this post was submitted on 21 Sep 2023
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Owners of the FreeStyle Libre 3, one of Abbott Laboratories’ flagship glucose monitors, received an email this week warning them to “disable automatic system updates on your iPhone” because the new operating system’s StandBy Mode and Assistive Access Mode “may impact your ability to receive time-sensitive notifications including glucose alarms and notifications indicating that alarms are unavailable.”

“Key Steps to Optimize your FreeStyle Libre System on iOS 17,” the email reads. “While our teams are working quickly to verify and confirm compatibility, we recommend that you disable automatic operating system updates on the smartphone using the mentioned apps. Please check the compatibility guide on myfreestyle.com before the new operating system is installed.”

Abbott is telling customers who have already upgraded to disable StandBy Mode, which activates the iPhone’s Lock Screen while it’s charging and placed on its side. They are also being advised to turn off “Assistive Access” mode, an accessibility mode for people with disabilities. Abbott says that this mode “will impact your ability to activate a sensor, modify your alarm settings, or receive glucose alarm notifications from our apps.”

Abbott writes on its website that failure to take action when users get an alarm, or failure to use the device “as instructed in labeling may result in missing a severe low or high glucose event and/or making a treatment decision, resulting in injury.”

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[–] [email protected] 60 points 1 year ago (5 children)

Why didn’t they warn people sooner? iOS 17 has been in beta for months. This seems more like incompetency on their side.

[–] [email protected] 23 points 1 year ago

Like so many parts of the health care industry in the US, people like to make money off of diabetes not invest in solutions.

[–] [email protected] 9 points 1 year ago (1 children)

I’ll bet money that no one actually tested this product on the beta at all.

They could’ve let Apple know about this during the beta period. They’re a big enough company and Apple is big on integrating with healthcare tech. They probably could’ve got some changes merged in.

[–] [email protected] 3 points 1 year ago (1 children)

See my other comment. Its been several years since i worked in the industry but Apple has a history of making changes that are not included in the beta

[–] [email protected] 3 points 1 year ago

Well, this is the total opposite of the incident you experienced nearly a decade ago. This wasn’t a sudden quick change. These features were announced and were available for almost 5 months.

[–] [email protected] 6 points 1 year ago (1 children)

Incompetence.

That’s literally the only answer. My guess is they can find a fix which even further underscores their incompetence at not having it ready at launch. I’ll give indie devs and small companies a pass on not having day one support for a new OS but large corps and especially medical apps like this have no excuse.

[–] [email protected] 8 points 1 year ago

I used to work at a mobile app test automation company and there is an alternative answer: apple is the fucking worst. They used to frequently make additional changes that are not in the beta just before release and other companies have no warning until its live. I remember when ios8 released in between the final beta and general release they ripped out the entire api our platform used to interface with phones. We had to rewrite iOS support from scratch in like a month post release. It was a disaster.

[–] [email protected] 2 points 1 year ago (2 children)

If something critical (lives) life depends on some software working, they probably should’ve always been recommending that people disable major .0 updates. That’s systems administration 101.

[–] [email protected] 1 points 1 year ago

I worked for a major (medical) company that would skip .0 releases, precisely to combat stigma and folks skipping it.

We did have one particularly bad release that we ended up telling folks to delay taking.

IMO, the real secret to most critical upgrades, and at the heart of skipping .0 releases, is to test in non-production, talk with super users and peers, and patch intentionally and quickly. If you have the resources.

[–] [email protected] 1 points 1 year ago (1 children)

True but it’s also on the doctor, pharmacist, and especially the vendor to communicate it to patients. Patients aren’t sysadmins and can’t be expected to know what sysadmins do.

That said, it’s also on the app developer to make sure their app works on release day. And that’s especially true for critical apps.

[–] [email protected] 2 points 1 year ago

Looking into this a bit more, it looks like both of the use cases they’re concerned about are pretty edgecase-y.

They’re worried about users not getting glucose notifications. And the user has to intentionally turn off notifications in a settings panel for one use case, and for the other use case, a caregiver must intentionally opt into a hidden accessibility mode that is literally designed to turn a smart phone into a dumb phone.

This smells like the Abbott legal team is being overly cautious.