Dexcom, FreeStyle, Senseonics or Medtronic? How to Pick the Right CGM Sensor

Are you managing your diabetes with injections or with injections and Afrezza? 

• You could potentially pick from many of the available sensor options. 

Are You Using an Insulin Pump? If so: 

• Are you utilizing an Automated Insulin Delivery (AID) System and want to get the biggest benefit possible from the algorithm your system uses? Then your options are limited to the sensors that are compatible with your AID system. 
• Do you use an AID System but find the required and compatible sensor is so inaccurate or so uncomfortable that you would prefer to switch back to a manual system and use a sensor that works better for your body?

Is it compatible with your current:

• cell phone model and operating system?
• AID system, or the AID system you are thinking about switching to soon?

Do you want flexibility with alert settings?

• All sensors offer high and low glucose alerts and alerts to tell you if the sensor is not working.
• Do you need different glucose alert settings based on time of day or certain scenarios in your life? You would likely prefer Dexcom sensors. 
• Do you want on-body alerts instead of only alerting on your cellphone or a handheld device? You might find the Sensionics Eversense 365 appealing. 
• Could you benefit from a fast-drop or fast-rise alert? The Dexcom sensors and the Eversense 365 offer these alert options. 

Do you care about calibrations?

• If you are glad to not need to deal with calibrations, then perhaps the FreeStyle sensors, or Medtronic Instinct or Guardian 4 sensors may work well for you. 
• If you find it frustrating to not be able to calibrate, then you will likely prefer the Dexcom sensors, or the Medtronic Symplera Sync sensor. 

Do you have allergies to your current sensors or sensor adhesives? Do you care how often you need to change the sensor?

Sensors vary in:

• Wear time (typically 10–15 days, depending on the model), but some need to be changed every 6-7 days. 
• Adhesive tolerance — some people develop irritation or allergic reactions to certain adhesives. If you are challenged by adhesives, it may be beneficial to use a sensor that you must change out more often and avoid the longer wear sensors. 
  • If you’ve had skin reactions before, this matters more than any app feature. I often recommend trying a one-month supply of a new sensor type to test out your ability to tolerate a different sensor. If you have skin reactions, be sure to talk with your educator about barrier wipes, rotating sites, and other prevention techniques.
• Placement sites — arm, abdomen, or other approved sites depending on the device. Do you need to consider “line of sight” or place the sensor close enough to a pod or pump that communicates directly with the sensor on your body instead of the sensor communicating with an app on the phone, then to the pump algorithm?

• Warm-up time before readings start (ranges from about 30 minutes to 2 hours)

Is it covered by your insurance, and what is your out-of-pocket cost?

• This is often the deciding factor, whether we like it or not. Coverage varies by insurance plan, pharmacy vs. durable medical equipment (DME) benefit, and whether you have Medicare, Medicaid, or private insurance. Two people with the same diagnosis can have very different out-of-pocket costs for the same sensor. 

The bottom line is this: Before you settle on a device emotionally, it’s worth a phone call

• to your insurance and a conversation with your pharmacist to see what’s actually affordable
• to your Certified Diabetes Care and Education Specialist to ensure it is compatible with what you plan to use it with (phone, pump), it has the alarm features you may benefit from, and that you have the details you need to make an informed decision.