I just finished my report covering an 18 month study of the Medtronic Enlite, and as I switched to the Dexcom G4 a while back, a preliminary comparison is added. When I read the different posts on this forum, then I think that the report might answer many questions. If remarks, questions, please contact me.
The report is being submitted to several large diabetic centra that have requested a copy, Medtronic management, Dexcom management and of course, we cannot leave out Roche, working on getting their new insulin pump/Dexcom sensor through approvals.
Dr. George, I assuming you have a PhD.. great analysis of the Dexcom and Medtronic sensor.. Do you think the possibility of Dexcom or Medtronic taking your advice and allowing users to adjust the values for a sensor.. I forgot what value it was ISG???.. but I see that in my business life certain Hall Chips can have different levels, and if you can do some simple calculating, then you can adjust for the sensistivity level of that particular sensor.. would be nice
Dear Metheniac, a pdf is attached. Jim, please, it's George. There is some difference with your office building. It's static, it doesn't move. The CGM sensors are different. A first point is that they cannot go through a quality control before shipping, as once in contact with a fluid, they are used. My experience is that every Enlite has a completely different response to glucose levels, and then the calibration procedure should be adaptable to the sensor's behavior. The Dexcom is much more stable, and although I do see differences between sensors, they are acceptable in order to return a reliable blood glucose concentration.
I hope that this answers your question.
Well-written, comprehensive report. I haven't fully digested all the info but I agree with your conclusion that the Dex G4 is an accurate system and a good value, too. My experience with increased accuracy on the 2nd week of the G4 is consistent with yours.
Did you write this as a non-affilated review? If you're a free agent, this isn't often seen.
Dear Terry, I'm a 40 year diabetic, no affiliation what soever. I only want to serve the diabetics community and get something out of the billions that are being spend. Lets just hope that Medtronic, Dexcom and Roche respond.
Dear Scott, thank you for the suggestion, but the Insulet-Dexcom deal broke up beginning of this year, and Insulet apparently signed a development agreement with a still unknown private held company.
Hello George, thanks for your wonderful report! It is an outstanding preparation, and much appreciated.
I spend much time on Facebook, where there are thousands of diabetics, many of whom use a CGM. There are many parents there whose T1 children use a CGM. Are you going to post your report on Facebook? If not, may I post it there?
I have used the older Dexcom 7+ sensors, and I had almost no accuracy with them. So much money wasted. I realize that the Dexcom G4 sensor is much better, but now I am using Medicare and CGM's are not covered. It is much too expensive for me. I have been T1 for 68 years, and have no serious diabetes related complications. I test 12-15 times per day, and keep charts that enable me to make appropriate adjustments on my Medtronic Revel pump. My control is good, but would probably be better with a Dexcom G4 sensor.
Hi Richard, Thank you for your interest. I'm not a facebook user, but please, I want my report to reach out to diabetics, and I would appreciate it very much if you could please post it. I have added a new version of the report to this message, as I had overlooked a few typos.
Richard, I forgot to say something important, which you are probably already aware of, but please don't forget that the Medtronic insuline pumps are not compatible with the Dexcom sensors. You'll have to switch to the Animas Vibe.
Thanks George. In the past I used the Dexcom 7+ with the receiver attached to my belt on the left, and my Medtronic pump was on my belt on my right. They did not communicate, of course, but I became accustomed to wearing all the equipment that way.
Hi, As I would like the document to be clear and understandable for everyone, I'm trying to take into account all remarks that I receive, and as such, we come to a new version. The comment was regarding the "Medtronic Paradigm", is it the Revel or the the Veo, which has the latest calibration algorithms. I did not add this detail to the report, as I was told by Medronic that the effect of the pump type is minimum, but just to be clear, I changed the document to Paradigm Veo. As more important remarks may come, I also added the document history.
I have just few questions regarding comparison to the pumps.
Does paradigm offer the same kind of bolus-functions (or menu)? And/or did you get any ideas of which of them you liked more? Where there any differences in the bolus functions?
I have not myself used Paradigm, only Animas. What I do like with animas are the bolus-menus and especially ezCarb and ISF. I also use from time to times ezBG which I found useful. Have not done any measurements of accuracy though but in certain cases even they work with good accuracy.
Animas has also 5 different trend-graphs for CGM. For me the first one (BG,arrow and IOB) and the second one (1 hour graph) have turned out to be very useful when it comes to prediction and follow up on bolus/food. Same thing if I have done a correction by bolus for a high BG, I follow up by arrows, values and IOB. It gives me the idea whether my correction dose might go right or wrong... Did you get any idea of the trend-graphs in the displays when comparing?
What I've seen about the reports Medtronic and Animas are offering I must say that it seems like Medtronic's reports are less userfriendliness than Animas/Diasend. Diasend gives very clearly the picture; BG-trend vs insulin usage. But I am though disappointed that one cannot record eating/exercise etc in Diasend. :)
Kian, As I wrote in the report, there is just no comparison between the user friendlessness of the Paradigm and Animas, and Medtronic is for me the winner. It offers the same bolus options as the Animas, is maybe a little bit more limited in graphs, but to be honest, with the poor accuracy that the Enlite gave me, I have never paid much attention to the graphs.
The reports, are you then talking about the report generated when you upload the pump data? If so, then yes, go for Dexcom. Medtronic has 2 versions of their reporting tool, one for patients, and one for medical specialists. The one for patients is very poor and never allowed me to draw any conclusions. You can download the pump data as a csv text file, but not all data of importance is present. I'm working with Medtronic top management though, and I hope to get some things changed.
You know Kian, after having tried the Minimed online tool, I wrote the whole deal myself, and I get info which none of the existing tools provide. For example: - hypo concentration as a function of the time in the day for a selected period in time, combined with bolus and carbo info
- BG tendency as a function of time in the day, for a selected period in time
- A pretty accurate value for my A1C (have about 2% deviation from lab value)
And as a matter of sensor evaluation:
- % of hypos caught, false alarms, total number of hypos, all for a selected period of time
- resume of the sensor accuracy, MARD and EEE (which is more practical I find) for a selected period in time
I'd be happy to post what I'm using, but it is far from ready for release, and I'm also not sure if other people would be willing to sacrifice 5 minutes a day to enter BGs, pump data, and meals/boluses. Will try to put in some time.
George, you gave me permission to post your study on Facebook. Someone there says that the Enlite has not been available for 18 months. She wants to know how your study has covered that length of time. Do you live in Europe? I think the Enlite was introduced at an earlier date there.
