I have been using the Freestyle Libre for over 5 years now. At first I thought it was amazing, but over time it’s inaccuracies mixed with my busier life as a parent and I began to wonder if it was really benefitting me anymore.
For the last 10 days I have been using a Bubble from Bubble Sweden to convert my Freestyle Libre from a simple flash glucose monitor to a CGM (continuous glucose monitor), with alarms and warnings that can make a huge impact on the life of someone with type 1. So what did I think?
What Is The Bubble CGM?
The Freestyle Libre is a flash glucose monitor. That means that it is constantly recording your interstitial fluid and using an algorithm to calculate an estimate for blood glucose. You use a reader (or in some cases your mobile phone) to scan the monitor and receive a reading plus directional arrows for your blood glucose over the last 8 hours.
The Bubble Libre CGM attaches to your Freestyle Libre and converts it to a continuous glucose monitor. By that, I mean that it provides up to date data straight t your phone without having to physically scan the sensor. Using one of the compatible apps you can set up alarms for high and low readings, set targets and reminders.
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Which Libre Is Bubble Compatible With?
The Bubble is currently compatible with Libre we get on the NHS here in the UK, as well as:
- Freestyle Libre 1
- Freestyle Libre 2
- US 10 Day Libre
- US 14 Day Libre
- Freestyle Libre Pro/H
What Is In The Box?
The Bubble comes in a small box – conveniently in a colour that matches my branding 😉 Inside the box there are just a few items, with everything you need for your bubble. There are:
- Bubble CGM
- Charging Cable
- 4 Sheets Adhesive Stickers
- Information sheet
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Setting It Up
Set up is really simple. The Bubble comes fully charged so you simply need to apply the adhesive and place it on to your Libre. I have used similar devices before so I was fairly confident in what I was doing, but I do think for a new user a little more guidance may have been helpful.
With the Bubble safely on your arm you can move on to using one of the apps and linking your Bubble to it.
Switching Bubble On And Off
Bubble arrives in unique packaging, and when it is removed it turns itself on. When you place it back in to the groove in the packaging it will turn itself off again.
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There is a small LED light on the Bubble which will alert you to it’s current state:
- LED light does not blink or light up when Bubble is turned on.
- Red LED blinks 1 time when Bubble is switched on or restarted.
- Red LED flashes when Bubble is charging
- Blue LED remains on when Bubble is fully charged and ready for use.
Bubble CGM App Compatibility
There are a couple of choices when it comes to linking your Bubble to your phone. For android users there is DiaBox and XDrip+ readily available, and for iOS you can access DiaBox and XDrip+ via Testflight. As an Apple user I can only pass judgement on those apps, but I welcome your comments below on how you found it with Android.
It is worth nothing that, regardless of which app you use, having you phone working as a CGM reader does drain your battery. I am usually at home for large parts of the day so it isn’t really an issue for me, but when we go out for the day I find it useful to take a portable charger with me to keep my phone going.
DiaBox was the first app that I used and initially I really liked it. Visually it is very clear to use, and it appears to be very user friendly. You can easily customise your alarms based on your individual needs and – most crucially for me – it didn’t lose connection every 5 minutes and require a restart.
DiaBox reads directly from the Libre and so the readings you see are exactly what the Libre has calculated. While this may be beneficial to some, I find the Libre really quite inaccurate and so the ability to calibrate the Bubble with a finger prick is vital. I have been informed that the calibration feature will be available soon, so I’m looking forward to that!
I also like to have my readings show on my Apple Watch – might as well make the use of the technology I have! The DiaBox app does send notifications to your watch, alerts for highs and lows etc, but it doesn’t have the compatibility to show your readings on the watch yet. I believe this is also in the works, but it is a “nice to have” rather than a complete deal breaker.
Once a calibration option has been added DiaBox would hands down be my app of choice.
After expressing my concerns with calibration to the team at Bubble I was guided towards Xdrip+ for iOS. It is not as graceful as DiaBox, nor is it as reliable – but it does work.
Aesthetically Xdrip+ for iOS is very basic. The graph goes up and down but there is no colour coding or “in target” areas. However it is simple to personalise the alarms and settings, and there is even the option to add a reminder to calibrate it.
I calibrate to Xdrip+ twice a day, first thing in the morning and again in the evening before my dinner, as this is when my blood sugars are most stable. By doing this I find the accuracy of Bubble to be great and I am comfortable using it to bolus and make corrections throughout the day.
With Xdrip+ there is also the option to link to your smart watch so your readings can be seen at a glance. You can choose to include the change since previous reading (so you can gauge if it’s going up or down) or just have a standalone number and arrow. I prefer the second option as it is clearer when you are just having a quick look.
Using Bubble Day To Day
Like most adults I shower every day, but I also take my kids to their swimming lessons. This leaves me submerged for around 30 minutes. The Bubble is designed with no holes in it to ensure its durability while in the water. It claims to be fine for up to 2m deep and 30 minutes submersion, the same as the Libre. I have used the Libre many times in the past for far longer than 30 minutes, and over time I will no doubt be exposing Bubble to similar conditions. I can only hope it can stand up to the job.
Does the Bubble stay stuck? This is one of the questions I have been asked most often, second only to queries about reliability of the apps. In my honest opinion, the adhesive is one area that is really letting the Bubble down. Personally, I have found that the stickers are only lasting around 24-36 hours, whereas with alternative brands I can get a full 14 days.
This may be due to the fact the adhesive sticks ONLY to your arm, with no actual attachment to the Freestyle Libre. While Abbott probably prefer that, I think it is letting down the Bubble and is an area that could do with significant improvement. I would not feel comfortable entering a pool while wearing the Bubble with only it’s original adhesive to secure it in place.
I have gotten around this by using the adhesive stickers from the MiaoMiao Libre CGM to secure the Bubble from when I had one previously. Since making the switch it has held in place with no concerns.
You can purchase a holder direct from Bubble for €9.99. I prefer not to have additional strapping on my arm but it could be something to consider.
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The Bubble boasts a battery length of 10 days, however I am getting a full 14 days out of the sensor. I am sure that, like all electrical items, over time this may decrease slightly, but for now I am happy to report no charging is required over the course of a single Libre sensor.
*Update* – I have now been using the Bubble for over 3 months and have never had the battery need required during the life of a Libre sensor. It has lasted a full 14 days each time.
How Do The Children React?
In my house I have 2 little ones, currently 4 years old and nearly 2. The 4 year old is not really an issue, but a handsy 2 year old who is often up in my arms can get a bit precarious at times.
I have worn similar devices (most recently the MiaoMiao) for quite some time now and so JJ wasn’t particularly phased by the change to Bubble. He is discouraged from touching – but the temptation to tug is often right there in front of him. With the original adhesive it would soon become detached unfortunately, but overall it’s not a huge problem.
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If you are considering a Bubble you are probably already accustomed to wearing a Libre, so having things attached to you won’t be that alien. When I first looked at additions to it I had some concerns about the comfort of adding extra bulk to my arm.
I don’t notice the Bubble on my arm. It is no bigger imposition than the Libre alone is. It doesn’t tug or pull at my skin, I lie on it when I sleep and the kids climb all over me with it. Discomfort doesn’t even cross my mind.
Is The Bubble CGM Worth The Price?
Currently, you can buy a Bubble for €129.99. While I don’t want to downplay the cost – I full appreciate that it is a lot of money – in the long run I do believe the cost is worth it.
I spent years self funding the Libre, on it’s own without any additional CGM functionality. This was £100 a month, and so a one off payment of just slightly more than that doesn’t seem so bad. The alerts for highs and lows are invaluable to me these days and I do honestly think the price is worth it. Because can you really put a price on your health?
I was sent a Bubble CGM in order to carry out this review. All words and opinions are my own.
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