 Hi guys, what's up? This is Dr. Ahmet Ergen. I'm an endocrinologist and a diabetes education specialist now I'm going to talk to you about CGM which is continuous glucose monitoring systems now We have a lot of videos compared in dexcom to Libre I did another video where I compared the Libre 2 to dexcom to Guardian But in that video I basically gave myself a bunch of insulin drop my blood sugar down and just wanted to see how Effective the CGMs were in the low-range which one was more effective now today I'm just going to tell you my honest opinion and in today's condition Which one is the best now? So when I say which one is best? I don't mean necessarily which one is more accurate or which one is less accurate, etc I'm going to give you a quick view of what they are and what would fit you best Because everybody is different some people like dexcom some people like Libre And a lot of people don't understand the nuances in between them or how even how to use them We even have a video about how to analyze and interpret The CGM now if you want to find the links for those videos They are in the description below So make sure you watch all these videos or continue to watch the playlist that we have about the CGM So you can be very well worse before you make any decision now Let's start with dexcom dexcom has been very popular The problem with dexcom that I see personally in my clinic is that number one it is Expensive it is the one of the most expensive CGM out there They have done well They were really doing well But the problem is they have those growing pains and Unfortunately, the orders take forever and their customer service kind of is not that great A lot of people get pissed because they blame the doctor's office They blame they never blame themselves and it's a problem when a company says we are doing everything right and everybody else is wrong That is a problem. So be careful about that with dexcom Some people have good experience some people have bad experience again I'm not here to bash dexcom with the customer service when it comes to their device Device is very nice. You don't have any finger sticks involved. It goes directly to your phone So and then when you share your data with your doctor So I see a lot of patients remotely virtually and I can see their blood sugar From home or from my office without having to invite them to my office, right? So that's the one of the beautiful thing we do all the time even before the COVID we have been doing this Seeing patients virtually so they don't have to travel to the office and spend half a day, etc So but I think dexcom does well when it comes to accuracy I think it's very accurate except if your blood sugars are plummeting super fast a few times I have seen personally like when I did this to myself and I dropped my own blood sugar Not that I'm diabetic, but I'm doing crazy things all the time But basically that's that's what happened the dexcom was lagging behind and Libra 2 which is the newest Libra in the market did better And now by the way, this video is not sponsored by any means So don't think that I'm getting paid from anyone even if I did you know that I will never say anything Incorrect or I would never hide anything from you guys because my priorities you the bottom line is dexcom is very good technologically advanced They have a cloud system. You can share your data easily Accuracy is very good. They have alerts that alerts you 20 minutes before your blood sugar drops. They have this Like every other CGM. They have the arrow system. They show you how fast your blood sugar goes up Again, I'm not gonna go into detail here because we have a video about how to analyze and interpret CGM Which link in the description below But definitely unit understand how to use your CGM So sometimes you may get you may get a camera for example for a thousand dollars And then if you think that you just gotta push the button, it's gonna work It will work But it's not gonna probably give you the full functionality that you want to get from the camera that you paid $1,000 for so same way unit to understand what that device that's expensive device that you got and Understand the details of it how it works or how what it does what it doesn't do And how you can get the most out of it. So very important try to understand dexcom That's why you have a lot of videos about that now How does it compare to Libre or Libre 2 now Libre the old Libre and the Libre 2 which are two different things now There are disadvantages and disadvantages to both now to be honest with you I did not like the original Libre because It has given a lot of false Positive low numbers like people will constantly come to me and say I'm waking up with the low blood sugar doc You know since I start using there's my blood sugars in the 50s 60s every morning And I'm like, do you feel anything they're like no I'm like, did you ever check the finger stick? They're like no. Well, yeah, check the finger stick because it's not correct You know more than 80% of the time when it says your blood sugar is 50. It's not really 50 It's maybe like 75 80. Yes, it's on the low side, but it's not really at the number that you need to pan it So that was the problem with the old Libre but what was the good thing about the old Libre is Although, you know, it still showed you by the way, it still showed the trends It shows you how you know your blood sugar trends. It may not make your finger stick like to the point Typically, there's around 20 milligram per deciliter difference But as long as what the difference is between your Libre and your meter then you can kind of do the math You know, like say, okay, well, maybe it's reading 20 higher 20 lower But and then you have to be aware of the false positives and false negatives Especially all Libre also was not very accurate when it goes about like 250 So if you're staying between 80 and 250 and you just want to see your trends the old Libre is great But a lot of false positive and false negatives You have to do a finger stick if you see something out of totally out of like normal Now the good thing about Libre was that also you were able to scan your blood sugars Now the the problem with the Libre overall is you have to scan it for for the for the device to keep recording your blood sugar numbers It's not like you cannot just forget about it and just check whenever you want on your cell phone So that scanning feature, I believe they're gonna get rid of that soon But you are still stuck with the you have to remember to scan now if you don't have if you're not using a phone If you're not into technology or too difficult for you and you're still using a meter Then you have to carry a meter with you which Dexcom also offers a two But I think it's kind of a pain to try to carry your meter with you I think that's one of the things that that defeats the purpose if I'm gonna carry a meter I might as well do a finger stick too. So it's like, you know, it's not in the world So why am I paying so much money or why am I, you know carrying an extra device on my body? You know that that wouldn't just give me a data instantly without me having to do anything extra But Libre, that's what it is You know, it's still for people who are like super scared of finger sticks or they're tired of finger sticks And they want to be able to do Check your blood sugar a hundred times, which is okay. And that Libre still works well But you know, again, if you're using a meter, you have to keep it with you and scan with you, etc And then when you're using a meter with all the Libre that will not automatically go to the cloud You have to use a phone app A smartphone app for data to be transferable to your physician remotely, so if you are using a meter that comes with Libre that is not going to be transferable unless unless you Connect with the cable to a system, which is Libre system you go and do it yourself before your physician visit That is possible. Although it seems simple, but half the time when I tell patients, hey, did you upload your data? They're like no and then I'm like we're already seeing the patient It's like, you know, when you have a lot of patients You cannot just tell people and then it becomes a lot of back and forth and so from from my standpoint I like people when their data is already in cloud. I can't click on it. I can't see But that's one of the downsides with Libre Now also Libre 2 came around which is great I tested myself and patients are telling the same thing their data shows the same thing Which is is much better accuracy So there is the false negative rays and false positive rays are much much less Their accuracy is as good as Dexcom right now and the cool thing about Libre is one-third of a price of Dexcom So if you're trying to get this like for yourself, you know, you don't have enough insurance or your insurance doesn't cover it I would say Dexcom is going to rip you off No, they're not gonna rip you off, but I mean they're expensive. That's what it is Okay, so you either buy it or you don't buy it. It's a free market, right? But the freestyle Libre is one-third of the price. So if I'm diabetic I'm not gonna pay three times more for something that I can get for three times less And actually they have a program if you didn't know and again, this is totally non-sponsored I'm just trying to tell you to you can benefit from it So you may go to Publix or you know any other big chain Pharmacy like Walgreens or CVS. They may sell to you for 130 dollars But but to be honest with you if you call the company and say hey My insurance doesn't cover that and I still like your product They're gonna send you a voucher for be for you to be able to get that for 75 dollars. So there you have it 75 I just saved you. Oh, what $50 or $60. So a lot of times I tell this to my patients I like oh really I know that and actually That's for freestyle Libre old Libre and the new Libre which is Libre 2 But also and we are talking about right now at November end of November 2020 so things may change But at least right now they have this program now another program They just rolled out is like they have this freestyle Libre if you go to my freestyle Libre dot US They give you I believe either two weeks or four weeks something free Like a sensors and you can give it a try and see if you like it or not I think that's also a great thing for people to to try because you know Think about it. You're gonna pay for something you want to try right? So I think that's a great thing for them to offer Libre 2 we said that it is much better accuracy than the old Libre But the downside of Libre 2 is they still do not have a phone app Which means that you have to carry that meter with you and you have to upload to their web app in order for your doctor to see your data Or you have to go to the physician's office for them to download and you have to do everything manually Versus the old Libre you can just basically use a phone app and scan your phone for your numbers and In between the numbers, you know, it's gonna keep recording One thing some people forget is that dexcom For example constantly keep recording your blood sugar, but Libre if you don't do it at least every eight hours That device will stop working on you So if you didn't check your blood sugar for two days, Libre will have no data for you to review retrospectively So you better keep scanning your numbers at least every eight hours for that sensor to continue to work So that's important to know Another thing you need to also know that both dexcom and Libre if you if your sensors fail early Which happens sometimes, you know, like dexcom works for 10 days Libre works for 14 days But not always sometimes the device will fail they're gonna say change sensor And then you just paid for it either you paid a copay or you just purchased out of pocket But then you have a failed sensor that's frustrating So a lot of people don't know this but you can call dexcom and Libre and say hey I have a failed sensor I'm just gonna send it right back to you and then you send it a new one right back to me that way You don't have to lose any money so Another good thing about dexcom. I'm going back and forth as I remember Dexcom works with a insulin pump, which is Tendem or T-cellam insulin pump, which is control IQ system, which I love Especially for type one diabetics, but even for top two diabetics But type one I think is the best batch best match for this type of system because When you use a pump that works with your CGM with your dexcom Where it's like you're like a closed loop feedback mechanism where your pump can adjust the insulin delivery based on your needs If your blood sugars are not running high your pump will cut back on the insulin if your blood sugar running high Because you don't give enough bolus with the insulin pump then the then then the dexcom will feed it back to To your pump and your pump will give you a little bit more bolus to try to keep your blood sugar under control So I have seen a lot of great cases where we had trouble managing people's blood sugar Especially with brutal brutal type one diabetic patients when they went on this system dated very well So but again if you are thinking about switching or using a pump in the future and if you like that T-cellam pump I wouldn't go buy librae because librae is not going to work with that pump So As I said librae is much cheaper and everything and it's easier to get your hands on it's a better customer service It's if you're a Medicare patient, it's a lot easier to get freestyle librae and so forth in at least in my experience but if you are Wanting to go on an insulin pump such as tandem pump dexcom may be a better option And I always tell my patients that think you know thoroughly because you don't you know Sometimes insurance companies will say I already have librae. We're not gonna give you anything else. Then you're stuck with librae So you have to consider those as well But if you want to go for a metronic pump, you know, which a lot of people love a great customer service great pump There's still a market leader But you don't really care about T-cellam or dexcom much or maybe they're too expensive for you Then you can definitely use a freestyle librae sensor with the metronic insulin pump And again, this is only for I'm talking about the pump users but if you don't have a pump then you just think about everything else we talked about for dexcom and librae comparison comparison now You're gonna tell me that you didn't talk about the The Guardian well, I don't talk about the Guardian because it's not my favorite It is it is a good sensor, but you still have to do a finger sticks and when you talk about finger sticks I'm not gonna be like no, not so sure but there are some people for example use metronic pump and metronic pump goes with the Guardian sensor and For those people who don't mind doing finger sticks, which there are a bunch of people by the way You think that people don't know the finger sticks, but I have a lot of people who don't mind finger sticks at all so for those people who can do two couple finger sticks a day and see their data 24-7 with just a few finger sticks and still have the luxury of pump communicating with their sensor Metronic and Guardian system is still a good option So I hope that video helped you guys if it did please give a thumbs up Please share this video with someone who may be considering to buy any of these devices And we will see you in the next video and remember we have a lot of diet videos We have a lot of other cholesterol you name it. 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