The FreeStyle Libre is a continuous glucose monitoring (CGM) system that doesn’t require a blood sample from a finger stick. It’s manufactured by Abbott, a company that produces other diabetes-related products, nutritional beverages, and baby formula.
The Food and Drug Administration (FDA) approved the FreeStyle Libre in 2017 for adults only. Since then, newer versions of the monitor have been produced for adults and children with type 1 and type 2 diabetes.
When the FreeStyle Libre was approved by the FDA in 2017, it was considered the first-ever non-blood calibration CGM system. This means you don’t have to use a finger stick to provide a blood sample.
Instead, the monitor works via a small sensor placed just below the surface of your skin. You need to place the accompanying screen monitor above the system to get your glucose reading.
Each sensor lasts up to 14 days. After this time, you’ll need to replace it with a new one. You must continue to purchase new sensors, but you have to buy the monitoring system only once. The monitor itself runs on rechargeable batteries.
FreeStyle Libre pros
- no blood sample required
- doesn’t need a finger stick
- painless sensor application process
- convenient for travel, work, and other instances when you’re on the go
- track glucose trends on your smartphone via an app you download after purchasing the system (available with some models)
- more affordable than other glucose monitors
- waterproof sensor for short periods of swimming and bathing in a few feet of water
FreeStyle Libre cons
- may cause irritation at the sensor insertion site
- the original version doesn’t alert you if your blood glucose levels are off until you actively check them (alerts are a feature with the Libre 2 and 3)
- results may not be as accurate as a traditional blood calibration system
- the sensor doesn’t actually measure glucose in the blood but instead in the cellular fluids
- you must have a prescription for the monitor because it can’t be purchased over the counter at big-box stores
Here’s a breakdown of how to use the monitor.
1. Insert the sensor
To set up the FreeStyle Libre, you must first insert the sensor into your upper arm with an applicator that’s included with the set. The sensor itself is about the size of a coin and is applied just underneath the top layer of your skin. This process is said to be painless, but some users experience mild skin irritation.
2. Wave the monitor above the sensor
Instead of checking your glucose several times a day with a finger stick, you wave the monitor above the sensor in your skin to check your levels anytime you wish.
3. Set reminders for yourself
Since the FreeStyle Libre doesn’t have automatic alerts when your blood glucose is at dangerous levels, it’s important to set reminders to regularly check your monitor. You should check your levels at least every 8 hours.
4. Switch out the sensor
The original FreeStyle Libre allowed users to wear the sensor wire
Like traditional blood glucose monitors, the FreeStyle Libre gives you information about your sugar levels. It can indicate either hyperglycemia, where your glucose levels are too high, or hypoglycemia, where your levels are too low.
When used over time, the monitor can also help you see patterns in your blood sugar levels. For example, you may notice they’re stabilizing or trending upward or downward. Such information is crucial to share with your doctor to help determine your diabetes treatment plan.
Overall, users appreciate the functionality and ease of use of the FreeStyle Libre. But there have been reports of unusual fluctuations in glucose readings, especially during the last day of the sensor’s life.
Research behind the Freestyle Libre
Some promising studies point to the FreeStyle Libre’s connections to a reduced risk of diabetes complications.
For example, a 2020 study found a 52% decrease in hospital visits for ketoacidosis in people with type 1 diabetes and a 47% decrease in those with type 2 diabetes.
Despite its approval, the
- skin irritation from where the sensor wire is inserted
- potential for false readings
- possible spikes or falls in blood glucose that aren’t detected until you wave the monitor in front of the sensor
- the possibility of blood glucose issues during sleep, in which the system won’t alert you (unless you’re using the Libre 2 or 3)
Abbott Laboratories, the company that manufactures the FreeStyle Libre, is not accredited by the Better Business Bureau. Also, the BBB page for the company shows multiple active alerts. None of the alerts are related to the FreeStyle Libre device, though.
While the BBB page features only 36 customer reviews, recent ones note some potentially life threatening inaccuracy issues with the device. Multiple people complain of faulty and failed sensors and mention having trouble getting replacement ones.
Abbott also has a low rating on Trustpilot, an average of 1.4 out of 5 stars. Most reviews cite poor customer service.
The FreeStyle Libre provides freedom from taking frequent blood samples throughout the day via finger sticks.
You may find the FreeStyle Libre easier to use if you have to travel. This CGM is also waterproof for up to 30 minutes at a time. You don’t have to worry about the sensor getting destroyed after a quick swim, shower, or bath. Avoid submerging the sensor beyond a few feet of water.
Who may want to consider other options?
This blood glucose monitor may not be right for all users. Given that there are concerns with the accuracy, your doctor may recommend a traditional blood glucose monitor if your condition causes frequent glucose spikes or crashes.
You may also consider having a backup monitor with traditional blood testing in case you experience symptoms of hypoglycemia that the FreeStyle Libre isn’t showing.
Note that the FreeStyle Libre isn’t approved for people on dialysis or pregnant people.
Once you purchase the entire system, you need to purchase only replacement sensors. Each sensor lasts for 14 days.
You’ll need a doctor’s prescription to buy the FreeStyle Libre. With private insurance, the monitor costs between $10 and $75 a month. This would equal about two 14-day sensors.
The monitor is also covered by Medicare, though you may still experience out-of-pocket costs for your diabetes care.
Aside from ease of use, the FreeStyle Libre has a lower cost than other CGMs.
The FreeStyle Libre is sold at pharmacies and medical supply stores. It’s not available on e-commerce or at big-box stores without a prescription.
How it compares to other glucose monitors
(Video) Get to Know FreeStyle Libre 2
How it compares to other glucose monitors
| Monitor | Type | How often to replace sensors? |
|---|---|---|
| FreeStyle Libre | non-finger-stick CGM | 14 days |
| Dexcom G6 | non-finger-stick CGM | 10 days |
| Eversense | non-finger-stick CGM | 90 days |
| Guardian Connect System | non-finger-stick CGM | 7 days |
| Rite Aid TrueMetrix Meter | finger-stick glucose meter | N/A |
| Walgreens TrueMetrix Bluetooth Meter | finger-stick glucose meter | N/A |
Other technologies are also expected in the future, such as a laser technique known as Raman spectroscopy.
Depending on your diabetes treatment plan and health, your doctor may recommend a traditional blood-calibrating CGM that requires finger sticks.
How much does FreeStyle Libre cost?
Cost depends on whether you have insurance coverage. But the average list price for the device is about $70. Also, you have to pay for replacement sensors. According to Abbott, these can cost between $10 and $75 monthly, depending on your insurance coverage.
Do you have to be on insulin to use FreeStyle Libre?
Technically, you don’t need to be on insulin to use the Freestyle Libre. The device’s purpose, though, is to help monitor and regulate blood glucose levels in people who require insulin.
How often does the FreeStyle Libre take readings?
The device takes readings every minute.
The FreeStyle Libre is a blood glucose monitor that doesn’t require blood samples or finger sticks. The readings are based on a sensor on your arm continuously for up to 14 days at a time.
You can check your glucose levels any time, but you should do so at least every 8 hours. You can do this by waving the monitor in front of your sensor.
While the FreeStyle Libre is perhaps easier — and more affordable — than other types of glucose monitors, it may not be right for every person with diabetes. The system carries the risk of inaccurate readings and doesn’t automatically alert you if your glucose is at a dangerous level.
Talk with your doctor about the FreeStyle Libre and other options. They can help determine which system is right for you.
FAQs
How can I improve my FreeStyle Libre accuracy? ›
...
5 Actions that improve Libre sensor accuracy
- Choose an appropriate time to apply the sensor when levels are stable.
- Keep your body hydrated.
- Get moving.
- Improve the quality of your sleep.
- Avoid stressful situations.
Freestyle Libre key points
For a complete glycaemic picture (to ensure all the data is transferred from you sensor), scan at least once every 8 hours. Most people will want to scan more often anyway- at least 6 times a day is recommended.
It is customary for patients to rotate the FreeStyle Libre sensor application sites between arms to minimize skin irritation. There is limited data on the degree of inter-arm differences with CGM technology and whether any observed inter-arm differences are due to system precision or physiologic causes.
Who should not use FreeStyle Libre? ›Limitations of Use
Freestyle Libre Pro and Freestyle Libre are not approved in children <18 years of age or for patients who are pregnant, on dialysis, or critically ill. Patients who are dehydrated or have high levels of vitamin C or salicylic acid may not get accurate readings with the system (2).
The gold standard for accuracy is a blood draw measurement and both finger sticks and CGMs have error margins (MARD) to that standard. Finger sticks tend to be in the range of 5-10% MARD, while the Libre has a MARD of about 9.7% over 14 days, and the Dexcom G6 has a MARD of 9% over 10 days.
Where is the best place to put the Libre sensor? ›The arm and chest sites were most preferred, with the greatest sensor failures from the back. Conclusions: The FSL-CGM is clinically accurate when the sensors are applied to alternate chest or back sites.
Can I put my FreeStyle Libre on my stomach? ›Insertion of FSL sensors into the abdomen should be discouraged in patients with type 1 diabetes.
What is too high for FreeStyle Libre reading? ›If “HI” appears in your reader, your reading is above 500 mg/dL; check your blood glucose again with a test strip. If a second “LO” or “HI” result appears, contact your health care professional immediately.
Why is my FreeStyle Libre reading lower than finger stick? ›If blood sugar is dropping fast - sensor readings will be higher than finger prick readings. If blood sugar is rising fast - sensor readings will be lower than finger prick readings. Across the day, this still provides a good picture of blood sugar trends, and the lag should not impact most routine treatment decisions.
What range should I set my FreeStyle Libre? ›Target Glucose Range is pre-set to 70 to 180 mg/dL on the FreeStyle Libre 2 reader.
Does FreeStyle Libre leave a needle in? ›
Does The FreeStyle Libre Puncture The Skin? The FreeStyle Libre uses a small needle as part of the sensor application process. No needle is left in the site at all, during the 14-day wear.
Can I put my Libre sensor in the same spot? ›To prevent discomfort or skin irritation, you should select a different site other than the one most recently used1.
What are the risks of FreeStyle Libre? ›The following are possible adverse effects of inserting a sensor and wearing the adhesive patch: local erythema (redness), local infection, inflammation, pain or discomfort, bleeding at the glucose sensor insertion site, bruising, itching, scarring or skin discoloration, hematoma, and adhesive irritation.
What are the complications of FreeStyle Libre? ›The commonest complications appeared to be skin discoloration, after which were ranked local itching, insertion site scarring, bruising, local pain, and local bleeding post sensor insertion.
Can you go through airport security with FreeStyle Libre? ›If you're wearing an insulin or continuous glucose monitor, you won't have to remove it to go through security. But because X-ray machines can damage your device, the TSA recommends you ask for a pat-down inspection. If you're using a continuous glucose monitor, make sure to bring its charger.
How accurate is FreeStyle Libre to A1c? ›The observational study of Abbott's FreeStyle Libre system, presented at the annual scientific sessions of the American Diabetes Association (ADA), pointed to an 0.8 percentage-point drop—from 8.5% to 7.7%—in overall A1c levels after six months of use. After one year, that drop came to 0.6 percentage points.
What is the failure rate of FreeStyle Libre? ›...
Search Alerts/Recalls.
| Brand Name | ABBOTT LIBRE FREESTYLE 14-DAY GLUCOSE MONITOR |
|---|---|
| Device Sequence Number | 1 |
| Product Code | MDS |
| Reporter Country Code | US |
| Number of Events Reported | 1 |
Can the sensor be worn on other places than the arm? The only the position under the arm has been clinically evaluated and approved for use of the FreeStyle Libre 2 sensor. It is applied on to the back of the upper arm with a simple, disposable device called an applicator.
What if FreeStyle libre falls off? ›As with the FreeStyle Libre mentioned above, once your Dexcom sensor falls off, that's it, you need to reapply another one and start over and this can be an expensive exercise.
Can you put a CGM on your stomach? ›medwireNews: The Dexcom G7 continuous glucose monitor (CGM) is accurate and well tolerated for up to 10.5 days when worn on the arm or abdomen, a study of adults with diabetes suggests.
How do you shower with FreeStyle Libre? ›
Can I bathe, shower, swim or exercise with the sensor on? Yes. The sensor is water-resistant and you can use it while bathing, showering, swimming or exercising. However, the sensor should not be submerged in water deeper than 1 metre or kept underwater for longer than 30 minutes at a time.
Can I wet my FreeStyle Libre? ›The FreeStyle Libre 14-Day and FreeStyle Libre 2 systems, which are 2-part systems and do not use a transmitter, are described as water-resistant. The manufacturer, Abbott, says the devices will continue working as long as they are not submerged more than three feet, or kept underwater longer than 30 minutes at a time.
Why does my Libre sensor hurt? ›Some individuals may be sensitive to the adhesive that keeps the Sensor attached to the skin. If you notice significant skin irritation around or under your Sensor, remove the Sensor and stop using the System. Contact your healthcare professional before continuing to use the System.
Can you wear a FreeStyle Libre during an xray? ›What to do with your Continuous Glucose Monitoring (CGM) device or Freestyle Libre during medical tests - The Ottawa Hospital. The sensor, transmitter, receiver or insulin pump should not be exposed to x-rays, CT scans, MRI, any radiation and/or strong electromagnetic fields.
Does FreeStyle Libre alert when sugar is low? ›The FreeStyle Libre 2 system has 3 alarms: Low Glucose Alarm - an alarm will notify you when your glucose falls below a level you set. High Glucose Alarm - an alarm will notify you when your glucose rises above a level you set.
Can FreeStyle Libre 2 give false readings? ›If the Sensor is becoming loose or if the Sensor tip is coming out of your skin, you may get no readings or unreliable readings, which may not match how you feel. Check to make sure your Sensor has not come loose. If it has come loose, remove it and apply a new one.
Is a CGM more accurate than a finger stick? ›Unlike finger stick tests where the glucose levels are measured in capillary blood, CGM devices measure it in the interstitial fluid. There is a time lag of 5 to 20 minutes before the vascular and interstitial glucose levels equilibrate. Hence, they can be unreliable at times, especially during rapid fluctuations.
Is interstitial glucose higher than blood glucose? ›However, since glucose must be transferred to the interstitial space from the blood, IG is lower and lags behind BG.
Why is my blood sugar higher in one hand than the other? ›Since interstitial fluid behaves as a different compartment relative to blood, it is possible that muscle/fat mass differences between the two arms explains the glucose level discordance between the arms.
What is a good time in range for diabetics? ›Most people with type 1 and type 2 diabetes should aim for a time in range of at least 70 percent of readings—meaning 70 percent of readings, you should aim for roughly 17 out of 24 hours each day to be in range (not high or low).
What is a good target range for diabetics? ›
The American Diabetes Association (ADA) generally recommends the following target blood sugar levels: Between 80 and 130 milligrams per deciliter (mg/dL) or 4.4 to 7.2 millimoles per liter (mmol/L) before meals. Less than 180 mg/dL (10.0 mmol/L) two hours after meals.
Can freestyle Libre go on inner arm? ›The Freestyle Libre device manufacturer has confirmed here that the back of the upper arm is the only FDA approved location for the CGM. Avoid placing the sensor directly over the muscle.
How do you remove a freestyle Libre needle? ›- Pull up the edge of the adhesive that keeps your sensor attached to your skin. Slowly peel away from your skin in one motion. ...
- Discard the used sensor according to your local regulations.
The sensor filament is less than 0.4 mm in diameter and is inserted 5 mm under the surface of the skin.
Can I put a bandaid over my Libre sensor? ›OVER-BANDAGE A medical-grade adhesive; bandage or tape. If using, it must be applied at the time of sensor application. It is important that you only remove it when your sensor wear is over as the sensor may come loose when peeling it off.
Will a Libre sensor set off a metal detector? ›Libre and air travel
The FreeStyle Libre can be passed through airport metal detectors so you are okay to keep your sensor on while going through these. It should not be exposed to full-body scanners (i.e. x-ray or millimetre radio-wave).
So whether you like the two-piece libre/center-sticker combination or the one-piece OverPatch, you can make use of ExpressionMed tape without worrying about your sensor readings.
Can you sleep on your Libre sensor? ›I put one on as soon as the new sensor goes on. If you sleep on your side it's fine because this big patch goes over it and no worries. It's a bit strange at first, but you get used to it. I'm fully a side sleeper so I lay on mine all the time.
Why does vitamin C affect FreeStyle Libre? ›Taking ascorbic acid (vitamin C) supplements while wearing the Sensor may falsely raise Sensor glucose readings. Taking more than 500 mg of ascorbic acid per day may affect the Sensor readings which could cause you to miss a severe low glucose event. Ascorbic acid can be found in supplements including multivitamins.
Is Dexcom better than Libre pros and cons? ›Which is better – Freestyle Libre vs Dexcom? Based on user experiences, the Dexcom is more accurate than the Freestyle Libre. However, the Freestyle Libre is less invasive and is easier to apply. Dexcom provides more alarms compared to the Libre and alerts patients of predicted highs and lows.
How many times can you scan FreeStyle libre in 1 day? ›
For a complete glycaemic picture (to ensure all the data is transferred from you sensor), scan at least once every 8 hours. Most people will want to scan more often anyway- at least 6 times a day is recommended.
How many times a day can you test with FreeStyle Libre? ›The FreeStyle Libre is a blood glucose monitor that doesn't require blood samples or finger sticks. The readings are based on a sensor on your arm continuously for up to 14 days at a time. You can check your glucose levels any time, but you should do so at least every 8 hours.
Does Tylenol affect FreeStyle Libre? ›Continuous glucose monitors (CGMs) — like Dexcom G6 and FreeStyle Libre — are wearable devices that track glucose (sugar) levels in the body. But some medications, including Tylenol (acetaminophen), can affect the accuracy of CGMs. This means your CGM might measure your glucose level as falsely high or low.
Who should not use freestyle Libre? ›Limitations of Use
Freestyle Libre Pro and Freestyle Libre are not approved in children <18 years of age or for patients who are pregnant, on dialysis, or critically ill. Patients who are dehydrated or have high levels of vitamin C or salicylic acid may not get accurate readings with the system (2).
Select an area of skin on the back of your upper arm that generally stays flat during normal daily activities (no bending or folding). Avoid areas with moles, scarring or tattoos. Choose a site that is at least 2.5 cm away from an insulin injection site.
Why is my FreeStyle Libre 14 day inaccurate? ›Freestyle Libre Inaccurate? Inaccuracies in freestyle Libre occur because of two main reasons. Either it does not measure the glucose in the blood, but rather the glucose in the interstitial fluid, or because of user error. There may be some other rare instances that can cause inaccuracies in your Freestyle Libre.
Can FreeStyle Libre be recalibrated? ›The FreeStyle Libre sensor is factory calibrated and manufactured with minimal sensor-to-sensor variation eliminating need for finger prick calibration2,3. The FreeStyle Libre system is clinically proven to be accurate and consistent over 14 days, without the need for finger prick calibration2.
What should target range be for freestyle Libre? ›Target Glucose Range is pre-set to 70 to 180 mg/dL on the FreeStyle Libre 2 reader.
What is the failure rate of freestyle Libre? ›...
Search Alerts/Recalls.
| Brand Name | ABBOTT LIBRE FREESTYLE 14-DAY GLUCOSE MONITOR |
|---|---|
| Device Sequence Number | 1 |
| Product Code | MDS |
| Reporter Country Code | US |
| Number of Events Reported | 1 |
Reading your reports
Remember, if your sensor is not scanned at least once every 8 hours, there will be a gap in your daily graph like the one shown here. To ensure you have a complete picture of your glucose data, be sure to scan your sensor often.
Can you put the FreeStyle libre on your thigh? ›
Our results indicate that the accuracy and precision of FSL sensors placed on the upper thigh are similar to the upper arm, whereas the abdomen performed unacceptably poorly.
What happens if my Libre falls off? ›If any of the sensors are defective or fall off, you will need to contact the manufacturer to obtain a replacement. Your specialist and GP cannot issue prescriptions to replace defective sensors or those that have fallen off.
Can I put a bandaid over my FreeStyle Libre? ›OVER-BANDAGE A medical-grade adhesive; bandage or tape. If using, it must be applied at the time of sensor application. It is important that you only remove it when your sensor wear is over as the sensor may come loose when peeling it off.
Can you wear a Libre on a plane? ›TRAVELING BY AIR
You may use your System while on an aircraft, following any requests from the flight crew. Some airport full-body scanners include x-ray or millimeter radio-wave, which you cannot expose your Sensor to.