libre 3 vs dexcom one

[Zinadane]

I've been in Libre 2 now for 2 years. I've tried to get switched up to the new L3 with no joy yet.
Anyway, after my annual review with some chap who was not really interested tbh.
The review letter comes through telling me he will ask the team to switch me to the dexcom one.
Well, tbh pros and cons but I would much prefer the L3.
So in the UK, is it my choice or is it what are the NHS pushing based on some cost analysis they have done?
It is prbably negligible either way, so should the patient decide on what they prefer?
What are others in the UK (midlands) being put on?

(mod edit to comply with forum ethos)

 

[Zinadane]

30 day cost to buy over the counter:
dexcom 7 153 eu
libre 110 eu
dexcom one not sure?
But I think I saw some deal being struck between dexcom with the NHS?

 

[EllieM]

I suspect it depends very much on which health authority you are with?

What was your reason for moving to L3 from L2? (I thought they were moving people to dexcom ONE (same price as libre) instead of G7 if there wasn't a good reason???)

I'd be interested to hear how you get on with the G7 should you end up going that route.(It's available for the same price as G6 in New Zealand and am contemplating the move).

 

[Zinadane]

Apologies, Dexcom one is the recomendation. (I've changed the thread title)
On paper the dexcom one is a cgm system, which is the main selling point.
For me this is not the main attraction as L2 is CGM via 3rd part apps (xdrip). so, I already have this.
I want L3 over L2, because it is newer, it is statistically a little more accurate.
But the main reason it is very small and is very thin!
I think for most peaople the cgm is the main thing and for the NHS this will be the cheaper option over L3.
I presume anyway, unless someone tells me different.
Also, Libre 14day lifespan over dexcom 10days, Libre is a winner for me!

 

[EllieM]

I think for most peaople the cgm is the main thing and for the NHS this will be the cheaper option over L3.

I thought the L3 was going to be the same price as the L2, which is the same price as the dexcom ONE ......

There are a lot of people claiming problems (maybe software?) with the L2 at the moment, but of course there are also a lot of L2 users, so I have no idea what proportion of L2 users are affected.

Not sure what the current status of the L3 rollout is in the UK?

 

[Zinadane]

I'm not sure on L3 toll out status.
I was surprised when when they have recommended me for dexcom.
They are probably all comparable on price, but my guess is the dexcom is like one dollar cheaper per month.
So at that point should the patient not be offered what they want.

 

[EllieM]

So at that point should the patient not be offered what they want.

It may be that the L3 hasn't got to your area yet so the consultant just decided to offer you the dexcom as an alternative to the L2???

 

[Ipodlistener]

Apologies, Dexcom one is the recomendation. (I've changed the thread title)
On paper the dexcom one is a cgm system, which is the main selling point.
For me this is not the main attraction as L2 is CGM via 3rd part apps (xdrip). so, I already have this.
I want L3 over L2, because it is newer, it is statistically a little more accurate.
But the main reason it is very small and is very thin!
I think for most peaople the cgm is the main thing and for the NHS this will be the cheaper option over L3.
I presume anyway, unless someone tells me different.
Also, Libre 14day lifespan over dexcom 10days, Libre is a winner for me!

Dexcom one is 2 hr warm up like G6. As it's a rebrand that won't work with a pump if you need it to. Also only lasts 10 days.
L2 28 day cover 2 hr WU
DO 30 day cover 6 hr WU

 

[oldgreymare]

TBH if your main reason to want the L3 is because it is so small, then I fear that you would hate the Dexcom One regardless of accuracy - same 2 piece hardware as a G6, just downgraded software and larger than L2. It's NHS price is very similar to that of Libre 2.

According to the current NHS drug tariff the following devices can be prescribed by either a GP or a consultant to any Type 1. So these are the ones that are 'on offer'.

Libre 2
Dexcom One
GlucoRx Aidex
Glucomen Day

At least according to my county's CCG Policy only a specialist consultant can prescribe the following CGMs and patients are subject to much more stringent criteria (chronic hypos, severe hypo unawareness, poor control in spite of pump use, etc) before these will be considered. While this Policy is due to be updated, I suspect in practice it will wait until the new NICE closed loop guidance is finalised to incorporate that as well. So I will be pleasantly surprised if this Policy is updated before 2024...

Libre 3
Dexcom G6
Dexcom G7
Medtronic Guardian Connect (but I think this is only available if issued together with a Medtronic pump)

I've never been a Libre user, but understand that the G7 is the same size as a L2. The G6 and Medtronic Guardian can be used for closed loop systems with compatible pumps, but L3 and G7 are still under testing for this.

Slight subject change - Have you noticed a change in the reliability and accuracy of the L2 over the two years you have used it? There seem to be many bad experiences from new users on this forum.

 

[Zinadane]

TBH if your main reason to want the L3 is because it is so small, then I fear that you would hate the Dexcom One regardless of accuracy - same 2 piece hardware as a G6, just downgraded software and larger than L2. It's NHS price is very similar to that of Libre 2.

According to the current NHS drug tariff the following devices can be prescribed by either a GP or a consultant to any Type 1. So these are the ones that are 'on offer'.

Libre 2
Dexcom One
GlucoRx Aidex
Glucomen Day

At least according to my county's CCG Policy only a specialist consultant can prescribe the following CGMs and patients are subject to much more stringent criteria (chronic hypos, severe hypo unawareness, poor control in spite of pump use, etc) before these will be considered. While this Policy is due to be updated, I suspect in practice it will wait until the new NICE closed loop guidance is finalised to incorporate that as well. So I will be pleasantly surprised if this Policy is updated before 2024...

Libre 3
Dexcom G6
Dexcom G7
Medtronic Guardian Connect (but I think this is only available if issued together with a Medtronic pump)

I've never been a Libre user, but understand that the G7 is the same size as a L2. The G6 and Medtronic Guardian can be used for closed loop systems with compatible pumps, but L3 and G7 are still under testing for this.

Slight subject change - Have you noticed a change in the reliability and accuracy of the L2 over the two years you have used it? There seem to be many bad experiences from new users on this forum.

Thanks @oldgreymare , that's good info.
L2 is as accurate as you can expect for this technology imo.
I just want the same thing in the smaller plastic case, lol!

 

[Zinadane]

In reply to your question @oldgreymare

It does feel to me like the L2 has improved in reliability and accuracy. Difficult to quantify but I do feel they are more accurate from when I first started on them. Also, I’m sure the adhesive is better than it used to be. Reliability, I would say maybe 1 in 10, I may get suspect readings or maybe an adhesive problem. But overall, I personally have very few problems with them.

Of course, always, be aware of compression issues, or extreme heat readings (ie bath or even sauna)

I think when you first using them it’s very easy to be over critical of the accuracy of them especially in conditions of fast rising or lowering bg levels. Initially, people’s expectations are probably too high, before they learn to understand how they work and their limitations.

 

[Blanchoid]

The things for me are:
Warmup time - I dont' want to be waiting for two hours...
The size - Libre 3 is smaller
Duration - Libre 3 is 14 days vs 10 for Dexcom One

My Diabetic team have said that is is down to cost! But you are indicating it is within a couple of pounds, which is insane considering our lives depend on this tech.

Time to email my local MP!! We need to stop this inadquate NHS which is not fot for purpose from dictating to us, we are their employers!!!

 

[Zinadane]

I am now using L3.
Very impressed and happy.
Functionality/accuracy is same as L2.
Size is a major improvement.
Haven't knocked one of yet.
IMO L3 should be the standard NHS offering.

 

[Ipodlistener]

The things for me are:
Warmup time - I dont' want to be waiting for two hours...
The size - Libre 3 is smaller
Duration - Libre 3 is 14 days vs 10 for Dexcom One

My Diabetic team have said that is is down to cost! But you are indicating it is within a couple of pounds, which is insane considering our lives depend on this tech.

Time to email my local MP!! We need to stop this inadquate NHS which is not fot for purpose from dictating to us, we are their employers!!!

The RRP might be the same. But the NHS get massive discounts.

 

[BadaBing]

I am now using L3.
Very impressed and happy.
Functionality/accuracy is same as L2.
Size is a major improvement.
Haven't knocked one of yet.
IMO L3 should be the standard NHS offering.

Congratulations @Zinadane! I'm envious.

Unfortunately, if the Libre 3 is currently costing the NHS as much as some of us think it is, integrated care systems (the former clinical commissioning groups) will do everything they can to avoid paying for Libre 3s for as long as possible.

The health postcode lottery continues.

 

[BadaBing]

The RRP might be the same. But the NHS get massive discounts.

@Ipodlistener I'm not sure the NHS does get a massive discount for the Libre 3 at the moment.

In another thread on this forum, someone was told by their consultant that 12 months supply of the Libre 3 costs the NHS £1,800. If that is correct, each Libre 3 sensor costs roughly the same as a Dexcom G6 sensor.

12 months supply of the Freestyle Libre 2 costs the NHS £840.

 

[Warwick1]

Sharing my two pence:

Over the past few years I’ve used the FL2, Dexcom G6, Dexcom G7, and Dexcom One.

Hands down the G7 is my favourite and would recommend if you can afford it. It is small and does not fall off or fail as much as the G6/ One, and it does not burn skin like the G6/ One. The smaller profile helps to avoid accidental removal by catching on doors and edges of tables etc. The G7 also has transmitter built in, so it’s easier to manage.

For NHS I would stick to FL2. FL2 and One have similar accuracy but FL2 has never burnt my skin, the software is decent, and (as I understand) it’s easier for the diabetes team to read via their online portal.

Dexcom One and G6 are basically the same, except the One has a really bad app that crashes on my iPhone (despite it being almost brand new) and requires a restart to access again + the G6 is pump friendly. Otherwise the “hardware” is the same.

Hope this helps.

Warwick

 

[BadaBing]

Someone has posted on Facebook this morning that from mid-july 2023, and following a software update to Librelink, the Freestyle Libre 2 sensor will become a real time continuous glucose monitor giving minute-by-minute readings on a compatible smartphone.

Apparently, the updated Librelink will also allow glucose readings to be sent to compatible smartwatches (presumably without the need to use non-Abbott authorised third party apps).

Abbott should be communicating this to Libre 2 users over coming weeks.

 

[Zinadane]

Librelink is a very basic piece of software. I never use mine, except to start sensors.
I think it is at the simplicity level, that makes it suitable to cover the vast majority of its users without them having to back it up with technical assistance.
I wonder why though that L2 is still being used, when L3 is a much better device.
Maybe running down old stock.

 

[BadaBing]

Librelink is a very basic piece of software. I never use mine, except to start sensors.
I think it is at the simplicity level, that makes it suitable to cover the vast majority of its users without them having to back it up with technical assistance.
I wonder why though that L2 is still being used, when L3 is a much better device.
Maybe running down old stock.

From the NHS's perspective, the Libre 2 is used and prescribed because - at the moment - it is cheaper for them to buy off Abbott (cost to NHS: £35 per sensor) than the Libre 3 is to buy (current guesstimate cost to NHS: £75 per sensor).

I think you are right though, eventually we will all move to a one piece real time cgm, either the Libre 3 or Dexcom G7.