Data Ecosystems and Remote Monitoring

Data Ecosystems and Remote Monitoring in Continuous [Glucose Monitoring](/)

A continuous glucose monitor (CGM) reading doesn't stay on your arm. It moves by Bluetooth to a phone app or receiver, then over the internet to the manufacturer's servers, where two different audiences can see it: family members who follow along in close to real time, and clinics that review weeks of history. As of October 2026, each of the three large US CGM makers runs its own version of that chain. Dexcom has Dexcom Follow for caregivers and Dexcom Clarity for clinics [1][2]. Abbott pairs LibreLinkUp with LibreView [3], and MiniMed offers the CareLink Connect app alongside its CareLink software [4].

From sensor to phone to cloud

Every system starts with what FDA calls the primary display: the app or receiver that talks directly to the sensor, shows the readings and alerts the wearer to a low or high [5]. Abbott's FreeStyle Libre 3 Plus sensor, for example, sends a reading to the wearer's phone every minute, with no scanning [3]. The phone then forwards that data to the company's cloud, but only while it's online: Abbott says the phone needs internet connectivity for glucose data to upload to LibreView and to reach LibreLinkUp users [3].

Everything past the phone is a copy, and FDA wrote that idea into regulation. In January 2015 the agency granted Dexcom's De Novo request (FDA's route for new kinds of low- to moderate-risk devices) for the Dexcom Share Direct Secondary Displays, creating a new device type, the "continuous glucose monitor secondary display," under 21 CFR 862.1350 [5]. In that design, the patient's Share app sent data through the internet to a Dexcom server, and a Follow app on another person's phone pulled it down [5]. FDA defined a secondary display as a tool for passive monitoring that must not be able to stand in for the primary display [5].

Caregiver sharing: Follow, LibreLinkUp and CareLink Connect

Dexcom builds a Share feature into its CGM system so up to 10 people can follow the wearer's glucose in the separate Dexcom Follow app, which needs its own internet connection [1]. Dexcom's comparison page lists Follow for both the Dexcom G7 and the Dexcom G7 15 Day [6]. Abbott's route runs through its Libre app: the wearer shares from the app, caregivers view readings in LibreLinkUp, and LibreLinkUp requires a LibreView registration [3].

MiniMed's path goes through the insulin pump. On the MiniMed 780G system, the CareLink Connect app lets the user share pump information with up to 5 care partners, who can view glucose levels and get alerts [4]. FDA's 2020 approval summary for the earlier MiniMed 770G spells out the plumbing. The MiniMed Mobile app receives data wirelessly from the pump and transfers it to CareLink, and the CareLink Connect app lets a care partner view it remotely [7]. MiniMed's US product pages now list the MiniMed 780G and MiniMed Flex pumps, not the 770G [4].

Does sharing help? Here's what surprised us. In a 2021 survey of 302 adults with type 1 diabetes who shared Dexcom data with at least one follower, 89.4% said sharing improved their confidence about hypoglycemia, and 36.1% said it reduced diabetes distress [8]. The benefits weren't automatic, though. They tracked how the main follower behaved: celebrating good stretches, offering encouragement during hard ones, and talking as a team about how the follower should respond to out-of-range values [8]. These were self-reported answers from people using the older Dexcom G5 Mobile and G6 systems, and the lead author has consulted for Dexcom and Abbott [8]. Dexcom stopped manufacturing the G6 after July 1, 2026, and recommends that G6 users talk with their doctor about upgrading to its G7 sensors [9]. How a follower should respond to an alert is a plan to make with your care team.

Clinic review: Clarity, LibreView and CareLink Personal

Clinic platforms are built for history, not live watching. Dexcom Clarity lets a user connect data with a clinic for review at any time, even remotely: the clinic provides a code, and the user enters it in the Clarity app under Profile, then Authorize Sharing [2]. Abbott's LibreView software builds clinician reports, led by the Ambulatory Glucose Profile (AGP): a summary of glucose statistics, targets and time in range [10].

MiniMed's CareLink Personal is free web-based software that collects data from a MiniMed user's pump, CGM, blood glucose meter and smart insulin pen [11]. Uploads go through the MiniMed Mobile app's Sync to CareLink feature or a Blue Adapter. At a visit, the user can share by signing in on the clinic's computer. Otherwise, the provider can send a remote sharing request using the user's CareLink username [11].

All three describe themselves as review tools. Clarity's labeling says treatment decisions should not be made from the software [2]. Abbott says LibreView is not intended to provide treatment decisions [10], and MiniMed calls CareLink report data an adjunct that isn't meant to be relied on by itself [11].

Third-party integrations

The CGM maker's cloud isn't the only place readings go. Dexcom's CGM app can send glucose data to Apple Health and Google Health Connect, but both show it on a three-hour delay, not in real time [12]. Dexcom apps on Garmin's Connect IQ platform put glucose on compatible Garmin watches and Edge cycling computers, as long as the phone has a data connection and is in Bluetooth range of both devices. Dexcom labels those apps for passive monitoring only [12].

Insulin pumps add another layer. As of October 2026, Abbott lists the FreeStyle Libre 3 Plus sensor as working with the Omnipod 5, Tandem t:slim X2, iLet Bionic Pancreas and twiist automated insulin delivery (AID) systems [13]. Pump makers run their own sharing apps too. Abbott's page says Tandem users can share CGM data with up to 20 people through Sugarmate by Tandem, iLet users can share glucose and insulin data with up to 10 through the Bionic Circle app, and the twiist insiight app shows caregivers glucose and insulin data [13]. One person's readings can end up in the CGM maker's cloud, the pump maker's cloud and a phone health app at the same time. How the sensor and pump talk to each other is its own topic, covered in interoperability with automated insulin delivery.

Where the chain has limits

Lag is built in. Dexcom explains that because the phone sends data to Dexcom's server, the information in Clarity is always older than what the CGM app or receiver shows, and the app or receiver is the one to use for treatment decisions [2]. Health-app copies run three hours behind [12].

Connections drop. Follow needs an internet connection [1], Dexcom's Share needs the phone within 33 feet of the G7 sensor [6], and Libre 3 Plus alarms reach the phone only when the sensor is within 33 feet, unobstructed [3].

Followers are a backup by design. FDA's special controls for secondary displays require the warning "Dosing decisions should not be made based on this device," along with measures that protect the data against unauthorized access and modification [5]. Dexcom tells users to depend on their own Dexcom app, not their followers [1], and Abbott says LibreLinkUp is not intended for dosing decisions [3]. We cover the security side in more depth in cybersecurity in connected CGM ecosystems.

Software can fail quietly. In July 2025 Dexcom began correcting Dexcom G7 app versions 2.8.0 and earlier, which could end a sensor session and stop reporting glucose without the expected "Sensor Failed" alert; FDA classified the action as a Class 1 recall [14]. Every follower screen, clinic report and health-app chart downstream inherits whatever the phone app at the start of the chain gets wrong.