Comparing CGM & Flash

Summary of Features, Function and Cost of Glucose Monitoring Systems Available in Canada

Continuous Glucose Monitoring (CGM) and Flash Glucose Monitoring systems provide a number of features that can help improve the efficiency and effectiveness of your diabetes care routine. This side-by-side comparison of the features of the different systems available in Canada is designed to help you find the technology that best meets your individual needs and preferences.

There are three companies providing CGM and Flash systems in Canada (presented here in alphabetical order):

  • Abbott’s Freestyle Libre (Flash Glucose Monitoring system)
  • Dexcom: G5 Mobile CGM system
    • stand-alone system, and
    • integrated system with Tandem t:slim insulin pump
  • Medtronic:
    • Minimed 630G Insulin Pump + CGM System, and
    • Minimed 670G Hybrid Closed Loop Insulin Pump + CGM System
For more discussion about the form and features of Medtronic CGM, Dexcom CGM, and Libre:
Choosing a Glucose Monitoring System (CGM & Flash)

More on Freestyle Libre

More on Dexcom CGM

More on Medtronic CGM

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Below is an overview of the side-by-side comparison chart of the glucose monitoring systems currently available in Canada:

View the complete CGM & Flash Comparison Chart in pdf format (mobile-compatible, downloadable, printable)   

Overview of CGM/Flash Comparison Chart


What kind of glucose monitoring system is it…Continuous or Flash?

Stand-alone vs Integrated:

Can I use it with an insulin pump?
Can I use it if I’m on injections and don’t want to use an insulin pump?

Accuracy:

Can I trust the glucose sensor?

How accurate are the readings?

Do I still have to poke my finger?

Calibration:

Should I enter independent fingerstick values to calibrate the system?

Water Resistance: (SEE NOTE on water resistance BELOW)

Can I wear the sensor in the bath, shower, swimming pool, etc?

Approved Sensor Sites: (SEE NOTE on approved sites BELOW)

Where on my body can I put a sensor?

Warm-Up Period:

How long do I have to wait for data after I insert a sensor?

Sensor Life:

How long does a sensor last before I have to swap it for a new one?

Transmitter Memory:

How much back-data does the transmitter store?
That is, how long can the transmitter and receiver be out of communication before data is lost?

Transmitter warranty:

How long do the transmitters last?

Transmitter Batteries:

What kind of batteries do the transmitters use?

Can I replace them when they die?

Receiver Options:

What kind of receiver can I use?

Remote Viewing:

Is this information sharable with others? (Can I see my son’s glucose readings when he’s over at a friend’s house, or my daughter’s glucose when she’s out on the soccer field, or my husband’s data when he’s traveling for work?)

Range:

How close does the sensor/transmitter have to be to the receiver?

Receiver Life/Warranty:

How long does the receiver last?

Receiver Battery:

What kind of batteries does the receiver use?

Can I replace them when they die?

Glucose Trends:

How do I know whether my glucose is steady, rising or falling?

Low/High Glucose Alarm and Alerts:

Will it notify me when my glucose is low (or high)?

Alert Before Low/High:

Will it notify me when my glucose is about to go low (or high)?

Rate of Change Alerts:

Will it notify me when my glucose is changing rapidly?

Will it turn off my insulin when my glucose is low?

Will it turn off my insulin when it predicts my glucose is headed for a low?

Alert Volume:

Can I make the alerts louder or softer?

Approved Populations:

What ages can use CGM/Flash?

Can I get one for my child?

Do I need a prescription?

How much does it cost?

Where can I get more information?

Where can I purchase it?

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Notes:

MARD = Mean Absolute Relative Difference, a measure of error (as an average %).
MARD represents the difference between the patient’s CGM readings and the glucose values obtained from a lab analyzer. A lower value means values are closer to the lab reference values (i.e. sensor is more accurate).

These sites are officially “approved” because the company has invested the time and money to conduct a study on the effectiveness and safety of the system on that body part. This doesn’t mean it can’t be used on other sites, it just means it hasn’t been tested on other areas, and its safety and effectiveness when used on alternate sites cannot be guaranteed by the manufacturer. At your own discretion (and perhaps guided by the personal experiences of other users), you can experiment with other insertion sites, to see what works well for you.

These are the official water resistance ratings, however, many people wear their sensors in the water for longer without problems, you just might need some additional skin prep to cover up the sensor or keep the sensor from falling off. YOUR DEVICE WARRANTY MAY DEPEND ON STRICT ADHERENCE TO THE WATER RESISTANCE RATING. If so, PLEASE FOLLOW IT CLOSELY!

View the complete CGM & Flash Comparison Chart in pdf format (mobile-compatible, downloadable, printable)   

More information on the above Continuous and Flash Glucose Monitoring systems:
More on Medtronic CGM
More on Dexcom CGM
More on Libre Flash Glucose Monitoring

References:

1. Bailey, T., Bode, B. W., Christiansen, M. P., Klaff, L. J., & Alva, S. (2015). The Performance and Usability of a Factory-Calibrated Flash Glucose Monitoring System. Diabetes Technology & Therapeutics, 17(11), 787–794. http://doi.org/10.1089/dia.2014.0378

2. Laffel. Improved Accuracy of Continuous Glucose Monitoring Systems in Pediatric Patients with Diabetes Mellitus – Results from Two Studies. Diabetes Technol Ther 2016; 18 (Supp 2).

3. Bailey, Chang, Christiansen. Clinical Accuracy of a Continuous Glucose Monitoring System with an Advanced Algorithm. J Diabetes Sc Tech 2015; 9(2): 209-214.

4. Veeze HJ. et al Poster 136 ISPAD 2014 : Real-life performance evaluation of the New Generation Enlite™ glucose sensor in patients with Diabetes Mellitus.

5. Garg, S. K., Weinzimer, S. A., Tamborlane, W. V., Buckingham, B. A., Bode, B. W., Bailey, T. S., Brazg, R. L., Ilany, J., Slover, R. H., Anderson, S. M., Bergenstal, R. M., Grosman, B., Roy, A., Cordero, T. L., Shin, J., Lee, S. W., … Kaufman, F. R. (2017). Glucose Outcomes with the In-Home Use of a Hybrid Closed-Loop Insulin Delivery System in Adolescents and Adults with Type 1 Diabetes. Diabetes technology & therapeutics, 19(3), 155-163.

This material has been developed from sources that we believe are accurate, however, as the field of medicine (in particular as it applies to diabetes) is rapidly evolving, the information should not be relied upon, as it is designed for informational purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate health care professional.

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