Libre 2 v Libre 3

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Kev C

Kev C

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Relationship to Diabetes
Type 1
Whilst in the USA last year, I noticed that Libre 3 patches were being advertised on Tv. They appeared to be smaller and thinner than the Libre 2 patches that we use here in the UK. I understand that Libre 3 is not available on prescription with the NHS, but I wanted to know if anyone has any experience of using both Libre 2 and Libre 3 and if so, what their experience was like, for example, was Libre 3 more accurate than the Libre 2 and would welcome any other comments they can offer, i.e. advantages/disadvantages, if any. Also, if there is anyone from Diabetes UK that can provide any information as to whether the NHS are likely to provide Libre 3 on NHS prescription in the near future? 🙂

Many thanks
 
Kev C said:
Also, if there is anyone from Diabetes UK that can provide any information as to whether the NHS are likely to provide Libre 3 on NHS prescription in the near future? 🙂
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From what I have heard from Abbott Libre 3 may be made available for sale in the UK at some point (like competitors eg Dexcom already are), but it is in a different class or category in terms of NHS funding than Libre 2.

Libre 2 is on tariff for prescription (including by GPs), but Libre 3 needs to have direct finding put in place between specialist clinic and manufacturer, in the same way that Dexcom G6 / G7 and insulin pumps/consumables do.

So I can’t see that Libre 3 will more categories and become prescribable any time soon I’m afraid.
 
I have been one of the lucky ones to start to receive funding for Libre 3.

To be fair, there are not too many differences from my point of view, yes they are smaller, and yes it’s continuous, however that’s not really a difference now as Libre 2 is continuous.

Accuracy wise they were both the same when compared against a BG meter, so one was not better than the other in that respect.

One observation…I had 3 Libre 3 sensors not apply properly compared to all the time I used Libre 2. 2 of those times caused me considerable pain I had to take them off and when I did it had bent.

Moving forwards, the funding has been withdrawn and I’m back on Libre 2.
 
I live in Germany so I can't speak to anything NHS-related, but I've had both Libre 2 and Libre 3.

I found the glucose line much smoother on the Libre 3 graph.

The sensors are definitely thinner and smaller.

Since the sensor is smaller, my endo said some users might have issues with adhesion since there's not as much to stick to your skin. I didn't have any problems.

The applicator and actual sensor are smaller, so less waste.

The packaging is much smaller (I get a three month supply at a time) so it takes up less space in storage.

Libre 3 has a reader identical to the Libre 2 reader, just grey instead of blue. Apparently this isn't available in some countries yet, but it does exist.
 
Acording to the meducal trials, libre 3 is the most accurate, more so than dex 6 or 7.
I find dex 6 to be accurate enough for me...any further accuracy would probably be unnecessary. I found libre 2 to be pretty inaccurate
 
Thank you @Finn, apologies for the slight bombardment of questions.

Are you using both the Reader and a phone app? Is the L3 Reader any more sophisticated than L2 Reader? I used the L2 Reader a lot for its speed and ease of portability, but also found it very basic, more akin to a Nokia phone from 25+ yrs ago and unworthy of today's tech. Ideal for when Libre was launched, but could (should IMO) have been upgraded for L2.

Does the Reader provide rtCGM? If the Reader and app are both active, does the Reader prevent (override) rtCGM?

Is L2 still obtainable in Germany, or completely phased out?

Do the Federal States of Germany provide a fairly standard level of medical support across the States? I appreciate there isn't a close copy of the NHS there, but is there some sort of equivalent or is it more akin to the USA and individual insurance arrangements in conjunction with deep pockets? I spent several years there 40 years ago, but my medical cover was provided privately and I was young enough to rarely need any sort of medical help. I was very aware of the differences in optician services and recall being very sternly told that I had to have compound lenses because I'd crossed an age threshold - not because I actually needed them! By a girl half my age who was very reluctant to accept my wishes.
 
Hello, my colleague’s kid has the Libre 3 NHS prescribed (with a Ypsomed pump. Some sort of “closed loop” system?) They love it after some ongoing issues with Dexcom G6 and 7 giving some wild readings? (And failings before the 10 day life is up.)
I currently use the Libre 2. Though, after a screw up with a recent prescription. I happen to be using the Dexcom G6 that I happened to have sitting about sent as a trial?
My colleague & I are currently swapping notes. He has said he’s had no problems with adhesion with his active 4 year old. Happier all round as opposed to the Dexcom. They had no experience with the libre 2.
 
Proud to be erratic said:
Thank you @Finn, apologies for the slight bombardment of questions.

Are you using both the Reader and a phone app? Is the L3 Reader any more sophisticated than L2 Reader? I used the L2 Reader a lot for its speed and ease of portability, but also found it very basic, more akin to a Nokia phone from 25+ yrs ago and unworthy of today's tech. Ideal for when Libre was launched, but could (should IMO) have been upgraded for L2.

Does the Reader provide rtCGM? If the Reader and app are both active, does the Reader prevent (override) rtCGM?

Is L2 still obtainable in Germany, or completely phased out?

Do the Federal States of Germany provide a fairly standard level of medical support across the States? I appreciate there isn't a close copy of the NHS there, but is there some sort of equivalent or is it more akin to the USA and individual insurance arrangements in conjunction with deep pockets? I spent several years there 40 years ago, but my medical cover was provided privately and I was young enough to rarely need any sort of medical help. I was very aware of the differences in optician services and recall being very sternly told that I had to have compound lenses because I'd crossed an age threshold - not because I actually needed them! By a girl half my age who was very reluctant to accept my wishes.
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I switched to Dexcom G6 earlier this year when I got a pump. I now loop with Dexcom G6 and I find it more accurate than FreeStyle Libre 2 or 3. The ability to calibrate is a big pro for me.

When I was on Libre 3, I primarily used my reader, so I got alarms on my reader. I think I wasn't able to get readings on the app once it was activated with the reader. I can't remember for sure. I think this is a difference with the Libre 2 - if you activate a Libre 2 with a reader, you can still scam with the app (I don't know if this has changed now that Libre 2 gives real time readings in the UK). I do know that I tried activating a Libre 3 with the app and the alarms were horrendous and not able to be changed or turned off, so I used only the reader for Libre 3. For Libre 2, I usually activated with my reader and was able to also scan with my phone.

The Libre 3 reader is exactly the same as the Libre 2 reader. It doesn't provide any extra functions except being an rtCGM.

I think Libre 2 has been phased out in Germany. Just over a year ago, they switched prescriptions over to Libre 3. I don't know if Libre 2 is still offered here.

Germany has compulsory insurance. You can select your provider and there are a few to choose from in each state. As far as I'm aware, they all provide basically the same coverage. I go to appointments, stick my insurance card in the reader and walk away without paying anything. Beside my monthly contribution, all I have to pay for are prescriptions (less than €10 a prescription).

All my pump supplies, including Dexcom, infusion sets, reservoirs and 2 cases a year are covered by insurance. That includes my pump (Tandem t:slim x2) - I didn't pay a penny for it. I do have to pay for insulin (€10 for 10x3mL cartridges), tablets and, when I was on MDI, needles, but many prescriptions are capped at €5 each.

I never needed much care until I was diagnosed two years ago and since then, I've been very impressed with the German system. I've had no surprise bills (except €10 for the ambulance on diagnosis and €10 per day when I was recovering in the hospital) and haven't been turned down for any tech that my endo has recommended.

My endo sees me once every 1-3 months for a 45-60 min appointment and blood tests. My GP also offers me blood tests if I see my GP between endo appointments. The diabetes support team are quick to respond to emails.

When I moved to a pump, they had a system set up where I did three days of basal testing in the hospital. They checked on my a few times a day, went through my CGM data and showed me what tweaks to make. It was a bit over the top considering I'm pretty good with tech, but it made the transition very easy.

I would say the care I've received in Germany is more like in the UK, but without the extraordinarily long waits. You're not going to get hit with a major bill or be turned down for something your doctor says you need. We do pay a monthly contribution, but it's a fixed portion of you income, so insurance shouldn't get to be unaffordable like it can get in the US.

Sorry for the epic reply. 🙂
 
The system in germany sounds better than the nhs, to be honest. The dexcom g6 is hard to get here, the standard is libre 2 and i see my endo every year.
Though are prescription are free.
It seems the nhs is kinda ok if you are self sufficient, can teach yourself diabetes management, and advocate for yourself.
There are just too many people on here with a sorry tale to tell about lack of diabetes information, help and support.
 
Tdm said:
The system in germany sounds better than the nhs, to be honest. The dexcom g6 is hard to get here, the standard is libre 2 and i see my endo every year.
Though are prescription are free.
It seems the nhs is kinda ok if you are self sufficient, can teach yourself diabetes management, and advocate for yourself.
There are just too many people on here with a sorry tale to tell about lack of diabetes information, help and support.
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Yes, it is difficult to read posts from people in the UK who aren't getting the support, tech or treatment they should be getting. And similarly, it's hard to hear about people in the US not being able to afford those things, or having big out of pocket expenses for the things they require to stay alive.

I think the system in Germany is pretty good, but I've never really needed this much care when living in the US or UK so I can only base my comparison on what I've read of others' experiences.

It does cost money though. For public insurance in Germany (what most people have), employees pay about 10% of their monthly income (capped at about €500/month) and their employer contributes roughly the same. Self-employed people pay both portions with a cap of just under €1,000). If you earn more, you pay more (to a limit). If you earn less, you pay less. How much you pay doesn't affect the care you are entitled to or any out of pocket expenses (prescriptions are always less than €10, an ambulance is always €10, a day in the hospital is always €10).

Whether you're an employee or self-employed, any dependents (a non-working partner or kids) are covered. If both partners are working, they both need to contribute separately (but if one stops working temporarily or long-term, they can shift on to the working partners coverage without any extra cost, just by notifying the insurance provider).

Private insurance is different and I'm not sure how it compares.

Public insurance also covers dental appointments (two check ups a year is common here), cleaning and essential treatment.

I was diagnosed during the pandemic and I've never had delayed treatment or appointments. All appointments have been in-person and for the 6 months after my diagnosis, I saw my endo monthly, or quarterly at a minimum.
 
Finn said:
Yes, it is difficult to read posts from people in the UK who aren't getting the support, tech or treatment they should be getting. And similarly, it's hard to hear about people in the US not being able to afford those things, or having big out of pocket expenses for the things they require to stay alive.

I think the system in Germany is pretty good, but I've never really needed this much care when living in the US or UK so I can only base my comparison on what I've read of others' experiences.

It does cost money though. For public insurance in Germany (what most people have), employees pay about 10% of their monthly income (capped at about €500/month) and their employer contributes roughly the same. Self-employed people pay both portions with a cap of just under €1,000). If you earn more, you pay more (to a limit). If you earn less, you pay less. How much you pay doesn't affect the care you are entitled to or any out of pocket expenses (prescriptions are always less than €10, an ambulance is always €10, a day in the hospital is always €10).

Whether you're an employee or self-employed, any dependents (a non-working partner or kids) are covered. If both partners are working, they both need to contribute separately (but if one stops working temporarily or long-term, they can shift on to the working partners coverage without any extra cost, just by notifying the insurance provider).

Private insurance is different and I'm not sure how it compares.

Public insurance also covers dental appointments (two check ups a year is common here), cleaning and essential treatment.

I was diagnosed during the pandemic and I've never had delayed treatment or appointments. All appointments have been in-person and for the 6 months after my diagnosis, I saw my endo monthly, or quarterly at a minimum.
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Thank you, very interesting perspective. I'm not surprised after over 10 years in total living and working in Germany between age 25 to 40.
 
everydayupsanddowns said:
From what I have heard from Abbott Libre 3 may be made available for sale in the UK at some point (like competitors eg Dexcom already are), but it is in a different class or category in terms of NHS funding than Libre 2.

Libre 2 is on tariff for prescription (including by GPs), but Libre 3 needs to have direct finding put in place between specialist clinic and manufacturer, in the same way that Dexcom G6 / G7 and insulin pumps/consumables do.

So I can’t see that Libre 3 will more categories and become prescribable any time soon I’m afraid.
Click to expand...
Thank you for your reply, very helpful.
 
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