Glucose sensor app said to be first third-party title to access Apple iPhone's NFC

Comments

• Reply 1 of 11

  rob53 Posts: 3,251member

  February 6, 2018 3:06PM

  As we all know, being “open” carries a lot of responsibility when dealing with security components, something many developers could care less about, especially android developers not used to worrying about any restrictions or security. 

  
• Reply 2 of 11

  roake Posts: 811member

  February 6, 2018 3:15PM

  This warning from the manufacturer’s site makes me wonder if this isn’t just a novelty.  After all, the entire point of checking finger-stick blood glucose levels is to get real-time results so that insulin can be dosed, or for a glucose log so that your doctor can adjust your oral medications.
  

  WARNINGS/LIMITATIONS: The FreeStyle Libre Pro System does not provide real-time results and patients should adhere to their blood glucose monitoring routine while using the system.

  
  https://www.myfreestyle.com/provider/?source=www.freestylelibre.us
  
  I suppose that if the glucose values recorded are not real-time, but are accurate, they may be sufficient for someone that is not taking insulin, but even so, the manufacturer says to continue the finger-sticks while using this system.
  
  And...
  
  

  The FreeStyle Libre Flash Glucose Monitoring system is a continuous glucose monitoring (CGM) device indicated for replacing blood glucose testing and detecting trends and tracking patterns aiding in the detection of episodes of hyperglycemia and hypoglycemia,

  Note the “aiding in the detection of ... hypoglycemia”.  Now another quote.
  
  

  IMPORTANT: The device may inaccurately indicate hypoglycemia. The results of the clinical study conducted for this device showed that 40% of the time when the device indicated that user sensor glucose values were at or below 60 mg/dL, user glucose values were actually in the range of 81-160 mg/dL.

  Inaccurate 40% of the time!  That’s almost as bad as flipping a coin (50%), so it cant be trusted for hypoglycemia monitoring.  Hopefully the hyperglycemia monitoring is more accurate.

  So in summary, you can use this device, but you still have to do the finger-sticks, and the device may be inaccurate.  Sounds like they have a long ways to go.

  edited February 2018
• Reply 3 of 11

  macgui Posts: 2,357member

  February 6, 2018 3:37PM

  roake said:
  Sounds like they have a long ways to go.

  Indeed. I have a friend who's 'pre-diabetic' and controls it with diet and exercise but does the finger-stick thing at least daily, sometimes multiple times during the day. (I know nothing about this, it may be a common practice for some.) 
  
  This Libre is great in concept and when much improved, will be a big improvement for many who need monitoring.

  edited February 2018
• Reply 4 of 11

  kenaustus Posts: 924member

  February 6, 2018 4:05PM

  The first challenge its FDA approval.  If they have that then it can be assumed that the device will be somewhat reliable.  The second challenge is insurance (including Medicare and Medicaid) accepting and paying for the device and supplies.
  
  The competition is going to push for improvements in performance/comfort of the entire market.
  
  Overall I happy and will wait to see how things shake out (including linking with the Apple Watch) before investing.
• Reply 5 of 11

  lordjohnwhorfin Posts: 849member

  February 6, 2018 4:16PM

  It's been approved and used in Europe for a a couple of years now. I'm pretty sure FDA approval is around the corner. Medicare/Medicaid coverage is going to be a different story, as it's a significant cost increase over the lancet/test strip combo, so I assume in the beginning it will only be covered for special cases (children, people on blood thinners, etc...) and eventually be extended to all as production ramps up and costs go down. An amazing product and it's fantastic that they were able to work with Apple to access NFC. I know they've been supporting Android for a long time but required an external reader for iPhone, that was very disappointing.

  
• Reply 6 of 11

  spike2013 Posts: 15member

  February 6, 2018 4:41PM

  As someone that's been using the Freestyle Libre system for about six months I'd say that the Libre definitely ISN'T a novelty. The difference between real-time and the results that the Libre gives are about 10 minutes different. The Libre - and other CGM systems do not measure blood glucose levels but the fluid within the body. None of the CGM type systems will be as accurate as a traditional blood finger-prick but they're getting closer. Medtronic and Dexcom both state a degree of accuracy - the same with the Freestyle system.
  
  The Libre does display the trend of what my blood sugar levels are doing - stable, going up or down. The Libre has been designated as accurate enough to base insulin dosing decisions on. It did take a few weeks to become comfortable with it vs a finger test. There are differences between what the FDA has decided vs what the rest of the world gets. In Canada. and the rest of the world, the sensor can be worn for 14 days and readings available 1 hour after the sensor is installed. The FDA says 10 days and (I think) 24 hours after sensor installation for readings. 
  
  Everybody's mileage will vary. I find the Libre to be pretty close to what a finger test gives me. The Libre definitely has a sweet spot where the accuracy is better. If my blood sugar is high, the Libre and blood test have a higher discrepancy. When low, the discrepancy is a bit off but not as much as when high. When my glucose is within my "normal" range the accuracy is very good.
  
  The new app will mean I have one less device to carry around. Right now I have my phone and a reader to scan the sensor with. If I can do it with just my phone my life improves.  If I could scan with my watch, even better. Although as the sensor is worn on the bicep scanning my left arm with my left wrist is more difficult. The sensor only has a certain range in which the reader can scan from. I used to do 5-7 finger tests a day. Now I do 1 in the morning and rely on the Libre, only doing another finger test if I feel something isn't right.
  
  Far from a novelty. This type of device is improving the life of diabetics but you need to know what you're doing with it. You're not handing your life over to a device but getting a tool to help make better decisions. The cost of the Libre is much lower than the Medtronic or Dexcom CGM systems which makes is more viable for some. 
  
  I think a non-invasive system is a long way off. The accuracy of a non-invasive device will be very problematic. Different skin tones, tattoos, body hair, watch snug or loose, etc. Apple will probably work with medical companies rather than build a glucose sensor into the watch. Any device that gives medical advice has to go through so many approvals it would be years before it came to the public. When Apple is introducing new devices every year, a glucose sensing watch that could take years to approve and then need to be re-approved when the next model comes out doesn't work. The Libre has been available in Europe for (maybe) 2 years. Canada since summer 2017 and only recently in the US. 

  
• Reply 7 of 11

  lkalliance Posts: 11member

  February 6, 2018 6:08PM

  I'm not yet comfortable with CGM units. As Spike2013 notes above, a CGM is especially useful for detecting trends. Even the most accurate blood glucose test only tells half the picture. I'm at X. Am I at X and falling? How fast? X and rising? How fast? A CGM need not hit the blood glucose with a lot of accuracy...it DOES need to accurately give me a sense of the trend. I can do a finger stick for the "accurate" reading.
  
  I get frustrated because the three pieces of technology I use (glucose meter for blood test, insulin pump for dosing, iPhone for logging) don't all work together as a trio. I can get a meter that will talk directly to my phone, but which then requires me to manually enter the reading into the pump for dosing. I can get a meter that will talk directly to my pump and transmit the reading and save a step, but then I need to remember to log the reading.
  
  (I happen to use Medtronic; it may well be that there is a different brand of pump/meter that will make them all work together, but I'm not interested in changing pump brands)
  
  At the moment I choose to have my meter talk to the pump.

  
• Reply 8 of 11

  avon b7 Posts: 7,666member

  February 6, 2018 7:27PM

  I'm not sure about the Libre but CGMs with alarms can be lifesavers. If you have problems during the night and glucose levels drop dangerously while you sleep, an alarm (to your phone?) can wake you up to take measures. IIRC the Dexcom can do this.
  
  Long term diabetics with unstable diabetes often become 'insensitive' to the symptoms and take longer to wake themselves up.

  
• Reply 9 of 11

  bestkeptsecret Posts: 4,265member

  February 7, 2018 6:00AM

  Thanks for the info @Roake.
• Reply 10 of 11

  loopychew Posts: 21member

  February 7, 2018 10:28AM

  I used the FSL for two weeks and was quite happy with the results, if I've since gone back to finger-sticking (my condition isn't so bad that I absolutely needed CGM, but there was a moment of worry and for a long, dark time I was extremely careless about monitoring).  Unfortunately I haven't done the two together so I can't say for certain how accurate it was, but for my own/my diabetician's purposes, it was effective.  Having this information recorded in Apple Health automatically without requiring a separate device would have been the cherry on top, even if people might have looked at me weird for tapping my underarm with my phone.
  

  
• Reply 11 of 11

  spike2013 Posts: 15member

  February 7, 2018 3:21PM

  I'm in the same boat - what combination of tools do I use to keep track of everything? I'm a Medtronic user as well. I used their CGM for a while but my insurance wouldn't cover it and stopped after about a year. The Libre is covered. What's the difference? Not a lot. I miss the ability to have the Medtronic CGM and pump communicate. I do use a meter that talks to the pump - but not as frequently as I used to since going to the Libre. I can scan the Libre as often as I want vs pulling out another $0.85 test strip (average price in Canada). Insurance companies, especially in the US, seem to want to place a cap on the number of strips a person uses per month.
  
  The Libre software has a lot of reports in it which are very useful - albeit slightly different, in numbers, from what the pump/CGM combo would give me. The alerts of the Medtronic CGM were also useful - something the Libre lacks. Between entering BG numbers on my pump to dose and the Libre reports I've got a enough data to keep my endocrinologist happy.
  
  I also like the fact that after over 30 years of finger tests the callouses on my finger tips are going away. 
  
  Face it - things are better but we're not there yet. 
  
  I am hoping the ability to scan the Libre with my iPhone comes soon.
  
  lkalliance said:

  
  (I happen to use Medtronic; it may well be that there is a different brand of pump/meter that will make them all work together, but I'm not interested in changing pump brands)
  
  At the moment I choose to have my meter talk to the pump.

  
  

  edited February 2018