The new year can be a time to set new goals and learn more about what tools are available to help you manage your T1D! In this newsletter, we are sharing the new features of each continuous glucose monitor (CGM) that is available in Canada. Please keep in mind that depending on your coverage and compatible devices, these may not be available yet. Speak to your diabetes team to learn more.
If you are new to CGMs, they are wearable devices that monitor glucose (sugar) levels every few minutes. You can view your glucose reading with a receiver, phone app and/or on your insulin pump. They also provide an arrow indicating the direction of your glucose to give you an idea of where it is heading. Diabetes Canada guidelines recommend that individuals living with T1D use CGM to improve A1C and lower risk of hypoglycemia, but also to improve quality of life and overall satisfaction with your management.
Let’s review new features and CGM options in Canada:
Abbott Freestyle Libre
The Freestyle Libre 2 is a 14-day wear flash glucose monitor which requires users to scan the sensors with a phone app or reader to view the sensor readings. Recently however, Abbott came out with an app update to allow users to view their sensor readings on the app without scanning the sensor. Scanning is still required when initializing the sensor and if there are any Bluetooth disruptions. If you use the Libre reader, scanning is also still required. Currently, Libre sensors are not compatible with any insulin pump.
The Freestyle Libre 3 is an even smaller sensor – about the size of a penny and it will also come with improved accuracy. It should be available in Canada very soon!
Medtronic Guardian Sensor
Medtronic Guardian 3 is a 7-day sensor that links with the Medtronic insulin pump to provide glucose values to deliver automatic basal and corrective insulin adjustments through the SmartGuard feature. The Guardian 3 sensors still require calibration; however, the much-anticipated Guardian 4 will no longer require calibration! The Guardian 4 sensor will look the same as Guardian 3 and last 7 days. Both Guardian models have a transmitter which needs to be charged weekly and attached to the sensor manually.
Dexcom
Lastly the Dexcom G6 is a 10-day sensor which can be used as a standalone sensor, or it can be linked to the Tandem t: slim insulin pump. The sensor provides the glucose values to the pump to deliver automatic basal adjustments and auto-corrections through Control-IQ. Like the Medtronic Guardian sensor, the G6 has a transmitter that lasts 3 months and must be inserted into the sensor.
Recently, the Dexcom G7 became available in Canada in October 2023. Unlike the G6, the G7 no longer has a separate transmitter. Instead, the transmitter is attached to the sensor upon insertion, and is thrown out with the sensor at the end of 10 days. The Dexcom G7 sensor is much smaller and has a 30-minute warm-up period compared to the 2-hour warm-up period with the G6 – less time wondering where your glucose level is at!
Some noteworthy changes to the alarms have been made to the G7 app as well. The Delay 1st High Alert, which can be particularly helpful for after meals, and you can also choose Quiet Mode up to 6 hours if you want complete silence for a short period. This feature is great for meetings, special events, or if you just need a break!
Speak to your healthcare team for more information on what CGM might work best for you