According to Abbott Diabetes DVP, Technical Operations, Marc Taub, one in nine people in the U.S. live with diabetes.
Speaking at DeviceTalks West in Santa Clara, California, he said that means everyone in the room at the time knows someone with diabetes. The condition requires constant attention and management, something Taub and Abbott aim to alleviate.
“Diabetes is a chronic disease and it’s hard to manage,” Taub said. “It requires a person’s round-the-clock care to manage. At Abbott, it’s our mission to create life-changing technology to help make it easier for people to live better lives.
“In this case, to make it much easier for them to better manage their diabetes.”
Today, Abbott is one of the market leaders in the diabetes space with its continuous glucose monitoring (CGM) technology. It continues updating its FreeStyle Libre 2 CGM, while it began rolling out the FreeStyle Libre 3 after receiving FDA clearance last year.
On top of monitoring, Abbott has work underway on integrating its CGM into automated insulin delivery (AID) systems. Its AID collaboration with Ypsomed and CamDiab is available in Europe, while the company works on integration with Insulet’s Omnipod 5.
“Thanks to advancements in technology, with diabetes, it looks much different than it did even five or 10 years ago,” Taub says. “Today, advanced diabetes technology can put rich, personalized information right into someone’s hands, empowering them to make the right decisions at the right time for better health outcomes.”
Moving on from the early days of diabetes care
Taub said early diabetes management included using a lancet to stick your finger, getting a drop of blood, putting a test strip into a blood glucose monitor and waiting for those results. That method is painful and inconvenient, he said. Plus, the stigma of glucose testing and fear of blood put people off from testing.
Abbott worked to reduce the pain of fingersticks by developing new technologies that required smaller amounts of blood. Older models of blood glucose meters required 5-10 microliters of blood. FreeStyle products needed just 0.3 microliters. With a smaller lancet, users felt less pain while getting results in about five seconds as opposed to around 30.
With that, blood glucose meters became the standard of care. But Taub says Abbott knew there was more.
“We knew continuous glucose monitors could solve problems for people with diabetes,” he explained. “First, they removed the barriers of painful fingersticks. And they give people better data.
“Continuous glucose monitors are a lot like your car navigation. They tell you, not only where you are, but where you’re heading, allowing you to make better decisions along the way.”
Developing the Abbott CGM technology
Abbott’s first CGM, the FreeStyle Navigator, utilized cutting-edge wired-enzyme technology. It translated the user’s electrochemical signal into glucose data from a sensor living just underneath the skin.
The sensor sits in the interstitial fluid, with a tail made from a thin filament about three hairs wide. Instead of blood glucose, it measured the interstitial fluid glucose every 60 seconds and transmitted that data to a wireless device.
Taub said the technology was groundbreaking when it launched in 2008, but that label barely lasted.
“It didn’t take long for us to realize that it wasn’t the right solution,” Taub said. “We thought it was a great technology but it wasn’t a great product. It was too bulky. It was complicated. There was a sensor, a transmitter, a receiver and we couldn’t make it at the cost and scale to be cost-effective. It was unaffordable for all but the very select few and you still had to do fingersticks to calibrate it.”
So, Abbott set out to make the FreeStyle system easier to use and more affordable.
Using feedback from people living with diabetes, the company went back to the drawing board, but with the same wired-enzyme technology.
“We created a new product designed to be simple, effective and affordable,” Taub said. “That’s how the FreeStyle Libre was born. I was lucky enough to be the technical lead for the development of the FreeStyle Libre, and I’ve been with Abbott for nearly 20 years. I have a huge connection to this product and it’s amazing to see what it’s become.”
Taub said that, when Abbott first introduced FreeStyle Libre in Europe in 2014, the demand for the product grew so high that the company shut its websites down to new customers after just 16 days.
What is the FreeStyle Libre CGM?
The Abbott sensor sends glucose data and trends to a reader or a smartphone. It helps people with diabetes track the effects of insulin, medicine and food on their body.
Taub said Abbott simplified the platform significantly from FreeStyle Navigator, with better ease of application and use. Users need no extra transmitter, and all the electronics are in the little white circle placed on the back of a person’s arm. The sensor, again the width of three human hairs, is painlessly inserted just below the skin into the interstitial fluid.
Abbott says the latest iteration of the FreeStyle Libre platform is the smallest and thinnest CGM sensor in the world at the size of just two stacked pennies. It’s worn inconspicuously on the back of the upper arm and is uncomplicated to apply, thanks to a one-piece applicator.
Beginning with a five-day sensor, Abbott worked its way to 14-day wear times before extending that to 15 days.
“We enabled automatic, real-time glucose data streaming from the sensor directly to your smartphone,” Taub said. “You can see updated readings on your smartphone every minute of every day. We designed that sensor to be easy to manufacture so we can produce sensors quickly and precisely and allow us to offer at a cost that can be considerably lower than our competitors and make it widely accessible.”
Abbott also made a factory-calibrated CGM, eliminating the need for fingersticks. Calibration takes place in the laboratory under controlled conditions.
Taub said it makes it more convenient for the user and minimizes error.
“In the end, we created the modern continuous glucose monitor,” Taub said. “We revolutionized glucose monitoring. FreeStyle Libre was introduced to make it easier for people to manage their diabetes.”
‘Where medical device meets consumer electronics’
Taub said FreeStyle Libre currently sits in an “interesting spot.”
It’s really where medical device meets consumer electronics,” he explained. “People have this amazingly intimate relationship with their sensor. They’re wearing it on the back of their arm. They’re wearing it every day. They sleep with it. They shower with it. They’re looking at the results on their phone up to dozens of times a day.”
Abbott adopted the increased popularity of digital health tools as part of its journey with FreeStyle Libre. The company built these tools into the FreeStyle Libre app, enabling remote monitoring from caregivers and healthcare teams. All updates still fall under Abbott’s goal of making it easier for people to manage their diabetes, Taub reiterated.
He highlights the system’s ease of use, broad availability and more. As scientists, product developers and designers, he said, everyone loves “inventing cool things.” After 20 years at Abbott, he says he appreciates that such innovation, without access, is meaningless.
“That’s what we did with the FreeStyle Libre system,” Taub said. “From the very beginning, our team at Abbott Diabetes Care prioritized affordability. We brought access to this technology to help reach more people.”
Today, Abbott offers FreeStyle Libre in more than 60 countries with full or partial reimbursement in more than 40. Its aims go even higher.
“We took steps at every stage to make it affordable and accessible,” Taub said. “We’re trying to reach millions and billions of people. Our goal is to help one out of every three people in the world by 2030. It’s an auspicious goal. The only way to do that is by designing products with access and affordability in mind from the very beginning.”