FreeStyle Libre 3: 'Almost Like Wearing Nothing'

Anne L. Peters, MD


September 06, 2022

Editor's note: The FreeStyle Libre user's data can be transmitted remotely to LibreView. Healthcare professionals can use LibreLinkUp to view user's data.

This transcript has been edited for clarity.

Today, I'm going to talk about the FreeStyle Libre 3, which is the newest continuous glucose monitor out in the market. It's been out for a little while, and I haven't done a video on it yet because I really wanted to see what patients thought about it. The bottom line is that my patients really love it. I thought I'd show it to you and discuss what I think is good about it as well as some of its drawbacks. This is a really good technology. Many patients are really liking the results they're finding, and frankly, they like wearing it because it's so much smaller.

For those of you who know me, I like things that come in small boxes. This comes in a very small box. If you compare it with the bigger box that it used to come in, this is about half the size. When you open it — and I've never done this before, so you're just going to have to bear with me — you see inside that everything is, in fact, smaller than the prior Libre 2 or the basic Libre.

The way you use this is really simple. For those of you who don't know, you twist it, you find the pieces inside, and it's ready to insert. You have to roll up your sleeve — I may not be doing this in exactly the right place, but this is mostly for observation purposes. Then you find where you're going to use it, you clean off the site, and then you stick it on. This is easy to teach and do.

You can see that I have no pain. This doesn't hurt me, which I love. Finger sticks hurt. This is the beauty of continuous monitoring. Look at this teeny, tiny sensor. This really, at this point, is the smallest sensor that exists. Yes, you can still see it, but the way it feels on your arm, how thin it is, and how small it is, it's as though people aren't wearing anything.

In addition to putting on the sensor, people need to download the Libre 3 app onto their smartphone, which is different from the Libre 2 app. One of several differences between this system and the prior Libre systems is that people don't have to swipe to get the glucose value. The Libre 2 had alarms for a high and a low glucose [value] that you could set that would alarm the individual, but you still had to swipe for a glucose value.

With this, you don't have to swipe. It's continuously going to someone's smartphone, which is nice for me clinically because there are no gaps in the data. There is a high alarm and a low alarm that patients can set on their phone.

It doesn't come with a reader yet, which is a barrier for some of my patients who don't have smartphones. This means it's not covered by Medicare, because they don't cover devices that are wholly based on a smartphone. Be that as it may, many of my patients really like this system. They increasingly are finding that their insurance will cover it. That's always a problem in the beginning of having something new, but we're finding that it's becoming easier and easier for people to get it.

For people who aren't on an automated insulin delivery system; who don't need the connection with a pump; and who don't need, say, a share feature like the Dexcom has, this is really useful. Like I always say, when it comes to my patients, I give them choices. I want to teach them about all the available tools and let them choose what works best for them. There may be features of the Dexcom that are better for certain patients, while this may be better for others. There are obviously no head-to-head comparative trials between the two.

I say, first of all, if a patient is doing well on what they're on, don't change them. If they want to try this, or if they're on the older Libre and they want to go to Libre 3, absolutely. There are many nice features to this. Work with your patients to see what tools are the most helpful.

I think technology is really exciting because we're getting more and more technology. There'll be smaller, newer sensors, and there are many things coming down the pike.

For now, this is the newest and the smallest sensor that we have. I think it's worth letting your patients try it if they want to. For patients newly on a Libre system, definitely prescribe the Libre 3, with the caveat that they must be able to use a smartphone and they won't be getting a reader — at least not yet — to use this device.

This has been Dr Anne Peters for Medscape. Thank you.

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