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FreeStyle Libre 2 blood glucose sensor

zgierzman 8028 55
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  • Image shows a used Freestyle Libre 2 glucose sensor with visible electronic components on the circuit board. .

    My father has recently started using a Libre 2 sensor to continuously monitor his blood glucose levels.
    A cursory browse of the internet results in the belief that it's a sensor for sticking on the skin, but something kept me guessing: how does it measure? Is there a way to measure non-contact through the skin?
    However, there must be something in it, because doctors prescribe it by prescription (you have to meet certain conditions), so the measurement is surely reliable.

    The 'life' of such a sensor is two weeks, so I had a close look at a used one.

    Image of a discarded FreeStyle Libre 2 sensor. .

    Immediately you can see the blade, about 5.5mm long made of some kind of composite. You can also see the sensor itself, 1 mm long, digging into the flesh for 2 - 3 mm.

    Close-up view of the Libre 2 sensor with applicator for glucose monitoring. .
    Close-up of a damaged Abbott Freestyle Libre 2 glucose sensor. .

    In order for this blade to penetrate the skin correctly, a special applicator is used. A releasable spring installs a sensor on the skin. Pictured is the sensor in the applicator.

    Freestyle Libre 2 glucose sensor in applicator on a blue background. .

    And the applicator itself - you can see the spring.

    Close-up of the Libre 2 sensor applicator showing the internal spring mechanism.

    I found a photo online of a sensor damaged during an incorrect application.

    Damaged Libre 2 glucose monitoring sensor with visible internal components.
    https://commons.m.wikimedia.org/wiki/File:Abbott_Freestyle_Libre_2_glucose_sensor-1158.jpg

    The sensor uses two types of wireless communication: RFID and Bluetooth 5.0.
    Data is downloaded to an application on the smartphone - RFID is used to pair the devices, which requires practically putting the phone to the sensor. Once paired, the data is sent conveniently via BT.
    If the smartphone is out of BT range for some time, re-pairing is required. The sensor itself has a memory for several hours of measurements.

    On the board, you will of course notice the battery, the body temperature sensor, the two ICs, the BT antenna and some small details. The RFID antenna is made in the form of a track surrounding the entire PCB several times.
    The larger chip is the RF430 from TI - its central part is a 16-bit MSP430 microcontroller with the corresponding peripherals - ADC, RFID controller etc.
    The smaller chip is the EM9304 - a Bluetooth 5.0 controller.

    The board is 0.5 millimetres thick, but it is four-layer.

    Printed circuit board from a dismantled FreeStyle Libre 2 glucose sensor. .
    Close-up of the internal electronics of the Freestyle Libre 2 glucose sensor. .
    Close-up of the internal components of the Freestyle Libre 2 sensor. .

    An ingenious way to constantly monitor sugar levels, get alerts on dangerously high or low levels, a mine of knowledge for the doctor.
    However, a lot of advanced electronics end up in the trash every 14 days.
    In my opinion, a two-part device could have been made - the sensor itself inserted into the skin separately (you know, nothing can be inserted into the body for too long), and the electronics separately for use with many more sensors. Sensor calibration data in the form of a QR code on the packaging, to be read via an app on your phone.
    Perhaps a less convenient solution, and not as 'cool', but now countless thousands of these devices end up in landfills every month. How many users are aware enough that they should dispose of them in some costly way? It's basically medical waste contaminated with patient blood and, at the same time, electro-junk.
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    About Author
    zgierzman
    Level 31  
    Offline 
    zgierzman wrote 1751 posts with rating 1483, helped 107 times. Live in city Zgierz. Been with us since 2005 year.
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  • #2 21252689
    indianka
    Level 16  
    A very interesting device and mega needed for people with diabetes or insulin resistance. Of course, this throwing away of the sensor after two weeks is a waste common in every field, because you can sell more and more expensive than if this needle/electrode was replaceable. On the other hand, keep in mind the US market, where everything has to be made in such a way that even a moderately intelligent chimpanzee can cope and there are no lawsuits against the manufacturer. As far as waste is concerned, I am more annoyed by the packaging of memory cards or other small items in shops in a sheet of thick plastic.
    I wonder how the measurement is carried out, some kind of electrochemical or photochemical method? I would rather bet on the second version, but then the sensor would have to accommodate the light source and receiver.
  • #4 21252782
    clubber84
    Level 37  
    I once wrote in a topic about the functions of smartwatches that the blood sugar measurement function included in them is a rubbish by a mile, but the author of that topic was/is a layman and did not believe that sugar cannot be measured "wirelessly", which is exactly what this medical device shows - it has a probe inserted into the tissue.

    Regards
  • #5 21252846
    ArturAVS
    Moderator  
    @zgierzman this two-week period of use is dictated by possible medical complications. After all, the "patient" has a foreign body in his body. That's why even dressings or, for example, women's tampons are changed (there is even a warning on tampon packaging against an allergic reaction of the body with prolonged use). Even when I was in hospital for about three months, I had my venflon needle insertion site changed every few days. By the way, I think a device similar in design to a cardioverter defibrillator would be a better solution, working for several years. I see that the price is about £300. A lot.
  • #6 21252862
    clubber84
    Level 37  
    ArturAVS wrote:
    I can see that the price is around £300. A lot.
    .
    The device is ferunded:
    Refund Freestyle Libre 2 .
    But it is up to the 'diabetic' to decide whether they want to use the new way of monitoring their glucose levels or the old (cheaper) way with strips.

    Greetings
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  • #7 21252869
    zgierzman
    Level 31  
    ArturAVS wrote:
    this two-week period of use is dictated by possible medical complications. After all, the "patient" has a foreign body in his body


    I realise this, which is why I wrote:
    zgierzman wrote:
    In my opinion, a two-part device could have been made - the sensor itself driven into the skin separately (you know, nothing can be driven into the body for too long), and the electronics separately for use with many more sensors. Sensor calibration data in the form of a QR code on the packaging, to be read via an app on your phone.

    Then, equipped with a rechargeable cell, the electronics could last for months, or even years. And a discarded probe every fortnight would be cheap and more environmentally friendly.

    ArturAVS wrote:
    I see that the price is about 300£. That's a lot.
    .

    It is prescribed by a doctor in justified cases. I don't associate what the reimbursement is, but then the price is more acceptable. In any case, my dad is not complaining.
  • #8 21252888
    tmf
    VIP Meritorious for electroda.pl  
    zgierzman wrote:
    A cursory browse of the internet results in the belief that this is a sensor to be applied to the skin. But something kept me guessing: how does it measure? Is there a way to measure non-contact through the skin?
    .
    As you described, it measures invasively - you insert this needle that measures glucose in tissue fluid. It's an electroenzymatic measurement - an enzyme (presumably glucose oxidase) oxidises glucose, accompanied by a flow of electrons (as in redox reactions), which is the current that the ADC measures.
    ArturAVS wrote:
    this two-week period of use is dictated by possible medical complications. After all, the 'patient' has a foreign body in his body.
    .
    This is one reason. Another is the problem of measurement stability - the electrode wears out, there is a protein enzyme deposited on it. Long-term measurement stability, on the other hand, is needed. There are implantable sensors, working on a different principle, which can even last more than six months.
    zgierzman wrote:
    Then, equipped with a rechargeable cell, the electronics could last for months, or even years. And a discarded probe every fortnight would be cheap and more environmentally friendly.

    Ultimately, maybe it wouldn't be more economical at all. Notice how small the sensor is and how delicate. So it would have to be in a separate housing that would be an adapter for the rest of the electronics. There's another problem - such a sensor has to be mega-simple to apply, so as simple a design as possible. Hence, a composite design is probably more convenient.
  • #9 21252951
    rysio68
    Level 15  
    ArturAVS wrote:
    I can see that the price is around £300. A lot.
    .

    After all, modern medicine is used to make money from diseases. The cost of production is probably £10-20.
    For example, in the Dark Ages, so about a hundred years ago, type II diabetes was "cured" by diet (fat and protein).
    Now it is incurable.
    Here a recipe on how to nurse diabetes:
    https://ncez.pzh.gov.pl/choroba-a-dieta/cukrzyca-typu-2-zalecenia-i-jadlospis-2/
  • #10 21253022
    tmf
    VIP Meritorious for electroda.pl  
    rysio68 wrote:
    After all, modern medicine is used to monetise diseases. The cost of production is probably £10-20.
    .
    Then produce and make money...
    rysio68 wrote:
    For example, in the Dark Ages, so about a hundred years ago, type II diabetes was "cured" by diet (fat and protein).
    Now it is incurable.
    .
    A hundred years ago, type 1 diabetes was dying because insulin had just been discovered. With type 2 diabetes one also lived poorly because there was no cure.
  • #11 21253157
    rysio68
    Level 15  
    tmf wrote:
    We also lived poorly with type 2 diabetes because there was no cure.


    They removed the cause and the problem disappeared. Now it is a "Civilisation" disease.
    We become metabolically ill not because of a lack of the drug, but because of the contents of the bowl.
    The contents of the bowl are given so that we do not get sick. The "perpetual motion machine" of pharmaceutical companies.
    I am not denying the achievements of medicine, but chronic diseases are treated instead of cured. A cured patient is a lost customer.

    Moderated By gulson:

    Report: The post lowers the level of the forum and promotes pseudo-science and Elektroda is a technical-scientific forum where there should be no place for pseudo-science especially in topics concerning medicine and such a serious disease as diabetes which is now a problem of civilisation.

    .
  • #12 21253194
    Jar-Woj
    Level 25  
    rysio68 wrote:
    ArturAVS wrote:
    I see that the price is about 300£. A lot.
    .

    After all, modern medicine is used to make money from diseases. The cost of production is probably £10-20.
    For example, in the Dark Ages, so about a hundred years ago, type II diabetes was "cured" by diet (fat and protein).
    Now it is incurable.
    Here a recipe on how to nurse diabetes:
    https://ncez.pzh.gov.pl/choroba-a-dieta/cukrzyca-typu-2-zalecenia-i-jadlospis-2/
    .

    In the so-called Dark Ages, it was not known what diabetes was, nor that there were different types, so it cannot be said that anything was treated.
    If, of course, we are talking about treatment in the modern sense based on evidence-based medicine.
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  • #13 21253215
    klamot
    Level 19  
    I am disabled due to my job (and type II diabetes), so I have LIBRE reimbursed by the National Health Service. Finally, no more stubbed toes. And this is how it looks on the hand.

    Glucose monitoring sensor on a person's arm. .
  • #14 21253231
    Macosmail
    Level 35  
    The increase in the number of cases is puzzling. I myself have several YOUNG diabetics in my midst, without being overweight in any way, who developed the disease as children or teenagers.
    Scientists fear that the number of sufferers will DOUBLE by 2050.
    Quote:
    .
    According to the WHO, over the past 20 years many countries around the world have seen an epidemic
    increase in the incidence of diabetes. In the USA, more than 17.5% of the population already has diabetes, with
    with increasing prevalence in people under 40 years of age and in children and adolescents.
    If the current trend continues in 2030, one in four and by 2050 one in three Americans will be
    will have diabetes. Similar epidemiological trends apply to most countries in the world,
    the threat of a 'diabetes tsunami' may also threaten Poland.
  • #15 21253256
    nikusert
    Level 41  
    I too have been using for two months, also reimbursed of course.
    My Brother-in-law, who lives in the USA, had a similar one six years ago.
  • #16 21253259
    rysio68
    Level 15  
    Jar-Woj wrote:
    In the so-called dark ages it was not known what diabetes was
    nor that there were different types of it, so it cannot be said that anything was treated
    .

    I was writing about the dark ages - a hundred years ago, insulin was discovered in 1922, so diabetes was known.

    Jar-Woj wrote:
    so it cannot be said that anything was treated, if of course we are talking about treatment in the modern sense based on evidence-based medicine.


    If we accept that herbs and other such shamanic methods do not cure, then they do not cure. Only patented chemical drugs cure. Previously, they helped recovery.
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  • #17 21253271
    klamot
    Level 19  
    I found another device like this:
    "As of 01.09.2022, the next generation Eversense® E3 system is now available in Poland.

    In the life of every person with diabetes, constant monitoring of sugar levels is an integral part of treatment. The new Eversense E3 system has been developed to facilitate daily glucose monitoring. It is the only system on the market with a long-term sensor that does not require frequent replacement.

    The system provides real-time information about changes in glucose levels, which you can read discreetly on your own compatible mobile device. Measurements are taken every 5 minutes and trend arrows indicate the direction of glucose changes. This allows you to have better control of your diabetes.

    The new Eversense E3 system provides exceptional accuracy and sensor durability for 6 months of use. In addition, it offers key improvements such as :

    the ability to make therapeutic decisions, e.g. for insulin administration, without the need to confirm blood glucose levels with a fingertip measurement
    reduced calibration frequency
    increased sensor durability
    Unlike other CGM-type systems, the EVERSENSE E3 lasts up to 6 months, whereas other sensors on the market need to be replaced every 7-14 days. Thanks to its safe and innovative technology, the new EVERSENSE E3 sensor is implanted (placed) under the skin, providing the convenience associated with daily use.

    The EVERSENSE E3 system's intelligent transmitter is equipped with vibration alarms, felt on the skin. These alarms inform of hypoglycaemia and hyperglycaemia and, depending on the settings, of the risk of these situations.

    As the only smart transmitter on the market, the EVERSENSE E3 system can be removed without removing the sensor, for example when you want to take a shower. From now on, you don't have to worry that removing the transmitter will mean the end of the sensor. All you have to do is put it back on after removal.

    This is a real revolution in glucose monitoring for people with diabetes!"
  • #18 21253300
    wojtek1234321
    Level 36  
    Diabetes is not the same as diabetes. Type I diabetes is quite different from type II diabetes. Type II is basically "only" pancreatic insufficiency, while type I is a genetic matter, the pancreas stops working at all, and even the body itself destroys the islets of Langerhans and does not supply the hormone - insulin.
    As for type two, "treating it with diet alone" has some measurable effects, because the body still produces some insulin, but not enough....
    With type I, there is no insulin at all and it has to be supplemented from the outside. Without insulin, the body is unable to absorb any carbohydrates and then it is "kaput"...
    I have been living with type I diabetes since 1991, since 1 April when I was diagnosed, on insulin from the beginning....
    Generally speaking, diabetes is the non-absorption of carbohydrates, and carbohydrates for the body are like "fuel" for the car, and insulin is the key that "opens" the cells of the body so that they can "burn" these carbohydrates....
  • #19 21253351
    juan cabrillo
    Level 27  
    Now it's completely different. When I was diagnosed (16.10.1984) blood glucose levels were not measured at home. There was nothing to do and no way to do it. A very coarse result was a urine test for both sugar and acetone (ketone bodies), but the results were not only time-lagged, they were very inaccurate - along the lines that if you had sugar and (god forbid!) acetone, it meant there was too little insulin. But when and by how much too little - guess the patient himself.
    The sugar in the urine was taken up when, in the absence of insulin, it was not burned in the tissues, but entered the kidneys with the blood and was removed from the body. Therefore, with uncompensated diabetes, kidney disease (and not only that) is one of the most common complications.
    At that time there were no disposable syringes (or some kind of pen) in our country, syringes were made of glass and were sterilised/boiled daily. Eh, old times...

    ...but that's just off topic...
  • #20 21253352
    indianka
    Level 16  
    >>21252846 .
    That's right, if the measurement is carried out using an electro-enzymatic method, the electrode will wear out at the same time as superinfection or inflammation may occur at the insertion site. I do not suspect that the manufacturer would make the electrode from a biocompatible material - titanium or some kind of ceramic. But we are back to square one - for economic reasons (for the patient), the electrode itself should be replaced and, of course, the site of insertion should be changed to avoid complications.
  • #21 21253372
    wojtek1234321
    Level 36  
    Maybe you can, but I doubt if with a complete lack of insulin "production" by the body. But well, in the "internet" everything is possible but not necessarily true, there are many internet "miracle workers"....
    I for this video will only say: Ha, Ha, Ha...
  • #22 21253515
    ro-x
    Level 14  
    wojtek1234321 wrote:
    Type I diabetes is quite different from type II diabetes. Type II is essentially "just" pancreatic failure, while type I is a genetic thing, the pancreas stops working at all, and even the body itself destroys the islets of Langerhans and fails to supply the hormone - insulin.
    .
    Type I diabetes is an autoimmune disease and not genetic. I contracted the disease at the age of 34 as a result of a storm of cytokines following a viral infection.
    And type two diabetes is not caused by pancreatic insufficiency, but by progressive insulin resistance.
    Don't make statements on subjects you know nothing about.

    As for sensors, there are systems where the sensor and the electronics are separate (e.g. Dexcom older generations, up to D5). There, the electronics last for a few sensors, then they get discharged and have to be replaced. I have tried with success to replace the cell, but there is one major problem - the device loses its waterproofness. Dexcom had another disadvantage - the size. This one makes a huge difference when you wear it permanently glued to your body.
    The Libre in the first version could be reset after 14 days and reactivated. A sensor reactivated in this way was able to work successfully for another 14 days, but not everyone. Some worked for several days and discharged completely, others started to show stupidity after a few days. Ot the battery is calculated to last a dozen days and no more.

    Please remember that medical devices must, as a matter of principle, meet a number of standards and be capable of being operated by non-technical people. This is a priority. Which doesn't change the fact that Abbott could do a programme to return used sensors. The electronics could be reset, the cell replaced and reused in a new case with a new sensor.

    If anyone would be willing, I have a whole bag of these sensors (with the sensor removed, no biological material). They could be used, for example, as NFC tags.
  • #23 21253755
    ArturAVS
    Moderator  
    Several years ago, I was given a faulty blood glucose meter from a friend who serviced equipment at a nearby hospital. I don't know what principle it worked on, but it was not in any way invasive to the person being tested. I remember that you would insert your finger and the device would illuminate it with various LEDs and after a few seconds give the result on the LCD. It was as if it was 'screening' the finger from the LED array with different wavelengths. There were no 'leaves' or punctures. At the time I wasn't too interested in it, now I'm curious about it because I have to check every few days (type 2). The interesting thing is that it only appeared after the stroke, and a few months before I was a specimen of health because I just had my periodic checkups then. As soon as I was hospitalized, I was put on insulin for about a month and no one even asked if I had any form of it. It was only when I refused to take another dose that the attending doctor interviewed me and they changed me to tablets.

    Is there any non-invasive method of measurement?
  • #24 21254036
    pawlik118
    Level 33  
    My child developed type 1 diabetes. It is an autoimmune disease that occurs randomly, without reason. It is not influenced by diet or lifestyle. Without taking insulin about 8 times a day one lives for 2 weeks. On top of this, the sugar fluctuates so that from 300 to 50 can go down in 20minutes. Ongoing monitoring is very necessary as it saves lives. Below 50 - 30 you lose consciousness and die.

    As for sugar sensors, the most popular are
    Freestyle Libre - works for 2 weeks, sensor together with transmitter
    Medtronic Guardian 4 - works up to 7 days, transmitter is detachable, separately rechargeable and reusable
    Dexcom - works up to 10 days, transmitter built-in, disposable.

    The sensors measure sugar levels in subcutaneous fluid. Accuracy is quite good, but often the sensor will die more quickly, or inadvertently break out. In addition, you need to drink a lot for the measurement to be reasonably accurate. With CT1, insulin pumps are still used, which administer insulin instead of injections. In addition, everything you eat must be carefully weighed and the amount of carbohydrates calculated, and the dose of insulin given based on this.
  • #25 21254078
    Rebeltec
    Level 7  
    I can cyclically deliver for testing, with needles removed of course ;)
  • #26 21254193
    Macosmail
    Level 35  
    pawlik118 wrote:
    My child developed type 1 diabetes. It is an autoimmune disease that occurs randomly, without reason. It is not influenced by diet or lifestyle.
    .

    This is the current state of knowledge, or perhaps just the 'consensus'. I for one am convinced that there must be reasons. Too many of these cases.
  • #27 21254669
    rysio68
    Level 15  
    Macosmail wrote:
    I am convinced that there must be reasons. Too many of these cases.


    Often conclusions, or at least suspicions, arise from an analysis of the entries in the child's health book.
  • #28 21254793
    Marcin125
    Level 28  
    zgierzman wrote:
    But every 14 days a lot of advanced electronics land on the trash heap.


    That's what I didn't understand...
    The choice is simple: either you save a human life or you save the whole world.
  • #29 21254956
    Wawrzyniec
    Level 38  
    wojtek1234321 wrote:
    Type II is essentially 'just' pancreatic insufficiency and Type I is a genetic issue
    .
    No. You are wrong. It is as ro-x wrote in #22. The genetically determined diabetes is MODY diabetes. The 14th variant of this diabetes is now known. I know this because I myself have had type II for 17 years and my son has type MODY5 and is treated by a professor in a Krakow hospital.
  • #30 21255007
    Macosmail
    Level 35  
    rysio68 wrote:
    Macosmail wrote:
    I am convinced that there must be reasons. Too many of these cases.


    Often conclusions, or at least suspicions, arise from an analysis of the entries in a child's health book.


    There are certain medical procedures whose basis of action is to "mobilise" the immune system.
    Who knows if, in some cases perhaps dependent on genetics, they don't do that too much.
    Since even a mushroom can be edible (and very tasty) or deadly poisonous in susceptible individuals.
    Crowfoot curl .
    Quote:
    Toxic fungus. For a very long time it was considered a valuable edible mushroom and was often harvested for its good taste, high yield and ease of identification. As an edible it was listed in atlases of mushrooms[7]. For a very long time, until the 1970s and 1980s, it was considered edible or conditionally edible[8] . For most people, the species was indeed harmless. However, some people developed cases of severe poisoning after ingesting it. The chemical contained in cowpea in some cases causes a fatal reaction in the human immune system , whereby the body starts to produce antibodies against its own blood cells. The stuck blood cells block blood flow in vital organs. Due to these cases, nowadays the cowpea subluxation is considered a poisonous species. Despite this, it is still harvested and eaten in many countries around the world (e.g. Eastern Europe)[7]. It was also considered an edible mushroom in Poland before World War II[9].

    Among others, the mycologist Julius Schäffer[10] was fatally poisoned by a meal prepared from the cowpea suberis[10].


    Similarly, the severe course of COVID in the young is gene-dependent.
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Topic summary

The discussion revolves around the FreeStyle Libre 2 glucose monitoring system, which utilizes an electroenzymatic method for measuring blood glucose levels through a subcutaneous sensor. Users express concerns about the sensor's two-week lifespan, the environmental impact of disposable sensors, and the reliability of measurements. The invasive nature of the sensor is highlighted, contrasting with non-invasive glucose measurement methods that are still under development. Participants also discuss the reimbursement process for the device, its necessity for diabetes management, and comparisons with other glucose monitoring systems like Eversense and Dexcom. The conversation touches on the economic aspects of diabetes treatment and the increasing prevalence of diabetes among younger populations.
Summary generated by the language model.
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