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Prickless Glucose Meter – Review and Compare
Prickless Glucose Meter … CGM?
In this post I will compare the prickless glucose meter from two competitors. The Freestyle Libre Flash, and the Dexcom G4/G5 both use technology that was recently approved by the FDA (Sept 2017). The approval is for Continuous Glucose Monitoring devices that don’t use a needle prick to the finger. Continuous Glucose Monitoring (CGM) is when your blood glucose is automatically and continuously monitored and recorded. Two pioneer companies in this new technology have their own product. Other large or medical tech companies have also been working on a prickless glucose meter and CGM devices. No doubt to gain access to the massive diabetes market, or because they want to build a better mousetrap. I expect other continuous glucose meters will be released in 2018.
What is the Distinction of CGM?
As of this writing, the FreeStyle Libre Flash product is only available by prescription in certain U.S. states. These devices could potentially benefit diabetes patients, mostly with one of two conditions. The first condition is a fear of needles. The second is a diabetes patient that requires either frequent or continuous monitoring. Fear of needles is fairly straight forward, and either of these types of products provide the same potential benefit. A main difference between the two products I’ll talk about is the frequency of data collection, and alarms connected to them. You will see additional elements that also may be very important.
A CGM device is continually collecting the blood glucose data on its own, without human interaction. When the blood glucose exceeds safe numbers, an alarm sounds to warn of the impending danger. Both of these product offerings are capable of being CGM devices. It may be appropriate to mention, other countries around the world have approved these devices before the U.S.
Cautions while using a Prickless Glucose Meter
In each case the prickless glucose meter sensor transmits signals, there may be circumstances where you need to exercise care. For example, in an airport TSA scan or maybe getting a X-ray, or MRI. I didn’t see any complaints surrounding credit card scanners, but the idea is to be careful not to kill your sensor. If your sensor quits working, you defeat the whole purpose.
The Freestyle Libre Flash
PRODUCT NAME: Freestyle Libre Flash
Price and Configuration
- Freestyle Libre Flash Reader: $85.00 (Required, Available by prescription)
- Sensor: $44.00 (Lasts two weeks)
- NightRider Blucon $110.00 + shipping (Continuous Glucose Monitor attachment, comes with a 2-3 week replaceable battery.)
- TransAm Blucon $50.00 + shipping (Single use waterproof version of the NightRider, last two weeks.)
- Total Start-up Cost: $239 using NightRider or $179 using TansAm
Abbott has been in the industry long enough to have a good reputation with their FreeStyle Family line of blood glucose meters. Their new offer is the FreeStyle Libre Flash. It is a prickless glucose meter and no longer requires a needle and test strips to measure your blood glucose. The Libre Flash uses a sensor mounted to your body instead of a needle. Obtaining a reading is as easy as swiping the reader by the sensor and pushing a button to collect data. The exception is when you use the CGM optional equipment like NightRider or TransAm add-ons from Blucon. It may be important to note that without an add-on, the FreeStyle Libre Flash is not considered CGM.
The basic Freestyle Libre Flash includes a Reader and a Sensor. The reader uses replaceable batteries, but the sensor is good for only about two weeks. The initial kit comes with one sensor and equipment to attach it to your skin. The sensor is about the size of a Susan B. Anthony dollar coin, is waterproof, and can communicate wirelessly to the reader device. When the sensor expires, you have to remove it and put a new one on. Obtaining the data from the sensor is quite simple, just put the reader close to the sensor and press the button. The reader sends a signal to the sensor to read the blood glucose. The sensor reads the blood glucose and sends data to the reader. The reader has a display where you can read your blood glucose and see information on a graph as well.
There are a couple of optional add-ons to the FreeStyle Libre that change it in an interesting way. The two add-ons transform the Libre into a continuous glucose monitoring device. Blucon Ambrosia has developed the NightRider with the capability to fit right over the sensor. It is about twice as thick as the sensor, making it a bit bulky and it isn’t waterproof. The dangers are that it more easily catches on clothing, but the good news is you can take it off before your shower. Putting it back on doesn’t require any calibration, but it has to be secured with something. The TransAm also transforms the sensor into a continuous monitor, but differs from the NightRider. The TransAm is waterproof so you wear it into the shower if you like, but it is a one time use device.
FreeStyle Libre PROS AND CONS
- You can monitor your blood glucose through your smart phone (iPhone or Android)
- You can use the built-in meter to check your blood ketone levels using b-ketone test strips
- The price is significantly lower that the Dexcom, even with the CGM add-ons
- The sensor is much smaller that that of the Dexcom G4/5
- With add-ons it becomes a continuous glucose monitor with alarms
- They offer discounts to users converting from a Dexcom system
- Some insurance plans cover this expense, I found no mention of medicare
- Accuracy is very close to actual glucometer readings
- More expensive that using the old method of monitoring blood sugar
- You have to wear a sensor stuck to your body for 2 weeks at a time unless it comes off, which would be another con
- You have to buy an add-on to get CGM benefits and alarms (either hypo or hyper glycemia)
- Doesn’t always preclude the need for finger pricks
- You must be 18 or older to use it, not allowed for children
The FreeStyle Libre Flash without the add-ons is accurate and very cost effective when compared to CGM devices like the Dexcom. With the add-on CGM devices, it still represents a significant cost savings. I feel as long as I am able to maintain a relatively stable blood sugar level, this would be welcome change. However, if I was a type 1 diabetic, and not so good at keeping my blood sugar stable I would not consider it without the CGM add-on.
WEBSITE/WHERE TO BUY
Because continuous glucose monitoring systems currently require a prescription in my state, you will need that first. Most Walgreens drug stores can order and receive them once prescribed.
The Dexcom G5
PRODUCT NAME: Dexcom G4/5
Price and Configuration
- Dexcom G5 Mobile Receiver: $355.00 (Required, Available by prescription)
- Dexcom G5 Transmitter Kit: $497.45 (Required, Lasts three months)
- Sensor: Dexcom G5 Sensor Kit $269.00 x4 (Required, Lasts two weeks plus)
- Skin Grip Adhesive Patches: $15.19 x20 (Conditional if needed)
- Total Start-up Cost: $1136.64
Prices listed are from Amazon.com.
Dexcom was founded in 1999 and has been developing CGM systems since March 2006. The Dexcom G5 is the latest Dexcom CGM system, launched in Sep 2015. Since the FDA only just approved the technology in 2017, it is now becoming more widely known and accepted in the U.S. The G5 uses a sensor to get continuous blood sugar readings from a sensor/transmitter mounted on your body. It requires four components listed above, and there is already a market for accessories to enhance the experience.
The G5 sensor typically lasts for up to three weeks, and the transmitter about three months. You stick the sensor on your body, and then attach the transmitter to the sensor. In order to keep it in place and free of water, you will need an adhesive cover, they call a skin grip adhesive. The sensor + transmitter is larger that the one used by the FreeStyle Libre. They recommend placing the sensor on your stomach because of its size. The receiver must stay within 20 feet of the transmitter in order to record the data stream. You can put it in your pocked and forget about it for a while if you use a smartphone app and keep your pocket on. The transmitter lasts three months and then you have to get a new one. (although some claim to have figured out how to extend transmitter life.)
The people at Dexcom have done a good job at using this technology to build a useful product. The transmitter is continuously sending data to the receiver so there is no need to swipe, like the Libre. On the receiver and with the App, you can set alarms, and get a graph of how your blood sugar level has been fluctuating. You no longer have to wonder what happened overnight as the receiver can display up to eight hours. Up to five people help monitor you, your doctor, spouse, mother, or anyone you like that is using the Dexcom Follow App.
Dexcom G5 PROS AND CONS
- Compatible with iPhone, iPad, and iPod touch with iOS 8.1 or greater, and any Android using V6.0 or later
- Your support team (up to 5) can remotely monitor your glucose data using the Dexcom Follow app
- The G5 is available for children from age 2 and up
- Allows web based tracking
- With the Dexcom CGM you get alarms (either hypo or hyper glycemia)
- Many insurance plans and most Medicare plans cover this expense
- The sensor/transmitter combination is bulky and sticks out from your body
- Skin grip adhesive patches are needed to secure and protect the transmitter
- Much more expensive that the FreeStyle Libre Flash
The accuracy of the G5 is very close to a glucometer, and with continuous data points the results are clearly beneficial. Sharing your information with others including your doctor is an excellent idea and could be life saving. Of the two systems, the Dexcom G5 is undoubtedly the higher cost CGM system. I didn’t see concrete evidence that insurance and medicare plans would cover these systems equally. That could be a concern, though it appeared Dexcom was a bit more concerned about insurance coverage. I personally feel CGM is not a smart expense for a diabetic who has shown success stabilizing their blood sugar.
WEBSITE/WHERE TO BUY
Continuous glucose monitoring systems currently require a prescription (at least in my state) you will need that first. Most Walgreens drug stores can order and receive them once prescribed.
Is the Prickless Glucose Meter for you?
After my research, I conclude using a Prickless Glucose Meter is not always a CGM:
- A CGM is not intended to be a novelty and can very quickly become an expensive annoyance
- An infection can occur at the point where the sensor is attached, if you are less careless in cleaning the area
- From annoyances to dangers to frequent re-calibrations, it is far better to not need a CGM
- For a diabetic that can quickly lose control of their blood glucose level, the CGM may be a blessing in disguise
- For a diabetic that doesn’t nee to the continuous monitoring and alarm elements a CGM is overkill
According to a type 1 diabetic family member of mine, who has used a prickless glucose meter for CGM for about a decade, comes this advice. “If you don’t need it, don’t get it.” She told me it was annoying, noisy, and it kept getting in the way. She is now 18 years old, became diabetic at 4 years old, and she quit using hers. So for all you type 1 diabetics out there, be vigilant, and the best of luck on your efforts. For all but the most diseased type 2 diabetics, I strongly urge you to work on your diet and exercise. I have written many articles on diabetes and encourage you to read any and all the following.
- What is the Cure for Type 2 Diabetes
- How to Reverse Type 2 Diabetes Naturally with (?)
- Own Your Type 2 Diabetes and Treatment