Freestyle Libre 2

The Freestyle Libre 2 sensor is now a real CGM even with the official app. Still, LibreLink cannot send data to AAPS. There are several solutions to use it with AAPS.

1. Use a Bluetooth bridge and OOP

Bluetooth transmitters can be used with the Libre 2 (EU) and an out of process algorithm app. You can receive blood sugar readings every 5 minutes like with the Libre 1.

Check the bridge and app you want to use are compatible with your sensor and xDrip+ (older Blucon and recent ones won’t work, Miaomiao 1 needs firmware 39 and Miaomiao 2 firmware 7).

The Libre2 OOP is creating the same BG readings as with the original reader or the LibreLink app via NFC scan. AAPS with Libre 2 do a 10 to 25 minutes smoothing to avoid certain jumps. See below Value smoothing & raw values. OOP generates readings every 5 minutes with the average of the last 5 minutes. Therefore the BG readings are not that smooth but match the original reader device and faster follow the « real » BG readings. If you try to loop with OOP please enable all smoothing settings in xDrip+.

There are some good reasons to use a Bluetooth transmitter:

  • You can choose various OOP2 calibration strategies (1): have the reader values using « no calibration », or calibrate the sensor like a Libre 1 using « calibrate based on raw » or ultimately calibrate the the readers like values with « calibrate based on glucose ».
    Make sure to leave OOP1 disabled (2).

    → Hamburger Menu → Settings → Less common settings → Other misc. options

OOP2 Calibration

  • The Libre 2 sensor can be used 14.5 days as the Libre 1

  • 8 hours backfilling is fully supported

Remark: The transmitter can be used in parallel to the LibreLink app without interfering with it.

2. Use xDrip+ direct connection

Libre 2 EU only

xDrip+ doesn’t support direct connection to Libre 2 US and AUS.

3. Use Diabox

  • Install Diabox. In Settings, Integration, enable Share data with other apps.

Diabox

4. Use Juggluco

  • Download and install the Juggluco app from here.

  • Follow the instructions here

  • In Settings, enable xDrip+ broadcast (which doesn’t send data to xDrip+ but to AAPS).

Juggluco broadcast to AAPS

Use with xDrip+

You can set Juggluco to broadcast to xDrip+ with Patched Libre Broadcast (you should disable xDrip+ broadcast), in order to calibrate (see here) and avoid 1 minute readings to be sent to AAPS.
Juggluco broadcast to xDrip+
You will then need to set xDrip+ data source to Libre 2 Patched App to receive data from Juggluco.

Best practices for calibrating a Libre 2 sensor

To get the best results when calibrating a libre 2 sensor there are some “rules” you should follow. They apply independently of the software combination (e.g. patched libre-app, oop2, …) that is used to handle the libre 2 values.

  1. The most important rule is to only calibrate the sensor when you have a flat bg level for at least 15 minutes. The delta between the last three readings should not exceed 10 mg/dl (over 15min not between each reading). As the libre 2 does not measure your blood glucose level but your flesh glucose level there is some time lag especially when bg level is rising or falling. This time lag can lead to way too large calibration offsets in unfavourable situations even if the bg level rise / fall is not that much. So whenever possible avoid to calibrate on rising or falling edges. -> If you have to add a calibration when you do not have a flat bg level (e.g. when starting a new sensor) it is recommended to remove that calibration(s) as soon as possible and add a new one when in flat bg levels.

  2. Actually this one is automatically taken into account when following rule 1 but to be sure: When doing comparison measurements your bg level should also be flat for about 15min. Do not compare when rising or falling. Important: You still shall do blood glucose measurements whenever you desire, just don’t use the results for calibration when rising or falling!

  3. As calibrating the sensor in flat levels is a very good starting point it is also strongly recommended to calibrate the sensor only within your desired target range like 70 mg/dl to 160 mg/dl. The libre 2 is not optimized to work over a huge range like 50 mg/dl to 350 mg/dl (at least not in a linear manner), so try to only calibrate when within your desired range. -> Simply accept that values outside your calibration range will not perfectly match blood glucose levels.

  4. Do not calibrate too often. Calibrating the sensor very often mostly leads to worse results. When the sensor delivers good results in flat conditions just don’t add any new calibration as it does not have any -useful- effect. It should be sufficient to recheck the status every 3-5 days (of course also in flat conditions).

  5. Avoid calibration when not required. This might sound silly but it is not recommended to add a new calibration if the blood glucose to flesh glucose level difference is only ±10 mg/dl (e.g. blood glucose level: 95, Libre sensor 100 -> do NOT add the 95, blood glucose level: 95, Libre sensor 115 -> add the 95 to be taken into account for the calibration)

Some general notes: After activating a new sensor and at the sensor’s end of life it does make sense to do comparison measurements more often than 3-5 days as stated in rule nr. 4. For new and old sensors it is more likely that the raw values change and a re-calibration is required. From time to time it happens that a sensor does not provide valid values. Most likely the sensor value is way to low compared to the actual blood glucose level (e.g. sensor: 50 mg/dl, bg: 130 mg/dl) even after calibrating. If this is the case the sensor cannot be calibrated to report useful results. E.g. when using the patched libre app one can add an offset of maximal +20 mg/dl. When it happens to you that the sensor does provides way too low values, don’t hesitate to replace it as it will not get better. Even if it might be a defective sensor, when seeing sensors that do provide way too low values very often, try to use different areas to place your sensor. Even in the official area (upper arm) there might be some locations where the sensors just do not provide valid values. This is some kind of trial end error to find areas that work for you.