The big news today from the Annual EASD meeting in Berlin? Abbott announced their “next generation” Libre, appropriately named Libre2, had received the CE Mark.
What do we know about it? Well the following two pictures tell you what we do know…
Ignoring the poor language about alarms being easy enough for patients to set, it seems that there is now a bluetooth link to the reader allowing it to alarm when high or low, or when the signal is lost.
Further to this, we can see there are communications every minute between the sensor and the reader. However, we also noted that the reader isn’t displaying readings in real-time, only when the sensor is scanned.
The press release also states that it costs the same as Libre 1 and that the sensor will last “up to 14 days”, like the original. We are also told that the alarms are user customisable and optional. And that’s about as much as we have…
That leads to a a whole heap of questions…
Questions, questions, questions….
So much information, and yet so little.
The questions that arise from this include:
- What is the data being transmitted every minute? Is it:
- A glucose value?
- A character denoting High, Low or “in-range”?
- A heartbeat showing locality with only highs and lows alerting?
- Will there be a phone app?
- How will this fit in with the roll out of Libre1 across Europe, and particularly the UK?
- Does the addition of alarms at a price that undercuts Dexcom significantly (£70 vs £159 per month) mean that for the UK, CCGs will refuse to fund Dexcom systems going forward, without significant price reductions?
- Does the above matter given the MARD of Libre and Dexcom G6 are supposed to be similar?
While I can’t answer these questions fully, it’s worth noting that in July 2017, the press announcement from Bigfoot and Abbott stated that Bigfoot would use the “next generation of its Freestyle Libre Sensing Technology”:
This is the same language as that used in the Abbott press release, so I remain hopeful that the minute-by-minute data is useful for a closed loop system, and that would be a real game changer.
Data every minute would allow us to detect fast climbs and falls significantly earlier and take action (accounting for the known delay in interstitial fluid.
There’s also the point that alerts are variable. This could be done either by transmitting a glucose value and alerting in software, or by providing a trigger value to the sensor where it would issue the alert message. Going on the previous architecture of the Libre, where only raw data comes from the sensor, the former would seem more likely.
So at this point, we await more information from Abbott and getting our hands on the system to see what we can uncover, and what they’ve encrypted.
Who knows, if this adheres to the JDRF open protocols initiative, they might even share that with us directly! However you look at it, and whether you like the paradigm of flash or not, it’s hard to deny that Abbott are attempting to disrupt the CGM market, both in pricing and in provision of their plans to healthcare providers. How will others respond?