.
The reader looks exactly the same as the first generation one; except for a dark blue tint and Abbott's logo and branding . The reader can be set up in 4 different languages: German, Dutch, French and English and it can display glucose values in either mmol/L or mg/dL.
You will need to keep this device with you at all times in order to get the alarms from the sensor .The actual range of the signal transmission is approximately 6 meters assuming there are no physical obstacles (eg.walls) in the way. Personally I actually only experienced these alarms while the reader was in my pocket so I am not sure what that is but they only happened a couple of times.
The bluetooth capability also comes with a bit of a price on the battery life of the reader. In my experience the battery lasted around three days with an average of 24 scans per day and both sound and vibrate alarms turned on. This could probably be improved by being more careful about turning off the meter (this will not disable the alarms just saves some extra battery ) and less excessive scanning ...
The reader stores the glucose data for up to 90 days and it can be collected the same way as before via a computer with Libre View.
Also same as the previous version it can be used for traditional fingerstick blood glucose and ketone monitoring using freestyle blood and beta-ketone sticks.
Alarms are off by default and can be turned on by accessing the new Alarms tab in the Settings menu.
There are three alarm types for; high glucose, low glucose and signal loss. You can choose to activate only the low or the high alarm but the signal loss will be activated automatically when you have either of the other two on.
The low glucose alert can be set between 3.3 - 5.6 mmol / L >> (60 mg / dL - 100 mg / dL).
The high glucose alert can be set between 6.7 - 22.2 mmol / L >> (120 mg / dL - 400 mg/ dL).
The alarms are repeated every 5 minutes and will not stop until checked or if the glucose values go back in range. The signal loss alert will only stop once you scan the sensor.
The alarm will go off when your sugars go out of your set range but after you stop it by scanning your sensor it will not alarm you again until your sugars go back into range first and than out again.
So for example if your high alert is set for 12.5 mmol/L and you scan to check your alarm , it will only go off again if your sugars drop under 12.5 mmol/L and than go back up again. I find this particularly problematic as say; if to continue with the example ..it's late and and you try to correct a 15 mmol/L and than go to sleep hoping it will come down but if it doesn't work even if your sugars go up to 22 you will not get an alarm unless they first drop under 12.5 mmol/L or whatever your high alarm is set to. Same goes for low alarms .
The only way somewhat around this is to constantly change your alarm value settings based on what you expect your sugars to do ... which is unrealistic in day to day use. I find this to be one of the biggest flaws in the system.
The alarm sound is the same for all three alarms and it cannot be changed but vibration is optional.
Also a big issue for me is that in order to have the alarms sounds you need to have all sounds activated which means anytime you scan you will hear a beep . The volume intensity is also linked to the same setting. If you have sounds off you will still get alarms but they will only vibrate. You also cannot choose to have for example the high alarm on vibrate only and the low with sounds as I would personally prefer to have during the day.
keeping the same price for the upgrade
same size and format we are already familiar with
not working with LibreLink App
reliance on the Libre Reader (extra device to carry,charge,keep in range etc)
lack of personalisation of alarms sounds and snooze times
loss of data if not scanned every 8 hours
inability to share/follow
no compatibility with existing 3rd party devices (MiaoMiao,Blucon, GSentry, BlueReader) or directly with apps ( Xdrip, Spike, Glimp)
Overall the FreeStyle Libre 2 system is great and a very welcomed update from the previous version with the biggest drawbacks at the moment being availability and the lack of compatibility with LibreLinkApp both of which are expected to be solved by Abbott in the near future.
Also don't forget to check out my YouTube video on Freestyle Libre 2 !
Further information references:
DISCLAIMER: I am not a medical professional; all the information on this website is based on my personal experience from living with t1d. Always contact a medical professional when making treatment decisions.