CGM Review: Dexcom G4 vs. Medtronic Guardian

CGMsThis CGM review will cover continuous glucose monitors from Dexcom and Medtronic.  The Dexcom G4, and Medtronic Guardian.  I’ve had the Medtronic Guardian since March of 2012.  I got the Dexcom G4 at the end of December and started using it last week.  First, let me just say that both have benefits and drawbacks compared to the other, however, I only trust 1 of them.  If you’ve done any reading online about CGM’s you probably already know which one I trust.

I was excited in March to be getting the Guardian.  At that time, I was only aware of the Guardian, and since it integrated directly with my pump, it was a no brainer to go with it.  I just called Medtronic and they dealt with insurance, who paid for it all.  (I have amazing insurance!)  When I received it, I was a bit terrified at the size of the needle.  So much so, that I told the Medtronic nurse I was going to send it back.  She calmed my concern over it, and got me to try it.  When I tried it, I was surprised that I barely felt it go into my skin.  After using it for a week, I called the nurse again to ask why it was so horribly inaccurate.  It was only ever close to being accurate in the mornings when I hadn’t eaten for 10 or 12 hours.  Once it told me my blood sugar as 146, but it was really 322!!!  I told her that if this is normal, it does me no good.  She said that it’s not as accurate when I’m rising or falling quickly, when my blood sugar is high, or if I calibrate it more than 3 times a day.  Well, it seems to me, that if it’s NOT accurate at those times, it’s no good to anybody?  People under good control don’t need CGM’s.  It’s the people on the blood sugar roller coaster that do, and if this CGM is admittedly inaccurate at those times, then what good is it?  Again she convinced me to stick with it.  6 months later and I’m still on the original box of sensors, with multiple  unopened boxes.

Darkness CGMThen I started to become involved in the diabetes online community, or DOC.  Everyone in the DOC raved about the Dexcom 7, with it’s comfort, accuracy, and that you can wear it for 7 days.  In the fall, I suddenly remembered that someone at Medtronic told me I have to re-order transmitters every 6 months.  Instead, I called Dexcom.  The G4 had just been released to rave reviews.  My insurance allowed it, and I got it ordered before end of year so there would be no out of pocket cost.  (Deductible was complete early in the year.)  So far, I’ve been absolutely thrilled with the Dexcom G4.  It’s accuracy is especially surprising compared to the Medtronic, especially when I’m spiking or crashing quickly, or running high.  My educator mentioned to me that it’s more accurate the more you calibrate it, so I’ve been doing that.  In just 3 days I’ve already noticed trends that I could never notice on the Medtronic because it was so horribly inaccurate.  I also like that it’s not integrated.  It allows me to set it on my desk at work, and monitor my blood sugar easily, without having to stand up and dig my pump out of my pocket.  I like that it’s brightly lit and in color so it’s easy to see in the dark, without my glasses on, when I feel low.

Over the last 2 days, I wore both sensors.  Granted, the Medtronic was past it’s 6 month mark, but it was never any good new, so who cares.  I was really just trying to prove to myself that I made a good decision this time.  At every OneTouch meter test, the Guardian failed in comparison to the G4.  Tonight, the G4 warned me of a low that I hadn’t noticed yet while the Guardian thought I was at 122.  Before the 48 hour mark, I just gave up on the Guardian and tore it off my skin.  I’m done with it.  The Dexcom G4 I have complete trust in.

Now, there are some drawbacks to the G4, but they’re minor.  What’s most important to me, and to anyone who needs a CGM, is accuracy, the the G4 is certainly impressive regarding it’s accuracy.  Below I’ve listed the benefits and drawbacks to each CGM.

Dexcom G4 Benefits:

  • Accuracy! Especially when you need it, when your blood sugar is changing quickly.  It seems the more I calibrate, the more accurate it is
  • Much thinner and more comfortable needle
  • The transmitter doesn’t have to be charged because the battery lasts 6 months
  • Not integrated into pump.  I actually like it not being integrated.
  • Color screen with red for lows, yellow for highs
  • Better range.  I can go anywhere in my apartment and not lose signal
  • It shows blood glucose as high as 400 compared to Guardian which is only 250
  • The site sticks to your skin before you plunge the needle in
  • Can move forward and backward in navigation of blood sugar history
  • Sensor lasts 7 days officially (14 unofficially), the Guardian only lasts 3 (6 unofficially)
  • Multiple alert profiles with differing sounds
  • You can adjust the rise and fall rate arrow alerts
  • When you don’t get it calibrated on time, it keeps tracking instead of stopping
  • Univeral USB charger and connection to PC to track data

Dexcom G4 Drawbacks:

  • Manual insertion of the sensor needle (no insertion catapult, it’s like taking a shot, but it was super easy and I can live with that)
  • The sensor sticks out away from your skin farther than the Guardian so it’s easier to catch on things (I’ve had no problems as of yet though)
  • You can’t go back in history and see the actual blood sugar values. You can only see the graph
  • Lots of plastic waste created each time you change a site. Every new site comes with a new insertion tool.  Really seems like a waste of materials.

Medtronic Guardian Benefits:

  • Ummmmm?  Ummmm?  Give me a minute.  I’ll think of something.
  • The guardian uses an automatic insertion catapult
  • If you use a Medtronic pump, you only have to deal with 1 supplier
  • Transmitter is smaller and doesn’t stick out as far from your skin as the G4
  • Although I don’t consider it a benefit, most people would, but it’s integrated into your pump, so you only have to carry 1 device, which you’re already used to carrying

Medtronic Guardian Drawbacks:

  • Horribly inaccurate.  Sometimes more than 200% off.  Often at least 100% off.
  • Smaller range than the G4.  If you’re in another room, chances are the signal will be lost.
  • The insertion needle is *insert colorful metaphor* HUGE . . . and leaves bloody wounds/scars
  • Integrated into pump. Which means you can’t leave it out on the desk at work, without having to stand up and dig your pump out of your pocket while you’re talking on the phone to a customer
  • Transmitter has to be charged with a battery operated charger instead of universal USB cable
  • Sensor only lasts for 3 days (6 days if you stretch it, but you’ll have a nasty wound if you do)
  • Uses proprietary bluetooth connection to PC to track data, which is horribly slow and often doesn’t work, or has driver problems, etc.
  • When you don’t get it calibrated on schedule, it TURNS OFF?!!!  

When I started this blog, it was so others could learn from my mistakes and not have to suffer them.  Please . . . learn from my mistake, buy the Dexcom G4.  And now my typical closing tag from G.I. Joe is more appropriate than ever . . . . .

 

 

********** Now ya know, and knowing is half the battle.  Go Joe!!! **********

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77 thoughts on “CGM Review: Dexcom G4 vs. Medtronic Guardian

  1. Hi Rich, just wanted to point something out that you mentioned above: “My educator mentioned to me that it’s more accurate the more you calibrate it, so I’ve been doing that.” The DexCom actually perfers WORSE if you calibrate more than 2 times in a 12 hour period. The DexCom technical support has mentioned this to me on more than one occation. You should only be calibrating it at MAX twice per every 12 hours (not including days when you are starting a new sensor). I usually only calibrate twice per day. Once when I wake up and once at dinner. That doesn’t mean don’t test, you can still test as much as you want, just don’t enter the result into the Dex each time.

    • I know that officially you’re only suppose to calibrate twice a day, but I’m actually having great results calibrating more often. I don’t know if I could psychologically handle only testing twice a day?! LOL! Thanks for the advice though. Maybe when I start my next sensor I try the twice a day calibration thing and see if there’s a difference.

  2. Hi Rich! thank you for this review. all my doubts about Dexcom G4 vs Medtronic Guardian have been answered and I’ve made my choice. great review!

    • Glad I was able to help you decide. If you have questions after you get it, ask away. So this means your insurance has kicked in, right? That’s awesome.

  3. Great review, thanks for taking the time to post. I know little about Medtronic, but also hadn’t seen a review from somebody on Dex G4 that wasn’t on Dex7. You brought up some different observations that I hadn’t thought of.

    • Some of those little observations are what I wanted to convey, because you won’t see those in normal reviews by review sites. They come from personal experience. I’m glad it helped.

  4. Thanks for the comparison. I have been struggling to decide if I should stay with MM or switch to Dexcom over the past few weeks. I have used MM’s CGM for the past 4 years or so, but have never been particularly fond of it due to the reasons you mention! But I love that it is integrated as I prefer to “hide” my diabetes if possible and two things to have on me sounds like a lot. You do make a point though about the Dex receiver being separate and easier to look at. I have read a lot of online posts as well and of course the majority favor Dex.

    I have been trying to research the Enlite sensor that MM is supposed to be releasing. I have found mixed things online about whether or not it has even been approved by the FDA yet and whether or not it will only be approved with their new pump that features low glucose suspend (called Veo in the UK). I even called MM today to inquire and they were as vague as ever. So if anyone has more info about Enlite I’d love to hear it!

    • Hi Jackie, and thanks for your comment. I don’t know anything about the Enlite sensor yet, but I know someone who might. My diabetes educator may know about it. She’s really savy about CGM’s because she’s type 1 and she tries them all so she can share with her patients. I’ll ask for you and comment when I know more. You know, I actually wrote an article last week about keeping your diabetes “top secret”. I don’t, as you can see. The whole world knows I’m diabetic. LOL!

  5. Same thing here, I used both Medtronic and Dexcom, and thank God for Dexcom!!! (started out with Seven plus and now I have G4). What a huge difference! I wish all diabetics worldwide had the G4 covered! Some people can only still dream about it. It gives me some much more peace of mind. For example when I wake up in the morning being able to see that it has been steady all night. He’s not even that far behind at all anymore. Yesterday, my Dex was showing 166, I tested and it said 167. Amazing! I ran the Berlin marathon last September and that would’ve never been possible without my Dexcom. He’s next to my wonderful husband, my best buddy!

    • Nice to meet you! Yeah, I’m really loving my Dexcom. If only Dexcom made pumps! They actually announced a partnership recently with a pump manufacturer, so maybe we’ll see Dexcom integrated into a pump soon?

      I like being able to see what it’s been all night too. My Medtronic I never trusted for that. The Dex is letting me fine tune my basals perfectly.

      I don’t even like running down the block, although I love exercise, but just not a runner. Always amazes me to hear diabetic runners stories.

  6. Hey Rich, just putting my 2 cents in.. I have actually not experience anything close to what you describe with the medtronic cgm. I have found mine to be accurate within 20 points at least 95% of the time. It is comfortable and i usually wear it for at least 6 days before changing. I can wait for the enlite to be available this year hopefully. Then bring on the closed loop system! Thanks for your opinion and for sharing your experience with the 2 cgms. Darci

    • Thanks Darci. Glad it works for someone. :) We’ll see how the Enlite does when it’s released. If it’s more accurate, Medtronic could win me back in the hopes of a closed loop system . . . . . unless Dexcom and T-Slim beat them to it. :)

  7. Rich,
    I also have used the Guardian for about 1 year now. I live in Australia and this is where Medtronic is testing the Enlite. It’s as useless as everything you wrote about with the exception of pain. It’s very painless although Often get some bleeding. I just removed a sensor today due to inaccuracy after 2 days.

    I’m in the market for a new pump and Animas have their Vibe pump with the Dexcom G4 built in which I’m going to get after reading your post.
    Many thanks.
    Craig

    • Hi Craig, I’m glad you found my article helpful. You may want to look into the t-slim if it’s available in Austrailia, because if I remember right, they announced a partnership with Dexcom late last year. Good luck in your research!

  8. Just plugged in my first sensor yesterday, and I must say loving it…

  9. Wow… great to read all the reviews, I’m a bit of a CGM Virgin but I was undecided as to which was the bes CGM, I had narrowed it down to two the Medtronic or a Dexcom G4… well at least I have decided now, I’m going for the Dexcom G4!!
    Now the only problem I have is if my Doctor will put me forward for one and if the NHS will pay for me to have one and pay for the cost of the weekly sensors/receivers.
    If they say I can’t have a Dexcom G4 but I can have a Medtronic I think I’d rather not have one! lol I will have to see what the Doctor says when I see him. I will let you know how I get on.
    Kind regards
    Jo

  10. I use both CGMs and I just started on dexcom. What I do (and it works on both) I only calibrate when my blood sugars are in a reasonable range (70-150) if it isn’t I discard the reading, correct and try again in 2 hours.

  11. Can you tell me if the British Dexcom G4 CGM will tell you the results in mmol/L as in the states your blood readings are between 110 & 150 for normal (I think) but in the UK our blood results for normal blood is between 4.0 & 7.0 so I’d obviously like to continue working with those figures, I would probably set a low reading at 3.5 and a high reading at maybe 10.0.

    Thanks Rizzo for the above comments, I didn’t realise that the Medtronic was 6 yrs old so yeah you could say now, that it is definitely dated!

    Cheers Jo

  12. Hi Rich,
    Thanks for getting back to me, it was a great report that you wrote and I have found it to be really helpful.
    I’m phoning my local hospital on Monday to see if I can make an appointment next time I’m home. (I work in Dominican Republic don’t go back home until July) hopefully I can find out if I’ll be eligible for a CGM then,
    I will let you know how I get on.
    Cheers Jo

  13. Indeed, Rich is spot on with his comparison of the two products. I tried the Minimed 21.5 gauge harpoon for a couple of weeks and was not happy with it: being harpooned every 3-4 days, and having the pump, the sensor, and the transmitter taped on me I felt like a Borg (Star Trek).

    I have used the Dexcom 7+ for about two years (same transmitter and reciever) without any issues, and I have found it good for up to 12-14 days. Transmitter broke recently, and the 7+ is being discontinued, so I will be upgrading to the G4 soon.

    The reason I need a CGM is to deal with changing pump basal rates with the seasons, and I have no obvious hypoglycemic symptoms below 40 mg/dL, so CGM is critical : anyone else have issues with their basal rates and time of year? These change are not related to temperature or climate (I have traveled to the tropics without a need to make any pump changes, and flying across time zones requires that the pump clock remains unchanged (three weeks without any change of the clock). This would be a separate discussion, but has anyone else observed these conditions with their pump?

    • Hey Marc, thanks for the comment. I used to fly across time zones with my pump, and after being in the new zone for a day, I found that my blood sugars would get all screwed up if I didn’t change my clock on my pump to match the new time zone. I haven’t had to do that for years though. :)

    • Hi, I need to make [minor] adjustments to my basal rate every few months, though had not noticed weather, which I will try to watch and report back if I see that, which would be interesting!

      I started seeing my insulin needs vary due to levels of stress and feeling supported or less so in my life. Yes, it’s girlie! But I had another girl tell me that after her Mom died she had higher insulin needs, and one doc told me that made sense, so I have considered stress/support important keys to keeping insulin needs lower, and necessary basal adjustments. Since marrying two years ago, I’ve needed to adjust my daily insulin totals, by about 35-40%, having adjusted both basals and my insulin-to-carb ratio just a smidge.

      Regarding Rich’s time zone comment below, I found the same thing, having just moved from the US to Europe. It took my body about 2-3 days to fully adjust to the new time zone, blood-sugar-wise.

      • Hey Jennifre, you know exercising helps with stress right? Do you have a formal exercise program you adhere too? Even if it’s just walking a few times a week?

  14. Hi, I have been using MM for just over two years, accuracy is horrible but I love the cgm concept. I live in Australia and have been using the enlite sensors are relatively painless but not accurate. I really want to hear more about the Symphony tcgm and the laser cgm but those appear to be some distance in the future. In the process of checking out DexG4 now. Hopefully get one after a one sensor trial, if that’s possible.

    Thanks for the info

    • Hello Lloyd! I can’t say enough good things about accuracy for the Dexcom. It’s so accurate I feel totally safe with it, knowing that I don’t have to question it’s readings. You should definitely call your local Dexcom office to get that trial you mentioned. :)

  15. I have a Dexcom G4 and LOVE IT. I tried the MM CGM that goes with my pump and the inaccuracies just didn’t make it worth it. It did help me figure out some trending, but it never alerted me to lows in a timely fashion. The G4 has been simply amazing. Low alerts have almost entirely been spot on and even the high warnings have been surprisingly accurate.

  16. I am seriously considering the switch from Mm to Dexcom G4.
    Although I have vanity to consider because the Dexcom size. But as many other D’s had mentioned accurate readings is the key. Lets see what my insurance says. Thanks for your help.

    • Yeah, ditch the medtronic, and get the dexcom. Life will be so much better. Regarding vanity, my dexcom makes me way more attractive. ;-)

  17. Love my G4. My sensors last 4-5 weeks, easy, no scaring, no issues, other than the sticky (which I tape down regularly). The MORE you calibrate, the better it is. I suspect anyone being told different, is not being told correct information.

    • 4-5 weeks?!!! I’ve ever tried that? The tape is always falling off after 2 weeks for me, even with extra clear medical tape on top of the sensor. Its still accurate for that long eh? Interesting.

  18. In about 5-7 days I will find out if my insurance will cover the G4. I’ve never had a CGM or a pump so this is all new to me. I really hope I can get the G4 because I think it would make life much easier. I am a constant tester. I run out of test strips every month and have to pay out of pocket for extra. Reading this really made me more confident with my decision of pursuing the G4.

    • I’m glad it helped you feel better. :) I just came from an endo appointment and I told my endo that I TRUST my G4, and I feel naked without it now. He told me he wants me to test more with my meter anyway. LOL! There really isn’t a need though. My G4 has never been wrong. EVER. In contrast, my Medtronic Guardian that I used to have was rarely ever right about my blood sugar. :) I truly hope your insurance will cover it for you, because it can make a world of difference. Good luck!

  19. Ok…I just received my worst hba1c level and my Dr. wants me to try the dexcom. My BIGGEST concern is the needle insertion. (Needle phobia…worst case scenario for type 1) How bad is it?
    Also, I have a 7 month old that’s “on” me quite a bit, and I’m concerned with having 2 sites for her to interfere with…thoughts?!
    Thanks for this review! I went to bed tonight with a 107 bs and just woke up with a 274. I’m quite frustrated. So, I immediately googled reviews of the dexcom and your site came up. :)

    • Hi Shauna! The needle is so tiny and thin that I can barely feel it when I insert it. It’s so much better than the needle of the Medtronic. That Medtronic needle is HUGE AND LONG. Plus, the Dexcom doesn’t leave scars after you wear it for 2 weeks. The Medtronic left scars after 3 days. I love my Dexcom (as you might have noticed), and can’t say enough good things about it. I think every diabetic should have one. The Dexcom will help you and your endo discover WHY you went high over night, and allow you to properly adjust your basals to be spot on. My basals are so perfect thanks to the Dex, that I can go for hours with a flat line blood sugar around 80, and feel comfortable with that instead of afraid I’m going to drop suddenly.

      • Well, I just inserted my first sensor!! It took me about 30 minutes to “pump myself up” to actually push the needle in, but I did it. I am waiting for my 2 hour setup to finish and then I can begin! You don’t realize how much your blog helped me to decide to go ahead and get the dexcom to try. My sister is also a type 1 and I am going to go and share it all with her tomorrow. Thank you!
        Btw… I was shocked at how little I felt the needle. I wish my sites were that easy.

  20. This is a great review! I had the navigator and absolutely loved it, and of course now it’s not available. I’ve been hesitant from earlier versions of the dexcom and not being particularly fond of MM overall, but I have heard that every time dexcom made a new version it actually improved by leaps and bounds, so I’ve been considering trying it. Your comments about accuracy are always my biggest worry. Now I just have to hope my endocrinologist is as good as everyone says at convincing the insurance to cover it. Thanks!

    • Hi Jon, from what I understand, the thing that makes insurance cover these CGMs is the doctor has to check a couple of boxes on a form that says you are experiencing hypo unawareness in your sleep. That’s what my doctor has to do or the order won’t go through.

  21. Totally agree with all your comparison. I had the MM CGM for 2 year and the inaccuaracy and alarms in the middle of the night that were 100% off made me want to drop kick the pump. Oh, you said that the sensor communication wasn’t as good like if your were in the other room with MM? Umm…try 4 inches apart? I found that the pump had to be touching the sensor or else I would get weak signal alarms all the time! When I “accidentally” lost my CGM transmitter at the park last week I wasn’t too sad, good riddins! I just wish the Dex G4 was link with a pump so I didn’t have another device in addition to my pump.

    • Yeah Brenda, it would be nice to have the G4 linked with the T-Slim, which they’re working on. I’d give up my Medtronic pump if that happens.

  22. I’m looking into the g4 and your site has been awesome. As I am getting ready to leave for college, In the next week, I am definitely interested in an extra means of “security” to keep from dropping by large margins over night like I often do. I’m also interested because I truly want to get my a1c in a “constantly perfect” range. About 5 years ago I tried the Medtronic, and was absolutely miserable with the stupid thing and until now I’ve been very apprehensive about trying another. The problem I face is that my endo works with Medtronic primarily and they already are hard to work with because i have the Animas Ping. Does the dexcom work we’ll with Animas? And do you have to purchase another meter to link with the CGM? Thank you in advance for your help!

    • Hi Megan,

      The Animas works great with the Dexcom G4 actually. I know a girl who uses both and loves them both. Her name is “Diabetic Danica” on YouTube, Facebook, and Twitter. Look her up and ask her about her experience. She’s also in college, so I’ll bet you’ll make great friends. :) The G4 doesn’t automatically link to the Animas, but it doesn’t have to. My G4 doesn’t link to my Medtronic pump either, and it still the most amazing tool for diabetes that I’ve ever seen. If you want a Dexcom, my advice is to call Dexcom’s sales number directly. Tell them you want the G4 as long as your insurance covers it, and give them your insurance info. They know exactly what to do to get it covered for you. That’s what I did. :) Good luck!

  23. Thanks Rich! I have the Medtronic pump and sensor already but, like you, had big blood sugar differences between my meter and the sensor. My doctor just recommended the dexcom to me but I was a little nervous to buy another one since my medtronic one did not work well and actually, for some reason, is not charging at all now-had it almost 2 years though so I am out of my warranty. I am definitely going to get the dexcom though. I appreciate your honest about both products, its always nice to hear another diabetics opinions on products we all use or may use. I especially like that the dexcom does not run through the pump since I take breaks from wearing the pump to allow my tummy to heal up (my skin seems a bit sensitive to having the pump in for 3 days). Thanks again for your insight!

    • You’re going to love having the Dexcom. I actually feel naked without it now days. I kind of rely on it now. Checking my blood sugars just isn’t enough for me. I need to be able to see the trends of my blood sugar or I feel like I’m not able to make good decisions about corrections or food to eat.

  24. I am a pumper but not a CGM user……. yet. I live in Alberta, Canada and we just got approval in June for insulin pump coverage so am in the market as my Medtronc pump is almost 7 years old. Like others, I am debating between Medtronic VEO with Integrated CGM (and Enlite sensors) and Animas Ping plus Dexcom G4. I have even considered going with Veo but still using Dexcom G4. Despite all pump supplies being free, I will have to pay for all CGM supplies other than the Medtronic receiver if I go for VEO as pump is covered. The Animas Vibe is not available here yet (expecting early 2014) but heard VIBE does NOT have the remote feature which is one of features that may make me change to Animas over Medtronic. From what I have read – similar to this and my one on one with Animas rep, I was leaning heavily towards PING and Dexcom. I actually think I like having separate units as I can check trends without having to dig out pump and like larger screen. However, after meeting today with Medtronic rep, she spoke more about the “low Glucose suspend basal feature” and HUGE improvements with the new Enlite sensor accuracy and lack of harpoon insertion so am back to square one with my decision. The Dexcom will cost me about $1500 in start up costs and each sensor about $75 (usage recommend 7 days) . Medtronic would have no start up cost and Enlite sensors would cost about $55 each. (recommend 6 day usage) Knowing the Dexcom sounds like it can be stretched longer overall cost will eventually become less but we are still talking a lot of cash. The G4 sensor and transmitter are also 2X as large as Enlite. Has anyone else compared Dexcom G4 with Medtronic Enlite sensor?

    • The enlite sensors just became available, so the only person I know who’s tried them is my CDE who was able to get one early. She said the Dexcom G4 is still more accurate than the Enlite. She was not impressed. I can say for certain that I stretch my G4 sensors 10-14 days regularly, WITHOUT WOUNDS. When I had the Medtronic Guardian, after just 3 days, I’d get horrible wounds that have left nasty scars. Regarding the low glucose suspend feature, I don’t see how that’s even helpful at this point. When you go hypo, it’s not because of a basal, it’s because of a bolus you took a long time ago that was to much, so suspending the pump hours later when you’re low isn’t going to help. If you have to go Medtronic due to cost though, I completely understand. Hope that helps. :)

      • I have talked to people using the Enlite and they all say the new sensors are MUCH better than the old ones for accuracy AND wounds. When they are finally approved in the US which I believe I just heard they got approval a few weeks ago, I am sure there will be many more reviews and opinions.
        Lets remember though that most peoples Glucometer is likely off by 10 -15% some even more. Also the sensor is not in the blood, it is in the interstitial fluid so the expectation of it being equal to exact BG level is incorrect. I still hear accuracy of G4 is slightly higher but pain and site condition are equal. Most say it is easier to insert Enlite too. I like the “predictive” alerts of Veo as it doesn’t wait until BG is higher than target but can sense it is moving in wrong direction and therefore you can intervene earlier but again, this is all based on accuracy of sensor. I think for me the size of the sensor/transmitter of G4 seem intimidating. My whole reason for liking the Ping pump is for the remote feature of pump as I have 2 small kids who climb on me a lot and hiding the pump so they don’t kick, stand on, knock off, etc is a huge plus so putting a transmitter that sticks out so much farther concerns me. The low glucose suspend I agree with you somewhat but despite the reason as to the low, if you are asleep or even unconscious, shutting off basal would result in BG getting higher and this could be really beneficial for small kids or elderly. The screen also displays a message too that you are diabetic and to get help when this is invoked with out manual intervention.
        All in all, I was leaning heavily toward Ping plus separate G4 but after recent visit with Medtronic rep I have to admit I am looking for more reasons that apply to my life situation. Medtronic CGM supplies are NOT covered for me, only the receiver as it is part of the approved Veo pump. In the new year, perhaps the Vibe will also be included which has the G4 sensors but that still seems a long way off for me.
        Thanks for much for the conversation as I think it is helpful to touch various aspects since every person has different reasons and expectations for a CGM

  25. I appreciate the info as I’m trying to chose which CGM is best for me. Oct. 26th. I will be going on my 56th year living with T1. Technology has come along way since 1958. Thanks

  26. Thx for saving me from the Medtronic CGM nightmare!
    Going to order the G4.
    Keep on Going with your reviews of new T1 (technology) stuff, appreciate it.

    • Hey Michael, glad I could help. I just read today that Medtronic was issued a warning letter in September for failing to achieve “Good Manufacturing Practices” for their pump reservoirs too.

  27. Thank you for the comparison! My son needs a CGM as he is having huge swings with his BG. Particularly overnight, I’m having to test him 2 and sometimes 3 times a night. Unfortunately we can’t get CGM s on insurance in NZ and there isn’t any help from the government. We are fundraising now and hope to have it by Christmas! They are NZD2500 here, seems expensive compared to other countries.

  28. I was in the clinical trial for Dexcom and was amazed at its CGM’s accuracy. The trial was overnight and involved having two IV’s, one in each arm, from which blood was drawn every five minutes and tested in the lab. The overnight tests were every 30 minutes. The lab technicians had three results from each test; one from the CGM and the two actual ones from each arm (these two IV ones were close but not always the same, even though these were drawn at the same time). The accuracy of the Dexcom CGM was truly remarkable.
    I also once used the Medtronic CGM and was extremely disappointed with its inaccuracies. I have stopped using this.
    My only regret is the Dexcom cost. I have not purchased it yet, because it is too expensive for me to start up and maintain. I continue to use blood tests.
    I agree with your comparison and I saw the actual proof.
    Thanks.

    • I’m sorry to hear that you don’t have a G4 yet Cheri. I hope things work out so that you can get one soon. Thanks for your input about your experience in the trial though!

  29. Hey Rich,
    Thanks for the great info (and thanks everyone else for your comments, too!)

    My daughter plays college volleyball, and with the intensity of the workouts, she continually battles with lows. She uses a Medtronic pump, and we tried their CGM several years ago. In short, it didn’t do the trick for her. Her new doctor referred us to the Dexcom CGM, so I’ve been researching that. Your review and the comments of other readers have been most helpful. We’ve been in touch with the Dexcom rep, and we’ve gotten the ball rolling.

    Sometimes my daughter goes off the pump for a period of time, and an attractive feature of the Dexcom CGM seems to be that it can be used without a pump. That seems pretty versatile!

    Have a great day!

    • Thanks for your comment Patrick. I’m sure your daughter will have a great experience with the Dexcom! Wish you the best.

  30. Any updates between the Dexcom vs the Enlite? Now that is has been out for about 5 months if some people can provide some insight that would be fantastic!

    • I’m afraid I haven’t used the Enlite, and don’t really plan to. Those I know who have used it, say it’s still not as accurate as their Dexcom. Sorry I couldn’t be more help?

  31. I live in canada and have manulife financial for coverage. I really hope they will cover a dexcom for me. I have terrible awareness lately. I was sleeping and thank god my cat woke me up. I was 1.7(30mg/dl) I could not believe I felt nothing. I also do not feel a high bloodsugar until i’m around 25.0(450mg/dl)
    I have been a diabetic since I was 11 and now i’m 23 and I still can’t get this disease under control. This device will save me, I believe it. I’m going into my doctors next week, fingers crossed dexcom will work their magic on manulife financial.

    • Hi Sarah. Hypo unawareness is exactly what helps you convince an insurance company to pay for one of these things. I hope you can get it covered too. Like you, I don’t feel my highs until I’m about 400 mg/dl. Been that way all my life. I hope you get your CGM soon!

  32. Do you know if the Medtronic has been updated to provide more accuracy since the time that this blog was created and now? Being female and liking my clothes, I do like the slim lines of the Medtronic, but hate the cost of 3 day sensors.

    Thanks in advance,
    Cynthia

    • Hi Cynthia. The Medtronic Guardian has been updated to the Enlite model, but it’s still not as accurate as the Dexcom. No one could pay me enough for me to give up my Dexcom. Sometimes I don’t calibrate it for 2 days, and when I do, it’s still with 5 or 10% accuracy. Oh yeah, and right now I’m on day 10 with my current sensor. I plan to stretch it to at least 14 days.

  33. Hi Rich – Not sure if this is still active or not but thought I would give it a try. I am Type 2 and very insulin restive. I have been taking insulin for 20 years, and it is getting worse. My Doctor and I have talked about a pump, but INS says no. I take about 150 units of Lantis and then between 20 – 50 units of Humalog per day. I admit I have very little exercise as I work out of my home, work about 12 hours per day, and life just gets int he way. I do know I need it. I run into issues though when I do have some as I tend to go low.
    This past weekend was the worst. I was going to my Grandson’s 4th birthday party, and knew I would end up eating “Sugar”. So I did not eat any breakfast, mowed the lawn and went to the party. 15 minutes later I was on the floor having an extreem reaction to low blood sugar.
    So here is the question. How does this work? I am trying to get my mind around it. There are alarms that go off to let you know something is about to happen, and these can be programmed in? My doctor and I have never talked about these before so this is all new to me.

    • Ugh. I hate Lantus. I had sooooo many seizures when I was on MDI with Lantus. Going on the pump cured me of seizures. Lantus cannot be tuned to your basal needs like a pump can, which is what leads to you dropping out when you exercise. You take more Lantus than anyone I’ve ever heard of. It scares me how much you take. I can’t give you any “advice” about what to do, but with regard to how a pump works, it allows you to PROGRAM your basal insulin needs for every hour of the day. It also allows you to PROGRAM your bolus carb ratios. For instance, I need more insulin for every carb in the morning, so if I eat 30 carbs for breakfast, I take 2.7u of insulin. If I eat 30 carbs for dinner, I only take 1.9u insulin. This is programmed into my pump. Makes life so much easier. Regarding alarms to let you know when something is about to happen, that’s a “Continuous Glucose Monitor” (CGM) you’re talking about. I have one of those 2, and it’s a life saver for hypo unawareness. I recommend the Dexcom G4. Tell your doctor you absolutely must have it. If he says you don’t need it, fire him. I’m not kidding. Hope that all helps man.

  34. Thanks Rich for the reply. You never know if sites go inactive or not. I found yours while looking up information on the G4. After this past weekend my wife and daughter are now a little nervous about everything. It was fine last Friday and now we are all trying to get a better grip on what is happening. I have started the process on obtaining a meter, and hope to have this soon. A whole new research study will be done by my wife and I about what foods do what to me. Maybe with a little bit more knowledge and some exercise I can cut back a lot on the meds I am taking. Once I do get on the path I will give you an update. Again Thanks!

  35. My new Dexcom G4 Platinum is on the truck to be delivered today. I have had a call with the educators and am looking forward to getting started in the morning. One thing that has changed since I spoke last was cutting the lantus back to 50 units 2 times per day and then using Humalog to keep the numbers in line. I think working with the new G$ is going to help a lot. Let me know that if I am having Asian food to expect this kind of a reaction and if I just have chicken on a salad I will have this slope. Looking forward to all of this!

  36. Rich – I am on my second month now with the Dexcom G4. It has opened my eyes! Now I do have a question for you. You mentioned earlier that you were going 10 – 14 days on the same sensor. How do you do that? My receiver is like clock work and every 7 days it says Replace!

    • LOL! All you do, is go click “start sensor” again. Don’t remove the sensor. Leave it in place. To easy right? I had to ask that same question once. Don’t feel bad. :)

  37. Great thread here Rich – you are sharing key information that a majority of healthcare people that work in diabetes care do not know. Please share your CGM experiences with your physicians and diabetes educators- it is the only way we can help other avoid the frustrating ‘trial and error’.

  38. Thanks for your info comparing the two CGMs. I have worn the Medronic (both Sof-sert and Enlite) since 2008. I notice that I use the monitor 8-10 times a day because I don’t ‘trust’ the CGM. I did a one week trial with the Dexcom G4 and the accuracy was similar, maybe the Dexcom was a bit better. But, I think I am ready for something that isn’t so frustrating- low alarms when not low, weak sensor , lost sensor, cal error notices all the time. Additionally, it usually bombs out around four days. I have been putting a lot of time, energy, and emotional investment into something which is not helping me- isn’t that the point of it. ? Lastly! I just got back from a safari trip to Zimbawbe, Botswana, and Zambia. The CGM drove me crazy after a day, and it was finger pricks for the rest of the trip. It was a relief and my blood sugar was fine. I have read everything I could find comparing the two. If anyone has anymore recent input, I would appreciate it. Thanks.

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