Which CGM is best? Dexcom G6 vs Freestyle Libre

Endocrinologist Perspective on Continuous Glucose Monitoring Systems- Dexcom G6 vs Libre

Dexcom G6 vs Libre :

• Both Dexcom G6 and Libre do not require fingerstick (most of the time).
• Libre device alerts you to do fingersticks more often than Dexcom G6 since the reliability of Libre is lower compared to Dexcom.
• Dexcom G6 is more accurate especially below 80 mg/dl and above 250 mg/dl blood sugar.
• Dexcom G6 does not require scanning the sensor via a meter or phone vs Libre needs scanning to find out the glucose level.
• Dexcom G6 is more expensive vs Libre. Without insurance forget buying Dexcom G6. Whereas, Libre can cost 120 dollars a month if you are willing to pay.
• Dexcom G6 has alerts and predictive high or low glucose alerts vs Freestyle Libre has no alerts. Unless you scan your sensor to find out, you are still in the dark.
• Dexcom continuously records blood sugars vs Libre stops recording if you have not scanned again within 8 hours.
• Dexcom can connect and help operate a closed-loop system with tandem insulin pump vs Libre can not be connected to any pump (and should not be due to low accuracy).
• Dexcom G6 has a cloud base system and can be connected or integrated with other systems easily such as apple care or SugarMDs app(the best and unique online endocrinologist led diabetes team).
• Libre sensors tend to fail more frequently than Dexcom G6 sensors.

To find out more, read the rest of the article and you will be glad that you did. So that you can make a smart decision about which product to choose. Do you need a prescription for Dexcom or Freestyle Libre? An endocrinologist who can help you 24/7? You are on the right website. Visit our main page and get hold of us.

As a chronic condition, diabetes does not have an ultimate cure, but it can still be successfully managed. Most patients with diabetes use meters and strips to monitor blood sugars on a day-to-day basis. However, another tool that is even more useful is the CGM system—a continuous glucose monitoring system.

So, you wonder which CGM is the best, right? Dexcom G6 vs Libre? We will talk about the best CGMs ( continuous glucose monitoring systems today). We will compare Dexcom G6 to freestyle Libre. We will talk about the cost/pricing, accuracy, safety of freestyle libre vs Dexcom G6.

We will give a few tricks in terms of how to get the coupons for your freestyle libre etc. If you wish to learn about our online diabetes doctors and our telehealth diabetes care center that can monitor your Dexcom G6 or libre remotely and treat you accordingly, contact us after you finish reading the article and remember to share with other people who may benefit from the information.

How to choose the right CGM?

So big question right? Dexcom G6 vs Freestyle Libre. We will talk about other CGM systems such as Medtronic Guardian and Eversense as well. Recently I had a patient. His name was (T.S.). He came to me and directly asked for a freestyle libre prescription. He heard about it on TV and he is tired of fingersticks.

When I asked him about what he knew about Libre he said a few words that are partially true. He really did not consider all the features, pros and cons as well as alternatives. It turned out that he actually needed Dexcom G6.

Opposite can be true for another patient. So, If you do not want to waste time and money you should take 10 min reading this article. That way you can make a much better decision and be happy with your decision.

Dexcom has been in the market for much longer. The latest version of Dexcom CGM is Dexcom G6. Freestyle libre entered the market in the last few years. There are major differences between Dexcom G6 and freestyle libre. 

Tune in and read the whole article to fully understand the differences between CGM systems.

Yes, Doing Fingersticks Suck!

Regardless, whether you have Type 1 or Type 2 diabetes, you know how difficult it is to deal with fluctuating glucose levels in the body. And, doing fingersticks sucks! As can be understood from its name, the CGM continuously records blood sugar level readings every 1-5 minutes without using finger-sticks.

Highs and lows in glucose levels can be dangerous as they induce hyperglycemia (high sugar levels) and hypoglycemia (low sugar levels). When the highs and lows happen frequently, it places a person at risk for the hospital admission.

Consequences of Low Blood Sugars

A person can suffer severe hypoglycemia which can lead to falls, seizures, traffic accidents, and other dire situations. If a person experiences hypoglycemia for a prolonged period and does not receive proper assistance, it can even progress into a diabetic coma. Continuous glucose monitoring systems such as Dexcom or libre can help avoid these situations. As you will see below Dexcom G6 as much superior to libre in terms of alerting and avoiding hypoglycemic situations. Since patients with type 1 diabetes are at much higher risk for hypoglycemia, Dexcom G6 is definitely a much better choice for patients with type 1 diabetes.

What Is Continuous Glucose Monitoring ( Dexcom G6 vs Freestyle Libre)?

Continuous Glucose Monitoring is a medical method that focuses on using a device, similar to an insulin pump, which is self-inserted into the skin non-surgically. The system then generates real-time readings of a person’s glucose levels.

Traditional finger prick-testing of blood glucose levels give readings of blood sugar levels when the finger-stick is used only. CGM, both Dexcom and libre, use allows users to see blood sugar trends anytime. Some CGMs do not even require finger-sticks for calibrations anymore. Dexcom and libre do not require calibrations or fingersticks. As of this writing, Medtronic's Guardian CGM system requires calibration with fingersticks twice a day(February 2020).

Is CGM is easy to use

CGM( Dexcom or libre) is perfect for personal use and usually recommended by endocrinologists because it’s simple and easy to use. People who live with diabetes can check their glucose levels with real-time readings anytime without fingersticks. CGM systems can be used with an insulin pump or independently. Additionally, these readings can also be generated on a real-time basis or collected over a short time period.

(American Diabetes Association, 2019)

Is CGM The Right Option For Me?( Dexcom G6 vs Freestyle Libre)

Some people love Dexcom G6, others are perfectly okay with freestyle libre. When I ask patients' opinions on Dexcom versus freestyle libre they have very little idea. Some people are already using an insulin pump to manage their glucose levels. They might believe that using a CGM system is not a necessity.

However, CGM systems like Dexcom G6 or Freestyle libre are vital tools. When used in conjunction with insulin pumps or even multiple daily injections, they can improve the quality of diabetes care. Both Dexcom G6 and Libre are approved to make treatment decisions based on readings as well.

If you identify with the following issues, then getting a CGM system such as Dexcom G6 or Libre is the best option for you

• If you are unable to meet and maintain the optimal levels of your A1C results
• You frequently experience low glucose levels
• You are mostly unaware of your blood sugar level
• You want to lower your A1C targets safely without triggering or causing a higher risk for hypoglycemia
• Your blood sugar levels fluctuate frequently

Before you get a CGM system, remember to consult your endocrinologist or seek help from knowledgeable specialists like the ones available on SugarMDs.

The Benefits of CGM Systems

Using a CGM system can make it easier for you to manage your diabetic condition and also live your life with more freedom. The following are the major ones:

Lower Your A1C Levels

As an outpatient device, CGM systems such as Dexcom G6 or libre have been found to be the most effective in helping people maintain and lower their A1C levels safely. It’s hailed as the best method for glycemic management for outpatient use!

Detect Lows and Highs

With constant readings being offered, the CGM system can give fairly accurate readings about your glucose levels. We will talk about why I say fairly since there are some problems associated with any CGM system in terms of correctness in certain conditions. The data gathered can alert you about your highs and lows before they occur. It can prevent people from experiencing hypoglycemia (low blood sugar) or hyperglycemia.

Why my Freestyle libre or Dexcom G6 readings are not correct sometimes? Is Dexcom G6 or Freestyle libre accurate to begin with?

We get that question a lot.  For both Dexcom and the libre readings may not be accurate and the blood sugars are rapidly changing such as after a meal when blood sugars are rapidly rising are rapidly declining. Between the Dexcom versus libre, Dexcom appears to be more accurate in the low glucose ranges below 80 mg/dL compared to libre.  

The causes for inaccuracy between the blood sugar fingerstick Dexcom G6 or freestyle libre

Most patients compare fingerstick blood sugar results to Dexcom G6 or freestyle libre results. That is actually a big mistake. The assumption is that the fingerstick result is accurate is incorrect, to begin with. Depending on the meter, fingerstick blood sugar results may be up to 20% plus-minus off compared to gold standard venous blood ( blood that is drawn via needle from the arm).

Moreover, blood sugars will be different between different body parts. For example, you may have a blood sugar of 100 at your fingertip, and at the same time, you may have a blood sugar of 120 at your toe. You may have a blood sugar of 105 in your legs.

Also, the meter readings can be off up to 20% as discussed above. In addition to that, Dexcom G6 and Freestyle libre reads blood sugar in the interstitial fluid, not in the blood. Since there is a delay in the transfer of sugar from the blood to the tissue, there always will be a slight difference between the blood sugars and the interstitial fluid sugars. This delay causes the difference in glucose results becomes larger when the blood sugars are rapidly changing that difference.

Concentrate on the trend of blood sugar rather than the blood sugar reading itself.

What most patients do not understand is that the trend of the blood sugars is way more important than the blood sugar itself.  The arrow indicators are more important than the exact number on the screen.  So, instead of trying to do fingersticks and try to match to readings from freestyle libre or Dexcom G6, concentrate on the direction of blood sugars.   Refer to our previous blog about how to interpret Dexcom G6 and freestyle libre.

Predict and Prevent Any Fluctuations

With the readings and data gathered, your Dexcom G6 and Medtronic Guardian CGM and Freestyle libre system can predict the direction of your blood sugar levels. These predictions can be vital to preventing fluctuations in your blood sugar level. The readings also help people to understand how different foods, activities, and medication can affect their diabetic condition.

Night Time Monitoring for Increased Safety( Dexcom G6 vs Freestyle Libre)

One of the biggest risks that a person faces is highs and lows while they are sleeping. A Dexcom G6 and Guardian Medtronic (but not Libre) CGM system can monitor and alert you at night should your blood glucose drops. Unfortunately freestyle libre does not have that feature.

You can also choose to notify someone about your blood sugar levels by sharing your glucose data. The timely warning can prevent you from experiencing side effects related to highs and lows. For more information, you can talk to specialists on SugarMDs or your endocrinologist.

Is CGM The Right Option For Me?( Dexcom G6 vs Freestyle Libre)

Some people love Dexcom G6, others are perfectly okay with freestyle libre. When I ask patients' opinions Dexcom versus freestyle libre they have very little idea. Some people are already using an insulin pump to manage their glucose levels. They might believe that using a CGM system is not a necessity.

However, CGM systems like Dexcom G6 or freestyle libre are vital tools. When used in conjunction with insulin pumps or even multiple daily injections, they can improve the quality of diabetes care. Both Dexcom G6 and Libre are approved to make treatment decisions based on readings as well.

If you identify with the following issues, then getting a CGM system such as Dexcom G6 or Libre is the best option for you

• If you are unable to meet and maintain the optimal levels of your A1C results
• You frequently experience low glucose levels
• You are mostly unaware of your blood sugar level
• You want to lower your A1C targets safely without triggering or causing a higher risk for hypoglycemia
• Your blood sugar levels fluctuate frequently

Before you get a CGM system, remember to consult your endocrinologist or seek help from knowledgeable specialists like the ones available on SugarMDs.

The Benefits of CGM Systems

Any Benefits from Dexcom G6 or Libre? Good enough? Using a CGM system can make it easier for you to manage your diabetic condition and also live your life with more freedom. The following are the major ones

Lower Your A1C Levels

As an out-patient device, CGM systems such as Dexcom G6 or libre have been found to be the most effective in helping people maintain and lower their A1C levels safely. It’s hailed as the best method for glycemic management for outpatient use!

Detect Lows and Highs

With constant readings being offered, the CGM system can give fairly accurate readings about your glucose levels. We will talk about why I say fairly since there are some problems associated with any CGM system in terms of correctness in certain conditions. The data gathered can alert you about your highs and lows before they occur. It can prevent people from experiencing hypoglycemia (low blood sugar) or hyperglycemia.

Why my Freestyle libre or Dexcom G6 readings are not correct sometimes? Is Dexcom G6 or Freestyle libre accurate to begin with?

We get that question a lot.  For both Dexcom and the libre readings may not be accurate and the blood sugars are rapidly changing such as after a meal when blood sugars are rapidly rising are rapidly declining. Between the Dexcom versus libre, Dexcom appears to be more accurate in the low glucose ranges below 80 mg/dL compared to libre.  

The causes for inaccuracy between the blood sugar fingerstick Dexcom G6 or freestyle libre

Most patients compare fingerstick blood sugar results to Dexcom G6 or freestyle libre results. That is actually a big mistake. The assumption is that the fingerstick result is accurate is incorrect, to begin with. Depending on the meter, fingerstick blood sugar results may be up to 20% plus-minus off compared to gold standard venous blood ( blood that is drawn via needle from the arm).

Moreover, blood sugars will be different between different body parts. For example, you may have a blood sugar of 100 at your fingertip, at the same time you may have a blood sugar of 120 at your toe. You may have a blood sugar of 105 at your legs. Also, the meter readings can be off up to 20% as discussed above.

In addition to that, Dexcom G6 and freestyle libre reads blood sugar in the interstitial fluid, not in the blood. Since there is a delay in the transfer of sugar from the blood to the tissue, there always will be a slight difference between the blood sugars and the interstitial fluid sugars. This delay causing the difference in glucose results becomes larger when the blood sugars are rapidly changing that difference.

Concentrate on the trend of blood sugar rather than the blood sugar reading itself.

What most patients do not understand is that the trend of the blood sugars is way more important than the blood sugar itself.  The arrow indicators are more important than the exact number on the screen.  So, instead of trying to do fingersticks and try to match to readings from freestyle libre or Dexcom G6, concentrate on the direction of blood sugars.   Refer to our previous blog about how to interpret Dexcom G6 and freestyle libre.

Predict and Prevent Any Fluctuations

With the readings and data gathered, your Dexcom G6 and Medtronic Guardian CGM and Freestyle libre system can predict the direction of your blood sugar levels. These predictions can be vital to preventing fluctuations in your blood sugar level. The readings also help people to understand how different foods, activities, and medication can affect their diabetic condition.

Night Time Monitoring for Increased Safety( Dexcom G6 vs Freestyle Libre)

One of the biggest risks that a person faces is highs and lows while they are sleeping. A Dexcom G6 and Guardian Medtronic (but not Libre) CGM system can monitor and alert you at night should your blood glucose drops. Unfortunately freestyle libre does not have that feature.  You can also choose to notify someone about your blood sugar levels by sharing your glucose data. The timely warning can prevent you from experiencing side effects related to highs and lows.

For more information, you can talk to specialists on SugarMDs or your endocrinologist.

About The Author

Ahmet Ergin, MD, FACE, CDCES, ECNU About the author: Dr. Ergin operates a large diabetes practice mostly in West Palm Beach, FL, and yet can see diabetic patients across the entire state of Florida via a unique telehealth platform which also allows him to track patient progress and be available at all times. Soon to be available in NY and NJ.