The Libre PLUS sensors are taking over!
What is happening
The newest FreeStyle Libre 3 Plus sensor is the world’s smallest, thinnest, and longest running CGM sensor you can put on your skin. And together with the Libre 2 Plus, they are now replacing the older Libre 2 and Libre 3 sensors, which are both being
discontinued by Abbott.
Abbott has recently in America and across Europe sent notifications on the discontinuation of their Libre 2 and Libre 3 sensors to their distributors, pharmacies, university hospitals and endo clinics that have been customers of these for the last
many years.
All while recommending they inform patients to migrate as soon as possible to their new Libre 2 Plus and Libre 3 Plus sensors instead. This will for many patients require both new prescriptions from their doctor and also updated coverage by relevant health insurance companies.
So what does this change really mean for the patient, what are the product improvements that make this change worthwhile? Are there practical or monetary implications you need to consider?
We will review some of these aspects in this article, what improvements the Plus sensors bring you, what about accuracy and costs, etc.
What is the Libre PLUS?
The Plus version of the sensors offer several good improvements and features to the sensors we did not have before. All while maintaining the basics of application and functionality staying the same. So essentially you apply the Libre sensor onto the back of your upper arm, from where it collects your glucose data from the fluid under your skin. Your receiving device (your smartphone or a dedicated Libre Reader) will provide you with real-time, minute-by-minute information about your blood glucose value, which they receive from the sensor via Bluetooth.
The system also uses customizable alarm settings to notify you whenever your blood glucose goes too high or if it drops too low. As there are distinct differences from their older Libre 2 and 3 sensors to the new Libre 2 and 3 Plus models, then also the product catalog numbers have been updated, as well as the product packaging now with a fresh sharp new look.
Key upgrades to the Plus sensors
Several special upgrades to the Plus sensors are really setting them apart from the previous standard Libre 2 and Libre 3 models. Most significant one is that the Plus sensors are now all approved by the regulatory authorities to interface directly with
insulin pumps. Some of the more advanced insulin pump users can now setup their pump to work in a closed-loop configuration with the Libre Plus sensor.
Next significant upgrade is that the Libre Plus sensors now can run for full 15 days, which is one day more than the 14 days the previous Libre 2 and Libre 3 could run.
This is now 50% longer than their nearest competitor from Dexcom.
The third special upgrade is good news for many parents out there having a diabetic child, as the latest Libre 2 Plus and 3 Plus models have been approved for usage now all the way down to from 2 years or older. The old standard Libre sensor models were only approved for users being 4 years old and up.
There is one more significant upgrade that has come at the same time, namely a brand new Libre app to use on your smartphone with these sensors. But this app is currently only available for users on the USA marked, but expected to be rolled out globally in the months ahead.
Now let us dive into some of the detailed specs and improvements in the following chapters.
PLUS sensor application
The Plus sensor applicators both look and work the same way as their prior standard sensor applicators did. So not much change here really, except for the patients that may move from the Libre 2 platform to the Libre 3.
With the Libre 2, the bottom sensor component is sealed in its own separate container and then you have one more sterile container with the applicator itself. So with Libre 2, you have as user to complete one more step by attaching these two components to each other before it can be applied to your skin. While with the Libre 3 platform, all has really been pre-assembled and as soon as you open the sterile seal top, then it is ready
to be applied onto your skin.
As with all prior Libre sensor models, then the back of your upper arm is the only officially approved skin location for applying the Plus sensors. Some users are using alternatives sites and also some doctors are prescribing them off label to be used at other skin locations. Especially the stomach or the upper thighs are frequently used as viable alternatives. E.g. if you have had scarring after surgery or have tattoos on your arms, then alternatives may be relevant. But if applying them anywhere else than your upper arm, then it is at your own risk.
Libre PLUS sensor design
If you are familiar with the previous Libre 2 and Libre 3 sensor models, then you will for sure be happy to learn that the new Plus models are using same sleek overall formfactor design. With same sensor material, the same matte white color. With practical rounded disc edge and slim line design, making them very discreet. Especially the Libre 3 / 3 Plus is so incredible small, with the size and thickness just as if you stack 2 pennies on top of each other.
Dexcom is the closest competitor to Abbott’s Freestyle Libre and the Dexcom G7 sensor is substantially bigger and 1.5 times thicker than the Libre 3 Plus sensor.
Wearing the Libre 3 Plus in practical daily life therefore also brings advantages, as it is so small and thin that it rarely ever snags on anything. Also during sleep, due to the much thinner form factor the Libre3 is much less likely to cause any ‘pressure low’ if you lay on your side while sleeping. This is otherwise a phenomenon that can cause CGM sensors to issue a faulty low blood glucose alarm during your sleep, as added pressure on a sensor can cause a restricted blood flow to it.
Libre PLUS receiving device
(phone or reader)
When you want to observe your blood glucose data readings from the sensor, then you have two options. Either you utilize the mobile app on your phone or you can use a dedicated Libre Reader device. To activate a new sensor, you click on ‘scan new sensor’ command and hold your phone/Reader close to the sensor for a couple seconds until you hear a beep. Then a 60-minutes warm-up cycle has started. When that is complete, you can start to receive the glucose readings in the app or via the Reader. Unfortunately, you cannot use both the phone and the reader at the same time because each Libre sensor can only connect via Bluetooth to one device at a time. So while this is not ideal, you will have to select which device you want to use for being the reader/connector for this to your sensor.
The sensor connects via Bluetooth and if no major obstacles are in the way, the reading distance is around 10 meters (33 feet). Both the Libre 2 Plus and Libre 3 Plus gets automatically the BG readings every minute from the sensor to the app, so it is very convenient and easy to use. (For all apps when outside USA. When using the new ‘Abbott for Libre app’, then this also works in USA. More about that described below).
If you by chance venture outside the Bluetooth read range, then the sensor has an onboard memory, in which it stores the blood glucose readings while you are out of range. And when the phone/app detects that the sensor is back within range, then all the missed data points will be backfilled in again into the app and the blood glucose graph you have on your screen there. The Libre 2 Plus has an 8-hour memory for this, while the 3 Plus can store all your data for the entire 15 days just in case.
The dedicated Reader costs around 75 US$/65 Euros. It needs typically to be recharged ever 3 days or so. But with this you have all your diabetes measures apart from your phone. The Reader can also function as a stand-alone fingerprick meter to measure your blood glucose that way. So, using the Reader and not the phone app is preferred by some users, as the Reader makes it both very simple but also reliable to capture the readings from your sensor or via a fingerprick stick if need be.
Other people may however prefer not to have to handle a second device, if already carrying their phone and preferring to have all-in-one when on the go. There are also more advanced reporting features available when using the phone app for this. The user interface is also much more intuitive to use and the graphics more elaborate.
The new Libre app
As part of launching the Plus sensor models to the marked and phasing out the older standard Libre2 and Libre 3, then a brand-new Libre app was introduced.
The new ‘Libre by Abbott’ app got a fresh new user interface as part of the Libre suite rebranding. The older Libre 2/2+ and Libre 3/3+ apps can still be used, but the new ‘Libre by Abbott’ app works with them all no matter which sensor model and it both looks and works much better than the older apps. The new app has all the familiar features that we are used to, like the home screen with minute-by-minute glucose readings coming in, the trend arrow and the 12-hour graph. You will also find the usual insights like time in range (TIR), average blood glucose value and your daily patterns.
These reports have a new refreshed modern look, but the core data content has not changed.
Big improvement this new app brings is especially if you are a Libre 2 user based in the USA, as this new app will enable you to get live BG updates automatically via Bluetooth to your phone app every single minute, just as also the users of the Libre 3 sensors have it. European customers and other regions have already had this function for a while, but now finally this function also comes to US based users of the Libre 2 platform.
One of the other big improvements is in the alarms section. You can still customize the low and high glucose alarms just like in the old apps. But on top of that, Abbott has added the option to snooze all the alarms for up to 6 hours. A nice feature, as we all know how aggravating it can be when once aware of the alarm situation, to not constantly being reminded about it again and again until we start to get back into good blood glucose range again. The only alarm that cannot be turned off is the urgent low alarm and that is understandable for safety reasons.
Though Abbott has certainly made a step in the right direction with this new app, then most people that have been using the native Libre apps are also aware there is still plenty of room left for further improvements. We are after all in 2025 and not back in 2015, which otherwise the app and user constraints are more looking like. Like a simple thing, zooming in or out from the graph to see the details of what is happening right now or what has been happening in the past couple of hours is not possible. Something we otherwise do daily in other apps, like when pinching or scrolling with our fingers in the web browser.
Another big miss in the Abbott Freestyle portfolio is an app for a smartwatch. We are now in 2025, and it is more than 10 years ago the first smartwatches were launched for both Apple and Android worlds. And still no native Freestyle Libre app to view your glucose readings on your wrist.
The only thing you currently can get on the watch are notifications of any low and high glucose alerts that the smartwatch can replicate and mirror from your smartphone system.
3rd party apps to the rescue
Per the limitations described in the chapter above in the native Libre apps, then many users are finding alternative ways to get more modern and feature rich ways to look at their BG data from their sensors and to get better support in managing their daily BG control of their condition.
This is reason why there is a cohort of alternative apps on the market, that offers all the basics but also many more smart features and user interfaces to you, when getting your BG data from the sensor. This includes typically full control of all aspects of the BG graph, and both horizontal time scale as well as scrolling/zooming in/out, as you may like. Next to this, also full access to truly customize how your alarm system is
configured, to match exactly your own personal preferences.’
More advanced features may also be like warnings being issued if your BG level suddenly rises or drops very fast, like to indicate you maybe forgot to take insulin for your last meal or as warning if you may head towards a hypoglycemic episode in some time if not acting now on a rapid dropping BG level.
Some of the most cherished features of such 3 rd party apps are their ability to show your BG readings live on your phone even when the lockscreen is active. This is done through pop-up notifications, which are possible to setup both for Apple and Android phones. And yes, most of these 3 rd party apps also have a smartwatch companion app, so they can also run with live BG readings coming on your smartwatch. For those that have tried such, this is really a game changer in daily convenience and access to track and manage your BG levels.
In no prioritized order, some of the 3 rd party apps that are on the market:
- Zukka / Xdrip4iOS (Apple)
- Sweet Dreams (Apple)
- Juggolo (Android)
- xDrip+ (Android)
Accuracy of Libre Plus sensors
But now let us talk about one of the most important parameters for any blood glucose sensor, namely its level of accuracy.
The unit used to describe a BG sensor’s accuracy is ‘MARD’, which stands for its Mean Absolute Relative Difference. It represents the average percentage difference between a BG sensor’s readings and a true blood glucose reference value, typically from a lab or a finger-prick test. A lower MARD percentage indicates therefore a better accuracy, meaning the BG sensor’s readings are closer to the actual blood glucose levels. So the lower, the better accurate the sensor is.
The new Libre 2 Plus and Libre 3 Plus sensors that runs for 15 days have a MARD of 8.2% which is exactly the same as the Dexcom G7 that runs for 10 days and a bit worse than the standard Libre 3 sensor which had a MARD of 7.9% but ran for 14 days. But in daily practice, all these sensors are far sufficiently accurate to support a great daily control and management of the blood glucose level. Such small differences
between them have little implication in practical life.
The time when accuracy should be considered is in the first 6-12 hours after starting a new sensor up, as they can be a bit unruly in their reporting. Several reasons for this, but they tend to settle down after some hours. As a reminder, the Libre app and Reader show a little blood drop icon on top of the screen, to remind you that relying on the sensor the first few hours is best done via a fingerpick validation check, if the sensor’s BG reading does not correspond with how you feel.
As with all previous Freestyle Libre sensors, then both the Libre 2 Plus and Libre 3 Plus are factory calibrated. That means that you as the user of them, never need to bother with any fingerpricks to re-calibrate them manually. That is because the Freestyle Libre sensor technology does not have the interpreted blood glucose value drifting over time.
So their calibration done at the factory at batch/lot level will suffice for the lifetime of the sensor to keeping it accurate.
Plus CGM enable insulin pump integration
One of the biggest game changers for the Libre plus sensors, is they have both been approved by the regulatory authorities for insulin pump integration. That means that insulin pump users can setup their pump to interface directly with the BG sensor, which than creates a closed loop with the pump to adjust the insulin release to match the need based on the continues BG readings.
This requires therefore also some close collaboration between both Abbott who makes the Freestyle Libre sensors and the respective insulin pump companies, who make the software applications that are used to control the pumps.
At present time, it is therefore not all pumps that work with all sensors. But this is clearly work in progress and more and more pumps will be added to the list. Currently we are aware of the following sensors and pumps have been set up and approved for
use together:
Libre 2 Plus:
- Omnipod 5, Insulet
- Tandem Control IQ
Libre 3 Plus:
- Eyelet, Beta Bionics
- Matt Tech (USA)
- My Life Loop (Europe)
- Twist, SQL
PLUS data Sharing & Integration
The Libre sensors also allow you to share your glucose data with up to 20 other people, like parents, spouse or other family members as well as with professional healthcare providers. You can activate your data sharing in your app settings for your profile. By doing so, the people you list as ‘followers’ here will by using their own private Freestyle Libre user account be able to view your real-time glucose data and also to receive customized notification about your glucose levels on their phone using the
Libre Linkup app.
Next to this, then the Freestyle Libre universe of sensors also allow you and others to log into the www.LibreView.com data
cloud, where you on e.g. a PC can view your BG data through many various pre-made data reports.
These can again be shared as you want with all your followers.
Apart from their own closed ‘data universe’ then the Freestyle Libre sensors are not very good when it comes to direct integration with other third-party apps and data exchanges with alternative data clouds. So other very popular health related data
clouds like Apple Health or NightScout are not directly open or supported by the native Abbott Freestyle apps themselves. Again, the use of alternative 3 rd party apps is needed for enabling such functions.
Cost & availability of the Plus sensors
The Libre 2 Plus sensor launched to the US and European markets already back in January 2024 and the Libre 3 Plus in the autumn same year. So they are no longer just brand new unproven products. But it takes time to shift manufacturing around and also scale up global supplies before such discontinuation of the older standard Libre 2 and Libre 3 platforms can be effectuated, as there are literally millions of daily users of them across the world.
Same also goes for all the administrative preparations of such a shift, as a new sensor, despite its being based on incremental improvements to an already approved technology, then it is still considered as a new product to the marked and needs its own catalog number, contracts to be established and new prescriptions for coverage from the assigned medical doctor. Same goes for the involved healthcare authorities and healthcare insurance companies that need to process the approval process of
associated patient costs for these.
With regards to involved product costs, then in general the new Plus sensors cost the same as the old standard Libre sensors they replace, when looking at the typical costs per day of usage. So, when the product transition settles in, then the overall costs for
the parties involved should in principle level out to be the same.
A quick scan across some of the major markets has shown the following price examples currently in place, though they may of course change over time: Medicare USA for out-of-pocket cost US$161 for 3 months coverage, which equals to around US$26.80 per sensor. With no insurance, out of pocket at Costco you can buy a 6-sensor bundle for US$193, which equals to around US$32.20 per sensor.
Abbott also still offers free support if contacting them online and with their coupons for cash-pay you can get two Libre3 Plus for $75, so approx. US$37.50 per sensor this way.
In Australia out of pocket payment is around AU$130 for two Libre 3 Plus sensors, so around AU$65 per sensor.
In Canada and Europe many folks are covered via work- or public healthcare insurance.
But for folks not covered this way, then direct purchase examples are CA$95 per Libre 3 Plus sensor in Canada and around €70 in continental Europe.
Discontinuation of older FreeStyle Libre sensors
The big change is of course that Abbot is indeed putting a hard stop into manufacturing and distributing the older versions of their Libre sensors. Meaning that the old standard Libre 2 and Libre 3 sensors are no longer being manufactured since September 2025. So as the different product hubs in the global supply chain and distribution centers will run out of the old products later this autumn, so will as well your ability to go to your local pharmacy or endo clinic to get refills from them.
So if you are using one of these older Libre 2 or Libre 3 models, please do contact your healthcare provider to check if you need a new prescription and when you might be switched to these new sensors if you haven’t already.
Comparing Libre 2 Plus & 3 Plus with Dexcom G7
Key performance criteria comparing the three BG sensor systems side by side:
- Abbott Freestyle Libre Plus transition information for healthcare providers
https://www.freestyleprovider.abbott/us-en/transition.html - Abbott Freestyle Libre 3 press release
https://abbott.mediaroom.com/2020-09-28-Abbotts-FreeStyle-R-Libre-3-System-Receives-CE-Mark-Features-Worlds-Smallest-Thinnest-Sensor-with-Best-in-Class-Performance-at-the-Same-Low-Cost-for-People-with-Diabetes#assets_2429_124427-111 - Abbott Freestyle Libre 3 sensor user guide httpFreestyleserver.com/payloads/ifu/2023/q3/ART41641-001_rev-A-web.pdf
- Abbott Freestyle Libre 3 Plus sensor user guide
https://www.freestyle.abbott/content/dam/adc/freestyle/countries/us-en/documents/Brochure_FreeStyleLibre_3_Plus_Getting_Started_Guide_Libre_App.pdf - Abbott Freestyle Libre 2 Plus sensor user guide
https://www.freestyle.abbott/content/dam/adc/freestyle/countries/us-en/documents/get-started-guide-FSL2-Plus.pdf - Abbott press release on approval to wear Libre sensors during CT and MRI scan
https://abbott.mediaroom.com/press-releases?item=124675
Dexcom G7 sensor user guide
https://s3.us-west-2.amazonaws.com/dexcompdf/G7/AW00046-05_UG_G7_OUS_en_MMOL.pdf
20+ years healthcare industry professional
40+ years diabetic type 1.
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