Tim Street Profile picture
Dec 4, 2022 13 tweets 5 min read Read on X
After two weeks, the #BattleRoyale (an n=1 comparison) for CGM is done. And there's clear water between the three sensors being tested, which were the Dexcom G6 & G7, plus the #Libre3. What follows is a brief summary of the results. /1
First up, the consensus error grids for all three sensors. Firstly, the Dexcom G6:
/2 Dexcom G6 Consensus Error Grid
Second, the Dexcom G7:
/3 Dexcom G7 consensus error grid
Thirdly, the #Libre3:
/4 Libre3 consensus error grid
And finally, all three of them overlaid on top of one another:
/5 Combined Consensus Error gi...
There are differences between the three:
1. The Dexcom G6 has a wider dispersion of points than the other two;
2. The Dexcom G7 looks like it slightly overstates values, while the Libre3 looks like it understates them.
/6
If we take a look at the calculated MARD from fingersticks, we get the following, and you'll notice the two values for G6 and G7. from start and after calibration. Both sensors were quite wildly off during the first 3-4 days.
/7 Table of MARD from Fingerpr...
As a result of multiple readings >20% from fingerpricks, both sensors required calibration, which had a significant impact on the MARDf value, and suggests that it may be worth keeping an eye on the early stages of these two sensors.
/8
If we look at the day-by-day MARDf calculations, this is very clear, although the pattern of a worse start, better middle and worse end sort of shows up.
/9 Day by day mard values for ...
Similarly, the 20/20 calculation (number of values outside 20% when above 100mg/dl/20mg/dl when below) shows that the #Libre3 in this test had far fewer results that were outside the range.
/10 20/20 Table showing that G6...
I have to admit to a little bit of surprise at this. I wasn't expecting the #Libre3 to produce such good results, especially as it is supposedly little different to the #Libre2, which when I tested it last, produced a MARDf of 9.6% via LibreLink and 8.6% via Diabox.
/11
Overall then, the results were not what I was expecting. If you want full commentary and data, please go to Diabettech to read the full report!

diabettech.com/cgm/battle-roy…

/end

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More from @Tims_Pants

Mar 12
A brief update on the #Simplera now that I'm three days into using it.

Whilst I haven't been closely tracking proximity to fingerpricks, I've done the occasional "soft calibration".

The Dexcom ONE that went on at the same time appears to be tracking more closely.

#ATTD2024 Three photos merged showing fingerpricks test at 7mmol/l, Simplera app with white text on black background showing 5.7mmol/l and xDrip from Dexcom ONE showing 7.1mmol/l.
The Simplera is regularly between 0.5mmol and 1.5mmol lower than the Dexcom ONE. At the current readings, it's a bit over 18% lower.

This sensor has been consistently low, but this is n=1.

The sensor is susceptible to compression lows, just like the ONE.

#ATTD2024
Let's talk about the app. The black background with white CGM trace & numerals are likely to be easier to see if you have vision problems, but the constant vertical axis set to the full range of the sensor, with no ability to reduce it, will annoy some.

#ATTD2024
Read 10 tweets
Mar 9
@MDT_Diabetes #Simplera time....

#ATTD2024 Image
Because we're now entering the "Simple Era"....

🤔

#ATTD2024
And side by side with a brand new Dexcom One.

Going to be fun....

#ATTD2024 Image
Read 7 tweets
Mar 6
So, we're off on Roche talking about their new CGM. How close were Diabettech's predictions?

#ATTD2024
via @diabettechdiabettech.com/cgm/a-new-cgm-…
Lots of focus on sleep and Hypos in @drpratikc 's presentation. Wonder why? 🤔
@drpratikc Where might this go next?

#ATTD2024 Image
Read 13 tweets
Aug 1, 2023
Remember this? Well now we've a few measurements to try and figure out how well it really works.

Obviously as an Interstitial Fluid based sensor there are going to be differences compared to blood tests, but what are they? /1
Firstly, it seems that CKMs are prone to the same compression problems as CGMs, which should be no real surprise. You can see this here overnight where readings are lost. /2 24 hour CKM chart showing loss of data overnight when presumably sleeping on sensor.
From a measurement perspective, values are noticeably different with ketones present. The blood tends to be considerably higher than the sensor reads. /3
Blood ketones 1.4, CKM ketones 0.8
Blood ketones 1.5, CKM ketones 0.7
Read 10 tweets
Oct 20, 2022
If you're in #Lomdon and have #T1D, you may be interested in this thread. It outlines the @NHSLdn_CN for Diabetes pan-London plan for #cgm access.

There are three linked documents and some commentary.

#GBDoc

/1
The first document is the written pathway, that outlines the suggested implementation of NG17 across London:

england.nhs.uk/london/wp-cont…

#CGM
#GBDoc
/2
The second document is a list of systems, split into three lists.

List 1 is the "specialist rtCGM" that needs your clinic involvement.

List 2 is FP10 (on prescription) rtCGM.

List 3 is FP10 isCGM (scanned).

england.nhs.uk/london/wp-cont…

#CGM
#GBDoc
/3
Read 10 tweets
Aug 9, 2022
#SixOfTheBest CGMs on the same grid.

Data from an n=1 experiment.

Caveat 1: earlier grid had an error, giving readings incorrect dispersion.

Caveat 2: Libre2 data from an earlier experiment due to device failing early in this test and replacement taking 10 days.

Thread.

/1
Calibration was done according to manufacturer directions:

Dexcom ONE & G6 - never;
Aidex - when I felt it was needed;
Glucomen Day - every 24 hours;
Medtrum Nano - Factory calibration was enabled, but calibration was done when it appeared to drift too much;
Libre2 - never.

/2
Dexcom ONE and Dexcom G6 have almost identical dispersion, as you might expect given the sensor and calibration technology is identical:

/3
Read 12 tweets

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