Like a G6

After being a loyal Freestyle Libre veteran for over 2 years now (for anyone who doesn’t know, I’m a right fangirl and love the Libre), I’ve allllwaays always been curious to try the Dexcom. From how it’s portrayed on social medial, I’ve always got the impression that Dexcom is the ‘one to have’, the ‘cool one’, the ‘best CGM out there’ (as silly as that may sound, even with Diabetes’s care I’ve witnessed plenty of ‘strong opinons’ online over how different people choose to manage their diabetes in different ways, and the Libre vs. Dexcom debate is always an interesting one) – so I wanted to know what all the fuss was about, and if it really could be a better set up for me – so I gave it a try.

On the release of the G6 in the UK last month, Dexcom released a ‘Starter Pack’ offer, where you could grab 3 sensors (each last 10 days, so a months’ worth in total), and a transmitter for £159. I thought this was a great chance to give Dex a try once and for all, and a week into my first sensor, I want to share how it’s been going so far.

First things first – do I like the Dexcom G6? Yes.

Will I be continuing with Dexcom G6 after I complete the starter pack? No, I don’t think I will.*

*(hear me out on this – I’ll explain more below)

So what do I like about the Dexcom G6 one week in?

A lot, actually! There’s a lot of features I really like about the G6…

The easy, pain free insertion – now when I say it’s easy and pain free, it really, REALLY is (I currently have a broken ankle, and if I can insert it with my leg half in the air with no trouble at all, it can’t be difficult).

Dexcom have moved to a simple ‘one push’ applicator like the Libre (probably even easier to do than the Libre I’d say!), and I didn’t even feel the sensor pinch my skin or anything on application. I’ve always loved the simplicity of the Libre application, and am really glad that Dexcom have moved this way (as the G5 was a little fiddly so I hear!) – now, the whole application process really does take just a few minutes from start to finish. My one request? Libre always throw in some alcohol wipes with every sensor – that would be nice with Dex, too!

Slim profile & wearing on my tummy – The G6 is super slim, and I don’t notice it day-to-day. For those who’d like it to be discreet, wearing it on your tummy really is, and I’ve found it very comfy (although note that with a broken ankle, I’ve lived in baggy shorts and dresses all week, without having any tight trouser waistbands to consider – so maybe just bare that in mind when working out how high/low on your stomach to place the Dex). I’d say thickness wise, it’s comparable to the Libre, but with the Libre being circular, the G6 is smaller overall. After loving wearing the Dex on my stomach this week, I’d definitely consider trying my next Libre sensor there (although note that the Libre isn’t approved for wearing anywhere other than the back of the arm, with Dex just approved for placement on the stomach for adults).

dexcom tum

Accuracy – the accuracy has been pretty on point when I’ve checked it against finger sticks, although I’d say comparable (from the majority of my experiences) to the Libre. You can see on my first day of Dexcom I still had one day left on my Libre sensor – and immediately they both came in pretttttty nicely in sync.

both compared
Libre vs. G6

I have had a few tests where Dex has been about 1mmol/l out from my finger stick – but that’s something I’ve come to expect (CGMs and FGMs take glucose readings from your interstitial fluid as opposed to your bloodstream, so are always subject to a degree of variability compared to finger stick tests) and not anything I wouldn’t personally complain about.

iPhone Widget & Smart Watch capability – something I’ve always been jelly of Dexcom users for is the ability to have their blood sugars on a Smart Watch. For someone who’s doing quite a bit of cycling and running*, commuting every day and dashing in and out of meetings, there are loads of situations where I think being able to quickly glance at a watch to see which way my sugars are trending would be beneficial.

Now as much I would have loved to go buy myself an Apple Watch and try this it out for myself, I really couldn’t justify spending another £329 on tech just for this G6 trial run – but one thing I did discover (and I love) is that the Dexcom app does have a widget option on the iPhone – so you can just swipe across and see your sugars & graph within seconds, even when your phone is locked.

dexcom widget
G6 Widget on iPhone

Pretty swish!

(*Was. Was doing. My bike broke my ankle so we’re not on great terms right now.)

Alarms – OK so I’m not going to touch on alarms toooo heavily here, as these actually creep into the things that I personally didn’t like so much about the Dexcom – BUT. I do think the alarm capability for different people can be a game changer and even lifesaving – it’s just I think different people will always have different needs. I’ll explain below.

Ok, so what don’t I like so much about the Dexcom G6?

Alarms – let’s talk about these first. In my opinion, the main differentiator between a CGM (like Dexcom) and an FGM (like Libre) is the CGM alarm capability. Dexcom allows you to set customisable alerts for when your blood sugars are too high or low, and it also has a new ‘Urgent Low Soon’ alarm which can predict if it thinks your blood sugars will fall rapidly within the next 20 minutes (which is amazing, isn’t it?). In my opinion, these alarms are an incredible option for:

  • Anyone who experiences hypo unawareness or those who don’t tend to wake up naturally from hypo symptoms whilst sleeping (these alarms can be lifesaving)
  • For parents with children with T1 and might need more help managing and identifying their high/low symptoms
  • For pump users: for me, knowing that I had an alarm set up if my blood sugar was to rise significantly would be a great safety net if I used a pump (for example, if my set failed during the night, I think I’d be unlikely to wake up and realise without an alarm – again, possibly preventing risks of DKA and being literally lifesaving).
  • For anyone who’d just like the added comfort of alerts

So why have I put this as something I don’t like? Because for my diabetes management right now – I don’t think it fits.

When my high alarm went off every 5 minutes on Tuesday evening, I found it annoying in all honesty, and ended up turning it off. My blood sugar was 17 mmol/l, and I had given myself a correction – but as we all know, correction shots take time to action, and I found the alarm reminding me that I’d essentially ‘messed up’ on my carb counting irritating.

When I woke up at 4am on Thursday morning, as soon as I tried to use my crutches my arms started shaking and I knew I was low – but my Dex wasn’t alarming, as it read as 4.1 mmol/l (still in my ‘good’ range). So again, the low alarms didn’t do anything for me.

Currently, I’m fortunate enough to wake up from my hypo symptoms when my sugars fall low in the night, and feel my symptoms during the day. I’m also on MDI, so don’t have the worry of a risk of a pump failure. So right now – I don’t feel that the added alarms are something I would personally benefit from. However – if I ever move to pump, or my hypo awareness begins to deteriorate, I fully expect to move to a CGM system with alarms to give me that added peace of mind – but for now, it’s just not something I personally require.

Loss of connectivity – Dexcom works through Bluetooth, so essentially for it to work full-time, you need to keep your phone in ‘Bluetooth Range’ (I think that’s around 30 ft?). The thing is, I’ve had times where my phone is in my bag just at my feet, or even on my desk next to me, and I’ve lost connectivity – which is fine – except it can take up to 10 – 15mins to reconnect – and that’s the frustrating part. Being used to using LibreLink, I’m used to being able to just pick up my phone and scan my sensor in a flash (whheyy pun), whenever I need to (e.g. when I’m rushing into a meeting or to catch a train and need to know my blood sugars pronto) – but there have been multiple times this week where I’ve left my phone in the next room (crutches don’t help with this FYI), and trying to get a Dexcom reading when I re-grab my phone just takes so long that I fingerstick instead. Annoying!

App Display – As much as I love the widget capability, I’m not so much of a fan of the app face for G6 compared to the Libre. One thing I love about the LibreLink app is that it tells you your time in target and your average glucose over the last 24 hours right on the home screen, and there are loads of options which are easy to access to see estimated A1c’s, daily patterns etc. – which I really rate.

libre app
All the info on the LibreLink app (I was having a good day!)

I think it’s a shame that the Dexcom app isn’t as informative in this way. It also bugs me that when you flip your phone sideways to see the 24hr view, there are no numbers up the side of the graph (to see exactly where your blood sugars were throughout the day).

dex graph
Example of the Dexcom G6 app graph

And finally…. price – If like me, you’re unable to access the Freestyle Libre on prescription under the NHS, the Libre will cost you £96.58 a month (2 sensors, VAT exempt). Dexcom offer a Subscribe and Save Plan, which is a 12-month contract for G6 working out to £159 a month – so £62.42 more a month.

Just to clarify – with the alarm capabilities that Dexcom G6 has over Libre, I do personally think that the product is more valuable and beneficial for those who require alarms, and is justified to be priced higher than the Libre.

But do I want to pay £62 more a month for a feature I currently won’t use? Nope.

In addition, I’m not a massive fan of having to sign up to a 12m contract, and there some other little niggly things (such as the receiver costing extra if you’d like one, the transmitter cutting-off potentially before the battery runs out etc.*) which I don’t love from a financial perspective.

All in all – I’m enjoying my time with the G6 – it’s a fab piece of kit. I can massively see how for many T1’s, the pro’s of the G6 outweigh any con’s, and it’s an essential part of their diabetes management. Like I said above, I do think that G6 can literally be lifesaving through its alarm feature – and at the end of the day, your health is priceless – so if an extra £62 a month can provide peace of mind and security for T1’s, then that’s worth it in my eyes.

But for me – without the desire for an alarm system, I think I’ll stick with my trusty old Libre for now. Will I move to G6 one day? Yes, I probably will – especially if I could find a way to make the G6 more cost-effective. But for the time being, the Libre gives me everything I personally need (except a valid excuse to buy an Apple watch, cry), and suits me just fine.

*I’m not sure on the facts on this one so please don’t quote me! I just know the G5 transmitter hard cut-off was programmed for after 3m, when the battery life had the capability to extend up to 6m.

 

 

If you want to find out more about the Dexcom G6 and Freestyle Libre you can find the websites here:

https://www.dexcom.com/en-GB/uk-dexcom-g6-cgm-system

https://www.freestylelibre.co.uk/libre/

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