Syringe and Vial
Freestyle Libre 2
Summary
Traditional syringe and needle. The most affordable insulin delivery option.
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
Needles
Classic syringes with plunger used to fill insulin for injection
Long-acting insulin
Basal (long-acting) insulin vial for steady release of insulin that helps control blood sugar between meals, and overnight.
Rapid-acting insulin
Bolus (fast-acting) insulin vial for meal time or high blood sugar correction.
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 but very 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
$$$$
Syringes are available worldwide in pharmacies or DME without prescription. Price Range: $0-$300/month depending on insurance coverage.
$$$$
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
28 Days
Open vials can be stored at room temperature (not above 80º F) for up to 28 days. Unopened vials should be stored in the refrigerator (36ºF - 86ºF.)
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
A LOT dexterity for insertion
YES text to speech
YES vibration alerts
3 sound sources
A LOT of dexterity needed
Patient Considerations
Active Lifestyle
Limited Adjustability. No way to adjust long-acting insulin for higher activity on the fly.
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
Limited customizability. Requires a high level of engagement and effort to avoid highs and lows but can be paired with a CGM for improved blood sugar control.
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. Must carry insulin vials and large syringes but nothing attached to the body.
Low profile sensor and small adhesive.
Easy Insulin Dosing
Requires attention. You have to do the math to figure out your dose. Unable to adjust basal in real-time.
Scanned sensor trends can be used for dose adjustment.
Easy to Use
Many steps. Requires effort to figure out doses and deliver insulin every single time you need it.
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. Vials and syringes can be hidden when not in use but very visible when in use. Frequent injections are unavoidable.
Hypoglycemia safety alarm. Discreet size but built-in hypoglycemia safety alarm alerts users when glucose is below 55 mg/dl and is always on.