Abbott

DX2Sydney 2018

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I’m at home today, nursing a sore throat and a cold which was most likely picked up at the end of Abbott’s third annual DX blogger event in Sydney earlier this week.

DX – which stands for Diabetes Exchange – is now into its third year Down Under. Abbott was the first company in the Australian diabetes space, that I’m aware of, who began talking to consumers when the FreeStyle Libre was launched in May 2016. From there we have seen other companies follow suit, providing more platforms for the lived experience to be heard (no doubt with a little push from some of my fellow diabetes advocates).

It was nice to be reminded of my first encounter with this special group of advocates back in May 2016, and how much my voice has grown and evolved since then. This group of oversharers have become somewhat of a close knit family over a short space of time, with a few new faces entering the fold every year.

While we were primarily convened ahead of the launch of the LibreLink app in Australia on June 5, we also had the opportunity to present some feedback to Abbott on the FreeStyle Libre.

My question to both Diabetes Australia CEO Greg Johnson and the Abbott team was around whether partial subsidies for Flash Glucose Monitoring in the form of co payments would be an option, as seen with our test strips and pump consumables. 

I have only ever seen full reimbursement noted by Abbott in official communications, and wondered whether more of a focus on partial reimbursement would help get the FreeStyle Libre subsidised sooner. Bionic Wookiee David also rightly corrected Abbott’s term of ‘reimbursement’ with ‘subsidy,’ given that consumers won’t be reimbursed for anything should the product receive federal government funding.

Professor Johnson told us that co payments were certainly an option as we often see through Medicare, and that Diabetes Australia were surprised by the Federal Government’s last election promise of fully subsidised CGMs for people under the age of 21.

Abbott’s Regional Director Peter Chalikias told us that reimbursement decisions rested with the Federal Government and the Department of Health, with the company’s priority to get the FreeStyle Libre into the hands of as many people as possible.

Jessica Shi, Abbott’s QA & RA Manager, must have been reading my mind when she addressed the need for call centre staff to better gauge the level of expertise from the person with diabetes reporting an issue over the phone. Nothing is more frustrating than receiving a basic lecture on what interstitial fluid is!

Once again, I cannot express how important it is to get in contact with the call centre should you have any issues with the product. Some of Abbott’s current priorities based on user feedback are cost, adhesion and accuracy. Cost reductions that Abbott are able to make in the manufacture of the FreeStyle Libre get put back into research and development that will potentially help to address these user issues. 

Does that mean we’re likely to see the product shift towards something that more closely resembles a Continuous Glucose Monitor? Would Abbott not prefer customers to be using a more trusted, in house data sharing solution, rather than third party products such as the BluCon Nightrider?

At this stage, it’s understandably not a priority. I personally wouldn’t want to see the FreeStyle Libre change. Providing consumers with choice is important, and the product in its current iteration means that more people will be able to access Continuous Glucose Data.

“Do you feel that you have had any input into the FreeStyle Libre by attending these events?”

My answer to this question I was posed last week was simple. None. 

I don’t have a technical mind. I don’t know anything about all of the research, development and regulatory compliance that goes into making a medical device as such. 

Abbott also know that they don’t need me, or any of the other bloggers in the room to sell their hugely successful product. Yet their continued respect and commitment to hearing what’s important to (highly privileged) people with diabetes through these DX events, is where I hope I am making a very small difference.

Any company operating in the diabetes space that chooses to engage with people with diabetes is a good thing.

It’s been a pleasure to be part of the DX Family.

Disclosures: Abbott covered my travel and accommodation costs to attend the DX event in Sydney. I was also fed and watered through the duration of the event, and received a goodie bag which contained a FreeStyle Libre sensor. There was no expectation that I would blog about anything covered at DX2 Sydney. My opinions and my time, including the annual leave I took from work to be here, are as always my own.

FreeStyle Libre Not Working?

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I’m appealing to the search engines with the title of my post today, because this is what I was hoping to find when I turned to Google for help with my FreeStyle Libre a few weeks back.

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I was about halfway into a sensor that I had purchased, when suddenly my reader stopped working. The screen wouldn’t start up when I hit the home button. There had been a few instances in the days leading up to this where my screen had blacked out for five or ten minutes at a time, but it always came back to life. I might also mention that this culminated on a Saturday morning, and I soon learned that I wouldn’t have access to customer service until 8am on the Monday.

When my reader still wasn’t responding well after an hour, I was frustrated. I reached out to @FreeStyleDiabet on Twitter with no reply (I’m not too sure where in the world this account is based).

I tried charging the battery with no success. I got an idea from the instruction manual that the device might be temperature sensitive, and kept it in my pocket while I was sleeping one night with no luck either.

I had no idea where I would stand in getting replacements for my reader and the $95 sensor I couldn’t make use of. Abbott were a little coy at the blogger event in Sydney regarding faulty sensors, and we were told that it would depend on individual circumstances.

When I got in touch with Customer Service on the Monday, they shipped me a new reader and replacement sensor on the condition that I send the faulty one back via supplied packaging. The replacements arrived via express delivery two days later, and I started the sensor up once again.

The replacement sensor, however, was wildly out of range. Most of the time, the readings on the Libre were far higher than what I actually was. I was constantly seeing numbers in the mid to high teens (and even 20s) after meals, and this really took a bit of a mental toll on me. I was pricking my fingers almost as much as I would without it, because I couldn’t trust the numbers. I was driving myself crazy, thinking about the prior two sensors I had used and whether the readings were this far out (and it didn’t only happen when glucose was high!)

I gave customer service a call once again, explaining my problem. I was reminded to factor in the 5-10 minute lag time, which I was confident I had. I was then asked to provide three Libre readings and their respective finger stick readings, and I was put on hold to do a control test. The customer service rep then came back and told me that he would send me a replacement sensor free of charge because I was reporting readings higher than the acceptable difference of 1-2mmol.

I was really impressed at how quickly I was issued with a replacement sensor over the phone. I had meter reports prepared prior to calling, almost expecting that I would have to send through evidence of inaccurate readings. Both times, my replacement products were shipped by overnight express to my doorstep instead of the usual 6-9 day delivery window.

However, I would have expected customer service available to me on weekends, even if just for a couple of hours. I also think that Abbott need to be more realistic about their products developing faults. The returns policy, which you can read here, is rather brief and doesn’t give the customer a feeling of confidence or support when the tech fails.

That being said, I am super grateful that Abbott resolved both of my problems with very minimal hassles.

FreeStyle Libre: First Observations!

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With the life of my FreeStyle Libre sensor coming to an end in a few days, I thought I’d better write some observations while they are fresh in my mind.

I first put my Libre sensor on during Diabetes Exchange in Sydney (disclosures are at the bottom of this post). We were advised that the best place to wear the sensor was on the underside of the upper arm. In similar fashion to an insulin pump infusion site, the sensor came packaged in what looked like an insertion device. It simply “clicked” into place on the arm.

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I’m the kind of person who easily gets annoyed by things. I fiddle with my watch, my medic alert bracelet presses too hard on my skin, and I am always picking at scabs. So I was pleasantly surprised that I have hardly noticed the Libre sensor. So far, the sensor has held nicely on my arm. I had one bath where the sensor was submerged in water for some of the time. I’ve had showers and changed my clothes every day, where the sensor is inevitably subject to some bumps and friction. The sensor is starting to look a little grubby around the edges, though, as it heads towards the end of its life.

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Being Winter, my sensor often sits under warm clothes and I notice it less. It is likely exposed to lesser impact and outdoor activity compared to the warmer months of the year. I’m also not sure how comfortable I’d feel wearing this $95 sensor to the beach under some rough waves.

Some of the other bloggers raised the issue of the Libre not having alarms to alert them of high and low blood glucose readings, which is a very valid point. I am not particularly concerned by this. Just as with finger pricks, I check often enough to be able to catch any impending highs or lows. I’m all for something simple, and that minimises the diabetes junk that I have to carry around with me. The Libre fits the bill nicely. As with anything, more features will mean an even higher price tag.

A great deal of my Libre use has been checking my glucose levels after meals. This has given me an insight into where my levels are heading after I eat, and in evaluating the need to readjust settings and ratios on my new insulin pump. We were told that data may be less accurate than a finger prick when glucose levels are rapidly changing, so please bear this in mind around my observations. 

My Libre reader has typically run around 1-2 mmol higher than the reading on my meter. I have also noticed a more significant difference where my Libre presents a reading greater than 15mmol. I have found greater accuracy where my levels are in single digits, and where there is no active meal bolus in my system.

That being said, the Libre has been super convenient to have while I’m transitioning to the insulin pump. It’s been a huge relief on my fingers at a time where I would likely be using test strips like water. Every morning, I plug it into the computer and upload the data to Diasend. It gives me access to detailed graphs that have tracked the movement of my levels through the night, which is extremely helpful in making decisions around my overnight basal insulin rate.

I walked around without my meter and test strips while I was in Sydney quite comfortably, too. The reader was quite easy to carry around, and fitted nicely into a t-shirt or jeans pocket. It was a really convenient tool to evaluate my blood sugar levels after some big Sydney meals, and a reliable indicator of glucose trends. I would definitely consider buying a sensor next time I plan on travelling.

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After a week and a half with my sensor, I am also feeling extremely challenged not to micromanage data. It’s extremely challenging to look at those annoying trend arrows after meals and not respond to them. It’s for the same reason that I’m not particularly interested in using a Continuous Glucose Monitor (not to mention the price!). I will definitely miss the convenience and the detail of my Libre data when my sensor shuts down on Thursday, but I am also very much looking forward to a break.

You can find out more about the upcoming Australian launch of the FreeStyle Libre at freestylelibre.com.au.

Disclosure: Abbott paid for my travel and accommodation expenses to and from Sydney. I received a FreeStyle Libre reader and 2 sensors free of charge. There was no expectation that I would blog about the Libre. All opinions expressed here remain my own.

Hey, Sydney.

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Today, I’m attending my first “official” diabetes event since I started my blog. I’m headed to Abbott’s Diabetes Exchange Program in Sydney, where I’ll learn more about the FreeStyle Libre which is launching in Australia soon.

What is the FreeStyle Libre, you ask? It’s a glucose monitor that measures blood glucose readings by “scanning” a small round sensor worn on the arm, rather than traditional finger pricking. I wrote about it in more detail over here.

I’m just an ordinary guy living with diabetes. While I don’t blog for the perks and the recognition, it’s a huge testament to my writing here that I would be included in such an event. These sorts of things never happen to me, so yeah it’s a big deal.

I’m also really excited for the opportunity to meet some of the folks in the Oz Diabetes Online Community who will also be present. While I love the Diabetes Online Community, these guys mean the most to me out of all of my DOC connections being closer to home. I watch their activity online with great interest and I try to follow their example when writing about diabetes here.

Which brings me to some disclosures. Abbott has paid for my travel and accommodation expenses to and from Sydney. I have been given a FreeStyle Libre reader and 2 sensors free of charge. There is no expectation that I will blog about the Freestyle Libre or anything else discussed at the event. I have not been paid to write anything. Any opinions expressed here and on social media are voluntary and remain my own. I have actually had to take time off work to attend this event.

You can follow along using the hashtag #DX2Sydney on Twitter later today, and keep an eye on my Facebook page, which you can ‘like’ here.

While I’m on the topic of travel, can I just say that Lost has ruined my life forever? I’m obsessing over the diabetes supplies I’m packing, wondering whether they will be enough to last me if I were stranded on a tropical island! Not to mention that stupid ending in the church…

See you soon, Sydney.

FreeStyle Libre To Hit The Australian Market

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Updated: You can read about the blogger event I attended in Sydney here, and my initial review of the product here.

Okay, well in case you haven’t heard this news already…

Abbott’s FreeStyle Libre Flash Glucose Monitoring System recently received approval from the Therapeutic Goods Administration in Australia, and is expected to be launched in the Australian market in the coming months.

The Glucose Monitoring System consists of a small round sensor that is worn on the back of the upper arm, and a “reader” that looks very similar to a blood glucose meter. Users need only scan the reader over the attached sensor in order to receive a reading, and 8 hours worth of historical data.

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The Libre has a few key differences that sets itself apart from a traditional Continuous Glucose Monitor (CGM). The sensor appears to be much more discrete, approximately the size of two stacked 20 cent coins. Sensors also have a life of 14 days, as opposed to traditional CGMs which last up to 7. Abbott also claims that the Libre eliminates the need for finger pricking, making glucose testing more convenient and discrete. Alternative CGMs need calibrating with finger pricks, and only guarantee glucose trends rather than historical data.

Unlike a CGM, however, the Libre is not a “live” glucose monitoring device. It is up to the user to complete the scan in order to obtain a glucose result and historical data. There are no alarms or indicators to alert the user when they are going high or low. I also don’t believe that there is any “sharing” functionality of data through smartphones, which many CGM users in the DOC place a high value on. It appears that data can be downloaded to a computer and generated in report format, similar to the Insulinx meter I have been using recently.

I know that many folks in the Diabetes Online Community do pay for the convenience, live data, sharing and peace of mind that a CGM offers them. I know that many have come to rely on this standard in their diabetes management, and I wouldn’t expect that the Libre would hold much appeal here.

I have previously expressed reasons for not wanting a CGM myself. I’m quite motivated to do my finger pricks as much as I need to. I’ll be switching to an insulin pump in May, and I can’t say I’m keen on wearing two devices. I can’t say that I could handle seeing “live” data all the time. At $75 for a sensor that lasts only 7 days, I can’t say that I can afford it either.

I believe that this is where the Libre would hold the greatest appeal.

I also know that for many who would like one, a CGM is out of reach. At a time where there is a strong push for greater access to glucose monitoring technology in Australia, the arrival of a new competitor in the Libre is an encouraging sign. I have only heard positive things about the Libre from European folks in the DOC who have tried it after traditional finger pricking.

The biggest factor here is likely to be the cost of the Sensors, which need replacing every 14 days. While Abbott is yet to comment, Seven News speculates a shelf price of $100 per sensor. Given that CGM sensors are not currently subsidised by the National Diabetes Services Scheme (NDSS) in Australia, I would not expect that Libre sensors would be, either.

You can read more about the FreeStyle Libre, and sign up for e-mail updates at freestylelibre.com.au.

Disclosure: Abbott sent me a Press Release regarding this news. I was not asked or paid to write this, and all opinions expressed here are my own.