While the FreeStyle Libre 2 has been available in Canada since early 2021, coverage for the second generation Libre system was limited up until late last year.
If you are wondering if you need to upgrade from the original Libre to the Libre 2, or if you are trying to decide if the Libre 2 is finally the one to take a plunge into sensor-based glucose monitoring, read on to get your Libre 2 questions answered:
What is the difference between the original FreeStyle Libre and the FreeStyle Libre 2?
Is the FreeStyle Libre 2 compatible with the original FreeStyle Libre reader?
Is the FreeStyle Libre 2 compatible with the original FreeStyle LibreLink mobile app?
Is it worth switching from the original FreeStyle Libre to the FreeStyle Libre 2?
Is the FreeStyle Libre 2 covered by insurance in Canada?
In Ontario, the FreeStyle Libre 2 system has been covered, as of November 30, 2021, by Ontario Drug Benefits (ODB) for people managing diabetes with insulin. ODB is available for individuals who are:
Age 24 or younger
Age 65 or older
Enrolled in the Trillium Drug Program
Ontario Disability Support Program (ODSP)
Ontario Works (OW)
Live in a long term care home
Receive home care services
Outside of Ontario, some public coverage is provided in Quebec, Saskatchewan, and Manitoba, though eligibility criteria is more limited. Scroll to the bottom of this page on the FreeStyle website to stay up to date on details regarding provincial coverage.
The FreeStyle Libre 2 may be covered by your private insurance provider. If your insurance coverage included the original FreeStyle Libre, chances are it would also cover the FreeStyle Libre 2.
How much does the FreeStyle Libre 2 cost?
The FreeStyle Libre 2 retails for the same price as the original FreeStyle Libre. Thus, if paying out of pocket, expect to pay about $90 to $120 per FreeStyle Libre 2 sensor (which lasts 14 days), and about $50 to $70 for the FreeStyle Libre 2 reader.
For those with a Costco membership, Costco offered the cheapest price I came across in Ontario, which sells the sensors for $88.99, reader for $48.99, and an 100 pack of Freestyle Precision Test Strips for $72.99.
As with the original FreeStyle Libre, I do recommend getting a prescription for the compatible test strips (FreeStyle Precision Blood Glucose Test Strips) for your FreeStyle Libre 2 system. The cost of FreeStyle Precision Blood Glucose Test Strips range from $70 - 90 for a box of 100. You want to make sure you are able to finger prick for confirmation when needed!
If you plan on purchasing the FreeStyle Libre 2 sensors to use without the reader (a.k.a. You are only planning to use the sensors with your phone), I’d recommend at least keeping your old glucometer on hand for times when you need to finger prick for confirmation.
What is the difference between the original FreeStyle Libre and the FreeStyle Libre 2?
The main difference between the original FreeStyle Libre and the FreeStyle Libre 2 is that the Libre 2 has optional glucose alarms that notify you if your blood sugar is too high or too low.
The alarms can be set up via the FreeStyle Libre 2 App, this allows the App to send you a notification, sound and/or vibration when your alarm is activated. In order for the alarm to work - you must keep Bluetooth on for your phone and remain within 6 meters of your phone.
There are three alarms possible:
Low Glucose Alarm (you can customize the value set between the range 3.3 - 5.6 mmol/L)
High Glucose Alarm ( you can customize the value set between 6.7 mmol/L and 22.2 mmol/L.
Signal Loss Alarm
If you plan to rely on the glucose alarms, be sure the Signal Loss Alarm is kept on. This will notify you when your sensor and phone have lost communication for 20 minutes. Also keep in mind that the sound level for your alarms will follow the volume and vibration settings for your phone.
Part of the reason the FreeStyle Libre 2 system has the ability to make use of glucose alarms is that the lag time on the Libre 2 (referring to lag time between blood glucose and sensor glucose) is shortened compared to the original Libre. While the original FreeStyle Libre lag time was approximately 5 minutes, the FreeStyle Libre 2 has halved that to about 2.4 minutes.
Is the FreeStyle Libre 2 compatible with the original FreeStyle Libre reader?
No. If switching over to the FreeStyle Libre 2 sensors, you will need to update the reader as well. The Libre 2 sensors does not work with the original reader.
Is the FreeStyle Libre 2 compatible with the FreeStyle LibreLink mobile app?
No, the FreeStyle Libre 2 sensors will not work with the LibreLink app. You will need to download the FreeStyle Libre 2 app instead. You’ll notice the format of the two apps are largely the same.
Just like the original FreeStyle LibreLink mobile app, you will be able to share your Libre data with your healthcare practitioner via the FreeStyle Libre 2 app.
Is it worth switching from the original FreeStyle Libre to the FreeStyle Libre 2?
In general, if your insurance coverage for the two Libre systems do not differ, I typically do recommend upgrading to the FreeStyle Libre 2 system as there is no cost difference.
While it may not feel like there are substantial changes between the original Libre system and the FreeStyle Libre 2, for the same price, you are getting a device with a shorter lag time (improved accuracy) and an optional alarm system.
Have other questions about the FreeStyle Libre 2? You may find your answer in my original post about the FreeStyle Libre or comment down below with your questions!
References
Alva S, et al. Accuracy of a 14-Day Factory-Calibrated Continuous Glucose Monitoring System With Advanced Algorithm in Pediatric and Adult Population With Diabetes. J.diabetes Sci. 2020:10.1177/1932296820958754
FreeStyle Libre 2. Abbott. https://www.freestyle.abbott/ca-en/freestyle-libre-2.html. Accessed Aug 25, 2022.
Flash Glucose Monitoring. Abbott. https://freestylediabetes.co.uk/freestyle-libre/flash-glucose-monitoring-temp#:~:text=The%20average%20lag%20time%20between,readings%20may%20be%20very%20similar.. Accessed Aug 25, 2022.
The FreeStyle Libre 2 system: Frequently asked questions. Abbott. https://www.freestyle.abbott/ca-en/faqs/freestyle-libre-2.html. Accessed Aug 25, 2022.
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