Libre vs Dexcom. Anybody used them both?

[TheBigNewt]

The Freestyle Libre was recently approved in the US. I see it's a little circular glucose sensor, they say lasts 10 days and that you also need a cellphone like reading unit that only lasts a few weeks. Someone said they could somehow rig it to alert you when you're heading hypo which I regard as essential. The Dexcom has a similar sensor for your arm, but does it have a similar separate reading unit, or can you just use your phone? I know it will alert me and others about lows. I've also read on this forum it's more accurate and maybe doesn't need a bunch of calibration. In fact an ad for Libre Freestyle I read said it doesn't have to be calibrated either. Has anyone used both? I'm also interested in cost, not sure how my private insurance would pay. Thanks in advance.

 

[Deleted Account]

I have used the Libre and the Dexcom G4 (I suspect you are asking about the G5).
I found the Dexcom to be most accurate but for me, neither were particularly accurate - the Dexcom woke me up alerting that I was hypo but a finger prick said 6.4.
I have spoken to others who find all CGM and flash GM inaccurate so I may just be part of the weird few.

However, I did not consider them a waste of money.
I found them both useful for understanding when my BG went up or down and an indication of whether the change was large.

As the Dexcom takes readings every 5 minutes and the Libre takes them every 15 minutes, the Dexcom was more responsive to change.
That said, interstitial fluid (which both use) is about 15 minutes behind BG. As a result, both are quite delayed in spotting hypos when I am exercising.

For me, they are a long way from replacing finger pricks but a good addition to diabetes management.

 

[Scott-C]

and the Libre takes them every 15 minutes,

Aargh, Helen, you've said this so many times and it is just so not true! The libre graph shows an averaged 15 mins for its plot, but if you scan several times within 15 mins, you definitely get different results. When I'm blutoothing 5 min scans from my blucon to xdrip+, I can see clearly from the delta that there are changes within a 15 min period. If you're going to blog about this stuff, please do so accurately.

 

[phdiabetic]

I have used both (for a week, I even used them simultaneously!). Dexcom will give you numbers on the receiver or your phone (or both!), the Dexcom app can also be used to transmit your numbers to other people (or other apps eg Sugarmate). You can also get various apps on your phone that will either turn the libre into a CGM, or simply provide an alternative to the reader (e.g. Glimp). At first the Libre was very accurate for me, it got worse over time. The Dexcom's accuracy is usually much better, but sometimes (usually when you are changing sensors and get blood in the pod) it will go crazy. The Libre doesn't need calibration, but the disadvantage of that is that you can't adjust it when it's reading way off. The Glimp app will allow you to enter calibrations. The Dexcom asks for a calibration every 12 hours, but it won't stop working or anything if you don't do it immediately. You can also calibrate at other times when it's giving inaccurate numbers. I am very pleased with my Dexcom. Usually I use the receiver during the day, and phone plus receiver at night so my parents can see my numbers and help out if I'm low. The Libre lasts longer but in my opinion it's worth shorter sensor life to get more accurate numbers. What's the point of wearing something for two weeks if it's wrong? So I would highly recommend Dexcom.

 

[Deleted Account]

Aargh, Helen, you've said this so many times and it is just so not true! The libre graph shows an averaged 15 mins for its plot, but if you scan several times within 15 mins, you definitely get different results. When I'm blutoothing 5 min scans from my blucon to xdrip+, I can see clearly from the delta that there are changes within a 15 min period. If you're going to blog about this stuff, please do so accurately.

Thank you for the correction. I found the Libre website incredibly vague in these matters.

 

[barrym]

Thank you for the correction. I found the Libre website incredibly vague in these matters.

I agree. Abbott themselves are ok on customer services, IMHO, but the librelink application suite is poorly designed. It might look glitzy on first impression, but considering they are hosting OUR data which is important to us, they are playing fast and loose. And the support poor. Just my 5p worth

 

[Neoncat]

I have used both and my preference is for the Libre. Neither of them eliminate the need for a finger pricking, so although I may get the odd sensor which isn't bang on I can get a feel for how far out it is. On that note I find the Libre is great when I am in range and I only really see drift when I am high. Since I use it mainly for monitoring trends I am more than happy with that. Also:

1. You are only supposed to wear the Dexcom on your tummy. As a pump user I feel like I have enough stuck down there already!
2. The sensor is smaller and I found it more comfortable to wear. I also wasn't keen on having the Dexcom stuck on the same spot on my skinfor so long if you are trying to extend sensor life.
3. The big one for me: I found the Dexcom so needy and intrusive! It was always bleeping to let me know about something and so I ended up turning off all but the low and very high alarm which pretty much defeats the point of it. Even though I was already doing those blood tests the fact I had to do the extra step of telling Dexcom about it, alongside the bleeping felt like it was always at the front of my mind.
4. It alarms when the sensor is out of range of the phone (which is what I used rather than the receiver) which meant I had to remember to carry my phone everywhere so people in the office weren't worried for me/annoyed by the noise. Again it just meant it was always top of mind.
5. I know there are good reasons why it was designed like this but the low alarm can't be silenced. So it goes off alerting everyone in the local area (again there are times when you want that but sometimes you would like to deal with it in private eg at the cinema or in a meeting) and you treat. But it can take 15 minutes for Dexcom to register the rise during which it will continue to alarm (again necessary in certain circumstances) and you will get cross because I KNOW I'VE TREATED ALREADY, JUST BE QUIET EVERYONE IS LOOKING!

On the plus side:

1. I did think it was awesome for when I was travelling or when I had just started on the pump and I was at risk for night time or surprise hypos.
2. If I was hypo unaware I would use it all the time.

If I could tell it to only alarm during certain periods (eg overnight) or it was part of a closed loop system I would consider the benefits enough to switch from the Libre, but as it is I only want to use it when I feel I am in a particularly high risk situation.

 

[DunePlodder]

I've only used the Dexcom G4, but whichever you go for I recommend using the xDrip+ app (Android). It gives you more control over the various alarms - I don't use the calibration alerts as I can work out for myself whether it needs calibrating.
It also allows calibration of the readings from the Libre which might be useful if, for example, it's reading consistently low.
Look for threads about the Blucon device which turns the Libre into a proper CGM.
I often put the G4 sensor on my arm.

 

[Scott-C]

Stephen Ponder, the author of Sugar Surfing, recently compared the two:

http://www.sugarsurfing.com/single-...-vs-Dex-A-Sugar-Surfers-experience?_amp_=true

I think @Stroudie has recently worn both dexcom and libre/blucon/xDrip+ simultaneously for a week or two. Stroudie, any views on how they compared accuracy wise?

Haven't used dexcom, just libre/blucon/xdrip. I think it is a viable set up. The repeat cost of dexcom transmitters kinda put me off it, compared to the one off cost of blucon, about £100. Also, the price of dexcom can be made comparable but only if the sensor can be reliably restarted, which doesn't seem to be too much of a problem but knowing my luck, I'd probably be one of the unlucky ones where it only lasts 10 days so wasn't willing to fork out the higher start up costs just to find out.

The only thing against it is the transmitter isn't waterproof so needs to be taken off for showers, but it's not a big deal.

I don't think there's any fundamental differences between the two sensors. It's the factory calibration which lets libre down, but if you're running it through xDrip+ yoi can easily calibrate just as you would do with dexcom. Many cgm users use xdrip+ in preference to the official dexcom app so you can arrive at the same end by two different routes. It's really the app which is doing the donkey work in terms of calibration and accuracy.

Any flavour of cgm is good in my view, it was just really the cheaper start up and ongoing costs of libre which swung it for me (and perhaps also the smaller amount of skin it takes up, and the inserter isn't as scary looking as dexcom!). Whichever one you go for, it'll be a revelation compared to strips alone.

 

[TheBigNewt]

I just got an email from Dexcom that said regular Medicare (which I have, also private insurance) now covers Dexcom 5, but only if one uses the Dexcom brand reader thing (looks like a cell phone with a screen) not if you use the phone app. Not sure if you can get around that because I want it to alert me/my wife at night if I head low (I won't wake up but I can usually tell during the day). I'd have to get a doctor to prescribe it every 6 months (not sure if I could prescribe it myself like I do with insulin). I would cover 80%. The Sugar Surfing link said you can reuse the Dexcom sensor. I assume you remove it and somehow stick it into another skin site. Anybody every do that? The sensor looks bigger than Libre looks like there's a plastic transmitter stuck on top of it to me in the picture here. Do the sensors have batteries in them?
Also, I'm confused about whether or not one must use/have the Dexcom reader thingy in order to get sugar readings from the sensor, or if all I'd need is a cellphone for that. I get that the Libre has to use the reader and that you have to buy a new one when the battery runs out but maybe not with the Dexcom?
Thanks in advance this is helpful.

 

[Draco16]

I think both are brilliant - they changed my life!

- I was struggling with burnout and not testing as much as I should and they help make things easy
- They told me about the need to pre-bolus. A good two hour reading can often hide a not so good couple of hours
- The trend arrow transforms your management away from 10 or so snapshot finger prick readings per day.

For any insulin dependent diabetic, if you can get one even for a couple of weeks you will learn so much. I would be in a much worse place without it.

I started with the Libre.
Easier to apply. Each sensor lasts for two weeks. The reader is simply recharged, mine still works two years on. A bit smaller, smoother shape, gets caught less. Out of 20 sensors I had one lose adhesion after 3 days. No calibration needed. Annual cost in UK (I think is c£1,300).

It was invaluable, but then I heard about the Dexcom G5 so switched as you still need to visibly scan (i'm weird and don't like doing that at work). If you have an Android phone you don't need the reader... but i'm Apple so the reader was another thing I needed to carry. No alerts (I understand Blucon now solves this). You need to reach across and scan the other arm... tricky on a bike, impossible on a motorbike! Mountain climbing... I feared dropping the reader in precarious positions. That said my second week with it I climbed Mont Blanc and the ability to scan in some pretty hair raising situations was incredible where finger pricking was not an option!

Dexcom G5
Application is a bit more involved (looks a bit scary!) but straightforward. I wear on my arm (recommendation is stomach). Sensor sticks to skin. They are recommended for one week, but you can restart them in the app after the week (you don't physically move them). A transmitter fits inside that last 90-100 days (you use it with replacement sensors). Then sends info to phone or reader. Needs twice daily calibration. Is a bit awkwardly shaped. Cost depends on how long you can make sensors last. I aim for 2 weeks (some people get 3 or 4) so I think brings it in at £2,200 annually.

I love the Dexcom as I further send the data to my Apple Watch, which is always easy to discretely and accessibly read in any situation. I end up checking it more, which for me is important as my blood sugar can move quickly, sometimes with Libre I just forgot. It alerts (you can adjust alerts to off or vibrate, bar the urgent low glucose alarm). With my iPhone it means no need to carry a reader.

 

[TheBigNewt]

Thanks @Draco16. I have an Android phone. So I just need to get the DexcomG5 sensors, no reader right? And attach the transmitter. The transmitter lasts like 3 months so use it with several sensors (I assume it has a battery in it right?). And all I'd need is my phone. And it alerts me when I head low which is mandatory for me especially at night. I don't have an Apple watch (or phone). I assume an app installs on the phone from Dexcom. My friend's 13 year old kid has one and it shows him what his kid's sugars are too. Now that Medicare covers the Dexcom G5 I may get one. They say you can't use it with your phone, just the reader, but I can't imagine how they could enforce that (or why they would care).

 

[Draco16]

Yep your set up will be

Sensor - last 1 to 4 weeks, you have to restart them after 7 days.
Transmitter - yes has a battery, fits in sensor cradle, lasts 90 or so days. When you physically apply a new sensor you fit the transmitter into the new sensor.
Reader or Phone - do check on the Dexcom wesbite that your Android device is compatible, if it's a fairly recent model i'm sure it is fine. Yes download the Dexcom app onto your phone and you are all set.

Good luck with it.

 

[Stroudie]

I wrote the post below in reply to another discussion so it might go a bit off topic but I wanted to thank Scott C for putting me on to Libre plus Bluecon Nightrider. It is saving me a couple of thousand £s per annum!!

I used Dexcom G5 for 11 months - the last sensor lasted 20 days - just close sensor down and click on start new sensor and off it goes again. The downside is that it may misbehave at some point but in my experience this was obvious. If you are very concerned about accuracy it pays to put the new sensor on 24 hours before moving the transmitter over as it less accurate on the 1st day.

To put the price of Dexcom sensors in to context in the last set of accounts that I have seen for year ending Dec 2016 Dexcom lost 64 million dollars while spending 100 million on R & D. They are burning cash in a race to dominate a 50/100 Billion? market. Keep your fingers crossed that they survive because there is competition out there.

I have switched to Libre because the Bluecon Nightrider is now available. This sticks on top of Libre and bluetooths to my phone. I use the xdrip+ app to give me 5 minute updates and the full set of alarms. It can also be calibrated with a fingerstick test. I use the Contour Next which seems to be the most accurate bg meter. xdrip+ then connects to Nightscout on the cloud which gives all the analysis you could want.

Only downside that I have found so far is that xdrip and Nightscout are open source so have not had to seek FDA approval as Libre and Dexcom have. But what the heck it all works brilliantly and of course if you can get Libre from the NHS in the UKyou do not have to pay the £2 - 3700 that Dexcom costs.

I ran Dexcom and the new set up side by side for 19 days and over that time Libre/xd/NightS was more accurate and needed less calibration than Dexcom. I did think that the 2 Dexcom sensors involved were not as accurate as usual though. I do love Dexcom but I prefer my new set up - not just because of the cost.Below are a set of links for anyone interested in looking in to this. The cost of the Bluecon is £130 plus £20 odd payment to customs so if your gp will prescribe Libre its a steal.

I hope all the links work as I have cut and pasted them. I am not good a t techie stuff and struggled to get all this set up but I think if I had these links at the time I would have got there quicker.

Ambrosia are the designers/manufacturers Nightrider. Ambrosia website: https://www.ambrosiasys.com Ambrosia Twitter: https://twitter.com/ambrosia_sys?lang=em Ambrosia LinkedIn : https://www.linkedin.com/company-beta/18036120/ Ambrosia Amazon : http://amzn.to/2zbUfVB

This is a facebook page only used by Nightrider owners or aspiring owners. https://www.facebook.com/groups/1880872478868072/

To get the xdrip+ app. https://github.com/NightscoutFoundation/xDrip

To get details of Nightscout http://www.nightscout.info/wiki/welcome/nightscout-for-libre. I used a Heroku site rather than Azure, which was slightly alarming as it wanted credit card details to set up, but I've kept an eye on it and it doesn't charge you (so far!).

Video explaining nightrider

How to connect Libre/Bluecon/xdrip+ https://github.com/gregorybel/xDrip-plus/wiki/

How-to-use-Blukon-with-xdrip Website for xdrip for ios https://github.com/JohanD…/iosxdripreader/…/master/README.md

Video about xdrip for ios :
:

Stroudie

 

[DunePlodder]

Hi @Stroudie An interesting & informative post.
Just one query re costs of using Dexcom (£2 -3700). Not clear what this refers to?
This thread
https://www.diabetes.co.uk/forum/threads/cgm-gm-price-comparison.75106/
Puts the annual cost of the G5 at around £1400/year, admittedly with a slightly optimistic (in my experience) 4 week sensor life.
The Libre 1248/year.

I use a G4 & spend around £1100/year. Thats about 3 weeks/sensor & one transmitter a year.
I had the batteries replaced in my last transmitter which should also help if it lasts well.

Obviously if you can get the Libre on the NHS it wins hands down cost wise but otherwise the Dexcom G4 can be cheaper depending on how long a sensor lasts. I'm on day 22 with my current one.

 

[TheBigNewt]

I have switched to Libre because the Bluecon Nightrider is now available. This sticks on top of Libre and bluetooths to my phone. I use the xdrip+ app to give me 5 minute updates and the full set of alarms. It can also be calibrated with a fingerstick test. I use the Contour Next which seems to be the most accurate bg meter. xdrip+ then connects to Nightscout on the cloud which gives all the analysis you could want.

Only downside that I have found so far is that xdrip and Nightscout are open source so have not had to seek FDA approval as Libre and Dexcom have. But what the heck it all works brilliantly and of course if you can get Libre from the NHS in the UKyou do not have to pay the £2 - 3700 that Dexcom costs.

Great post thanks. I assume I can buy the Bluecon Nightrider in the US without a prescription as well as the Libre. Question: if you use the Nightrider Bluetooth transmitter on top of the Libre sensor, and transmit to your phone (I have Samsung Android) do you need the Libre "reader" too? Or can you just forget that part.

 

[barrym]

Question: if you use the Nightrider Bluetooth transmitter on top of the Libre sensor, and transmit to your phone (I have Samsung Android) do you need the Libre "reader" too? Or can you just forget that part.

The minor advantage of having the reader is as a backup. If you start the sensor with a reader you can use a phone too. If you start with a phone you can't use a reader. You can only use one phone at a time.

 

[TheBigNewt]

The minor advantage of having the reader is as a backup. If you start the sensor with a reader you can use a phone too. If you start with a phone you can't use a reader. You can only use one phone at a time.

If you use a reader can you use 2 phones to get hypo alerts (like the Dexcom)? I really want to be able to get hypo alerts at night.

 

[tim2000s]

There is a key point in the Nightrider (and even xDrip with the Nightrider). Neither pays attention to the thermistor data so while you can calibrate Libre daily with xDrip, it's not fully interpreting the data available.

 

[barrym]

If you use a reader can you use 2 phones to get hypo alerts (like the Dexcom)? I really want to be able to get hypo alerts at night.

Don't understand the question. You can only scan the sensor with one phone regardless of whether you use a reader. Without blucon there is no proactive transmission of data again regardless of how that data is acted upon.