CGM Choices for 2022: Pros and Cons

 

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Which CGM will you choose?

Time to get excited! Type 1s will be getting access to real-time CGM from April onwards.

It won't only be FreeStyle Libre available on the NHS in England, there will be the possibility of seeing glucose levels without the need to scan and the possibility to get glucose levels updated directly to a smartwatch too!

This blog follows on from 6 Choices of CGM for 2022 (click here to read this first) which explains the change to the NICE guideline which will enable this choice to open up to all type ones in England.

Here, we have looked at the advantages and disadvantages of each of the 6 choices to be available through the NHS Supply Chain with the agreement of your hospital diabetes consultant or team. Of course the options may also be available in other countries and for self-funders.

The 6 choices covered here are:

1. Dexcom G6
2. FreeStyle Libre 3
3. GlucoMen Day
4. Touchcare Nano
5. Guardian Connect
6. MeiQi sensor
 

If you have been using a FreeStyle Libre, you may not have been aware that this considered a flash device as you need to scan it to see glucose levels. This article outlines some of the alternatives to a Libre 1 or 2 device, where the device provides continuous glucose monitoring (CGM) in real-time ie. the glucose level shown on a reader, or usually a phone app, is the level that is being measured at the time - there is no time lag.

About Dexcom 

The Dexcom G6 is generally regarded as the market leader in the real-time CGM market. This version of the system has been around for approximately 4 years and is due for an update. The G7 was due to be released in 2021 but has been delayed by the pandemic. In the meantime it is expected that the G6 will become more widely available in the UK via the NHS with the change to NICE guidelines from April 2022.

There are lots of options with the Dexcom app which give flexibility to the way individuals manage their diabetes, not least the ability to see real-time glucose levels on a smartwatch (Apple). But there are also some concerns that the company haven't yet addressed as you'll see below, and the cost for a shorter period of wear, which is higher than other CGMs, may put off many self-funding their diabetes care.

Dexcom's advertising is fronted by Nick Jonas, Singer and Actor, and you may have noticed they are advertising quite heavily on commercial radio in the UK.

Pros Cons No calibration, but option to calibrate for increased accuracy 10 days use Alerts can be customised for different times and days Updates glucose levels every 5 minutes Can send data directly to smartphone app and apple watch Medical waste. Not recyclable  Real time alerts for high, low, rate of change, predictive urgent low More expensive than FreeStyle Libre and others Single button application Requires new transmitter every 3 months Alerts by sound and vibration   Ability to sound alerts when phone is on silent   Approved for children over 2 years old   Can be used with a separate receiver

More information: www.dexcom.com

 

About FreeStyle Libre 3

Libre 3 is an upgrade to Libre 1 and 2 but won't be available in the same way as previously and cannot be requested from GPs directly. It is currently available in Germany and France, however, there is only an Android app - the Apple app is expected to be available from end of March 2022.

Libre 3 is due to be released in the UK in the next few months. In a previous blog we have outlined the features expected for Libre 3 - click here to read our Libre 3 update.

Pros Cons Very small, slim round profile No watchface complications Updates every 1 minute  App is currently only on Android (Apple app due to launch end of March 2022) Easy application  Less options with alarms on app than other CGMs No calibration  Some users find the inability not to be able to calibrate a negative No overlay or patch needed (although may depend on personal preference) Parts not widely recyclable (although reduced plastic & packaging from Libre 1 & 2) Lowest cost CGM

 

More information: www.freestylelibre.co.uk (Libre 3 information not yet available) 

 

About GlucoMen Day

Menarini are the company behind GlucoMen Day, part of a European pharmaceutical  company headquartered in Florence, Italy. Promotion for the GlucoMen Day CGM highlights 2 key features, that it is needle-free and eco friendly. Unlike other systems there is no guide needle. However, the insertion process is quite drawn-out compared to attaching a FreeStyle Libre, although once a user gets used to this, it probably wouldn't be an issue.

Training for how to use the product can be carried out online through their demonstrative videos. Reviews so far have commented favourably on the system although there is concern at the cost. GlucoMen is available as a starter pack to trial over 4 weeks (current price £199 including 2 sensors and 2 transmitters and more). Subscription is currently £129 per month. All prices are exclusive of VAT.

Pros Cons Updates every 1 minute directly to smartphone Not as slim and aesthetically pleasing as other sensors No guide needle used for insertion of sensor Requires regular calibration Warm-up takes 55 minutes Use on abdomen only authorised Reusable components – lasting up to 5 years  Application takes longer as involves separate components and requires underlay Fitbit watch-face Transmission distance only 3m 24/7 UK customer support team Pricing similar to Dexcom G6 Webshop setup for direct orders -  through NHS & self-funding. Next working day delivery.

More information: www.glucomenday.co.uk

About Touchcare Nano

Medtrum offer 2 products (in the UK), a patch pump and standalone CGM, the Touchcare Nano. Currently only the patch pump is available on a trial basis.

Medtrum are a Chinese company, but they have an office serving the UK and provide customer services by phone and email. The webshop is not yet setup but they confirmed the price to us as £35 per sensor, putting them on par with Libre although a transmitter is also needed at an additional cost.

Medtrum marketing seems in its infancy but they have a friendly approach, referring to their customers as Medtrum Heroes. There are basic videos online and downloadable guides.

Pros Cons  Smooth, slim, ergonomic profile  Although up to 14 days wear, only 10 days are guaranteed Updates glucose levels every 2 minutes direct to app Separate transmitter needs attaching to sensor, but this is rechargeable, so a pro too (1 year warranty)! Calibration free (but option to calibrate if preferred) Website shop not yet setup but can purchase by phone (UK)   Compatible with Android and Apple smartwatches. Overtape is recommended to hold sensor in place Sensors are similar price to FreeStyle Libre, but requires separate transmitter at significant additional cost   Starter packs available for self-funders - pay as you go option   24/7 Technical helpline available to support users and 24 hour replacements   Waterproof IP68 standard (higher rating than other CGMs)

More information: www.medtrum.co.uk

About Guardian Connect

Medtronic are an American-Irish registered medical device company headquartered in the US. They are a well-established supplier of pumps to the NHS and they are to be included on the NHS supply chain for standalone CGM with their Guardian Connect system.

The cost of the Guardian Connect system is in the region of £200 per month for self-funders and a major drawback at present is the lack of webshop for buying direct. The Medtronic website in the UK refers users to pharmeddirect.com but this does not provide full information before placing an order.

Information and data for the Guardian Connect is not provided in depth on Medtronic's website and the details below are based on information at present. There may be further pros and cons - to be updated as this is ascertained.

Pros Cons  Predictive alerts up to 60 minutes in advance, for highs and lows  Bulb/seashell shape appears bulky - not a slim profile unlike other CGMs Ability to track insulin delivery, meals and exercise on app Up to 7 days wear only Carelink app can send texts to alert followers to high/low levels Requires regular calibration   No separate receiver ie. glucose levels sent to phone only   Needs underlay tape   Purchases go through Pharmeddirect.com - currently no direct webshop

 

More information: www.medtronic-diabetes.co.uk

About MeiQi

There is limited information currently available on this option but we will update this as soon as it becomes available. Information to date appears to suggest that the sensor may need to be scanned to get glucose levels, however, we hope to confirm this with more details on the specification in the near future.

Meiqi is made by the largest medical company in China. 

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We hope this gives you an overview of the CGM devices you could be discussing for your diabetes care with your healthcare professional. We will post full reviews of each of these are other CGMs in the near future which will be based on real user experience.  Please do continue to follow Love My Libre, and if you're not already, subscribe to Libre Life to keep up-to-date.

Thank you for reading.

Notes

1. NICE Guidelines apply in England only.
2. Not all product or options will be available to all T1Ds, in all markets or countries.
3. The list of products available through the NHS Supply Chain is reviewed every 2 years to allow for new products to be included.
4. The NHS Supply Chain lists further products for use with pumps including closed loop options.

Disclaimer

Details and data is correct to the best of the author’s knowledge at the time this blog is published. We do not accept responsibility for any errors or omissions. Information is for guidance only and it is recommended that you confirm specific details and suitability yourself with the supplier, or your healthcare provider.

Love My Libre is not associated or affiliated with any of the aforementioned medtech providers. Content here and on our website www.lovemylibre.com does not constitute medical advice or replace the relationship between you and healthcare professionals nor the advice you receive from them.

The author of this blog has type 1 diabetes and uses the FreeStyle Libre 2 which is provided on NHS prescription. We do not have any affiliate relationship with Abbott or FreeStyle Libre.

All third party devices and apps mentioned are registered trademarks of their respective owners.