Many of us with T1D have been loyal to one particular continuous glucose monitor (CGM) brand, often choosing based on accuracy, comfort, or simply what our diabetes care team recommended first. For me, that has always been Dexcom, most recently the Dexcom G6. However, when I made the exciting decision to try the Twiist insulin pump, I ran into a compatibility hurdle: at the time, the only sensor compatible with it was the FreeStyle Libre 3+.
Switching sensors is always a bit nerve-wracking, and when you are using the CGM as the brain of an automated, closed-loop insulin delivery system, the stakes are even higher. There is no perfect sensor, but because my insulin delivery decisions and my safety depend entirely on the data streaming from the sensor, it needs to be consistently and reliably accurate.
After wearing the Libre 3+ with the Twiist pump for over a month, I now have a clear picture of where this technology shines and where it hits some snags. Continue reading for my honest Freestyle Libre 3+ review.
Please note, this post is unsponsored, and this was just my experience with the Libre 3+. If you are considering switching to a new CGM, make sure to have a conversation with your diabetes care team.
Where the Freestyle Libre 3+ Shines
The FreeStyle Libre 3+ has several features that genuinely feel like steps forward in diabetes technology, particularly in lifestyle integration and ease of use. For those hesitant to switch sensors, Abbott offers a “try before you buy” program, which is a fantastic way to ease into a new system.
Small and discreet
First and foremost is the incredibly small size. I absolutely loved this! It is significantly smaller than its competitors, which means it’s less likely to catch on doorways and significantly easier to hide discreetly under clothing. While officially cleared for the back of the arm, the compact size allows for more versatile placement. Coupled with a straightforward, pain-free, one-step application process, the experience of starting a new sensor is speedy and simple.
15-day Wear
The wear time is also a major plus. A 15-day wear time means fewer sensor changes and less adhesive residue to scrub off your skin. And unlike the Dexcom G6, which requires a grueling two-hour warm-up, the Libre 3+ is ready to report data after a quick one-hour warm-up period.
Frequent updates
Another plus of the Libre 3+ is that it updates readings every minute rather than every 5 minutes, as with most other systems, so you will likely notice sooner if your blood sugar is rising or falling significantly.
Replacement sensors
Lastly, getting a replacement sensor when I needed one was easy and straightforward. I was able to do it within minutes on their website.
The Challenges
While the small profile is a clear winner, a sensor’s success ultimately rests on its accuracy, especially in a hybrid closed-loop system. This is where I experienced some concerns.
Accuracy Issues
I noticed accuracy issues, particularly during the first couple of days of wear, which is common with all CGMs, but felt more pronounced with the Libre 3+ to me. This inaccuracy is a major liability when the pump relies on that data for automated insulin dosing. I generally noticed that the Libre 3+ was reading noticeably lower than both my Dexcom and fingerstick data, so I was getting less insulin delivered. As a result, my blood sugar was running higher than I like.
No calibration
The inability to calibrate the sensor, while standard for Libre CGMs, meant I had no manual way to correct those accuracy concerns when they appeared.
Compression lows
Another frustrating issue was the frequency of compression lows. If I lay on the sensor, the reading would plummet, triggering false alarms and even pausing insulin delivery unnecessarily. This occasionally happened with my Dexcom, but it was much more frequent and sensitive with the Libre.
Limited features
Beyond the raw numbers, the user experience is currently limited by the closed-loop integration. When using the Libre 3+ with an insulin pump, you have a limited view of data compared to the full Libre app experience, and you can’t connect to multiple devices. This is a functional step backward for parents or partners who rely on seeing shared data. I also found the sensor would frequently lose connection when I moved too far from my phone, disrupting the automation cycle.
Skin irritation
Finally, after removing the CGM, the Libre 3+ consistently caused more irritation and a more visible mark than my previous Dexcom sites, as shown in the image below. The thicker filament seems to cause more sensitivity and scarring for me.
Given the recent recall of certain Libre products, including the Freestyle Libre 3+, it’s understandable that trust in the hardware’s consistency is a factor we must weigh carefully. Looking back, I wonder if the recall impacted some of the sensors I used.
Final Thoughts
In my opinion, the FreeStyle Libre 3+ shines in terms of its small size, easy application, shorter warm-up time, and 15-day wear time. However, for a user who relies on the data to power a closed-loop system, accuracy and reliability are the top priorities. Due to the accuracy concerns, the inability to calibrate, the prevalence of compression lows, and the limited data viewing options during pump integration, I decided not to stick with the Libre 3+ at this time.
I know of many people who absolutely love the Freestyle Libre 3+, so I highly encourage you to take advantage of the try-before-you-buy program and test it out for yourself if you have been considering it. CGM companies are constantly innovating and making changes and improvements to their products, so I am more than willing to give the Freestyle Libre another try down the road, but I have decided to go back to the Dexcom G6 for now.
Before you go, make sure to follow along on Instagram (@mamabetesblog) for more real-life tips, product reviews, recipe ideas, and exclusive content, and don’t forget to sign up for the free Mama-Betes newsletter!