Abbott FreeStyle Libre User manual

© The ISCHIA study group, 2019 (Ver. 0.7)
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INSTRUCTIONS FOR PROPER USAGE OF THE FREESTYLE LIBRE
[General information]
• This document briefly shows how to use FreeStyle Libre properly. For more
information, please read the official user guide and package insert before use. In
addition, please read the reference document "For Patients Using FreeStyle Libre".
[Sensor settings]
Note: To review the complete procedure, please see the package insert of FreeStyle Libre
sensor.
• FreeStyle Libre sensor should be attached to the back of the upper arm. Avoid scars,
moles, and bumps. Please note that if you wear it on the side of your upper arm, it may
easily hit objects as you walk and be knocked off.
• Select a sensor site location at least 2.5 cm away from the insulin injection site.

© The ISCHIA study group, 2019 (Ver. 0.7)
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• Before insertion of a sensor, clean the site with an ethanol wipe, and dry it sufficiently.
• When undergoing X-ray, MRI, or CT examinations, remove the current sensor and
attach a new one after the examination.
• If the sensor site becomes red, painful, or swollen, contact your doctor.
• Be careful not to remove the sensor when you bathe or wipe yourself with a towel.
• If the sensor comes off or becomes unstable on the skin within 14 days, remove the
sensor immediately and put a new one on.
• If you notice obvious bleeding after inserting the sensor, remove the sensor and attach
a new one.
• The sensor automatically stops functioning after 14 days. Read the user guide or the
package insert to learn how to remove and replace the sensor.
• The sensor can be used at temperatures between 10 and 45 °C. Although you can take
a bath with the sensor still on, you should be careful not to hook or pull the sensor while
washing or wiping yourself. Do not immerse your sensor for 30 minutes or longer in
water. (Please refer to "FreeStyle Libre user guide")
[Interpreting the sensor glucose levels]
• The glucose levels displayed on FreeStyle Libre reader are based on the glucose
concentration of the subcutaneous interstitial fluid, not on the actual glucose

© The ISCHIA study group, 2019 (Ver. 0.7)
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concentration in your blood. The sensor glucose levels are usually delayed by 5 to 10
minutes (or longer in some cases) compared with the actual blood glucose levels.
• Therefore, the sensor glucose levels scanned by FreeStyle Libre sensor may differ from
the actual blood glucose levels measured by fingertip blood sampling. If the reading of
the sensor and actual blood glucose levels measured by fingertip blood sampling are
different, prioritize the blood glucose levels measured by fingertip blood sampling.
• The sensor glucose levels scanned by FreeStyle Libre are just an approximation of the
blood glucose levels and are not approved as a substitute for the blood glucose levels
The sensor filament is
less than 0.4 mm wide
and is inserted up to
5mm deep in the
epidermis

© The ISCHIA study group, 2019 (Ver. 0.7)
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measured by fingertip blood sampling in Japan.
• Do not use the sensor glucose levels when measuring the meal-time insulin dose or
insulin dose to correct hyperglycemia; confirm the actual blood glucose levels by
fingertip blood sampling for such purposes.
[Effective use of FreeStyle Libre]
• Scan frequently, at least 10 times a day.
• Monitor the direction of the glucose trend arrow, not merely the current sensor glucose
levels.
• The direction of the trend arrow indicates whether the sensor glucose level is rising,
stable, or falling.

© The ISCHIA study group, 2019 (Ver. 0.7)
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↑
Glucose is rising quickly (more than 2 mg/dL per minute)
↗
Glucose is rising (between 1 and 2 mg/dL per minute)
→
Glucose is changing slowly (less than 1 mg/dL per minute)
↘
Glucose is falling (between 1 and 2 mg/dL per minute)
↓
Glucose is falling quickly (more than 2 mg/dL per minute)
[To prevent hypoglycemia]
• If the arrow points directly downward (↓), this indicates that the blood glucose level
is falling quickly, at a rate of more than 2 mg/dL per minute (equivalent to 120 mg/dL
per hour).
• When the arrow is pointing directly downward (↓), you should carefully assess the
risk of hypoglycemia, either with or without hypoglycemic symptoms, reflect on the
amount and timing of the previously administered insulin dose, exercise content, meal
content, and glucose fluctuation patterns.
• If you feel that hypoglycemia is impending, measure your blood glucose value using
fingertip blood samples if necessary, and ingest an appropriate amount of carbohydrates,
such as glucose, to stop the rapid reduction in the blood glucose level.
• What and how much to take to prevent impending hypoglycemia may differ among

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individuals; therefore, discuss such issues with your doctor or diabetes team in advance.
• Consuming carbohydrates may cause rebound hyperglycemia, especially when you eat
too much; pay attention to the change in the blood glucose level afterwards. As there
can be a delay in the rise in sensor glucose levels, confirm the blood glucose level by
fingertip blood sampling if necessary. Remember that the changes in the sensor glucose
levels are approximately 5 to 10 minutes delayed compared with the actual blood
glucose levels.
Note
1. The original educational materials used in the study have been developed in Japanese, and
this version is its English translation.
2. The original educational materials include figures distributed by Abbott Japan, LLC, Tokyo,
Japan, through its website at the following URLs:
Abbott, New development in glucose monitoring (in Japanese), (April 22, 2022 2:45 PM).
https://www.myfreestyle.jp/hcp/products/pdf/pdf-products-01.pdf
Abbott, Overview and features of the product (in Japanese), (April 22, 2022 2:45 PM).
https://www.myfreestyle.jp/hcp/products/freestyle-libre/overview.html
Figures in the [Sensor settings] and [Effective use of FreeStyle Libre] sections are hand-
drawn based on the pictures distributed by Abbott.