The FreeStyle Libre 2 is a revolutionary device that continuously monitors glucose levels without the need for routine fingerstick tests. It offers real-time glucose readings, alarms for high and low sugar, and easily integrates with your mobile device. It is part of Abbott’s Freestyle Libre family, a popular choice for people managing diabetes and is approved for individuals aged 4 or older.

Setup the Freestyle Libre 2 in a few Steps

Prepare your Device

If you are using a smartphone, download the FreeStyle Libre 2 app available from the App Store (for iOS) or Google Play store (for Android). Alternatively, you can still use the Libre 2 sensor by using the dedicated FreeStyle Libre reader.
When setting up the app, you will need to select how you count carbohydrates (either in grams or portion size). This features becomes more important if you are using the FreeStyle Libre 2 alongside an insulin pump.

Prepare your Sensor

Choose a site on the back of your upper arm and ideally you should avoid any areas with scars, moles, stretch marks or lumps. If you are on insulin, you should avoid those injection sites as well.

Clean the area on your upper arm with just plain soap (preferably non-moisturizing and fragrance free) where you will apply the sensor.  You could follow up with an alcohol wipe (provided in the box) to disinfect the skin and remove any oily residue on the site.

Remove the sensor from its packaging and make sure the codes on the sensor pack label and the sensor applicator match.

Next peel open the lid on the sensor pack and unscrew the cap on the sensor applicator. Line up the dark marks on the sensor applicator and sensor pack. On a flat and hard surface press down firmly on the applicator onto the sensor pack until it comes to a stop. Lift the applicator and the sensor should now be attached to the applicator.

Place the sensor applicator onto the prepared site and press down firmly. Gently remove the applicator and check to make sure the sensor is secure.

Activate your Sensor

Once the sensor is attached, you will need to scan it with the reader or mobile app to begin using it. The sensor will then be activated and following a 1-hour warm up it will be ready to provide you with glucose readings. It is important to keep in mind that you are only able to pair the sensor with one device – either with the app on your smartphone or with the FreeStyle Libre 2 reader.

Understanding the Readings on your Freestyle Libre 2 App

Your glucose levels are shown in real-time, and you can also view trends for the past 8 hours, 12 hours, or 24 hours. The data will help you understand patterns in your glucose levels throughout the day.

You can scan the sensor with your smartphone or reader at any time to get a current reading. The sensor takes glucose readings every minute and stores the data every 15 minute interval for up to 8 hours on a rolling basis.

The glucose readings range is from 2.2 to 22.2 mmol/L. If your glucose reading on the FreeStyle Libre 2 sensor is below or above the range, then you will not get a numerical reading and the app or reader will display a message that the value is out of range.

The app or reader will show a range of 3 to 21 mmol/L. But the graph on the app will scale up to 22.2 mmol/L automatically to accommodate for glucose readings above 21 mmol/L when needed.

The numerical values are displayed in a variety of colours to help you determine where you are at with a quick glance. The app and reader also displays glucose trend arrows to indicate the rate of change.

Red	Green	Yellow	Orange
Low glucose (below 3.9 mmol/L)	Within the target glucose range	Between the target glucose range and high or low level	High glucose (above 13.3 mmol/L)

You can customize the high and low glucose alarms through the app or reader settings. For example, if your glucose goes above or below a certain threshold, the system will alert you. There is also a signal loss alarm that will notify you if there have been no communications for 20 minutes with the app or reader. You should scan the sensor at least every 8 hours to avoid gaps in your daily graph.

Important Considerations of the Freestyle Libre 2

Just like other glucose sensors, the FreeStyle Libre 2 system inserts a thin filament underneath your skin and measures your glucose levels. However, it is important to keep in mind that the sensor is measuring the glucose levels in the interstitial fluid. Therefore, there is some variability in the glucose levels measured in your interstitial fluid versus in your blood.

With that said, a blood glucose reading is still important when your glucose levels are changing rapidly or if the readings on your Libre 2 sensor does not match the symptoms you are experiencing.

Interestingly, the FreeStyle Libre 2 reader also doubles as a blood glucose monitor and when paired with the FreeStyle Precision Test Strips will allow you to measure your blood glucose levels. With this built-in reader, you can also test your blood ketone levels using the FreeStyle Precision Ketone Strips.

Your phone or reader should be within 6 metres and ideally be unobstructed. If you are further than that you may not receive glucose alarms.

The FreeStyle Libre 2 sensor has been tested to withstand immersion into 1 metre of water for up to 30 minutes. It is also protected against insertion of objects >12 mm diameter. (IP27). You can bathe, shower and swim with your FreeStyle Libre 2 sensor.

FreeStyle Libre 2 has not been evaluated for use in pregnant women, persons on dialysis and people younger than 4 years old. More crucially, those that are critically ill should not use the FreeStyle Libre 2 system.

Those taking more than 500 mg of ascorbic acid, or better known as Vitamin C, could interfere with the FreeStyle Libre 2 sensor readings which could cause you to miss a low glucose event.

Some FAQ with the FreeStyle Libre 2

The FreeStyle Libre 2 sensor should be removed prior to a medical appointment that consists of strong magnetic or electromagnetic radiation and may include MRI, X-ray or CT scans.

The sensor can be exposed to common electrostatic (ESD) and electromagnetic interference (EMI), including airport metal detectors.

Some airport full-body scanners include X-ray or millimetre radio-wave, which you cannot expose your sensor to. In these situations you should request alternative screening methods or remove your sensor to go through a full-body scanner.

Other Applications for the FreeStyle Libre 2

LibreLinkUp

The LibreLinkUp app allows FreeStyle Libre 2 users to share glucose readings with family members or caregivers. You are able to make up to 20 connections and LibreLinkUp supports notifications for high and low glucose alerts. Caregivers can also access glucose trends, history, graphical views, and logbooks of recent readings and alarm events through the LibreLinkUp app.

LibreView

If you’d like to share your glucose readings from the FreeStyle Libre 2 sensor with your healthcare provider, they can access and review them remotely using LibreView. It can also provide interactive reports on glucose trends, daily patterns, estimated a1c and the time spent in range. This app works best with those using the FreeStyle Libre 2 app on their smartphones. If you are using the reader, you would need to connect to a computer with LibreView in order to upload and interpret the data from the reader.

If you want further information you should visit FreeStyle’s website and consult the FreeStyle Libre 2 manual.