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Why Freestyling still makes more sense
Angry type 1s have voiced their outrage this week at the news that Abbott have partnered with a tech sports company to launch Libre Sense, a glucose sport biosensor. The company, Supersapiens are backed by many high-profile professionals from the sports industry with strong links to cycling. The product was recently tested by two teams on behalf of Supersapiens in their preparation for the Tour de France.
Essentially a Libre device there are more than a few changes that clearly target the product in the sports and athletics arena, rather than for the management of diabetes. Those with diabetes, however, have been quick to denigrate the use of technology for others and the outward appearance is that they are rather protective of the tech that they see as specifically their own. Abbott are very clear in their statements that Libre Sense is not a medical product and this is echoed in Supersapiens website and promotional material too.
Whilst the device and physical application look very much like the FreeStyle Libre as we know it, the app and data that flows from the device to the Supersapiens app appear markedly different. The Libre Sense provides real-time data to athletes every minute so to offer full continuous glucose monitoring (CGM), rather than flash-based, something very much wanted and needed by Libre wearers and T1s in general. In this respect it’s easy to see the reason for the accusations that as type 1s we are being ‘sold’ an inferior product that won’t be available to us until Libre 3 launches. Dexcom offers this functionality now and the delay to automate readings to being a true CGM have fuelled the growth of third party transmitters and associated apps. It’s not known how many Libre wearers use these ‘hacks’ which although not medically approved or regulated, are sometimes suggested by health care professionals as a means to improve control of diabetes.
It’s also unknown how many people are self-funding the purchase of the FreeStyle Libre and although we assume this is mainly type 1s, there may also be type 2s and indeed others, perhaps athletes, buying the Freestyle Libre Sensor over the counter – there’s nothing to stop them doing so in the UK. Recent radio and newspaper advertising suggests that Abbott is looking to grow the type 2 market.
The initial suggestion in Forums was that these self-funders would be ‘better off’ switching to the Libre Sense. However, the main reasons I suggest that this doesn’t make sense are that the app appears to be very focussed on providing data that assumes glucose is always within a non-diabetic range and the range of readings is too restrictive for most with diabetes, being from 55 mg/dL up to 200 mg/dL i.e. 3.1 to 11.0 mmol/L. This also shows that it’s not for ‘us’ in that the measurements of glucose concentration are given in US standard units of mg/dL rather than the mmol/L we commonly use in the UK. The Libre Sense states that it is for up to 14 days and whilst this is also given by FreeStyle Libre, in practice many of us assume that it should last the full 14 days and in fact Abbott will frequently replace those reported as falling off, ‘faulty’ or ending sooner than 14 days. This is particularly important to those receiving the sensor on prescription. It’s not clear if Supersapiens will be offering any guarantee or replacement in the same way and the website appears to require users to submit a request by email if there are any issues.
Another point is that the biosensor will not be compatible with any of the diabetes apps such as LibreView or the FreeStyle reader and for those required to provide readings to their DSN or team via LibreView then this almost certainly means the Sense is not suitable. Although self-funders may not find this an issue, it could be another factor to consider alongside the fact that when purchasing from Supersapiens there is no means to claim the VAT exemption available to FreeStyle Libre.
Although I conclude that the Libre Sense is not a suitable replacement to the FreeStyle Libre, there are likely to be benefits to the FreeStyle Libre community of athletes using the device. Some of the downsides and issues faced by users will quickly become apparent and subsequently addressed when there is a commercial arrangement in place, as between Abbott and Supersapiens. I’d suggest that this will improve the Libre algorithm and in time, the accuracy and reliability of the readings. Other ‘bug bears’ such as the stickability of the sensor may also come to the fore.
If this improves the tech, then I’m all in favour of Libre Sense and hope that it will transform the wearables market. With these devices becoming more ‘normal’ and helping remove the stigma of being 'diabetic' - we can be athletes too!
Love My Libre is not associated or affiliated with Dexcom, Abbott or FreeStyle Libre. Content here and on our website www.lovemylibre.com does not constitute medical advice or replace the relationship between you and healthcare professionals nor the advice you receive from them.
The author of this blog has type 1 diabetes and uses the FreeStyle Libre 2 which is provided on NHS prescription.
FreeStyle Libre is a registered trademark of Abbott Diabetes Care Inc.
Dexcom and Dexcom G6 are registered trademarks of Dexcom Inc.