by Randy Knapp, ACBDA board member
Over the last two years, I have used the Abbott Diabetes Care Libre Link version 1.0 and the Dexcom G6 continuous glucose monitor (CGM) systems, and I thought I would share my observations about the technologies from a historical perspective, leading up to today’s cutting-edge advances in treating and better managing diabetes.
Both devices offer the ability for the user to check blood sugar levels without a finger stick. Both devices can be accessed through the use of an app on a smartphone. In my case, I used an iPhone to monitor my blood sugar readings. The Libre Link CGM takes approximately 1 hour to warm up and needs to be changed every 14 days. The Dexcom G6 takes 2 hours to warm up and needs to be changed every 10 days. Both devices can be independently installed by a blind user, but the way they install is different.
Version 1.0 of the Libre Link sensor is a one-piece system that can be installed on the back of the upper arm. There are no codes to enter, and it mounts securely. To obtain a reading, you must use the camera on the phone to scan the sensor. The reading is sent to an app on the phone, and it will speak the result with its own voice or by using voiceover.
Version 2.0 of the Libre Link sensor incorporate the following changes:
Customizable, Optional Real-Time Alarms
This is the biggest advancement for the Libre 2.0. Low blood glucose alarms can be set between 60-100 mg/dl and your high blood glucose alerts between 120 and 400mg/dl. The user will get an auditory alert (or a vibration) which will prompt him or her to scan their sensor with the reader to get the glucose value. These alerts are optional and all of them can be turned off.
iCGM Designation.
The Libre Link 2.0 received the iCGM designation from the FDA, which means there can be digital communication between the Libre Link 2.0 and other devices such as smartphones, insulin pumps, smart pens, etc. Collaborations with Tandem, Insulet and Bigfoot have been announced to develop a semi-closed loop system. This means that users of the Libre Link 2.0 sensor and an insulin pump can work together to create an efficient way to manage blood sugars.
The Libre Link Sensor has been approved for use with children as young as 4 years old.
Changes for Libre Link Version 3.0
Abbott Diabetes Care claims that the latest sensor is the smallest, thinnest sensor on the market, about the size of two stacked pennies. It can be installed on the back of the arm with a one-piece applicator.
Monitoring has become more efficient. Results are automatically reported to a phone or, currently, to an inaccessible hand-held reader every minute, resulting in real-time blood glucose readings.
Readings are more accurate, especially at the extremes.
The Dexcom G6 can mount on your stomach or the back of your arm. The sensor is comprised of two pieces: the sensor and the transmitter, which mounts on top of the sensor. The transmitter and the sensor have codes that must be entered into the app before the sensor is started. The sensor lasts for 10 days, but the transmitter lasts for 3 months and can be moved from sensor to sensor for use. Codes for the transmitter and sensor can be scanned with a smartphone and can be entered manually or by taking a picture.
The Dexcom G7 will be the newest product from Dexcom and will be available late 2022 or early 2023. At the time of this writing, specific details about this product are unavailable, but individuals living with diabetes and vision loss very much look forward to working with Dexcom to ensure it is fully accessible.
Both devices worked the way one would expect them to, and the one that is best for you to use is an individual decision, based on input from you and your doctor. The benefits of real-time monitoring cannot be overstated. It is a revolutionary tool that will help you to better manage your diabetes and help you to learn about how your body processes a variety of foods in your diet, with the ultimate goal of living a happier and healthier life!