Get Abbott Freestyle Libre 3 Readings on Your Apple Watch

It's almost time for me to say goodbye to Dexcom.

I have blogged about my trials with Abbott Freestyle Libre 3 and talked about switching for some time. After quite a number of years, I have fallen out-of-love with Dexcom, and my new goal is to avoid using the new and not-so-improved G7 model. Yes, Dexcom G7 has a 30-minute warm-up time. But that's only a half-hour shorter than Abbott Freestyle Libre 3 warms-up, but you get four fewer days of use from Dexcom G7 compared to Libre 3, which means Dexcom ends up costing you and your insurance company a lot more money (insurance companies PBMs make up for it with legally-exempt rebate kickbacks from Dexcom). And, Dexcom has introduced a new and different CGM model called Stelo (see https://www.businesswire.com/news/home/20240305044213/en/ AND https://www.prnewswire.com/news-releases/fda-clears-first-over-the-counter-continuous-glucose-monitor-302080602.html for more) which uses the exact same sensors, but the software is written only for Type 2 patients and has no alarms. But unlike the G7, the Stelo can be worn for 15 days instead of the miserly 10 days that Type 1s receive with G7 even while it uses the exact same sensor. In other words, for the benefit of alarms and data-sharing, Type 1 patients are forced to pay 35% more money for the exact same sensors.

We also know the older Dexcom G6 model will be going away before too long. When that happens, I have read enough not-at-all-glowing patient reviews of new Dexcom G7 model that I might seriously wish to avoid it completely. Except that Dexcom pays legally-exempted rebate kickbacks to the Caremark unit of CVS Health/Aetna and the OptumRx unit of United Healthcare Group for "formulary exclusion" of rival CGM products (notably Abbott Freestyle Libre) from their prescription formularies. Ironically, both United Healthcare and Aetna do cover a rival CGM known as the Eversense CGM (co-marketed with Ascensia Diabetes Care), but because that must be inserted by a doctor, it is considered by insurance to be a "medical" rather than a "pharmacy" benefit. But I have friends who have switched to Dexcom G7, and most have found the Libre 3 to be superior in many ways to newer Dexcom G7. Not only is Libre 3 priced 35% less than Dexcom (thanks to its 14-day wear-time compared to Dexcom's miserly 10-day wear-time), plus Libre updates every minute compared to only every five-minute updates with Dexcom which is a major advantage for Abbott Libre.

And, thanks to cash-pay programs from the major CGM manufacturers (including both Dexcom as well as Abbott, catch my coverage of Abbott's Libre cash-pay program at https://blog.sstrumello.com/2023/12/abbott-gets-real-about-formulary.html for more info), that is entirely feasible without breaking the bank. But before I switch to Libre, I need to ensure that I will have all the functionality I now have with my Dexcom G6. For more info on Abbott's Libre cash-pay offer, visit https://www.freestyle.abbott/us-en/private-insurance.html and look under the tab for "Cost & Coverage" for more. In essence, in order to get the Abbott eSavings cash-pay voucher, call Abbott's Customer Care by telephone at 855-632-8658 (available Monday to Friday from 8AM - 8PM ET). You must call, provide them with some basic information, and ask them for the eSavings voucher so you can buy two Libre sensors for no more than $75. The offer applies to anyone. Also note that eSavings vouchers expire at the end of each calendar year, but you can (and should) call Abbott Customer Care at the beginning of each new year and they'll email you a brand new one.  

A number of years ago, I received a gift of an Apple Watch 3 (I still have the Apple Watch 3 model). The idea was that it would enable me to see my blood glucose readings since I never hear the alarms coming from my phone which is buried inside a bag someplace. I am still using the exact same watch (and the same watch-band for that matter) and I have no desire to upgrade (sorry Apple). I do find using Apple Watch extremely convenient (if imperfect) way to look at my blood sugar readings on my wrist instead of my digging out my mobile phone out of my bag. In fact, I have found that Dexcom's G6 Apple Watch app is known to lose connectivity with my iPhone, forcing me to click on the Dexcom watch app and rotate the watch's digital crown (the old-fashioned dial on the right side of the watch) until the readings show up again. But, for example, when I'm driving my car, and the readings are suddenly no longer visible on my wrist, its a nuisance to deal with. My point is that even Dexcom's current watch app isn't perfect. There are rumors that newer watch models will enable direct connectivity to newer model Apple Watches, but I don't want to buy a new Apple watch for $399 to $799. I'd rather use my old watch until it stops working.

Abbott, for its part, is a CGM giant on a worldwide basis, selling twice as many sensors as Dexcom does in nearly every country outside the United States. But Abbott's approach to peripheral support such as watch applications is handled differently. Libre has all of the Dexcom functionality, but the software does not come directly from Abbott but from third-party developers. That makes Abbott's job with FDA (the European Medicines Agency, Health Canada, etc.) vastly easier than Dexcom's route.

Instead, Abbott is following their traditional pattern of not building and maintaining its own apps, but is instead giving its API (Application Programming Interface) to third-party app developers to deliver the same functionality as Dexcom has with its own apps. That's a mixed blessing. Innovators can turn functionality around quickly and on-the-fly compared with coders from the company itself which tends to be very slow. But, I can tell you that yes, indeed, you CAN view your Libre 3 blood glucose readings on your Apple Watch because I have done it!

Frankly, I've been annoyed with how poor the technical instructions have been to enable patients to view their Abbott Freestyle Libre 3 readings on an older model Apple Watch 3. The instructions completely suck and the online community has been less-than-helpful other than to say that it is technologically possible.

For example, Justin Eastzer, a podcaster (also a YouTube channel of the same name) called @Diabetech gave in a video incredibly brief instruction on his YouTube channel, and for me, but I found his instructions were inadequate and did not even work. So I opted to turn to another for how to do it called (similarly enough known as Diabetotec) at https://www.diabetotech.com/blog/Syncing%20Your%20CGM%20with%20Your%20Smartwatch/, and while their instructions were slightly more thorough than Justin's were, again, both of them suggested a necessity of having to download and use TWO third-party apps called Gluroo and also Nightscout (so I needed TWO apps to get one function, with a bunch of useless additional functionality and vague instructions on how to make all the different pieces work together to view it on my Apple Watch.

All I want is to see my f'cking Libre 3 readings on my Apple Watch; why the heck do I need all that other crap? 

Then, in a Facebook group, a few people there had suggested a different alternative to the Gluroo/Nightscout dual app with their inadequate instructions on how to do it: those users suggested a different (any only one) third-party app I had never heard of before which is called "Sweet Dreams – Sugar Tracker". It is developed by a UK-based developer named Marwan Elwaraki.

"Sweet Dreams – Sugar Tracker" was just a single app, then in the app, I entered my LibreView account login info into the "Sweet Dreams – Sugar Tracker" app, and then almost instantly, Libre 3 readings showed up on my Apple Watch 3. That literally took me about 10 seconds to set-up, and voila: the "Sweet Dreams – Sugar Tracker" app shows up as a "Complication" on my Apple Watch and I had instant CGM readings, and unlike Dexcom, readings are updated every minute because Libre 3 does that (Dexcom only updates every five minutes).

I couldn't get anything easier than that!

The app also enables some interesting capabilities, such as changing the color of the app's logo, for example. Mostly, I aimed to replicate the exact alarm readings I had in place for Dexcom. That worked very easily as well.

Let me forewarn everyone: I have only tested that this works on Apple iPhone and Apple Watches; I do not believe there is a comparable app which might work on phones using Google's Android operating system. In fact, the developer is an Apple iOS coder, so I don't think it ventures into Android at all. If you use an Android phone and, for example, a Samsung smart watch, then you'll have to go with the more convoluted Gluroo/Nightguard option which I was unable to set up anyway (there were far too many options and settings and no one mentioned which ones to use in either of the two apps you need to use). But if you're an Apple iPhone/Watch user, then "Sweet Dreams – Sugar Tracker" was a very easy option.

While I intend to continue using Dexcom G6 as long as I can (until inventory of G6 sensors is depleted), I feel pleased that "Sweet Dreams – Sugar Tracker" offers functionality that Dexcom offers, and with Libre's longer wear-time, I may save myself about 35% and concurrently deny CVS Caremark a rebate kickback from Dexcom which they worked very hard to force me to help them get.