From the Guidelines
The FreeStyle Libre 2 is a reliable and effective continuous glucose monitoring system (CGMS) that can be used as a substitute for self-monitoring of blood glucose (SMBG) in adults with diabetes requiring frequent glucose testing, as supported by the 2019 American Diabetes Association standards of medical care in diabetes 1.
Key Features and Benefits
- The Libre 2 provides real-time glucose readings without requiring fingerstick calibration, reducing the pain and inconvenience of multiple daily fingersticks.
- The system offers optional real-time glucose alarms for high and low readings, trend arrows showing glucose direction, and comprehensive data reports showing patterns over time.
- The sensor is water-resistant for showering and brief swimming, and the technology works by measuring glucose in interstitial fluid rather than blood, which explains the 5-10 minute lag time between readings and actual blood glucose levels.
- According to the studies, use of an intermittently scanned continuous glucose monitor, such as the Libre 2, can be considered as a substitute for SMBG in adults with diabetes requiring frequent glucose testing, with a Grade C recommendation 1.
Important Considerations
- Users should be aware that acetaminophen may interfere with readings, and occasional fingerstick tests are still recommended during times of rapidly changing glucose levels or when symptoms don't match readings.
- The Libre 2 is particularly beneficial for people with diabetes who need frequent glucose monitoring, such as those with type 1 diabetes or insulin-dependent type 2 diabetes, as it can help reduce hypoglycemia rates and improve glycemic control 1.
- The system's accuracy and effectiveness have been supported by studies, including the ASPIRE study, which showed that the low-glucose suspend function reduced hypoglycemia over a 3-month period without raising HbA1c levels in persons with type 1 diabetes and known nocturnal hypoglycemia 1.
From the Research
Libre 2 CGMS Overview
- The Libre 2 CGMS is a type of intermittently scanned continuous glucose monitoring (isCGM) system used in patients with type 2 diabetes mellitus (T2DM) on insulin therapy for its benefits in disease management 2.
- The system allows for the assessment of glycemic control and identification of glycemic patterns, facilitating informed therapy decisions 3.
Efficacy and Safety
- Studies have shown that the use of isCGM devices, such as the Libre 2, is effective and safe in improving glycemic control in patients with T2DM on basal insulin or non-insulin therapy 2.
- The system has been found to reduce glycated hemoglobin (HbA1c) levels and improve time in range (TIR) percentages, indicating better glycemic control 2, 4.
Comparison with Other Therapies
- A comparative study found that insulin glargine, a basal insulin, was more effective than dapagliflozin in stabilizing glycemic variability in patients with T2DM inadequately controlled on triple drug combination therapy 4.
- However, the use of CGM systems like the Libre 2 can help individualize diabetes management and improve glycemic control, regardless of the therapy used 3, 5.