[DISCLOSURE – PLEASE READ: The team at Abbott reached out to me and asked if I’d like to trial the Freestyle Libre system. I said yes. After my doctor approved a prescription for the device, Abbott sent out the scanning device and two sensors at no cost to me. This whole review needs that bias lens in place. Good? Good. Thanks for reading.]
When I was first handed the Autolet lancing device back in 1986, I remember being completely freaked out. And rightfully so, because that thing was a beast and blasted my fingertip to bits on a regular basis.
But over time, lancing devices became smaller and less painful. And meters became smaller, less cumbersome, and more accurate. In 2006, I tried a CGM for the first time and my mind was BLOWN because there was this device, stuck to my body, sucking out interstitial fluid and offering up a trend graph of my blood sugars. And it alarmed when my numbers went above or below my personalized thresholds. Streaming video of my blood sugars versus a polaroid picture version is progress in my book.
And for the last week or so, I’ve been trying out the Freestyle Libre system. (Note: they asked that I always use it’s full name – the Freestyle Libre system – so please excuse my formality here on this weblog posted to the world wide web.) I’m wearing this device in addition to my Tandem X2 insulin pump and my Dexcom G5 CGM, so I’ve gone full robot. Pros and cons? Don’t mind if I do.
Freestyle Libre system PROS:
The insertion process is a cake walk. To be fair, I’ve only put in one sensor so far, but it was as painless as this needle crap can be. And the adhesive is amazing. I’m clearly a fragile flower in the skin department, with rash reactions to lots of adhesives, and I’ve also spent a lot of money and time taping down pump sites and Dexcom sensors in order to get the 
approved time out of them. But the Freestyle Libre system has been stuck to the back of my right arm for 8 days now without any puckering or shifting.
The wearability of this device is also very good. The profile of the transmitter is very low, making it harder for door jams and bra straps to grab. It doesn’t leave a giant lump underneath my clothes, and the completely circular shape leaves no snaggy sharp edges. Subtle, and I like it, and it was harder for my son to grab onto and use to climb me, which was another bonus. And if I had a child with diabetes, I’d be very inclined to check this device out for them, when taking into account wearability and pain factors.
No calibrations are required, which is kind of magical to me. This thing goes on, stays stuck, and doesn’t ask me to do anything other than scan it when I feel like scanning it. And I have scanned it like crazy. The first day, I scanned a whole bunch of times and enjoyed the little BOOP! noise it burped out when activated. And I also appreciated being able to add notes after checking my BG, citing food, exercise, etc.
The screens are nice, too. Every time I scan, I see where my blood sugar is, where it’s been, and an arrow indicating where it might be headed. I can also see a daily graph, average glucose for some time spans (7, 14, 30, and 90 day assessments) and also Time in Target, which is a real win for me, as time in range means more to me than my A1C results. Unfortunately, the touch screen on my device sucks and I have to press the screen at least three times in order to get it to respond. I assume it’s not like this on all devices. I haven’t downloaded the software yet to see my data, and I could also take the Tidepool route, as they recently added the … Freestyle … Libre … system to their slate of supported devices, but I’ll explore those options in the coming weeks and report back ASAP.
And the basic operations of the device? A big pro feature. It’s supposed to make me check my BG regularly. It accomplishes that goal. Not having to prick my finger at all is a huge bonus, and it takes half a second to get a result. (I was also able to easily and reliably scan the sensor through a long sleeved t-shirt, a sweater, and a heavy winter coat. The thing has good range.) I scan at least 10 times per day, and it’s easy and painless. A huge plus.
Freestyle Libre system CONS:
It doesn’t alarm when my blood sugar is out of range. That’s a big deal to me, especially since I don’t often feel my low blood sugar symptoms. Also, after using a traditional CGM for over 10 years, I’ve grown accustomed to the data being not only available but LOUD. The alarms have potentially saved me from dangerous situations, and I am grateful for them. I also rely on them, as they catch me when I forget to check in on my BG.
The 12-hour warm up period is not optimal. I’m already frustrated by the 2 hours I have to wait for Dexcom to get hot, so the 12 hour waiting period for the Freestyle (wait for it …) Libre system to ready itself for use is agonizing. I put my sensor on at 9 in the morning and had to wait all day for data. Granted, the sensor works for 10 days after it is inserted, but the 12 hours? Not fun.
The scanner device is another separate piece of technology that I need to keep charged and have with me at all times. I’ve left it in my car overnight, on the kitchen table when I meant to have it in my purse, etc. I’m sure that I’d become used to remembering it, just like I did when I had to carry a Dexcom receiver, but at the moment, I forget more than I’d like.
My results seem to run on the lower side when compared to my Dexcom G5 CGM and my Freestyle Freedom Lite glucose meter. Like just now, my Dexcom said I was 146 mg/dL, my meter said I was 145 mg/dL, and the Freestyle Libre system said I was 113 mg/dL. I’ve been using the Freestyle Libre system for nine days now and it has been consistently lower that my other devices. I will report back after longer use times, but for now, that’s the trend I’ve seen.
Overall assessment?
The Freestyle Libre system is easy to use, but it doesn’t replace the Dexcom CGM, for me. Continued use would take a bite out of those annoying things, like forgetting the scanner at home. Does it make checking my blood sugar easier? Yes. Are the trends useful? Yes. But the fact that it doesn’t alarm is the biggest drawback for me, and I am not sure I’ll ever change my opinion on how important those alarms are for me. Also, I have years of Dexcom use and trust, so it’s hard to accept new tech without bucking up against the idea of change.
These are just initial impressions, and I’m very happy to have the chance to check this tech out. More on all this stuff in another week or so, after I’ve ripped off this sensor and checked to make sure my skin is still there. For now, I’ll embrace this new method of diabetes cyborgishness and see where it goes.
Thanks for the Tidepool mention. Getting the Libre added was a big deal for us. 🙂
I’m pretty mad about their adds (negative advertisement over Dexcom). I liked the idea of this product but with company like Animas exiting the pump market, I’m starting to be scare at company like Abbott and Medtronic. I want my options and no it doesn’t replace a CGM.
my son uses the Libre, for a few months now, and we only have a 1 hour start up.. 12 hours would be crazy slow!
I think looking at it as a CGM is unfair. I would rather compare it to the a glucose meter. It seems less than a Dexcom or my preference the Medtronic system, because it is. I hope I get to try it out, it looks pretty cool
Fascinating. I can see this being a great Freestyle Libre System for some folks.
Hope you’re skin’s still there! (I think I missed an update on your skin response to Dex’s change in adhesive properties.) My robot kid is wearing 670g, Guardian3 and DexcomG5. Her self-imposed pain in the ass college prep assignment. BUT. Wow. No overnight Dexcom wails in over 3 weeks!!
Thanks for this post!
I understand your preference! 🙂
I am also trialing it at the moment. As a LADA 1.5 who still produces some insulin and is only taking long-acting insulin I don’t need the alarm so its a perfect alternative to a glucose meter…But I do agree with quite a few the drawbacks…
Can you update us on how you prevent skin sensitivity with Dex com .
My daughter is unable to use the Dex Com because she has an allergic reaction on her skin. Tough pads worked for a while but no longer. Please update us on how you are still using the Dex Com and not getting skin rashes. She is considering other options. Her endocrinologist told her about the Libre system.Possibly the med Tronic CGM and pump system.She wore the Metronic CGM sensor pad and did not have a skin reaction after a week. Presently she is wearing a tea sometime but is due for a pan upgrade the summer
T slim
I’ve seen this system all over the internet and can’t decide if I want it or not LOL (not that I would end up with one anyway at this point). When I wear my CGM (which is maybe one week a month at this point because I’m lazy about setting it up), I usually put the alarms on silent anyway. I don’t have problems with severe lows sneaking up on me, I just like to be able to look at my hip and know what my BG is (currently on a medtronic 530G, trying to get a 670G through my insurance). I think I would totally be on board with this system if I didn’t have a possibility of getting a 670G where my CGM and pump could communicate to adjust my basal rates. If that technology wasn’t available, I’d probably go for a “Freestyle Libre System” (TM) (R) Capitalized, Etc….
I’m also skeptical of the 12 hour warm up period, but that could be avoided by inserting a new sensor before you remove the old one, right?
12 warm up not really true, you should allow up to 12 hours before activating the sensor but that isn’t essential. Warm up time is actually 1 hour to activate the sensor, then you can scan as often as you like. Alarms, it’s not a cgm and doesn’t purport to be one, it’s a flash sensor based testing system. Finally, if you have an android phone and the software then you don’t need the reader. Personally after using this for two years I can only say it’s a massive game changer for me, the prediction lines are great and the ability to analyse food impacts also really useful.
If you review a product be more aware of the overview, it’s not a cgm, it’s cost effective and versatile. It does have some drawbacks but not too many and it’s a massive step in the right direction however it’s not for everyone but having choice is good.
I don’t work for Abbott I just buy and use their product.
I tried to scan it several times and it only showed me how many hours were left in the calibration period. I didn’t see any actual results until the 12 hours were up. 🙁 It seems like a US thing?
Also, I’d love to connect with you re: a write up outside of sixuntilme. Would that be okay? I’ll email you.
I purchased my Libre on Tuesday (haha, I don’t have to use the full name!). For me as a Type 2 who is only on oral meds and would be laughed at if I even thought about asking for a CGM, the Libre has been a true gift. I’m a teacher who can’t stop what I’m doing to poke my finger, but I can quietly scan my arm. (I turned off the sounds; it’s set to vibrate.) Best part for this Type 2? Insurance actually paid for part of it! They paid about $20 for the reader and about $55 for 3 sensors. Yes, I now pay more than I would for test strips, but it’s been worth it. The biggest con for me: The first night (after my 12 hr warm-up – ugh), I slept on the arm with the sensor and got false lows.
Those who say it’s a 1 hr warm-up didn’t buy theirs in the States. The FDA here asked for a 12 hr warm-up. Also the sensors only last 10 days instead of 14.
Hi, Kerri, nice write up.
I’m in Scotland and have been using libre for about a year now. The version sold in Europe has a 1 hour start up and lasts for 14 days. However, as you’ve found, the American version has a 12 hour start up and lasts for 10 days. Many users found that the slight trauma caused by the needle inserter and the foreign body response caused by the presence of the sensor filament, both of which chew up glucose, caused flaky readings for a while. So, many users apply a day before activating to give it time to settle down. It is believed by observers here that the FDA may have mandated a 12 hour start up to allow it to settle. Either that, or Abbott learned a bit from users and decided we were right to attach a day before activating!
On the question of alarms, a former Abbott employee set up Ambrosia Systems in San Francisco. They make a small transmitter called Blucon Nightrider. Pop it on top of libre with a sticking plaster or armband. It reads libre every 5 minutes and then bluetooths it to their in house app, LinkBluCon. That app is very basic, so don’t bother doing that. Instead, run it to xDrip+, which had its roots in the Nightscout Foundation. Many dexcommers use xDrip+ in preference to the official dexcom app. xDrip+ was tweaked in September to take data from the Blucon transmitter, as well as G4, G5, and home made things like limiTTer. Doing it this way means you can calibrate libre, making it comparable in accuracy to dexcom, and you get alerts as well. Turns libre into full blown cgm for $100 one off cost.
Thanks Kerri. I was wondering about the lack of calibration, that part is amazing. What about restarting the sensor after the 10-14 days are up? Can you do that as with the Dexcom, or that’s it?
It certainly sounds like a very useful BG meter on steroids, but the lack of alarms would be a deal breaker for me. Even with alarms it’s too easy to sleep through the night and end up waking up to a roomful of burly EMTs!
Sure please send me a mail
The USA version of the Libre is different to the rest of the world. The USA version has a 12 hour warm up and 10 day sensor life believe. The rest of the world sensors that have been out for a couple of years have a 1 hour warm up and 14 day sensor life. I think this has to do with accuracy and FDA regulation.
[…] put my first Freestyle Libre system sensor on and fully expected it to be exactly like my Dexcom CGM. And it’s […]
Thank you, Kerri. This was very helpful. You answered my question re:scanning through clothing!
It is interesting that FDA have put a 12 hr warm up and 10 days on the sensor. In Canada it is 1 hr warm up and 14 days. I have found the readings are accurate after 1 hr. After 10 days the sensor is still so stuck on my arm it is hard to remove. I have been using the Libre since Christmas and have come to rely on it. Because it is not covered by insurance or Alberta Health I cannot afford to wear it full time although I am on my 6th sensor. I also thought it was reading 1 mmol lower than my finger prick but looking at the statistics the average BG was very close to the finger prick BG. Where the Libre shines for me is in the back-country skiing and hiking in the mountains. I have had problems in the past when I was not aware of my lows slogging up a mountain. I would stop to do a finger prick and would have to put on my glasses and shield my meter under my coat so I could see it. I used my Libre for the first time skiing into the Tonquin in February, a 10 hr slog. The Libre meter was in a pocket and I could scan it often. I did not need glasses and the screen was bright enough even with the snow and sunlight I could read it. The trend arrows were a life saver for me. I am on the Animas Ping pump and strongly leaning towards the Omnipod as a replacement. I like the idea of not being attached to a pump with a hose. Omnipod also use the FreeStyle glucose and ketone tests. The Libre is also very useful for confirming the basal and carb to insulin settings.
My 10 year old daughter was diagnosed with type 1 at 6 years old and we started using the Freestyle Libre as soon as it was available.
We really like the device and it’s made so much about managing her diabetes so much easier, even with any draw backs it may have and that’s pretty huge.
The problem for me is that my wife and I have two different health benefit providers, hers covers the freestyle and mine does not, this is soooooo confusing for them every time I order, I just get a pit in the bottom of my tummy when I’m faced with having to place an order. They direct bill my wife’s plan but it only covers 80% so then it takes two or three days for their system to realize that the order is not fully paid for, they of course won’t send them out until it’s fully paid for so I first have to order then wait for a few days and call them again, explain the situation to them three or four times and possibly talk to two or three different people before they catch on and can finally take my credit card number for the balance owing and then ship them out to me, and this happens every single time I order, this is incredibly frustrating and cumbersome and just not that complicated, surely we are not the only people out of their thousands of customers with this situation!!
I realize that we can just pay for the entire order then go through the process of submitting a claim, we have done it that way, it is also a cumbersome process that becomes fairly time consuming and somewhat administrative so it becomes a choice between two equally frustrating processes.
Thank goodness we are lucky enough to have the privilege of coverage when so many people do not, to live in a time in which we have so much choice in great technology that allows us to live long lives with this disease and of course I would go through any process to make this disease easier to live with and manage and I am truly, truly grateful for that, however, a little customer service goes a long way, diabetes is a big enough pain in the ass all on its own!!
Have been wearing my libre sensor 4 days. My doctor told me to compare the reader
info twice a day with blood tests. A few times the reading have been the same but most of the time the 2 readings are at least 20 points off in either direction . Twice the readings differed by 35-40 points! I love everything about this system except the accuracy. Does anyone else have this problem ? I live in the USA.
My daughter just started the libre she had her sensor on and it got pulled out in a soccer game need to put on another one but has not been 10 days how do I reset it?
How is the 1 hr possible? It automatically goes to a 12hr warm up phase. If you have a special secret please, do tell. I know the Dexcom is 2 hour.? Thank you,
Charity Rutherford
Thanks for he info. My little man (15 month old) was just diagnosed with Type 1. We are looking at getting this system while waiting for a closed loop pump system. We want to make his life somewhat painless and the finger pricks are the worst part for him.
1 Hour is the non US version.
[…] checks (or, in some cases, eliminates it completely). Diabetes blogger Kerri Morrow Sparling writes that when she started checking her sugars with an Autolet lancing device back in 1986, “That thing was […]
After 10 days we replaced my sensor. It had left two abrasions and puncture marks on my arm. Unacceptable as diabetics heal more slowly and after rotating the device every 10 days I would have an arm with multiple wounds. The readings were amazing however! Problem being they were not accurate with them my meter and previous finger stick readings. Wasn’t that the point? It is sad to see how desperate we are for a bit of freedom and relief that we accept/ take seriously a device with so many drawbacks. It doesn’t work!
I’m in the US and have been using my Libre for two months now and I really like it, not having to use the finger sticks much is really amazing and freeing in many ways. I’ve been able to keep better control and see how different foods affect my blood sugar levels and how fast/slow my insulin kicks in also. My biggest complaint has been with the 12 hour delay, which is ridiculous, and the fact that it counts towards the 10 day usage of the sensor, meaning you really only get 9 1/2 days of use out of each sensor, not 10 in the US, this is not good. So finger sticking is not gone of course, but largely replaced at least. Maybe someday the US healthcare system can catch up to the rest of the world! 🙂
Thanks for all this great feed-back, its good for new diabetics to understand better.
I have had major issues with the customer service from Abbot here in HK and in the US. No one answers the phone or no follow-up on the email address shown on the official web-site.
I think the Freestyle Libre is a great product but I’m sure you’ll all agree, we need immediate replies when we have problem with blood sugar reading products. I have had to go buy a different reading system due to the lack of customer support from Abbot.
I have stopped using this now as I have lost confidence in the company.
SAD!!!
Best wishes to all,
Ian.
I was able to purchase the freestyle Libre system without a prescription, and when I called into customer service about issues that I was having with the sensors they wanted to argue with me about me purchasing the monitoring system without a prescription and basically they could not help me. My experiences with the sensors, the first sensor would not stick and the ultra fine needle bent. II sensor only stayed attached for 3 days before falling off. This is a lot of money to pay for it system that does not work
I’m in the USA. My physician told me a work around for the 12 hour warm up. 12 hours before the sensor expires, place a new sensor on other arm & scan with a second reader. The newer sensor will begin working when the first stops-hence no waiting!! My insurance covered both readers, but the cost is pretty low even if you must pay out of pocket
I’ve only been using the Libre for 6 days but it solved two problems for me the very first time I used it.
The two problems were waking in the morning with perspiration smelling of onions, and a sensation of nausea. The LIbre showed I was going low during the early morning hours, but was unaware of it because my usual “low”sensations of increased heart rate were absent.
The problems were solved by reducing basal insulin and checking BG at random waking intervals. I knew the morning nausea was not pregnancy ( I’m male 😉 but suspected some sort of deadly gastric disease. I now have neither onion aroma nor nausea, quite a relief.
I’m in the US and the Libre with 3 sensors cost me $140. That’s likely much cheaper than it would cost to have medical professionals resolve my problems. It would be nice to have BG results that better match finger-prick tests, but the Libre lets you judge whether you need a backup finger-prick test.
I’m Type 2 for 25 years, now using basal and bolus insulin.
I have been working to use the Free Style Libre but it is not working for me. I can get one disk on but HAVE BEEN LUCK Y TO KEEP IT ONE FOR 2 DAYS BE FORE COMING OFF, I ALSO HAD THE TROUBLE OF THE BLUE RING ON THE APPLICATOR NOT WORK. I CONTACTED SOMEONE ANSWERING THE PHONE T THE NUMBER ON THE BOX. after TALKING TO THEM I WAS SENT 4 BOXES, NOW I I HAVE SIX, COUNTING THE ONES I PURCHASED none OF THE APPLICATORS WORKED I GO NO HELP AS TO WHY I AM having so much trouble It looks like I have TO GO BACK TO STICKING OR TRY ANOTHER PRODUCT
Kerri,
I have a number of conditions I a have, but I have Type 2, am 47, but very sensitive & and have a terrible sweet tooth. I rarely check my glucose levels (I always run high unless I skip a few meals. I wondered if the Libre would help me do so more often – but I am scared to death about the pain of the needle sensor. Is there any way to figure out if I could tolerate the sensor before buying the system – since I know I’ll have to pay for it out of pocket.
My libre in the usa only took an hr to calibrate and work. Love not having to prick the fingers..
Didn’t even feel anything from the application.
Can I check my blood through my clothes sleeve or the sensor needs to be uncovered?
I did it through my clothes, no problem.
The FDA set a 12 hour warm up so Dexcom and Medtronic would have a 2 hour warm up time to make their sensors stand out against the Libre. If Libre was able to use the 1 hour warm up that would cause most of the people using the other systems to switch to Libre so the FDA forced them to use a 12 hour warm up time.
Freestyle Libre 10 or 14 day
Before you insert the sensor you see a stainless steel needle. I know it is needle because it is hard. However upon pulling it out after 10 days, the needle is not there. What happened to it? Did it retract inside the sensor? You can only see the black filament. Has anyone notice this or know what happened to the needle?