People Switching Cgm Brands: How Many And Why?

Continuous glucose monitors (CGMs) are a convenient and less uncomfortable way to monitor blood sugar levels compared to traditional methods. They are usually worn on the belly or arm and can be connected to a smartphone, a receiver, or both. There are several CGM brands available in the market, including Dexcom, Medtronic, Freestyle Libre, and Eversense. While these CGMs share some similarities, they differ in various aspects, such as the frequency of readings, water resistance, smartphone capabilities, and cost. As a result, users may switch between different CGM brands based on their specific needs, preferences, and insurance coverage.

Cost and insurance coverage

Section title: Cost and insurance coverage

Continuous glucose monitors (CGMs) can be expensive, ranging from $2,000 to $7,000 per year without insurance. The average yearly cost is $1,200 to $3,600. The cost of a CGM depends on the brand and the required components, such as a transmitter and replaceable sensors.

Most health insurance plans cover CGMs and their supplies if you have a prescription for the device. Medicare covers CGMs as durable medical equipment under Part B with a 20% copayment. If you have a private Medigap plan, it may cover the copayment. To get coverage from Medicare, you must be diagnosed with type 1 or type 2 diabetes and either be taking insulin or meet the hypoglycaemia requirements. Your doctor must write a prescription and confirm that you or your caregiver knows how to use the monitor. The monitor must be FDA-approved and purchased from a Medicare-approved supplier.

Medicaid also covers CGMs, but this may only be for people with type 1 diabetes. Usually, Medicaid deductibles, copays, and other out-of-pocket costs are very low. Contact your state Medicaid program for specific details.

If you don't have insurance, you may be able to get financial assistance or discounts to help with the cost of a CGM. For example, GoodRx offers and manufacturer savings programs can help you pay less for popular brands such as FreeStyle Libre and Dexcom. Abbott, the maker of FreeStyle Libre, offers the MyFreeStyle program, which provides a voucher for a free 14-day sensor and reader for a $0 copay. Dexcom offers a Patient Assistance Program for customers who lost their health insurance due to the COVID-19 pandemic.

Accuracy and consistency of readings

The accuracy and consistency of readings are crucial factors when choosing a continuous glucose monitor (CGM). Inconsistent or inaccurate readings can lead to incorrect decisions about medication, diet, and exercise, which can be dangerous for people with diabetes. Here are some considerations regarding the accuracy and consistency of CGM readings:

Calibration Requirements

Some CGMs require daily or twice-daily fingerstick calibration, which can be inconvenient and lead to discrepancies in readings, especially when blood glucose levels are rapidly changing. For example, the Medtronic Guardian Connect and Eversense CGMs require fingerstick calibration. On the other hand, the Dexcom G6 is the only CGM on the market that does not require calibration and is FDA-permitted to make diabetes treatment decisions without fingerstick confirmation.

Reading Frequency

The frequency of readings varies among CGMs. Some devices, like the Dexcom G6 and G7, are real-time CGMs that automatically update your receiver or smartphone app with new glucose levels every 5 minutes. In contrast, the FreeStyle Libre 2 takes a reading every minute, and the FreeStyle Libre 14 Day tracks glucose levels every 15 minutes. These are considered flash glucose monitors, which continuously monitor glucose levels but only transmit the data when you scan the sensor.

Warm-up Period

After inserting a new sensor, CGMs have a "warm-up" period before they start providing accurate readings. This period can vary between devices, typically ranging from 30 minutes to 2 hours. During this time, you will need to rely on a separate glucometer to check your glucose levels.

Sensor Life

The sensor life, or how long a sensor can be worn before it needs to be replaced, differs among CGM brands. For example, the Dexcom G6 and G7 sensors last for up to 10 days, while the FreeStyle Libre sensors can be worn for up to 14 days. Longer sensor life can be more convenient and reduce the cost of replacement sensors.

Alerts for Out-of-Range Readings

Some CGMs offer alerts or alarms when glucose readings are out of the target range. This feature can be particularly important for people who have hypoglycemia unawareness and may not realize when their glucose levels are dangerously low. However, not all CGMs have this capability, and some allow you to silence the alerts. For example, the FreeStyle Libre 14 Day system does not have alerts, which can be a concern for people at risk of hypoglycemia.

Integration with Other Devices

The ability to integrate a CGM with other devices, such as a smartphone or insulin pump, can enhance its accuracy and consistency. For instance, the Dexcom G6 can be used with a dedicated receiver, an insulin pump, or a smartphone app, providing flexibility and real-time data. Additionally, certain CGMs can be integrated with an insulin pump, allowing the monitor to automatically adjust or pause insulin delivery based on changes in glucose levels.

Ease of use and data sharing

The ease of use and data sharing capabilities of continuous glucose monitors (CGMs) are important factors to consider when choosing a device. These features can make a significant difference in how well you are able to manage your diabetes and the level of convenience you experience while using the device. Here are some key points to consider:

Data Accessibility and Sharing:

• Many CGMs offer data sharing capabilities, allowing you to share your glucose readings with your healthcare team and loved ones. This can be done through smartphone apps or dedicated receivers.
• Consider how many people you may want to share your data with and check the maximum number of users supported by the device. For example, the Dexcom G6 allows sharing with up to 10 people, while the Medtronic Guardian Connect supports up to 5 people.
• Data sharing can provide peace of mind for both you and your loved ones, especially if you experience hypoglycemia unawareness (difficulty telling if your glucose is low).
• Additionally, data sharing with your healthcare team can help them make more informed decisions about your treatment plan.

User Interface and Data Visualization:

• The user interface and data visualization methods vary among CGMs. Some devices use simple graphs and trend arrows, while others offer more detailed reports and predictive insights.
• Consider your personal preferences and how you would like to interact with the data. Do you prefer a simple and intuitive interface, or are you interested in a more comprehensive analysis of your glucose data?
• For instance, the Guardian Connect System by Medtronic provides detailed glucose data, including time in range information, which shows how long your glucose levels remain within your ideal range each day.

Smartphone Compatibility:

• Most modern CGMs offer smartphone compatibility, allowing you to view your glucose data on your phone via a dedicated app. This can be more convenient than carrying a separate receiver device.
• Check the compatibility of the CGM app with your smartphone's operating system (iOS, Android, etc.). Some apps may only be available on specific platforms.
• Additionally, consider the Bluetooth range offered by the device if you plan to use your smartphone as the primary receiver. For example, the Abbott FreeStyle Libre 3 offers a 33-foot Bluetooth range, which is significantly longer than some other devices.

Alerts and Notifications:

• Alerts and notifications can be a crucial aspect of CGMs, especially for detecting and preventing hypoglycemic events (low blood sugar).
• Some CGMs offer customizable alerts for high and low glucose levels, allowing you to set alarms or vibrations to notify you when your readings are out of the target range.
• For example, the Dexcom G6 and FreeStyle Libre 3 have optional alerts for out-of-range readings, as well as special alarms for dangerously low glucose levels that cannot be turned off.
• On the other hand, the FreeStyle Libre 14 Day system does not have alerting capabilities, which can be a concern for those at risk of hypoglycemia.
• Consider your personal needs and preferences when evaluating the alerting features of different CGMs.

Data Storage and Reporting:

• The amount of data storage and the ability to generate reports vary among CGMs. Some devices may only store a limited number of recent readings, while others can provide reports for up to 90 days.
• If you intend to use your CGM data for in-depth analysis or want to track long-term trends, choose a device that offers more extensive data storage and reporting capabilities.
• For instance, the Dexcom G6, in combination with the Clarity app, allows you to generate reports for yourself or your healthcare team by automatically loading your glucose data onto the app.

When choosing a CGM, carefully evaluate the ease of use and data sharing features offered by different devices. Consider your personal needs, preferences, and how you intend to use the device to make an informed decision.

Water resistance and durability

The durability of a CGM is also crucial, as sensors typically need to be replaced periodically. The frequency of replacement varies among different brands and models. For instance, the Dexcom G6 and G7 sensors last up to 10 days, while the FreeStyle Libre sensors have a longer lifespan of 14 days. Additionally, the Eversense CGM System features a sensor that is implanted subcutaneously and lasts for up to 180 days, requiring replacement less frequently than other CGMs.

Compatibility with other devices

Smartphone Integration

Many CGMs offer smartphone apps that allow users to view their glucose data and share it with their healthcare team and loved ones. Some CGMs, such as the Dexcom G6 and the Medtronic Guardian Connect, have dedicated apps that provide real-time data and alerts. Other CGMs, like the Abbott Freestyle Libre 2 and 3, use third-party apps like LibreLink and LibreLinkup to share data. When choosing a CGM, ensure that the app is compatible with your smartphone's operating system (e.g., iOS or Android).

Smartwatch Integration

Some CGMs can also integrate with smartwatches, allowing users to view their glucose readings directly on their wrist. For example, the Dexcom G6 works with smartwatches, while the Eversense CGM from Senseonics provides on-body vibration alerts for low or high glucose levels, even if your smartphone isn't nearby. If you prefer to use a smartwatch to monitor your glucose levels, ensure that your chosen CGM is compatible with your specific device.

Insulin Pump Integration

If you use an insulin pump, choosing a CGM that integrates with your pump can be beneficial. The Dexcom G6, for instance, can connect with insulin pumps such as the Tandem t:slim and Omnipod. This integration allows for automated insulin delivery based on your glucose readings, enhancing the convenience and effectiveness of your diabetes management.

Other Devices

In addition to smartphones, smartwatches, and insulin pumps, some CGMs can connect to other devices. For example, the Medtronic Guardian Connect system has a website called CareLink that enables users to send glucose data to care partners. When considering a CGM, think about the devices you already use for diabetes management and choose a CGM that offers compatibility to create a seamless experience.

When deciding on a CGM, it is essential to consider the devices you currently use or plan to use for diabetes management. By choosing a CGM that is compatible with your smartphone, smartwatch, insulin pump, or other devices, you can ensure that you have easy access to your glucose data and that your devices work together effectively.

Frequently asked questions