For people with diabetes, life is what happens in between pricks. It is a mad dash to put children to bed or finish an assignment before they once again have to inject their bruised bodies with more insulin or prick their fingers to check sugar levels. Over 415 million people with the disease all around the world live this way, by 2040 that number is set to reach 642 million. Although a cure is not in sight yet, significant strides are being in ameliorating the everyday burden. Abbott Diabetes Care has developed a flash glucose monitoring system called Freestyle Libre that promises to allow diabetics to measure their sugar level without having to draw blood. We spoke to Marc Taub, senior director for research and development at the company, to find out what went into developing this technology.
Salus: How would you describe Freestyle Libre to someone unfamiliar with the product?
Taub: Normally, if someone with diabetes wants to measure their blood glucose they would literally make themselves bleed onto a strip and put it into a meter. A few seconds later it tells you what your glucose is at that instant. Freestyle Libre is a sensor that’s worn on the back of the arm for 14 days. If the user wants to get their glucose values they’re able to take a reader device and bring it near to the sensor, through clothing, to get their glucose value without having to do a finger prick.
Salus: How does it work?
Taub: There’s a sensor inserted just below the skin that measures the glucose levels in the interstitial fluid, that’s the fluid that the cells of the body bathe in. It’s about the size of a 2 Euro coin. The user can swim with it, shower with it, perform all aspect of their lives. They can painlessly, discretely measure their glucose levels whenever they want to.
Salus: How is it applied?
Taub: The device comes with a single-use disposable applicator that applies the sensor to the back of the arm. An adhesive helps it to stick on the back of the arm and at the same time it inserts the little tip of the sensor beneath the skin. The user does it themselves every 14 days. It compares very favourably to a finger prick in terms of application, it’s very simple and is nearly painless to apply.
Salus: How did you go about developing it?
Taub: The basic science in Freestyle Libre is built on an earlier sensor that Abbot had, called the Freestyle Navigator which used our wired enzyme technology. We made improvements so that the sensor can be used for 14 days and so that it does not require user calibration over that time.
Salus: What are some of the main advantages of the product?
Taub: With a standard glucose meter you just know your glucose levels at that time, if you test four times a day for instance, you know your levels four times a day. With Freestyle Libre it’s continuously measuring your glucose levels. So with every scan it will tell you your levels at that instant but it will also tell you what your glucose has been doing the last eight hours. So that way when you wake up every morning you can understand what happened over night or when you check after meals you can understand what that pizza at lunch did. It also gives you an arrow indicating where your glucose is heading. The position of the arrow indicates how fast levels are changing.
Salus: What kind of testing did you go through to get where you are now?
Taub: We’ve done more than a dozen rounds of “human factor” testing. It started from the basic concept where we took plastic solid parts in a ziplock bag imagining what packaging would be and showing people drawings of where the screens would be. We talked to doctors, nurses, caregivers etc. In every round we learned something and we got closer to more functional prototypes. We did them in multiple countries to make sure this would be effective all over the world.
Salus: What were some of the international differences you came across?
Taub: The reader on this product is text based. That’s quite different from most blood glucose meters. We had to make sure we had a device that you could show Chinese and Japanese characters on. We wanted to make sure we came up with language that could be easily and readily understood by people with a range of education backgrounds. We spent a lot of time on translations and user interface design.
Salus: How has your rollout been so far?
Taub: It’s available in eleven countries in Europe. It’s also in Brazil, Australia, India and South Africa.
Salus: What are some of the developments you are planning?
Taub: We recently got a pediatric indication that allows Freestyle Libre to be used by children as young as four. The app is called Libre Linked. Everything I’ve talked about until now involves a hand-held scanner, but now you can also use an Android based smartphone. Users can scan the sensor in exactly the same way with the app.