Continuous glucose monitoring, known as CGM to mass with diabetes (PWDs), has the potential to change lives and bring tonic insight into how one manages this status.

But what are the best CGM options and how do they compare?

The cardinal all but nonclassical CGMs available in the United States A of leaping 2021 are the Dexcom G6 and Abbott FreeStyle Libre.

Here is DiabetesMine's detailed compare of these two systems, including how they each bring on, what makes them different, how accurate they are, and how such they cost.

"(Users) can read a fate about the impact of lifestyle on glucose values, such as intellectual nourishment intake, number and quality of sleep, Beaver State type of exercise. That can be very eye-opening for the patient and motivate them to change behavior to improve glucose values," said Rachel Stahl, a registered dietitian and diabetes care and education specialiser (DCES) at New York-Presbyterian and Weill Cornell Medicine.

San Diego-based Dexcom G6 has been manufacturing CGM technology since its inception in 2005, and its sensors are designed to become more accurate, reliable, and convenient with each upgrade. The current Dexcom G6 model, which is authorised for use in ages 2 and sr., has been available since 2018, and the new Dexcom G7 is expected in 2022.

From its earliest model to the latest transportable on twist, Dexcom G6 has cemented its post as the most popular full-featured CGM usable.

How does it work?

The Dexcom G6 has two parts that click together and are worn on your physical structure as a single whole: the sensor and transmitter.

10-day sensing element. Each sensor comes housed in a moldable white and orangeness car-inserter. A single-campaign button inserts the detector's lilliputian cannula into your shin and adheres the whole to your body with a inbuilt medical adhesive.

The sensor is water-resistant and then canful represent worn in the shower or while swimming. It is Food and Drug Administration-approved for wear on your abdomen and upper buttocks. The sensor is built to net for 10 days before IT automatically shuts off, though sometimes sensors fail other. In this case, the company testament ship customers a replacement.

Transmitter. This little gray plastic oval is the brains of the system. IT clicks into the clear plastic bracket of the sensor at one time inserted on your skin. Each transmitter has a 3-month battery life and is meant to be disposed of one time low. Every 5 minutes, the G6 transmitter sends glucose readings via Bluetooth connectivity (with a range of approximately 20 feet) to a smartphone app or a set-apart handheld touchscreen receiver where the user can view the data.

Warmup prison term. The G6 has a 2-hour warmup ahead the sensor starts generating glucose data.

No "required" fingersticks. Even though the G6 is factory-calibrated and doesn't require any fingersticks to substantiate a glucose reading, some PWDs still opt to two-bagger-fit their readings with a traditional fingerstick meter. The G6 does allow users to "fine-tune" the scheme if they opt by logging a fingerstick result. This give the axe sometimes assistance keep the CGM on track.

Programmable alerts. You can set apart your glucose alert ranges for high and low ranges, and set your preferences for loud or vibration alerts for different times of twenty-four hour period OR night.

There are "Do Not Disturb" and "Snooze" features on nigh alerts, although those options are out of action along important alerts like "Urgent Low Soon" and "Sensor/Transmitter Failure."

The "Urgent Broken Soon" alert is a non-optional warning whenever the sensor picks up that glucose levels are falling firm and predicts you'll drop to 55 milligram/decilitre within 20 minutes.

Motile app control. Most G6 users no more need a receiver, simply opt to control and view the CGM via the company's nomadic app, which deeds with all but iOS and Android phones (check compatibility here). The app home screen displays a circle with the current period of time glucose level and appropriate gray/red/lily-livered color code dependant on whether you're "In Range," "Squat," Beaver State "High."

The circle too has an arrow that points in the management you'rhenium trending, and below that is a graphical record screening 3 hours' worth of glucose data in a broken business. Want to view more than the past 3 hours of CGM data? Turn your smart phone horizontally to learn up to 24 hours of data and scroll back accordingly.

Data analysis. The Dexcom G6 mobile app is designed to earmark people to see glucose trends for the past 1, 3, 6, and 12 hours. But to review more comprehensive information, people can use the Dexcom CLARITY platform. You can access it online, or directly connected your phone by clicking on the flyspeck green icon from the G6 mobile app, displayed in the top right recess of the crosswise aspect. Users can also grant access to share data with their healthcare professionals.

Remote monitoring. A built-in feature in the Dexcom G6 app allows remote wake of data and trends by adequate 10 authorized followers, who potty varan a user's glucose readings straightaway.

Interoperability. What's unique to Dexcom G6 right now is the consolidation of its CGM with insulin pumps such American Samoa the Tandem t:slim to create a "shuttered loop" system that can automatically adjust insulin amounts based happening glucose readings. Dexcom G6 will also forg with the unused OmniPod 5 tubeless patch ticker awaited later in 2021.

How accurate is it?

The standard measurement of CGM performance is called the mean absolute relational difference (MARD). With this bill, the lower the number, the better the truth. Clinical information for the Dexcom G6 shows it has a MARD of 9 percent with uninterrupted accuracy o'er the time a sensor is dog-eared.

This is slightly more accurate than the FreeStyle Libre 2, according to the clinical subject results. However, individual users' experiences may depart, and many PWDs who have used both Dexcom G6 and FreeStyle Libre 2 report comparable accuracy.

How more than does it cost?

The total cost of any CGM system depends happening supply needs and the typecast of coverage the user has.

Lead off by checking your insurance plan's coverage of CGM. This leave include whether they cover purchase at your topical anesthetic chemist's, require a mail-order distributor, or whether they classify CGM as "durable Greco-Roman deity equipment" (DME). DME may require a higher deductible before your coverage kicks in.

Dexcom G6's CGM has traditionally been classified as DME for all but indemnity plans, but it's now becoming more common for the Dexcom G6 to glucinium uncommitted through pharmacies.

Not entirely insurance policy providers throw yet embraced this shift, which may proffer cost nest egg with simply needing to pay a single categorical copay.

Commend, there are two separate pieces of hardware needed to use the Dexcom G6: transmitter and sensors, both of which require a prescription and have different price tags attached.

If purchased at retail price from Dexcom G6 with most commercial insurance plans, the costs are (Eastern Samoa of Exhibit 2021): a total of $237 for the G6 transmitter, that lasts 3 months, and a sum of $349 for a three-clique of sensors (30 years' valuable).

At national pharmacy chains the likes of CVS and Walgreens, cash prices diverge simply most locations queried by DiabetesMine quoted the price for a G6 transmitter at evenhanded nether $300, and roughly $400 for the three-pack box of G6 sensors.

You can also purchase a Dexcom G6 with a prescription at Costco Pharmaceutics, as endless as you are a Costco member ($60 annual fee) and sign for their free pharmacy platform. Prices are less expensive here:

  • G6 transmitter: a total of $146.04 each
  • Three-ingroup box of G6 sensors: a total of $318.54

Note that you may see online search results viewing variable terms points, supported in real time-defunct early Costco Pharmacy discounts. Since Costco discount prices are periodically tuned, Be destined to check in advance of driving to the store to purchase.

Medicare besides covers the Dexcom G6 for those connected certain "intensifier insulin therapy" regimens, and eligible PWDS oftentimes see a "bundling" of their CGM and diabetes supplies including examination strips. Pricing varies depending along one's Medicare plan and any supplemental insurance insurance coverage the user may receive.

Abbott Diabetes first brought its FreeStyle Libre to the United States in 2017, and since mid-2020 the FreeStyle Libre 2 simulation has been available. It is FDA-sanctioned for use in kids arsenic young as 4 years rusty as well as adults with either type 1 or type 2 diabetes.

How does it put to work?

14-day detector. FreeStyle Libre 2 uses a round, fully-disposable sensor the size of two well-stacked quarters, worn on your upper arm for best results. A sticky adhesive on the back side keeps it loving to your skin. It is also fully pee resistant equivalent the Dexcom G6 sensing element.

It's approved to most recently 14 days until you need a novel sensor (4 days longer than Dexcom G6). Just like with Dexcom G6, Abbott's technical school bear can assist in replacing a sensing element that doesn't last as womb-to-tomb as it should.

Not continuous. What's different is that although the FreeStyle Libre 2 is generally referred to as a CGM, it is not studied to beam real-prison term information like the Dexcom G6 does. Instead, it's technically a "Flash Glucose Monitor," meaning users have to manually purloin the FreeStyle Libre 2 handheld reader over the detector to get glucose readings, as often or as teentsy as they choose.

Handheld reviewer. Glucose results are transmitted to the handheld subscriber, a blue device that resembles a traditional glucose fingerstick beat. Information technology measures 95mm tall x 60mm wide x 16 millimeter thick, and weighs 645 grams. It has built-in Bluetooth Low Energy, which is important because that allows for optional glucose alerts for high and low readings — unlike the earlier FreeStyle Libre mould that did not offer alerts.

No fingersticks at completely. Like Dexcom G6, the FreeStyle Libre 2 is FDA-approved for manipulation without the need for backup readings from a fingerstick time to substantiate accuracy.

Warmup time. FreeStyle Libre 2 has a 1-hour warmup period earlier IT starts generating glucose data. That's a full hour shorter than the competing Dexcom G6.

Optional alerts. With the FreeStyle Libre 2, you can turn on optional alerts that derriere beep or vibrate to notify you about high or low glucose readings. The thresholds are programmable from 60 to 100 mg/dL to trigger a low alerting, and 120 to 400 mg/dL for a screechy alert. While these alerts activate without a need to scan the sensor, you still need to scan the sensor to get an actual glucose resolution.

The power to set alerts can comprise a deciding factor for many PWDs in considering different CGMs. Setting up alerts is especially important for people who are uneasy about safety overnight. At night, contralto blood glucose levels can be flat Sir Thomas More treacherous as citizenry frequently father't feel symptoms operating theater wake in the lead in time to dainty themselves by rights.

Phone app scanning and information. The FreeStyle Libre 2 didn't originally work with the ambulant app, as the earlier good example did. Simply that changed in late July 2021, after the FDA cleared the Libre 2 mobile app so that you're able to run down the sensing element and see glucose results directly on a harmonious smartphone.

Data analysis. The data give the axe be analyzed on the proofreader, or on a smartphone using the company's FreeStyle LibreLink app.

Unaccessible monitoring. The FreeStyle LibreLink app also offers remote data sharing with equal to 20 people, twice as more as Dexcom G6.

Interoperability. FreeStyle Libre 2 is not currently compatible with any other diabetes devices, although it is being tested with other devices, including the future connected insulin pen system from Bigfoot Biomedical, for one.

How accurate is it?

This latest FreeStyle Libre 2 has a 9.3 percent total MARD score (9.2 percent for adults, and 9.7 percent for children). That means information technology's not quite a equally accurate as the competing Dexcom G6, reported to clinical data results.

How much does it cost?

Here are the approximate prices for the FreeStyle Libre arrangement, largely gettable through pharmacies:

  • With commercial insurance, Abbott reports that most of its customers pay between $10 and $75 per month for FreeStyle Libre 14-day sensors at participating pharmacies.
  • The regular list price is $54 per sensor, according to Abbott, although retail pharmacies like Costco and Walgreens quote prices of $58 to $69.
  • The hand-held lecturer runs $70.
  • Users can opt to use the FreeStyle LibreLink rotatable app for iOS or Android for no charge.

Abbott does not sell this twist directly, but information technology can Be set through your healthcare professional. The company began building out its channel for chemist's shop purchase in 2020.

The monetary value for FreeStyle Libre 2 is clearly hundreds of dollars below the cost of a Dexcom G6 scheme, and affordability has been one of the big marketing points for FreeStyle Libre since the induce-sound.

Lizz Baldyga, World Health Organization lives with type 1 diabetes (T1D) in Bay State, started out exploitation the FreeStyle Libre for 2 long time ahead eventually switching to the Dexcom G6 because of concerns over accuracy. She constitute that the FreeStyle Libre was oftentimes off by 100 Mg/dL points, but that isn't what she's experienced with the G6, and she prefers the continuous nature of it compared to the need for manually scanning to get a resultant role.

"I lovemaking that the Dex reads mechanically, so I can just glance at my phone and visualize a reading," she tells DiabetesMine. "I also love the alarms, which (the early-generation version) didn't have as an selection when I switched. I've seen my A1C throw away a trifle besides since switching to Dex, and that's a oversize win for Pine Tree State."

Michigan T1D Michelle Bates-Phipps, who was diagnosed in her 20s in 1991, says she started off victimization the earlier Dexcom G5 model with an integrated insulin pump back in 2017 and eventually upgraded to the G6.

But despite how some she loved the Dexcom G6 — particularly the glucose trend-detection and being healthy to share data with her hubby and furbish up — it was as well expensive because her insurance only covered 50 percent of her total costs. Contingent the supplier she secondhand, the Dexcom G6 was costing her $180 to $200 per month, she says.

So, she switched to FreeStyle Libre, which is very much more affordable as it's covered better by her insurance plan.

"FreeStyle Libre gives me most of the tools that Dexcom G6 did at just over one-fourth the damage," she says. "Dexcom G6 has to a greater extent bells and whistles, and I experienced less sensing element failures than with FreeStyle Libre, but it does what I need IT to."

Until the FreeStyle Libre 2 mobile app is sanctioned for the United States, Bates-Phipps says she'll continue using the preceding model of FreeStyle Libre with the 14-solar day sensors, so she doesn't have to keep a separate handheld receiver polar to scan the sensors.

Lauren Plunkett, a DCES in Minnesota WHO lives with T1D herself, has used both Dexcom G6 and FreeStyle Libre and says there are different features that can personify pleasing to users dependent on their needs and wants. She's recapped her experiences using both in a blog post Here.

For those who see a primary care for Doctor of the Church instead of an endocrinologist or diabetes specialist, Plunkett says it can often precipitate to that medic's familiarity with CGM and diabetes technology generally. As a result, whatsoever PWDs May not puzzle over clean-cut explanations operating theater support in deciding on a particular device.

"What I've found with the FreeStyle Libre, information technology's with great care easy to bolt it connected your arm and you're good to go," she says. "The frustration with both systems will e'er beryllium with the persistence of it reading your glucose. The last thing anyone wants is to cost far from home on a run, and your CGM stops reading. Information technology's classic of both to send packing you right when you don't want them to. But the majority of the time, especially overnight, it's so helpful to have a CGM on you to project what the trends are. The point is to help you make better decisions in your diabetes management."

New York DCES Stahl, who often advises some inpatient and outpatient on CGM use, said, "Patients can get very frustrated and real lose confidence in the device when they see that the value is much diverse from a (fingerstick) blood glucose value.."

She added that "situations such as postprandial (post-meal) or during exercise in which glucose is dynamical rapidly, are especially prostrate to these discrepancies."

All but often, Stahl and Plunkett say access and affordability are the biggest concerns for PWDs in considering a CGM. These insurance concerns often guide a person's choice more than anything else, they tell.

Both Dexcom G6 and FreeStyle Libre 2 present world-shaking benefits for glucose direction, just they each go with specific pros and cons that can influence user choice.

Dexcom G6 is considered to exist the most accurate and sufficient full-featured CGM connected the commercialize, while FreeStyle Libre is a much "restrained tool" that offers less — and completely nonmandatory — alerts and alarms.

The peregrine app capabilities and information-sharing with Dexcom G6 offer more options, and the "Urgent" alerts are peculiarly important for people who tend to experience frequent hypoglycemia, especially nightlong.

Patc the FreeStyle Libre will eventually be integrated into automated systems with insulin pumps, that interoperability is currently an area where Dexcom G6 wins.

For many, access and affordability via policy coverage clay the key divisor in choosing a CGM — and FreeStyle Libre currently wins here with its lour price full stop.

Equally Plunkett puts it, "Insurance breaks hearts. Often, there's No rhyme Beaver State reason (to coverage decisions) and that dictates what particular CGM person can utilise, no matter what they may prefer. It would interchange the world of diabetes if everyone could get get at to a CGM."