CGM - Continuous Glucose Monitor

[ER_Hopeful]

just found out about this little device,

, seems pretty neat. would like to use it to track the GI of the different types of food I eat. I'm on the low end of prediabetic but my wife is diabetic.


Interested in the Freestyle libre 3. Anyone had of these or a different brand? I think you buy the sensor (which sticks to your arm) and it talks to your smart phone. Can't seem to find a lot of info on how to buy one. I know you can't just buy it online or OTC. Do I just ask for a Rx from my doc and then get it from my local CVS/Walgreen, etc? Is the sensor only good for 14 days ? If you want another tracking session then you need another Rx/sensor ? Can I share the sensor, say I wear it for 7 days and then my wife wears another 7?

 

[badatmath]

It says online it requires a prescription.

https://www.support.freestyle.abbot...eStyle-Libre-3-system-require-a-prescription-

 

[sengsational]

Those are approved for the indication of diabetes, not for the indication of "improving health by learning about how different foods affect blood sugar". As a result, most corporate owned doctors won't prescribe it. This is a direct result of how our sick care system operates. Maybe a concierge doc would prescribe one.

If you want to go for a deep dive, search Peter Attia MD CGM and listen to whatever (long) podcasts you find.

The device is a "wear it, then toss" (consumable). It pierces the skin.

 

[RetiredHappy]

Medicare pays for its use if you are Type I diabetic. If you are type II diabetic then it is not covered. My husband's endocrinologist would write a prescription for him but he would have to self pay, as he is a Type II diabetic.

 

[bigcmagor]

My mother is living in a nursing home and was getting her finger pricked four times daily to check her glucose level. I decided spare her this pain and started buying the libre 2 monitors for $73 per 14 day sensor using Goodrx at Walgreens. Her insurance will only cover these directly if supplied by a durable medical supplier - who carries them. Good luck with that.

 

[pacergal]

My brother uses one, he loves it! Not having to poke his finger several times a day, plus it is more accurate, he gets real time notice on his phone on Highs and Lows, so can manage his blood sugars much better.
His A1c is way lower than it used to be.

 

[zl55lz]

Medicare pays for its use if you are Type I diabetic. If you are type II diabetic then it is not covered. My husband's endocrinologist would write a prescription for him but he would have to self pay, as he is a Type II diabetic.

Medicare does pay for it for Type 2 diabetes if certain criteria are met (can be found online). I know someone who is Type 2 and it is fully covered via Medicare and secondary insurance but they are on insulin because oral med didn't work for them, and they have to meet several other criteria which are submitted by dr.

 

[Tom57]

I am a type 2 diabetic who has been using Libre for over 3 years. It does save me from having to stick my fingers 4 times a day. My Endocrinologist prescribed this Libre CGM and I have an excellent employer-sponsored Medicare Advantage plan that covers my CGM. That means my co-pay for the CGM and the 14-day quarter-size "stickers" is exactly $0.00 (zero). Great product at a great price!
My A1c is now below 6.0, but I do not know if that is due to Libre CGM or the 5 diabetes prescriptions I take for my type 2 diabetes.

 

[zl55lz]

I am a type 2 diabetic who has been using Libre for over 3 years. It does save me from having to stick my fingers 4 times a day. My Endocrinologist prescribed this Libre CGM and I have an excellent employer-sponsored Medicare Advantage plan that covers my CGM. That means my co-pay for the CGM and the 14-day quarter-size "stickers" is exactly $0.00 (zero). Great product at a great price!
My A1c is now below 6.0, but I do not know if that is due to Libre CGM or the 5 diabetes prescriptions I take for my type 2 diabetes.

Apparently due to a change in regs, a Type 2 diabetic can also be approved for Medicare coverage of the CGM if on oral medication, if certain criteria are met.

 

[Zathras]

The cost is about $500/month. Insurance may cover most or all of that. Just wanted you to know, so you only get it if it would truly help.

I use the Dexcom CGM.
CGMs are composed of a sensor (this is the part that gets tossed and replaced every 10-14 days).
A Transmitter/battery. For the Dexcom these are replaced every 6 months.
An applicator, to apply the sensor to, and under, the skin. The Dexcom one works very well. I am assuming the Libre one does too, but don’t have personal experience.

 

[schenbew]

OP - I've used the FreeStyle Libre 3 for several months now. I'm a health enthusiast, not diabetic, and wear it to learn how I react to various foods, exercise, and stress. I think there is great value to everyone in wearing a CGM, diabetic or not, but that's for another post.

My primary care doc writes the needed prescription (suggest you tell, not ask, that you want one!), and since I'm not diabetic, I pay the the cash price at Costco. Just picked up 2 x Free Style Libres on Friday at Costco for a total price of $61. I'm fortunate that this is an expense I can easily afford. Each one lasts 14 days, so that's almost one full month of coverage.

CGMs measure your blood sugar via a very small "probe" inserted just below the surface of the skin into the interstitial fluid. Once you "install it", it stays on until it expires or falls off. Strongly recommend buying an additional patch to cover it...long showers and swimming cause my sensor to fall off before 14 days if I don't. I also find I have to avoid sauna and steam room use since they REALLY cause a shortened sensor life for me.

To use it, download the associated app on your phone (I have an iPhone and it's seamless) which continually reads the sensor and will display the current reading once you open the app. After approximately a week of readings, the app will generate a computed A1c reading, which I found to be very close to my blood measured A1c reading. It also will generate additional charts to help you learn what your normal blood sugar regulation "rhythm" is.

I experimented with the Libre2, but found it to be somewhat inaccurate and stopped using it. The Libre3 is much more accurate, typically +/- 10 mg/dl of a traditional finger stick measurement.

here's a link to the Abbott website to get a better insight into the phone application:

https://www.freestyle.abbott/us-en/products/freestyle-libre-3.html

Good luck in this pursuit!

 

[RetiredHappy]

Apparently due to a change in regs, a Type 2 diabetic can also be approved for Medicare coverage of the CGM if on oral medication, if certain criteria are met.

My husband's endocrinologist said if he needs to be on insulin, it will be covered by Medicare, otherwise no. He is on once a week Trulicity injection but it does not meet the criterion.

This is from Libre Freestyle website: https://www.freestyle.abbott/us-en/...he FreeStyle Libre 2,on some days every month.

Manage your diabetes with more confidence‡§3 with the FreeStyle Libre 3 or FreeStyle Libre 2 systems. They’re covered by Medicare for people managing diabetes with insulin*1. Ask your healthcare provider about the FreeStyle Libre 3 or FreeStyle Libre 2 system, if you take insulin for your diabetes.

 

[zl55lz]

My husband's endocrinologist said if he needs to be on insulin, it will be covered by Medicare, otherwise no. He is on once a week Trulicity injection but it does not meet the criterion.

This is from Libre Freestyle website: https://www.freestyle.abbott/us-en/...he FreeStyle Libre 2,on some days every month.

Manage your diabetes with more confidence‡§3 with the FreeStyle Libre 3 or FreeStyle Libre 2 systems. They’re covered by Medicare for people managing diabetes with insulin*1. Ask your healthcare provider about the FreeStyle Libre 3 or FreeStyle Libre 2 system, if you take insulin for your diabetes.

Regs have changed, insulin use now not always necessary:

https://diabetes.org/advocacy/cgm-continuous-glucose-monitors/faqs-medicare-coverage

 

[RetiredHappy]

Regs have changed, insulin use now not always necessary:

https://diabetes.org/advocacy/cgm-continuous-glucose-monitors/faqs-medicare-coverage

Thanks. It still does not apply to my husband.

 

[FLSUnFIRE]

Those are approved for the indication of diabetes, not for the indication of "improving health by learning about how different foods affect blood sugar". As a result, most corporate owned doctors won't prescribe it. This is a direct result of how our sick care system operates. Maybe a concierge doc would prescribe one.

If you want to go for a deep dive, search Peter Attia MD CGM and listen to whatever (long) podcasts you find.

100% Get sick then throw lots of mostly other people's money at it (taxpayers and insurers) but prevention and self-awareness? No! Brought to you by the same people that make HFCS cheaper than sugar (well, at the store anyway) and recommend a diet based on simple carbs! Seriously, not "approved" to know what's going on in your own body without a gatekeeper. Should probably be grateful for the heartrate monitor on my Garmin. Frustrating that there are tools out there that that could potentially save/improve lives and are not made more available.



Outlive is a good read but you can get all the points from a podcast or two interviewing Peter Attia. With respect to diet and glucose/insulin response, I also enjoy Jessie Inchauspé's perspective.

 

[euro]

just found out about this little device,

, seems pretty neat. would like to use it to track the GI of the different types of food I eat. I'm on the low end of prediabetic but my wife is diabetic.


Interested in the Freestyle libre 3. Anyone had of these or a different brand? I think you buy the sensor (which sticks to your arm) and it talks to your smart phone. Can't seem to find a lot of info on how to buy one. I know you can't just buy it online or OTC. Do I just ask for a Rx from my doc and then get it from my local CVS/Walgreen, etc? Is the sensor only good for 14 days ? If you want another tracking session then you need another Rx/sensor ? Can I share the sensor, say I wear it for 7 days and then my wife wears another 7?

CGMs are extremely useful if you are interested in controlling your carbohydrate intake, because you get instant feedback every time you eat/drink. For data geeks like myself this is amazing.
Contrary to common belief, you CAN get CGM without prescription online. Just have to find the right vendors. That said, as other have pointed out, of course, insurance will only cover it when prescribes, so you will spend a pretty penny without insurance. But it CAN be done.
You cannot share an individual sensor with your wife because it can only be inserted once (a tiny sensor is inserted about 1/8-1/4 of on inch deep each time you use a new sensor). But you CAN alternate every 14 days with your DW, if that is what you want.
Personally, I have used Dexcom 6 and 7 sensors for several years, just to monitor glucose content of various foods. You'd be amazed how many hidden carbs many of today's foods (particularly processed ones) deliver! I'm not diabetic, so I do this mostly for data and diet control reasons, but if I were diabetic, I would use CGM for sure.

 

[latexman]

I’ve been/was pre-diabetic for years. My blood glucose and A1C were high but stayed right below the limit for my PA to precribe anything, which frustrated her greatly. So, she gave me a Dexcom G7 CGM. The continuous data allowed her to observe many periods of blood glucose levels above the limit and she prescribed Metforin. That was about 6 months ago. Since then, I lost weight, my blood glucose levels reduced to near normal and stabilized. I feel better. Plus, there’s studies that suggest Metformin extends your longevity.

 

[dmpi]

It says online it requires a prescription.

https://www.support.freestyle.abbot...eStyle-Libre-3-system-require-a-prescription-

Interesting. You can buy the finger prick monitors without a prescription. But they're only $50 vs $500 for this system.

 

[schenbew]

Interesting. You can buy the finger prick monitors without a prescription. But they're only $50 vs $500 for this system.

I think $500 is a bit high, if measured on a monthly basis. Using the Costco Pharmacy site, assuming you are a cash buyer with no insurance, a one month 3 x Dexcom G7 sensor (10 days per sensor) costs about $172...similar prices are available at other pharmacies:

https://www.costco.com/cmpps?drugIdentifierParam=53172552256&drugNameParam=Dexcom+G7+Sensor

2 x Free Style Libre3 (14 days per sensor) costs about $120...I've always received an additional coupon available only at checkout that cuts this cost in half.

https://www.costco.com/cmpps?drugIdentifierParam=53172552256&drugNameParam=Dexcom+G7+Sensor

 

[dmpi]

I think $500 is a bit high, if measured on a monthly basis. Using the Costco Pharmacy site, assuming you are a cash buyer with no insurance, a one month 3 x Dexcom G7 sensor (10 days per sensor) costs about $172...similar prices are available at other pharmacies:

https://www.costco.com/cmpps?drugIdentifierParam=53172552256&drugNameParam=Dexcom+G7+Sensor

2 x Free Style Libre3 (14 days per sensor) costs about $120...I've always received an additional coupon available only at checkout that cuts this cost in half.

https://www.costco.com/cmpps?drugIdentifierParam=53172552256&drugNameParam=Dexcom+G7+Sensor

Interesting. I've bought the finger prick tester (without a prescription) because I wanted to test more than one a year, which would be only during my physical. Pricking my finger is painful and you never get use to it. I would assume these new systems are more pain free. That alone might be worth some added cost. The ability to monitor would be nice but I consider it sort of overkill for what I want. I just want to test maybe once every 3 months.

 

[audreyh1]

Every 3 months - it’s more useful to have your A1C measured. That gives a 3 month average for blood sugar. A finger print is instantaneous and can be all over the place.

 

[Zathras]

Interesting. I've bought the finger prick tester (without a prescription) because I wanted to test more than one a year, which would be only during my physical. Pricking my finger is painful and you never get use to it. I would assume these new systems are more pain free. That alone might be worth some added cost. The ability to monitor would be nice but I consider it sort of overkill for what I want. I just want to test maybe once every 3 months.

I am not sure if this helps. When you prick you finger, use the fleshy part just to the side of your finger pad.
The finger pads have lots of nerves, the sides have fewer.

 

[RetiredHappy]

We have lab work done every 6 months which always include A1C. It was sort of a blessing to me when I met my husband because I realized that I did not want to become a diabetic like him. Diabetes runs in my family. My A1C was 5.6 then. I changed my diet and check my blood sugar regularly. So, 17 years on, I am still not diabetic. I had carby food yesterday and my reading was 85 this morning. An hour after my usual bowl of oatmeal with milk this morning, it was 91. Golfing 4 to 5 times a week also helps.

 

[Masquernom]

Buying the patches doesn't seem that expensive at Costco. We have iphones to read them. But, is there a subscription charge for the app for the phone to read the patches?

 

[Zathras]

Dexcom does not, and I don’t believe any of the others do either.
That said, in addition to the sensors, you also need to buy the battery/transmitter. The Dexcom one lasts 3 months, the others may be longer.