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):
- Freestyle Libre (Flash Glucose Monitoring system)
Libre 2 has been approved in Canada and will be coming soon. Check back here for updated info about its new features and functionality, including glucose monitoring that is CONTINUOUS.
- G6 Continuous Glucose Monitoring (CGM) stand-alone system, and
- G6 CGM integrated with Tandem t:slim insulin pump - with Basal-IQ™ technology
Control-IQ technology has been approved in Canada and will be available in March 2021. Check back here for updated info.
- Minimed 670G Hybrid Closed Loop integrated Insulin Pump + CGM System
- Minimed 630G integrated Insulin Pump + CGM System, and
- Guardian stand-alone CGM system
Medtronic Minimed 770G has been approved in Canada and will be coming soon. Check back here for updated info.
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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Look HERE for a printable, downloadable pdf chart, with side-by-side comparisons of the Continuous/Flash Glucose Monitors currently available in Canada…
…including answers the following FAQ’s to help you choose the best system for you:
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?
Can I trust the glucose sensor?
How accurate are the readings?
Do I still have to poke my finger?
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?
How long do I have to wait for data after I insert a sensor?
How long does a sensor last before I have to swap it for a new one?
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?
How long do the transmitters last?
What kind of batteries do the transmitters use?
Can I replace them when they die?
What kind of receiver can I use?
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?)
How close does the sensor/transmitter have to be to the receiver?
How long does the receiver last?
What kind of batteries does the receiver use?
Can I replace them when they die?
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?
Can I make the alerts louder or softer?
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?
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!
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. Shah VN, Laffel LM, Wadwa RP, Garg SK. Performance of a Factory-Calibrated Real-Time Continuous Glucose Monitoring System Utilizing an Automated Sensor Applicator. Diabetes Technol Ther. 2018 Jun;20(6):428-433.
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.
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