Expect Buzz About CGM With New FreeStyle Libre 3

The new FreeStyle Libre 3 will lead to more buzz about continuous glucose monitoring (CGM) for patients with diabetes.

Libre 3 is similar to Libre 2 in that it’s for ages 4 and up...and uses a sensor worn on the upper arm that’s changed up to every 14 days.

But Libre 3’s sensor is a bit smaller. Plus it automatically sends results to a smartphone app. Older versions require scanning with a separate reader or smartphone to display results.

Libre 3 will be touted as the most accurate CGM...based on how closely its results match finger-stick glucose. But point out that patients still need to check a finger stick with a standard meter if prompted...or results don’t match how they feel.

And Libre 3 still isn’t integrated with insulin pumps yet.

FreeStyle Libre 3 costs about $120/month for 2 sensors...the same as Libre 2, but generally less than other CGMs (Dexcom G6, etc).

Watch for mix-ups with sensors for Libre, Libre 2, and Libre 3. All are available for now...but they aren’t interchangeable.

Expect CGM to be covered by most payers. But a prior auth may be needed...or it may be covered as durable medical equipment (DME).

For now, Libre 3 isn’t covered by Medicare as DME...since there isn’t a durable component (reader, etc). Stay tuned for changes.

Put the role of personal CGM in perspective.

Fewer finger sticks may sound appealing...and some patients may find CGM helpful to track patterns, see the impact of meds, etc. But any benefit hinges on actually using the data to guide changes.

So far, most evidence for CGM is in patients using multiple insulin injections per day. Evidence is still limited about whether CGM reduces risk of severe hypoglycemia or improves A1c with non-insulin regimens.

Continue to help individualize glucose monitoring.

For example, consider CGM for a motivated, tech-savvy patient on multiple daily insulin injections or with frequent hypoglycemia. But don’t jump to CGM for most patients using only oral meds.

Get our resource, Continuous Glucose Monitoring, for help with billing, sensor adhesion, and how to interpret results.

Key References

  • Diabetes Care. 2022 Jan 1;45(Suppl 1):S97-S112
  • Curr Diab Rep. 2021 Dec 9;21(11):49
  • Medication pricing by Elsevier, accessed Sep 2022
Pharmacist's Letter. October 2022, No. 381003

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