“The Freestyle Libre 3 is going to be the thinnest, the smallest, and the most accurate sensor in the world.”
That’s what Dr. Mahmood Kazemi, M.D, told me last month. I met Dr. Kazemi, Abbott’s Chief Medical Officer for diabetes care, at the American Diabetes Association’s annual scientific conference. He gave me a sneak peek at the new continuous glucose monitor (CGM). He thinks it’s the best ever made:
“When you look at the innovation that the Freestyle Libre 3 is bringing to the CGM market, it’s actually unmatched. When you see it, you’ll see that it’s unmatched in its size. And beyond that, it’s unmatched in its accuracy, and it’s the only CGM with a 14-day wear.
“I’m an endocrinologist by training, and I practiced for many years. When I think back to what I had to offer my patients, the Libre 3 system would basically be science fiction. People could not even conceptualize that it could be this small, this thin, this discreet, and that it could last for 14 days with such great accuracy.”
This article will preview the features of this latest Freestyle CGM system. And, when possible, I will compare it to its biggest competitor: the Dexcom CGM system.
The Size
The list of features starts with the “form factor,” as Dr. Kazemi called it. This sensor is tiny – Abbott, the manufacturer, compares it to two pennies stacked on top of each other.
For any patients especially concerned with the size of their CGM sensor – whether you hate the feeling of clunky devices attached to your body, or constantly find yourself bumping your sensor into door frames and catching it on clothing – the Libre 3 immediately leaps to the top of the pack.
The new Dexcom G7 will also be impressively small, far smaller than the G6 system … but it’s still not quite this small.
Image courtesy of Abbott Laboratories.
The Wear Length and Accuracy
Another huge feather in the Libre 3’s cap: the 14-day sensor length. A single sensor lasts two weeks.
Accuracy data presented at the conference suggested that the Libre actually reaches its peak of accuracy around day 10 of the sensor’s life.
“With all CGM devices, when it’s first inserted, it’s not always as accurate. It’s not just ours, it’s any CGM device. But the great news with this device, when you look at the accuracy data, is that even when it’s in the early phase of its use it still has an amazing accuracy profile.”
The truth is that both Dexcom and Abbott claim to have created the world’s most accurate continuous glucose monitor. I don’t know if we’ll be able to say which device is the true accuracy champion. The important thing is that both are well within federal accuracy standards, and both accurate enough to mostly eliminate the need for fingersticks.
No More Scanning
If there was one obvious sticking point with the previous Freestyle Libre CGM systems, it’s the fact that users didn’t just get their blood sugar numbers automatically beamed to a dedicated receiver or smartphone. They had to manually scan the sensor by holding their device over the sensor for a few moments.
Scanning is unnecessary with the Freestyle Libre 3 – your smartphone will update with new blood sugar readings automatically. Abbott’s promotional material has not stressed this point, perhaps in an effort not to disparage the Libre 2, which is still fairly new and still selling well. But to me, it seems like one of the most important improvements for the new device. In our survey of CGM users, manual scanning was frequently mentioned as a major annoyance with the older generations of Libre CGMs.
Updates Every Minute
Another bonus? The Libre 3 will provide new blood glucose readings every 60 seconds.
“The closest competitor offers readings every 5-minutes. With the Freestyle Libre 3, you do not have to wait. You will know where your glucose is going on a minute-by-minute basis, and if you’re having a low, that’s very important information.”
Interoperability
Abbott still has some work to do here: the Freestyle Libre 3 will not be approved in the United States for use in a closed-loop automatic insulin delivery system with the Omnipod, the Tandem t:slim, or any other insulin pump. Why? The FDA believes that the Freestyle Libre sensor may give inaccurately high blood sugar readings to patients that consume high doses of vitamin C.
Dr. Kazemi assured me that “we are actively working on having that [warning label] removed from the system.” They plan to submit information to the FDA later this year that may help remove the label and open up the possibility of integrating the Libre 3 into a closed-loop system.
Other Features
The Freestyle Libre 3 brings many other features to the table, some of which were introduced with the Libre 2 model, and some of which will be new:
Glucose alarms
Glucose trend arrows
Remote monitoring for family members/caregivers
Data sharing with healthcare professionals
Advanced data analysis in the smartphone app
33-foot Bluetooth range (50% more than Dexcom and Medtronic)
One-piece applicator – a big improvement over the previous applicator, Dr. Kazemi told me.
With all of these features above, the Libre 3 positions itself as a true competitor of the Dexcom G6 and G7 systems, not just a less expensive alternative.
Cost
Given the vagaries and complexities of health care economics, it’s difficult to say exactly what any one patient will pay for a Libre 3. For those of us lucky enough to have generous health insurance policies (or live in countries with robust socialized healthcare systems), the Libre could be practically free. For some of us, it may be prohibitively expensive.
But we can say that the Freestyle Libre products usually cost less than the competing Dexcom products. That’s been true for years, and it’s not likely to change. Abbott is promising that Libre 3 will cost exactly the same as the Libre 2.
Dr. Kazemi told me, “Abbott is not charging a premium for bringing such great improvements to the technology. We really just want to make sure that people have access. That’s what we’re all about, accessibility and affordability.”
Abbott, just like Dexcom, is doing what it can to get insurance coverage for patients with type 2 diabetes. CGM technology can be vital for patients with T2 that use insulin – and even for those without a major risk of hypoglycemia, it can be a wonderful tool for optimizing blood glucose levels.
When will it be available?
The Libre 3 is already available in some parts of Europe. In late May, the FDA extended formal approval for the system in the United States, but it hasn’t been released yet.
Dr. Kazemi could only tell me that it would be available in the US “later this year.”