Afrezza
Freestyle Libre 2
Summary
Inhalable regular human insulin. Cartridges come in three doses: 4, 8, and 12-unit doses.
The FreeStyle Libre 2 is the thinnest, all-in-one glucose sensor/transmitter and requires scanning using a handheld reader or compatible smartphone with an app. This sensor lasts for 14 days and only needs fingersticks as backup. Optional low and high blood sugar notifications are available for this system.
FDA approved for insertion on the back of the upper arm (ages 4 years and older).
MARD of 9.3%
Components
Inhaler
Small refillable inhaler contains a compartment for powdered insulin containing cartridges.
Cartridge
Cartridges come in three doses: 4, 8, and 12-unit doses. All color coded.
Sensor
Sensor uses a thin, flexible filament inserted just under the skin to measure glucose levels every minute. Push-button applicator allows sensor to be placed on the body in one step.
Receiver
Conveniently access glucose readings using a reader, smartphone, or both. Available for both iOS and Android devices.
Device Details
Overview
Nothing on the body when not in use. Visible when dosing.
All-in-one glucose sensor/transmitter with low and high blood glucose alarms can be worn on the upper arm.
Affordability and Access
$$$$
Widely covered. Price range; 0-$99/month, depending on insurance coverage. $35/month for medicare and commercial insurance plans.
$$$$
Widely covered. Provided by pharmacies. Price range; $0-$100/month. Often the cheapest and easier to access sensor.
Data Monitoring Options
No Options
Yes
After each sensor scan with the mobile app or reader, data is automatically sent to the user’s LibreView account which enables sharing with HCPs and caregivers via the LibreLinkUp app. Data upload is possible with Glooko and Tidepool data-management systems.
Data View Options
No Options
Yes
Freestyle Libre 2 app provides glucose readings and alarms, multiple data views, the ability to share glucose data and real-time alarms with LibreLinkUp, and the ability to connect to a clinician's practice through LibreView.
Duration and Storage
10 Days
Open cartridges last up to 10 days. Sealed cartridges may be stored in a refrigerator at 36°F - 46°F until the expiration date.
14 Days
Sensors last 14 days and work between 50ºF - 113ºF. They are shipped in orders of 1-3 months at a time - which is 2-6 boxes at a time.
Vision / Auditory / Dexterity
NO text to speech
NO vibration alerts
LITTLE dexterity needed
YES text to speech
YES vibration alerts
3 sound sources
A LOT of dexterity needed
Patient Considerations
Active Lifestyle
Body free of devices. Does not remain attached to the body.
Water-resistant for up to 3 feet deep for 30 minutes and light on the body, does not get in the way of activity. The reader must be within 1.5 inches of the sensor to scan it.
Avoiding Highs and Lows
Very short-acting. Absorbs quickly through the lungs to correct high blood sugar but requires attention to prevent lows.
Optional glucose alerts for low and high glucose levels. Trend arrows show the direction glucose is heading, with the rate of change.
Comfort
Many components. Have to carry multiple cartridges that can be bulky.
Low profile sensor and small adhesive.
Easy Insulin Dosing
Less precise but easy dosing. Dosing may be less precise due to the inhaled method of dosing, but color-coded cartridges make dosing easier. Dosing can also be done based on small, medium, or large meals and can be administered 1-2 hours post meals.
Scanned sensor trends can be used for dose adjustment.
Easy to Use
Simple design. Whistle-like device for inhaling insulin.
Requires scanning. Self-application and manual scanning are required. Easy self-application.
Fewer Fingersticks
Frequent finger-sticks are required.
Factory-calibrated sensor. Finger-sticks needed for backup only.
Privacy
Hideable. Small, discreet, and portable device that's not as noticeable as injections.
Hypoglycemia safety alarm. Discreet size but built-in hypoglycemia safety alarm alerts users when glucose is below 55 mg/dl and is always on.