7  Advanced Topics

8 Advanced Topics

8.1 Other Sites

Sites that are useful for general background

• Abbott Freestyle Libre Users (Facebook): https://www.facebook.com/groups/748445301888935/

  • Active (20K members) and includes people from Abbott

• Diabettech site: https://www.diabettech.com/freestylelibre/

• QS Guide: Testing Food with Blood Glucose: another nice overview: https://quantifiedself.com/blog/qs-guide-testing-food-with-blood-glucose/

• Quantified Self Conference 2018 had a breakout session: see their notes here: https://forum.quantifiedself.com/t/qs18-links-and-resources/5885/4 which are based on a lengthy May 2017 thread by Gary Wolf in the same forum.

• Freestyle Libre Tips and Hacks: Youtube videos by Nerdabetic

  https://www.youtube.com/watch?v=o7R5Of-iWfk

• Reddit: /r/Diabetes

  • Especially check the thread on “Things you wished you knew about the Freestyle sensors”

8.2 Using AI

From Glucose Patterns to Health Outcomes: A Generalizable Foundation Model for Continuous Glucose Monitor Data Analysis Lutsker et al. (2024)

8.3 Software Packages

Interpreting blood GLUcose data with R package iglu an R package with zillions of CGM-related functions

8.4 Hardware

8.4.1 Freestyle Libre hardware information

• Freestyle Libre sensor teardown: Blogger Ido Roseman takes one apart, with photos.
• Reddit forum says: “it would appear that Libre sensors use NfcV, while S8 does not support NfcV (ISO 15693) but happily talks over NfcA and NfcB (ISO/IEC 14443). “
• Insulin calculator: settings/professional and password = CAA1C

8.4.2 Freestyle-compatible

Hardware devices that work with the Freestyle Libre. Using an NFC reader that talks directly to the Libre sensor, they send information to a bluetooth phone.

• MiaoMiao Shanghai company $200
• Ambrosia Systems Nightrider: $110 NFC-to-bluetooth device
• Bubblan: Supports All Libre Sensors except US Libre2 version : 139.99€

8.4.3 Other hardware

• Bionous: Seattle-Bellevue company that claims to have a low-cost non-invasive glucose reader (PHWare)
• Jobst Technologies Biosensors: hardware company that sells biosensors that detect glucose.
• http://tula-health.com/content/tech.html is raising money for a non-invasive CGM.
• OnDuo: An open resource doc about Google-Verily and Sanofi’s diabetes program that features CGM.
• Medtronic Guardian: open resource doc about another sensor+phone integrated CGM with prediction capabilities

8.5 Scientific articles

• Journal of Diabetes Science and Technology (2020) concludes that Freestyle Libre 2 performs within 20% of blood values.
• Lancet article (2016) that established the accuracy of the underlying CGM technology
• Glucotypes (2018): Stanford study claims people respond differently to foods
  • See news article summary
  • Upload your data to their online app here: https://abreschi.shinyapps.io/shinySpecClust/
• Personalized Nutrition by Prediction of Glycemic Responses (Cell: Zeevi et al 2015)
  • Highly-cited study showing differences are driven by the microbiome
• “Continuous Gluose Profiles in Healthy Subjects” (2007) study.
• FDA approval document: more details about Freestyle Libre and its authorized uses
  • (see similar approval for Dexcom, a de novo iCGM)
• “Hunting the Deceitful Turkey” 100+ page book about the tech behind non-invasive glucose monitoring

A handy table of CGM clinical trials (via AMJC)

Clinical Trial RCTs

9 Other Summary Resources

Other places to find more links and other information

Continuous Glucose Monitor page for the open source Loop project.

Lutsker, Guy, Gal Sapir, Anastasia Godneva, Smadar Shilo, Jerry R Greenfield, Dorit Samocha-Bonet, Shie Mannor, et al. 2024. “From Glucose Patterns to Health Outcomes: A Generalizable Foundation Model for Continuous Glucose Monitor Data Analysis.” https://arxiv.org/abs/2408.11876.