The End of Diabetes: The Eat to Live Plan to Prevent and Reverse Diabetes

The continuous glucose monitor (CGM) has undoubtedly become the diabetes game changer. When it comes to monitoring your blood sugar effortlessly and frequently, fingersticks simply cannot compare. The devices can be expensive, depending on your insurance coverage, but having this constant stream of data can aid you tighten your overall management and improve both your A1C and Time In Range. 

Not sure which CGM is right for you? Here is a quick rundown of the continuous glucose monitors available on the market.

The Competitors

Dexcom G6

Dexcom’s current model, the Dexcom G6, is probably the most successful CGM ever released. This is the gadget that convinced many people with diabetes that CGM technology has finally been done right. Many of the best features of the G6 were never seen before. Let’s review some of the features:

• The sensor is inserted with an easy one-button applicator
• Glucose data is automatically transmitted to a smartphone, smartwatch, or Dexcom receiver each 5 minutes
• The Dexcom sounds alarms for both low and high blood sugar readings, and alarm threshholds can be personalized.
• Glucose data doesn’t just indicate your blood sugar level, but also trends. It predicts if your blood sugar will continue to rise or fall.
• You can also transmit your blood sugar data remotely to caretakers and loved ones – a godsend for parents (and school nurses).
• It can be worn for 10 days (though some have hacked the device to extend it)

The G6 is also probably the leading CGM for interoperability: the capacity to sync it with other devices. It’s therefore the choice for most loopers.

Keep your eyes unlock for the unlock of the Dexcom G7, which will be even smaller and easier to use. It’s expected to debut sometime in 2022.

FreeStyle Libre 2

For a few years, almost everyone agreed that the Dexcom G6 was the best CGM on the market. But with the release of Abbott’s newest model, the FreeStyle Libre 2, there’s now some serious competition for that title.

The new Libre 2 adds most of the game-changing features that once set the G6 apart, and actually beats it in other ways. Here are the details:

• The Libre 2 also has customizable low and high blood sugar alarms
• It also has an easy one-button sensor application
• Glucose data is displayed on either a Libre receiver or a smart device
• The Libre 2 also shows upward and downward glucose trends
• The LibreLinkUp app automatically sends glucose data to remote users

One primary difference is that the Libre 2 is, strictly speaking, a flash glucose monitor. Your receiver or smart device does not automatically download data from the sensor – you require to physically scan the sensor by holding your device within 1.5 inches of it for about one second. (Low and high blood sugar alarms, however, will sound without scanning).

But the Libre boasts a few big features that Dexcom cannot compete with yet:

• The sensor lasts 14 days
• The sensor is the smallest on the market, about the size of a quarter

The Libre 2 also tends to be less expensive than the G6.

Medtronic Guardian Sensor 3

The Medtronic Guardian Sensor 3 is the least talked-about of the major CGM systems. Most users of the system purchase it to use in concert with the MiniMed 670G and the 630G insulin pump systems. To be honest, unless you’re utilizing one of those Medtronic pumps in a loop system, extremely few of our community members would recommend the CGM.

It has a few definite drawbacks. It is not FDA-approved for treatment decisions, meaning that before you make a blood glucose decision (like dosing insulin) in response to the Guardian Sensor data, you’re supposed to confirm with a fingerstick. It’s also not approved for children below 14, and the sensor only lasts 7 days. For more details, check out our article on the tech.

The Eversense XL CGM System

A unique option that most people with diabetes are unfamiliar with, the Eversense CGM system uses an implantable sensor that sits underneath the skin for up to 90 days. You do have to wear a comparatively bulky transmitter on top of the sensor implant, although it can be removed and replaced with ease.

Eversense almost went under during the COVID-19 pandemic (it wasn’t a good time for a product that requires a trip to the doctor’s office every 90 days), but it was rescued by another business and is now back on the market.

The Eversense CGM shares many of the features of the traditional CGMs. It offers high and low blood sugar alerts, it beams its data to your smartphone, and it allows remote users to monitor blood sugar readings. The transmitter also vibrates during alarms, which is both more discrete and means you don’t need to have your smartphone within earshot to benefit from the alert system.

Users may or may not like the Eversense sensor and transmitter setup. The bulky transmitters stick onto your body for about one day – they must be removed regularly for re-charging and to apply a new adhesive. However, it’s nice to realize that the sensor won’t get knocked off by a door frame, and if you want to remove the transmitter temporarily, it’s easy to do so.

The system also requires two fingerstick calibrations per day.

The Eversense is really the new kid on the block. When we asked followers for their opinions on CGMs, not a single man or woman that had tried the Eversense responded. You can find reviews of the system elsewhere, such as this one from our partners at BeyondType1. If you’ve used the Eversense CGM, we’d really like a lot to hear your thoughts!

How to Try a CGM for Free:

We know that, unfortunately, many of us are at the mercy of confusing health insurance plans. It’s possible that one CGM will be significantly less expensive than another for you, which may tie your hands – that is, if you’re lucky enough to have coverage for a CGM to begin with. We also know that it can seem nearly impossible to find out from your insurance how much medical equipment will actually price you.

The major CGM manufacturers comprehend how frustrating the system is, and have made an effort to get samples of their products into your hands without a lot of red tape.

Dexcom will send you a free sample through its Hello Dexcom program.

And Abbott will send you a free sample through its MyFreeStyle program.

Medtronic will also send you a free sample through its Guardian Connect evaluation program.

Which CGM is Best? Here’s What Our Community Thinks

I believe it’s fair to say that most of our readers prefer the Dexcom G6 (and that they really, really don’t like the Medtronic Guardian Sensor 3). If there was a single most representative comment, it was this one:

“I hated Medtronic, liked Freestyle, really like a lot Dexcom.”

Many believe that Dexcom is the gold standard. They often prefer the fact you do not need to scan the sensor:

“I?? really like a lot the Dexcom! I like that I can see it on my Apple Watch and phone without having to scan it like the Libre.”

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“I am currently using Dexcom G6. I like that it displays on my Apple Watch and gives me alarms. I also enjoy not having to scan it and that it lasts (for me) without issues for 10 days.

Some values Dexcom’s superior interoperability:

“I personally prefer Dexcom because it is a lot more compatible with other apps and pumps. I personally have had far fewer issues than when I used Libre. Libre would not persist the full 14 days I think mainly because of how active I am.”

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“I love my Dexcom 6 because I loop with Omnipod, which has been life-changing.”

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“Dexcom + the Sugarmate app changed my life.”

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“There are pros & cons to each. I went from Libre to Dexcom primarily for a closed-loop system with Tandem. The extra adhesive perimeter is a plus with Dexcom. It’s beyond me why Libre didn’t consider that, especially when you wear their sensors for 14 days.”

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“Dexcom connects to my phone and Garmin Forerunner 945. This is great when you are training.”

But not everyone agrees! The Dexcom’s larger size and cost received a fair share of criticism:

“I hate the wonky readings the first 24 hours, I find it to be slightly bulkier than other CGMs, and I get compression lows If I sleep on my Dexcom.”

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“I started with the Dexcom and found it to be too intrusive and uncomfortable. I love, love, love the Libre 2! Can’t go wrong with either though. Game changer for us!”

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“Libre to Libre 2 all the way. However, with the smaller G7 coming out we are going to give it a shot. The direct to watch is what we’re excited about.  My son hated the other Dexcom, said they were uncomfortable and painful to insert.”

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“I used Dexcom for years and it was obnoxious and obtrusive (not to mention $$$$). I switched to Libre2 and I love this little thing so much more than Dexcom. It’s easy to use, relatively inexpensive, lasts forever, it fits into MY life (no alarm fatigue!), I’ve never had one fail (in 3 years), and numbers have been really exact for me based on lab test results. Love it!

I’m in the US and with the help of a 3rd party app, my libre 2 data is collected through Bluetooth and transmitted to my phone. Easier than Dexcom, available at the pharmacy, and cheaper by far. And I know there is much dispute, but my sensors are always dead-on accurate.”

Libre users are also excited about the upgrades that came with the Libre 2:

“I’ve only ever used the Libre Freestyle and Libre 2.  They were both effective tools but I preferred the Libre 2 as it had enhanced accuracy and I like the high/low glucose alarms.”

The poor Medtronic system really came in for a beating:

Dexcom G6. I have a Medtronic one and hated it. Alarmed all the time, was often off, etc. Love my Dexcom”

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“Dexcom is SO much better than Medtronic. But SO expensive.”

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“I started with Medtronic and happily changed to Dexcom. More accurate, feels more secure on my arm… looks better too and lasts longer than the Medtronic did.”

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“I started with Medtronic and I didn’t like it. It always went off and never got any sleep with it on. Then I switched over to Dexcom and have had no problems.” 

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“I love the Dexcom G6 that I have right now. I have used Medtronic’s CGM that worked with their pump before and did not like it anywhere in close proximity as much as the Dexcom. The Dexcom is much more accurate and reliable and I have not had any problems with the Dexcom staying in place as I did with the Medtronic one.”

Finally, we most valued the opinions of those that are familiar with all three:

“I wore the Guardian Sensor by Medtronic for 3 years before I agreed to give the Dexcom G6 a try. I wore them side by side for 6 weeks before I conceded. I had been a loyal Medtronic customer. Been with Dex for nearly two years.  Management has never been better. I helped my type 2 stepmom get started on the Libre and she liked it. But after seeing my graphs on the Clarity app, she decided to give the Dexcom a try. In 6 months her a1c is 6.6.”

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“I used Medtronic, Libre, and now Dexcom. I disliked Medtronic but it was what I had to begin with. It started getting really twitchy near the end before I switched to Libre. For the Libre, I really liked the low cost, the long wear time, and the accuracy. I disliked having to scan to get numbers but it wasn’t bad … Have been on Dexcom/tSlim now for about a month and absolutely LOVE it! I find it pretty accurate. Love having the alarms again (mostly – lol). I just wished my insurance covered a larger chunk of my costs for supplies.”

Takeaways

There you have it. The Dexcom is probably the king, but it can be very expensive and some find the sensor too bulky. The FreeStyle Libre 2 requires annoying manual scanning, but users love how slim it is, that it lasts 14 days, and the lower cost. (And as for the Medtronic Guardian system, the less said, the better).

We hope that the thoughts and opinions of other community members help you to figure out which CGM is right for you!

Diabetes Daily

The End of Diabetes: The Eat to Live Plan to Prevent and Reverse Diabetes