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The aim of this study was to evaluate the long-term effectiveness of the FreeStyle Libre 2 device in reducing time below range levels 1 (TBR-1) and 2 (TBR-2), compared with the first-generation FreeStyle Libre device without alarms, in people with type 1 diabetes mellitus. A longitudinal observational pre-post study of a single cohort was conducted in a cohort of 93 people with type 1 diabetes mellitus who switched from FreeStyle Libre to FreeStyle Libre 2 in routine clinical practice. At 24 months post-switch, significant improvements were observed in TBR-1 (p = 0.001) and TBR-2 (p < 0.001). A significant direct association was identified between years with diabetes mellitus and change in total basal insulin dose from T0 to T1, with a coefficient of 0.14. Additionally, a significant inverse association was found between annual income and coefficient of variation, with a coefficient of -6.3, as well as between annual income and TBR-2, with a coefficient of -2.45. Switching to a flash glucose monitoring system with alarms was associated with improvements at 24 months in time below range, coefficient of variation, and HbA1c in individuals with type 1 diabetes mellitus.