CHOOSING A CGM

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How to Make a Decision on Which Continuous Glucose Monitor is Right For You

The multitude of benefits which cgms offer to help manage diabetes more effectively, have led many people to switch from traditional blood glucose meters to continuous glucose monitor technology. Cowen Investment Banking’s vice president of healthcare equity research, Ryan Blicker, notes that 2019 witnessed sales of cgm devices grow by 60%.[1] While increased cgm utilization is an important step in successful diabetes management, the initial process of choosing a cgm can be intimidating. The following article will explore some important things to consider when choosing a cgm, offer a comparison of three popular cgm models, and discuss the advantages the Freestyle Libre offers over the others.

 

What to expect when you switch to a continuous glucose monitor

Here are some benefits you will experience as a result of using a cgm:[2]

  • More frequent blood glucose readings
  • Ability to manage daily glucose levels more accurately
  • Long-term cost effectiveness over traditional blood glucose meters
  • Easier to monitor long term glycemic trends
  • Ability to see direction blood glucose levels are moving in throughout the day
  • Greater ability to prevent hyper/hypoglycemic incidences
  • Greater ability to prevent long term health complications associated with diabetes

Common features among cgms today[3]

  • Predictive direction of blood glucose level
  • Data share option via receiver and/or phone app
  • Initial required warm-up period before sensor use
  • Calibration via fingerstick or sensor scan
  • Sensor/transmitter inserted subcutaneously
  • Ability to record exercise, food, and insulin in activity log

 

 

A Comparison of Three Popular CGM Models & Advantages of the Freestyle Libre

 

Are there important differences between each cgm system?

There are certainly a number of shared features, such as the ones listed above, that are common to every cgms. As this technology only continues to grow, there is also room for technological advancement within each system. However, there are significant distinctions between them that should be noted. What are some advantages that the Freestyle Libre offers over other models?

Most Cost-Effective

Perhaps one of the most significant barriers preventing people from switching over to a cgm is the initial cost factor. Even knowing that it will be financially beneficial in the long run, many individuals cannot afford the up-front cost of switching. Unfortunately, often those that would benefit from a cgm most have the greatest difficulty in affording one. Unlike the Medtronic Guardian & Dexcom G5, the Freestyle Libre is approved by Medicare. Compared to the other cgm models, the Freestyle Libre is the most inexpensive system.[4]

 

Long Lasting Sensor

Another feature which makes the Freestyle Libre both cost effective and convenient is the long sensor lifespan. The Medtronic Guardian sensor lasts one week and the Dexcom G5/G6 sensors last seven and ten days, respectively.[5] The Freestyle Libre sensor lasts up to fourteen days,[6] resulting in cost saving benefits from a longer lifespan on top of the initial lower cost of the system.

 

No Fingerstick Calibration Necessary

One of the most revolutionary features of which the Freestyle Libre was the first to pioneer, is making the need for fingerstick calibration obsolete. Although cgms are able to provide a great deal more insight into glycemic occurrences that traditional blood glucose meters, other cgms including the Medtronic Guardian and Dexcom G5 still require fingerstick calibrations to ensure accuracy in glucose readings. Instead, the Freestyle Libre uses a handheld reader to scan the sensor to provide an instant glucose reading.[7]

 

Storage For 8 Hours of Data

The Freestyle Libre sensor includes storage capacity for 8 hours of glycemic data to allow for greater monitoring of glucose trends throughout the day. It takes one reading every 60 seconds and then transfers data to the reader ever 15 minutes.[8] The frequency of readings and large storage capacity makes the Freestyle Libre ideal for daily glucose monitoring that is both accurate and explanative.

 

Shortest Warm-Up Time

It only takes one hour for the Freestyle Libre warm-up time, as compared to two hours for the Dexcom and Medtronic models.[9] Again, this contributes to an overall greater level of convenience which many find appealing when managing diabetes, which requires constant attention to maintain healthy glycemic control.

Accurate readings with acetaminophen

Many diabetes must be cautious of glucose reading inaccuracy due to the presence of acetaminophen, a common fever reducer and pain reliever. Unlike the Dexcom G5 and Medtronic Guardian, the Freestyle Libre offers confidence to users that any glucose readings will not be thrown off by any acetaminophen in the system.[10]

 

Who Should Use Freestyle Libre?

 

The Freestyle Libre is specifically designed for anyone 18 or older (or younger with physician prescription)[11], managing type 1 or type 2 diabetes.

Particularly, diabetics needing more control over their glucose levels to prevent hypoglycemic/hyperglycemic instances are encouraged to adopt the Freestyle Libre technology.

The Freestyle Libre system specifically, as compared with other models, is beneficial for anyone with diabetes looking for a cgm which is most cost effective, user friendly, and convenient. It is also ideal for anyone who does not want to do use fingersticks.

For those wanting more information on how factors like medication, diet, and exercise affect glucose levels, this device would be highly beneficial.

Summary

Continuous glucose monitoring systems have gained enormous popularity within the diabetic community due to the the multitude of features that make diabetes management more convenient, accurate, efficient, and overall successful compared to reliance on traditional blood glucose meters.

There are a variety of cgm options currently on the market, so it is important to know what to look for in a cgm and what makes each model unique.

The Freestyle Libre offers many advantages over other cgms, including cost effectiveness, long sensor life, no fingerstick calibration, data storage capacity, short warm up time, and accurate glucose readings with the presence of acetaminophen.

[1]Rachal, M. (2019, December 9). Rivalry of the Year: Abbott and Dexcom’s race to dominate CGM. Retrieved from https://www.medtechdive.com/news/rivalry-cgm-abbott-dexcom-glucose-monitoring-dive-award/565923/

[2]Funtanilla, V. D., Candidate, P., Caliendo, T., & Hilas, O. (2019). Continuous Glucose Monitoring: A Review of Available Systems. P & T : a peer-reviewed journal for formulary management, 44(9), 550–553.

[3]Integrated Diabetes Services. (2020, February 2). Continuous Glucose Monitor Comparisons, Reviews by diabetes educator. Retrieved from https://integrateddiabetes.com/continuous-glucose-monitor-comparisons-and-reviews/

[4]Integrated Diabetes Services. (2020, February 2).

[5] ibid

[6]Abbott Industries . (2018). FreeStyle Libre 14-day System: Glucose Sensor & Reader. Retrieved from https://www.freestylelibre.us/system-overview/freestyle-14-day.html

[7]Funtanilla, V. D., Candidate, P., Caliendo, T., & Hilas, O. (2019).

[8]Integrated Diabetes Services. (2020, February 2).

[9] ibid

[10]Scheiner, G. (2018, April 19). Review of the Freestyle Libre. Retrieved from https://integrateddiabetes.com/in-depth-review-of-the-newly-approved-freestyle-libre/

[11] ibid

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*Fingersticks are required for treatment decisions when you see Check Blood Glucose symbol, when symptoms do not match system readings when you suspect readings may be in accurate, or when you experience symptoms that may be due to high or low blood glucose.

Reference 1: Data on file. Abbott Diabetes Care. 2, FreeStyle Libre 14 day User’s Manual

Indications and Important Safety Information

FreeStyle Libre and FreeStyle Libre 14 day Flash Glucose Monitoring systems are continuous glucose monitoring (CGM) devices indicated for replacing blood glucose testing and detecting trends and tracking patterns aiding in the detection of episodes of hyperglycemia and hypoglycemia, facilitating both acute and long-term therapy adjustments in persons (age 18 and older) with diabetes. The systems are intended for single patient use and require a prescription.

CONTRAINDICATIONS: Remove the sensor before MRI, CT scan, X-ray, or diathermy treatment.

WARNINGS/LIMITATIONS: Do not ignore symptoms that may be due to low or high blood glucose, hypoglycemic unawareness, or dehydration. Check sensor glucose readings with a blood glucose meter when Check Blood Glucose symbol appears, when symptoms do not match system readings, or when readings are suspected to be inaccurate. The system does not have alarms unless the sensor is scanned, and the system contains small parts that may be dangerous if swallowed. The system is not approved for pregnant women, persons on dialysis, or critically-ill population. Sensor placement is not approved for sites other than the back of the arm and standard precautions for transmission of blood borne pathogens should be taken. The built-in blood glucose meter is not for use on dehydrated, hypotensive, in shock, hyperglycemic-hyperosmolar state, with or without ketosis, neonates, critically-ill patients, or for diagnosis or screening of diabetes. When using FreeStyle LibreLink app, access to a blood glucose monitoring system is required as the app does not provide one. Review all product information before use or contact Abbott Toll Free (855-632-8658) or visit www.freestylelibre.us for detailed indications for use and safety information.html. . FreeStyle, Libre, and related brand marks are trademarks of Abbott Diabetes Care Inc. in various jurisdictions. Other trademarks are the property of their respective owners. ©2018 Abbott. ADC-09691 vLO 10/18

*The FreeStyle LibreLink app and the FreeStyle Libre 14 day reader have similar but not identical features. Fingersticks are required for treatment decisions when you see Check Blood Glucose symbol, when symptoms do not match system readings, when you suspect readings may be inaccurate, or when you experience symptoms that may be due to high or low blood glucose.

The FreeStyle Libre 2 app and the FreeStyle Libre 2 reader have similar but not identical features. Fingersticks are required for treatment decisions when you see Check Blood Glucose symbol and when your glucose alarms and readings from the system do not match symptoms or expectations

‡‡‡Based on the sensor being replaced once every 14 days, and scanned at least once every 8 hours.

§§§Glucose readings are not available during 1-hour warm-up, when sensor is too hot or too cold, when you see an error or "LO" or "HI" message, or no current glucose reading