By Jimmy McDermott and Maeve Serino

FreeStyle LibreLink app allows FreeStyle Libre users in the US to obtain a real-time glucose reading directly on their iPhone. Plus, LibreLinkUp now available for caregivers to remotely monitor glucose and trends

Editor's Note: This article was updated on April 16th, 2019 with the availability of LibreLinkUp in the US.

The FDA has approved FreeStyle LibreLink, an iPhone app for scanning the FreeStyle Libre sensor. Abbott’s FreeStyle Libre users in the United States can now see their real-time glucose number and trend arrow directly on their iPhone – no separate handheld reader device required. Just like the current reader device, the FreeStyle LibreLink iPhone app can be used to start a new sensor. FreeStyle LibreLink users can also now share their current glucose and trend arrow with caregivers through the LibreLinkUp remote monitoring app. For background on the FreeStyle Libre, click here.

FreeStyle LibreLink and LibreLinkUp are now available and free to download from the Apple App Store. FreeStyle LibreLink is compatible with iPhone 7 and later and LibreLinkUp is compatible with iPhone, iPad, and iPod touch. Both apps can be used with the 10-day or 14-day wear FreeStyle Libre sensors. FreeStyle LibreLink and LibreLinkUp are currently not available for Android users in the US.

Since Medicare’s updated policies on smartphone CGM use, we presume that FreeStyle LibreLink will also be allowed for Medicare beneficiaries as well.

Features of the FreeStyle LibreLink App

An iPhone with the FreeStyle LibreLink app can either replace or be used in combination with the FreeStyle Libre reader. If you want to freely switch between the iPhone and separate reader, you must start a new sensor with the reader (not the app).

The FreeStyle LibreLink app offers several improved features over the reader:

Text-to-speech glucose readings, which may be valuable for visually-impaired users,

Ability to log small insulin doses of 0.1 units,

Option to add notes on food, insulin dosing, exercise, and any other comments (though notes can’t be added retrospectively), and

Support in 26 languages (the FreeStyle LibreLink app is now available in 24 countries).

Similar to the reader, we love that the FreeStyle LibreLink app includes CGM data reports right in the app (e.g., time-in-range, patterns), rather than having to download a separate app or go to a web portal.

The FreeStyle LibreLink app does not communicate continuously with the sensor or offer alarms – the sensor must be “scanned” at least once every eight hours to obtain a real-time glucose reading and recent history (the sensor can store up to eight hours of data). This differs from other CGMs that automatically send real-time glucose data directly to your smartphone (Dexcom’s G6, Senseonics Eversense, Medtronic’s Guardian Connect).

A few limitations:

To obtain a reading, the FreeStyle LibreLink app must be open on screen, meaning it cannot be used from the iPhone’s lock screen.

In the US, FreeStyle Libre is still only approved for individuals 18 years old and up. It is currently under FDA review for children 4 years and older.

LibreLinkUp Remote Monitoring App

With the recent FDA approval, FreeStyle LibreLink users in the US and Europe can now share glucose information with caregivers using LibreLinkUp, the remote monitoring app. The person with diabetes scans a FreeStyle Libre sensor with his or her own FreeStyle LibreLink iPhone app, allowing the caregiver to remotely view the current glucose and trend within LibreLinkUp. Similar to Dexcom Share, users must invite loved ones to follow their glucose levels. But unlike Dexcom Share, LibreLinkUp does not allow caregivers to see the glucose graph – only the current value and trend (like a logbook of recent scans, see photo).

Watch this video produced by Abbott to see several of the FreeStyle LibreLink app’s features and appearance: