Libre 3 update - Answers to your key questions

Libre 3 is now available in Germany and we can now give answers to 15 key questions about Libre 3!

What we know so far...

Abbott announced that FreeStyle Libre 3 had received a CE mark for marketing in Europe over a year ago (September 2020) and whilst we still await its launch in the UK and most of Europe, it is now available in Germany for iphone users, and so this update gives us an opportunity to confirm some of the features you will see with the new model.

 

1. WHEN WILL LIBRE 3 BE AVAILABLE?

 

Libre 3 was to be launched in some European countries earlier in 2021. But, it seems that due to the pandemic and pershaps other reasons not given by Abbott, Libre 3 has so far only had a limited release in Germany.

There’s no firm information on a UK launch date, whether through the NHS or self-funded, and it now looks unlikely to be in 2021. With Libre 2 it first launched in quite a few other EU countries before a UK rollout, but we remain hopeful that we could see it in pharmacies early in 2022.

 

2. HOW DOES IT COMPARE?

 

FreeStyle Libre 3 CGM sensor

The most noticeable feature of Libre 3 is its slimmer profile as it is 71% smaller than Libre 1 and 2 in terms of volume. Visually it compares to two stacked pennies, appearing more discrete.

Being smaller it will be less prominent when worn on the arm and can easily be worn under clothing and so avoid attracting negative comments, or being confused with other objects or uses. However, users have noticed that whilst this firstly seems advantageous they have had concerns that it is more likely to be knocked and the adhesion seems less secure as it has a reduced surface area to keep it in place.

 

3. IS LIBRE 3 A CGM?

 

The good news is that Libre 3 is a true  continuous glucose monitor (CGM), and no longer just a flash device. The system gives users real-time glucose level readings meaning that levels are sent every minute to a smartphone and you see these directly on a graph on your phone. You can also see the levels on an Apple Watch, though not a graph.

 

4. DO I NEED TO SCAN?

 

FreeStyle Libre 3 sensor CGM compared to Libre 1 sensor

With Libre 3 you scan your arm with a compatible smartphone to initiate the sensor as with Libre 1 and 2. However, you no longer scan to get a reading as these are continuously updated to the app on your phone. 

There is no Reader for Libre 3 and Abbott are not producing one so Libre 3
will only work with a compatible phone. Currently there is only an app for iphones although an app for android phones is expected to follow soon. Compatible phones are currently iphone 7 and newer models.

Note: Libre 3 uses NFC to initiate the sensor with the phone and bluetooth is used to transmit glucose levels directly to this device.

 

5. IS THERE A NEW APP?

 

The LibreLink App has been refreshed and has to be downloaded from the Apple store. The menu of reports and functionality is largely the same ie. it shows time in range, estimated A1C and sensor usage etc. The main difference is that the graph updates every minute with real-time glucose levels - there is no time lag!

However, the app depends on the sensor being close to your phone to maintain connectivity and when there is no signal then you will not see updates to your glucose levels until it connects again - you can’t scan!

 

6. HOW IS LIBRE 3 APPLIED?

 

Abbott Freestyle Libre 3 CGM applicator

The Libre 3 has a new one-piece applicator which differs from Libre 1 and 2. The applicator is alrady loaded with the needle ie. you do not need to push the 2 parts together. 

To attach the sensor you unscrew the cap on the applicator and holding it in place on the upper arm press firmly. ThIs change means that Libre 3 has an easier method for attaching the sensor and reduces the amount of plastic used for the product.

As now with Libre 1 nd 2 there are no alcohol wipes included in the Libre 3 box.

 

7. WILL LIBRE 3 STICK?

 

It is not known if the adhesive used for Libre 3 is different to Libre 1 or 2. Users in Germany have not commented on any issues with sensitivity of the adhesive. However, there has been some concern that the small size of the sensor means that it is forgotton and more prone to being caught on objects eg. sofas or bags. It is also suggested that adhesion of the sensor may be adversely affected when hot or sweating etc.

 

8. CAN I WEAR LIBRE 3 ANYWHERE ELSE?

 

The back of the upper arm is still the only position that Libre is approved to be placed. Although many users postion their sensor in alternative areas of the body you will need to put it in the approved position if relying on glucose readings from the sensor for driving (in the UK).

 

9. ARE THERE ALARMS?

 

The same alarm options as available on the Libre 2 will be available with Libre 3 and as there’s no scanning the alarms should relate to real-time levels shown on the phone. The advantage here is that this should allow for anticipating falling or rising levels and give users time to take appropiate steps before alarms sound.

 

10. WHAT ABOUT FOLLOWERS?

 

Unfortunately, we don’t yet know if Libre 3 will have the capability for caregivers to follow users glucose values in real-time. No compatible app is currently listed with the German instructions for Libre 3,  but there’s no reason to think this feature won’t be available in due course.

Libre 3 provides updates to healthcare professionals via LibreView, as with Libre 1 and 2.

 

11. IS LIBRE 3 ACCURATE?

 

FreeStyle Libre 3 CGM iPhone screen and sensor

The accuracy for Libre 3 is based on Libre 2  which has a MARD of 9.3% over 14 days. Libre 3 still requires a warm-up of period of 60 minutes and may be not as accurate for the first 1 or 2 days but as glucose levels are shown in real-time users should see a closer correlation to finger prick tests.

 

12. WHAT WILL BE THE COST?

 

The reduced application process for the Libre results in a 41% reduction in plastic used in the production process and a 43% reduction in carton paper due to the smaller box in which the Libre 3 is packaged. 

 

13. HOW DOES LIBRE 3 ADDRESS SUSTAINABILITY?

 

Libre 3 is expected to be priced the same as Libre 2, and in doing so should retain its competitive advantage over Dexcom.

No doubt this will be welcomed by many users and is a step-up by Abbott but it does not address the lack of a proper system to recycle materials, which is left to the end-user and varies depending on local council facilities and policies.

 

14. WILL I STILL NEED A THIRD PARTY TRANSMITTER?

 

To receive real-time data on your phone or Apple watch you won’t need a third party product such as MiaoMiao, Bubble or BluCon NightRider and their associated apps. These products - which are unapproved as medical devices- may still offer some features that enhance the usability of a Libre, but essentially they will no longer be necessary for operating a Libre as a full CGM.

 

15. WHAT ABOUT PUMPS AND CLOSED LOOPS?

 

It’s known that Abbott have been working towards integrating the Libre with Automated Insulin Delivery Systems so although unlikely to be available at launch we can expect news on the options with Tandem and Insulet in 2022.

 

Disclaimer:

Love My Libre is not associated or affiliated with Abbott or FreeStyle Libre. Content here and on our website www.lovemylibre.com does not constitute medical advice or replace the relationship between you and healthcare professionals nor the advice you receive from them.

The author of this blog has type 1 diabetes and uses the FreeStyle Libre 2 which is provided on NHS prescription.

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[1] FreeStyle Libre and associated product names are registered trademarks of Abbott Diabetes Care Inc.

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