Libre or Dexcom???

[rachel162]

Hey guys!

Ok so some advice needed: about a month ago I decided to self fund a Dexcom CGM to try and limit the excessive amount of horrific hypos I was having, to get some hypo awareness back, and to get a closer look at my basal rates, ratios etc so I could try and get a better picture of what wasn't going as well as I thought. It is expensive but I absolutely love it, and am already (nearly 4 weeks in) starting to get some hypo awareness back. I only bought 4 sensors initially and wasn't sure I intended to buy any more. I'm managing to get around two weeks out of each which is great.

I got an email yesterday saying that if I wanted to I'd be able to order the libre next week (I signed up a few months ago). I know it will be much cheaper to run and as a result I'll be able to have it for much longer than my Dexcom, and in fact many people use it on a permanent basis, but is it as good? Is it as accurate? Or more so? How long can you make the sensors last for? My worry is that as it wouldn't be automatically updating my readings every few minutes without manually scanning it, would I miss the hypos that I'm now being alerted to by my dexcom just as they start to happen? I still feel fine, for example, at work when I have my low alert set to 3.9 just so I can correct before reaching the too-low-to-do-anything-about-it stage. And a libre wouldn't sync up with my animas pump the way my dexcom does. But I wouldn't have to manually test to calibrate it which would be nice. And if it's giving me the same info as my cgm but much cheaper and just with occasional scanning, and no blood tests, and my only (albeit kinda serious) worry being my lows, it might actually (questionably) be better...Can you sync it with diasend? Does it have the same delay as the cgm (ie will it still be 10-15 minutes behind where your body actually is?) Ah so many questions!!

Has anyone had any experience of both, and would be able to offer their opinions, or just answer some of my many questions??

Thanks in advance!!
Rachel x

 

[catapillar]

Hi Rachel,

I don't have any experience of the libre, but I do have a dexcom. Even though it is self funded, I don't think I would consider switching to the libre because, like you, I have no hypo awareness and I need the alarms offered by the dexcom. I tend to wear my sensors for three or four weeks, to get a bit more value out of them. You've already done the big capital cost for at least 6 months, can you think about it again in 6 months? Or is the waiting list for the libre really that intense?

At the risk of interfering, I just wonder if your low alarm is set a bit too low? I have had to roll my eyes & ignore my nurse when she has told me to set my low alarm at 4.5 (because I don't need a low alarm to tell me I'm hungry but I can't afford to risk getting in the habit of ignoring the low alarm) but I do set it a 4.2. I think your interstitial fluid runs about 20 mins behind your blood sugar, so by the time the dexcom is showing 3.9 you might be quite a bit lower than that. Also, if you're trying to get hypo awareness back you should probably be trying to stay over 4, rather than just correcting it when you dip below. (Confession: I could absolutely do with taking my own advice here!)

Sorry not to be of more help in the comparison, hopefully a libre user will answer some of your questions.

 

[pinewood]

If you don't need the alarm I'd go for the Libre because a) the sensors have a much thinner/smaller profile; b) it's much cheaper; c) no calibration and d) most of the accuracy reports I've read have actually put Libre ahead of Dexcom. The only benefits to Dexcom are: a) the alarm; and (b) you don't need to carry a reader around and can link directly to your phone (G5 only). With Libre, your sensors last 2 weeks and can't be extended, but personally I'd remove after 2 weeks anyway as I don't think it's particularly good for your skin to keep it in the same place for > 2 weeks. Yes, you can sync with Diasend and yes it's still got the usual interstitial fluid delay.

A lot of people get skin reactions from the Libre adhesive, but I get around this by firing the sensor over a Compeed plaster. Never had any issues with my sensor falling off early, but others do, but Abbott are excellent at replacing for free and I find their customer service to be exceptionally good. I think Dexcom has a similar following of people who have a reaction to the adhesive, so wouldn't choose one over the other on that basis.

 

[tim2000s]

@rachel162 Given that you are using the Dexcom alarms, I'd suggest that the Libre probably doesn't meet your requirements. It is really a replacement for fingerpricking rather than a CGM, as you have to actively scan it.

If you don't have hypo awareness, while it will tell you where you are and where you've been, it won't alert you to where you're going.

The Libre sensor accuracy has tested well against finger pricking and shows well on the time lag vs blood (Dexcom is typically 10-20 mins, where as the accuracy study for the Libre is 5-10 mins) as well. As others have said, the sensor for the Libre is lower profile, which may or may not be important.

In terms of cost, once you've paid for the Dexcom transmitter and receiver, the costs are not too far apart - the Libre is £50 for two weeks max. The Dexcom is £65 for as much life as you can get out of the sensor, which is down to your care and attention, as you know.

I like to think of it as Fingerpricking is a map without a compass (where do I go from here), the Libre is a basic sat nav (this is where I am now, the route I've taken and a direction I'm going), and CGM is Sat Nav with traffic prediction (as the Libre, but letting me know what's coming and suggesting that I might need to change direction).

 

[DunePlodder]

Hi Rachel162. Which Dexcom are you using? The way that the transmitters are sold in the UK the G5 is much more expensive than the G4 - as much as 4 times as much annually for the transmitters.

It sounds to me like you benefit from the alarms which the Libre doesn't have. I'd say continue with the Dexcom at least until your transmitter dies since you've invested £360 in it. Perhaps that will be enough to regain your hypo awareness.

There are lots of posts about extending the life of sensors. The main thing is to ensure it doesn't move by adding a Tegaderm patch or similar. The longer they last the better the cost comparison with the Libre.

I've never had a hint of infection despite once keeping one on for 7 weeks! That was a one off, I now get about 3 weeks.

 

[CarbsRok]

Keep the Dex as it has alarms and you have already paid the bulk of the cost for it. As others have said 3 and 4 weeks plus can be got out of the sensors.

 

[rachel162]

Hey guys, sorry for delayed reply, had a crazy-busy few weeks!

To try and respond to everyone in one post:
- my hypo awareness/symptoms are improving massively with the Dexcom, and I reckon within the next month or so they should be almost perfect. I know I might be lower than the reading actually says, but often I'll have noticed before it's too bad, and even when my Dexcom's caught up I now rarely end up below 3 which is better than regularly being in the 1s as I have been over the last few months! I do still need the alarms for now, and I have paid for the transmitter, so I'll probably wait until my current transmitter dies and then reconsider switching to the libre.
- my low alert is set quite low, but the next setting on my pump is 4.4. As I often run in the low 4s for long periods with no problems I'd rather not have to do so with alarms constantly going off!
- I do like the fact that the libre is smaller/thinner, I'm not too bothered about it being low profile per se, but my current sensors definitely annoy me more than my pump with them being bigger and less comfortable.
- Does the libre not have trend arrows to show you where you're going? I thought it did once you scanned it; the ones on my Dexcom have been a massive help and I would definitely miss having them.
- In terms of keeping sensors on longer: I use Flexifix and can keep my sensors on for a good 3 weeks, but after 2 weeks or so they seem to have real problems picking up readings and my pump will have hours at a time where it will just display ???. Any suggestions? If I'm going to have that problem I may as well just use the libre, which although only slightly cheaper will at least save on fingerpricks!

Thank you for all your help/suggestions!
R x

 

[Nick_noaddedsugr]

Libre is amazing. I tried it and it sorted my sugar out really quickly. Only problem was I could afford the cost of keeping it going also the sensor that sticks to your arm is really solid