Dexcom G7 vs Libre 3: The Ultimate Comparison Guide
CGM Systems in Modern Medicine
Medical technology has expanded significantly over the past decade to include digitally-managed monitoring devices. Glucose monitoring devices are currently in vogue, replacing the conventional methods requiring consistent calibrations and fingerpricks. In a May 2022 announcement, the FDA approved the Freestyle Libre 3 continuous glucose monitor, setting the base in the diabetes care scene. Like its predecessor, the Libre 2, this new device featured a 14-day accuracy gauge. Compared to other competitors in the global market, the Libre 3 tech automatically optimizes blood glucose measurement and sends real-time updates to the users’ smartphone interface. In its introduction to the medical community, the Freestyle Libre 3 CGM was described as the ‘thinnest, smallest, and most accurate’ glucose sensor for diabetes care. Its compact design – about the size of two stacked U.S. pennies – seamlessly fits into optimal diabetes care, allowing users to consistently check their glucose levels without a fingerstick.
Table of Contents
- Libre and Dexcom G7
- Device Features
- Similarities between Libre 3 and Dexcom G7
- Differences between Dexcom G7 and Libre 3
- Differences in a snapshot
- Conclusion
Libre and Dexcom G7
The Dexcom G7 was submitted for FDA approval in 2021. By March 2022, the device had received usage approval in Europe following multiple clinical observations and operations reports to confirm accuracy, safety, and compatibility in different patient demographics. Just as with the Freestyle Libre 3, the Dexcom G7 was designed with directive ideas from its predecessor – the Dexcom G6. As an improvement on the Dexcom G6, the new G7 device featured a 10-day accuracy system and a continuous glucose level update delivered every 5 minutes to a smartphone interface. Designed for use in patients 2 years of age and above, the Dexcom G7 received wide acceptance in the medical community as a preliminary result confirmed its accuracy in the digital monitoring of glucose levels in both type 1 and type 2 diabetes.
Size comparisons and the number of device pieces were a big deal in the development and marketing of digital monitoring devices. The Dexcom G7 scored high on this feature with a 1-piece design that eliminated the cumbersomeness of using the Dexcom G6. Unlike the Dexcom G6, the G7 has no separate transmitter and features a compact, disposable unit with both sensor and transmitters integrated. It is also 60% smaller with a lightweight design for improved wearability. Dexcom’s intuitive design and the inclusion of a wide range of device extension has greatly improved the acceptability of the G7 within the medical community. The G7 helps the user monitor fluctuation in blood glucose levels by measuring the real-time concentration of glucose in the interstitial fluids and presents the data on a reader or smartphone interface. With the Dexcom G7, diabetics are saved from the difficulties of multiple fingerpricks, with the risk of diabetic emergencies also significantly reduced.
The FreeStyle Libre 3 belongs to a popular line of FGM (Flash Glucose Monitoring) systems designed and manufactured by Abbott. As in the Libre 2, the Libre 3 is also designed as a low-cost glucose monitoring device, however the Libre 3 is Abbotts first bluetooth transmission-enabled CGM (Constant Glucose Monitor). The in-built sensor of the Libre senses fluctuations in the glucose in the interstitial fluids under the skin and automatically relays the reading to a smartphone interface. Compared to other CGM systems available today, the Libre 3 reportedly has Bluetooth integration with a range of up to 33 feet. At this range, usage flexibility is greatly improved as users can roam free to a considerable distance without the mobile interface and without losing transmitted readings. Approved by the FDA for use in diabetes patients 4 years and above, this is a popular choice of device for the management of diabetes in the United States and Europe.
Beyond merely detecting fluctuations in blood glucose levels, the Libre 3 is designed to significantly improve usability. Its mobile apps are easy to navigate and use, available on both Android and iOS platforms. The FreesStyle mobile app allows Libre 3 users to track glucose concentration, set up customizable glucose level alarms, and track trends in glucose metabolism. Alerts can warn users of a potential diabetic emergency, when glucose falls out of the desired range and trends too low or high. As a functional add-on, Abbott designed the FreeStyle Libre 3 mobile app to perfectly integrate with the FreeStyle Libre digital ecosystem. Digital healthcare solutions in this ecosystem including the LibreLinkUp and enable users to remotely share their glucose level trends with caregivers and healthcare professionals.
Device Features
Comparing the Libre 3 and Dexcom G7 to Previous Diabetes Care Technologies
Small, disposable single-unit designs
As a standard improvement on previous generation of technology in diabetes healthcare, the new line of CGMs are designed as a single-unit disposable device. In the Dexcom G7, the sensor and transmitter units are designed as a single unit saving users the stress of depending on an independent transmitter unit. The new CGM devices are simply inserted in the subcutaneous space on the buttock around the navel or upper arm.
Continuous transmissions
Depending on the design, the new generation CGMs are equipped with technology that allows for continuous real-time monitoring and a rolling record of blood glucose levels. This eliminates the need for daily fingerpricks as glucose level values are transmitted continuously to a smartphone interface. In the Dexcom G7, glucose values are transmitted every 5 minutes.
Customizable Alerts
The devices have customizable alert systems helping users track extreme changes in the levels of glucose in the blood. The Libre 3 CGM has optional alert settings for hypoglycemia, hyperglycemia, and signal loss scenarios. The Libre 3 also comes with a ‘silent alarm’ that vibrates to help manage alarm anxiety in some patients.
Mobile Phone Interface
CGMs available today – including the Dexcom G7 and Libre 3 – are designed to be used with the users smart phone, compatible with both iOS and Android platforms. With the devices app users can track glucose levels as they trend, connect with a community of other users, remotely manage alerts and share glucose values with healthcare professionals.
Insulin Pumps and other Integrations
The new generations of CGMs are focused on providing diabetes care with customizable features that empower the user. Some of these CGMs are designed to be compatible with external insulin pump systems. Pumps that can connect to the CGM can use live glucose data from the sensor and assist in managing insulin dosing.
Similarities between Libre 3 and Dexcom G7
Today, both Libre 3 and Dexcom G7 are widely used in different parts of the globe. The ease they offer in continuous glucose monitoring and the mobile interface’s real-time update has made it popular among different patient demographics. In a bid to help you better understand these devices better, we have compiled a list of important similarities between both devices.
Continuous Glucose Monitoring (CGM) Module
Both devices directly report real-time values of blood glucose levels on a digital interface using similar technology. The Continuous Glucose Monitoring technology features a glucose-oxidase-based sensor inserted into the subcutaneous fatty tissue and in contact with the interstitial fluid. Depending on the design, the continuous glucose may either display the concentration of the measure at a set interval or store the value calculated at every predetermined interval. In clinical settings, aggregated results of all values calculated are archived on cloud storage or downloaded for further clinical analysis.
Low Energy Bluetooth Tech
A high point for both devices is the transmission of blood glucose values to a receiver. With these two devices, these values are transmitted to a digital interface using low-energy Bluetooth technology. Although worn in close contact with the skin, these devices are completely safe and constitute no serious risk to the users’ health.
Smartphone Interface and User Community Programs
Both CGM systems are designed to include the transmission of glucose level trends to a mobile interface. Dexcom’s G7 device is designed to interface directly with two different apps on users’ smart devices. The Dexcom Follow App allows users to share their glucose number with a community of 10 followers, adding an extra layer of community support for first-time users. This feature has been widely applauded in the Diabetes Care community as it facilitates user-to-user support on device calibration, charging, and transmitter replacement. The Dexcom app provides real-time access to glucose reports, archives report series, and helps users keep track of their glucose level. Users can also keep their healthcare providers in the loop by sharing daily glucose reports using the Dexcom App. Similar to the Dexcom mobile interfaces, the Libre 3 has smartphone apps that also provides remote monitoring of glucose readings. Readings can be archived or downloaded for further analysis.
Customized alerts
Both devices are designed to alert the users in cases of high and low blood glucose levels. Customized alerts warn the user about an impending low or high level of glucose in the blood. This feature, available on both devices, makes it easier to manage the dosage and injection frequency of insulin in diabetics. Customized alerts like these have been found to significantly empower diabetics manage their glucose levels.
Differences between Dexcom G7 and Libre 3
Since both devices are manufactured by two different companies, there are fundamental differences in their designs. These differences are targeted toward enabling a user-friendly experience. Today, diabetes care models are increasingly implemented on telemedicine platforms, prompting the need for the digitization of monitoring devices used for virtual monitoring. The Libre 3 and Dexcom G7 model excel in these areas as the remote transmission is enabled using a few distinct methods of operation. In this review, the biggest differences between both devices are highlighted below;
Sensor Life
Sensors are the most important single unit in CGM system. The sensor measures the concentration of glucose in the interstitial fluid. The Dexcom G7 model comes with an extended wear of 14 to 15 days compared to the Dexcom G6 with a sensor wear time of 10 days. Since it also comes as a single, disposable unit combining the transmitter and sensor in one single piece, users can simply remove the entire device and insert a replacement. The technical problems carrying the transmitter over to a new sensor unit every 10 days is avoided. Just as in its predecessors, the Freestyle Libre 3 has a 14-day sensor life.
Warm Up Period
Warm-ups are important and are performed immediately on sensor insertion. During a device warm-up period, the sensor automatically calibrates itself in readiness for the first transmission of glucose level values. In the previous Dexcom generations, the warm-up period is estimated at 2 hours. In Dexcom G7, the warm-up period is significantly reduced to 30 minutes. For the FreeStyle Libre 3, the warm-up period is approximately 60 minutes.
Sensor Accuracy
The Dexcom G7 is widely reported as the most accurate CGM on the market today. Accuracy in CGM systems is measured based on the Mean Absolute Relative Difference (MARD) metric. This metric basically measures the variability between the actual blood glucose level – confirmed by a fingerstick and the sensor reading on a CGM. A low MARD value translates to a high sensor accuracy. For users wearing the Dexcom G7 on the upper arm, the MARD for this device has been reported to be an estimated 8.2 percent. As a bonus feature, the G7 explores artificial intelligence in predicting future levels of glucose values based on trends measured in the past. On the other hand, the reported MARD score for the FreeStyle Libre 3 is 9.2% making it less accurate compared to the Dexcom G7.
Integrations
CGM device integrations are very important as they help the user extend the functionality and the scope of diabetes care. Integration, in this sense, describes the range of external devices that can be linked with or added to the device. Creating closed-looped insulin pumps systems are perhaps the most popular of these extensions. In addition to smartphone integrations, the Dexcom G7 is designed to be compatible with Tandem and Omnipod Systems. Dexcom also announced a possible upgrade that might improve the integration compatibilities of the G7 to include SmartPens. At the end of 2022 Abbott announced its first automated insulin delivery (AID) system in the world to work with Abbott’s FreeStyle Libre 3 sensor.
A German hybrid closed-loop system named mylife™ is thanks to the partnerships of CamDiab’s algorithm that can automatically adjusts insulin dosage on Ypsomed’s insulin pump. mylife™ YpsoPump®, based on accurate2, real-time glucose information from FreeStyle Libre 3 sensor.
Although this AID solution is currently not available in the United States, hopefully this is just the first of many potential partnerships to integrate the FreeStyle Libre 3 into more AID solutions.
Reader Ranges
In the previous version of the Libre device, users are required to scan the device to view current readings of glucose levels. Although the Libre 3 no longer requires scanning, users are limited to taking readings from their compatible mobile interfaces.
Differences in a snapshot
Transmission frequency
Dexcom G7: Transmits data every 5 minutes
Libre 3: Transmits data every 10 minutesSensor Life
Dexcom G7: Sensor lasts 10 days plus a grace period of 12 hours
Libre 3: Sensor lasts 14 daysAccuracy
Dexcom G7: Very accurate with a MARD score of 8.2%
Libre 3: Less accurate to Dexcom G7. MARD score of 9.2%Integrations
Dexcom G7: Tandem t:slim, SmartPens and Omipod 5
Libre 3: none (when typing this blog)
Conclusion
It is tough to determine which is better as the FreeStyle Libre 3 and the Dexcom G7 are the popular choice for diabetics around the world and are now more similar that their predecessors.
If you are already using a CGM and are looking to upgrade, we suggest sticking with the app interface you are using. This way it will be a smooth transition and you will have more time to focus on the things that really matter. For example if you are comfortable with the mobile interface of the FreeStyle Libre 2, we would suggest going with the Libre 3.
Since the Libre 3 and Dexcom G7 are more alike than ever before – when it comes to accuracy, alerts and both reduce the dependence of bleeding from your fingertips, the device to choose may come down to the individuals insurance coverage, lifestyle, management plan and glucose management goals.
Personally, if I had to only choose one, I would go with the Dexcom G7 as it is more accurate and has pump integration options available.
REFERENCES
https://product.nzms.co.nz/dexcomg7-pricing
https://www.cnbc.com/2022/10/14/review-abbott-freestyle-libre-3-cgm-for-diabetics-.html
https://www.dexcom.com/en-us/g7-cgm-system
https://www.freestyle.abbott/eu-en/products/freestyle-libre-3.html
https://freestylediabetes.co.uk/freestyle-libre/introducing-freestyle-libre-3
https://www.dexcom.com/en-gb/faqs/how-long-can-i-wear-sensor-g7
https://www.freestylelibre.de/produkte/freestyle-libre-3-sensor.html
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