From the Guidelines
The Libre sensor is a good continuous glucose monitoring system for people with diabetes, offering accurate blood sugar readings and convenient diabetes management. The system consists of a small sensor worn on the upper arm for up to 14 days and a reader or smartphone app to scan the sensor for glucose readings. Libre sensors provide not just current glucose levels but also trend data and patterns over time, helping users make better decisions about insulin dosing, food choices, and physical activity. According to a study published in the Annals of Internal Medicine 1, the sensor measures glucose levels every minute, records a measurement every 15 minutes, and can display up to 8 hours of data on the receiver.
Key Benefits of Libre Sensor
- Offers accurate blood sugar readings without the need for frequent finger pricks
- Convenient diabetes management with a small sensor worn on the upper arm for up to 14 days
- Provides trend data and patterns over time to inform decisions about insulin dosing, food choices, and physical activity
- Generally reliable, though some users may experience occasional inaccuracies, especially during rapid blood sugar changes
- Most insurance plans cover Libre sensors, making them accessible for many patients
Clinical Effectiveness and Safety
Studies have shown that the Libre sensor has excellent accuracy compared with SMBG 1. However, accuracy is lower at high and low glucose levels. Outcomes conflict regarding the accuracy of the Libre sensor versus real-time CGM. In patients with type 1 and type 2 diabetes, the Libre sensor may decrease hypoglycemia risk. Recent studies show both excellent performance and potential for benefit in several special populations of patients with diabetes, including pregnant women with diabetes and persons with type 1 diabetes and hypoglycemia unawareness.
Recommendations for Use
The Libre sensor can be considered as a substitute for SMBG in adults with diabetes requiring frequent glucose testing. For best results, users should calibrate the sensor according to manufacturer instructions and understand that there may be a slight lag between blood glucose and interstitial fluid glucose levels that the sensor measures. The convenience of painless monitoring often leads to more frequent checking and better overall diabetes control.
From the Research
Libre Sensor Evaluation
- The FreeStyle Libre (FSL) system is a widely used device for continuous glucose monitoring (CGM) in individuals with type 1 and type 2 diabetes 2.
- Clinical trials and real-world studies have demonstrated the efficacy and safety of FSL systems across diverse populations, including individuals with type 1 and type 2 diabetes, adolescents, and pregnant women with diabetes 2.
- The FSL system is user-friendly and meets the needs of patients and healthcare providers, allowing for the review of glucose metrics and pattern identification, and supporting educational strategies and patient-tailored treatment 2.
Benefits of Libre Sensor
- CGM, including the FSL system, has been shown to reduce risks of hypoglycemia and hyperglycemia, glycemic variability, and improve patient quality of life for a wide range of patient populations and clinical indications 3.
- The use of CGM can help reduce HbA1c and mean glucose, and is beneficial for people using either multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) 3.
- The FSL system can improve diabetes-related satisfaction in people with diabetes and parents of children with diabetes, as well as the clinician experience 4.
Cost-Effectiveness of Libre Sensor
- Cost-effectiveness analyses have indicated that CGM, including the FSL system, is a cost-effective adjunct to type 1 diabetes management that is associated with reduced diabetes-related complications and hospitalization 4.
- The FSL system is a cost-effective glucose monitoring alternative to blood glucose self-monitoring (SMBG) for individuals with type 2 diabetes in Sweden who are treated with insulin but are not reaching their glycaemic goals 5.
- The use of the FSL system can generate an incremental cost-utility ratio of SEK219,127 and SEK144,412 per quality-adjusted life-year (QALY) gained, respectively, for individuals with type 2 diabetes with baseline HbA1c of 8-9% and 9-12% 5.