Four years in the past, my life modified after a coronary heart assault on the age of 33. While a fast coronary angioplasty meant my coronary heart was principally positive, the exams performed on the identical time revealed a much bigger continual downside: I’m a diabetic. Since that analysis — which I anticipated sooner or later in my life given my household historical past of sort 2 diabetes — I’ve labored laborious to vary my life and food plan radically, and a steady glucose monitor (CGM) has been instrumental in reaching that.
Unless you’re an advocate for well being tech or a diabetic like me, you might not have heard of Dexcom or Abbott, the 2 corporations that kind an oligopoly within the CGM house. Yet, you’re in all probability right here since you’ve seen or heard one thing in regards to the Dexcom Stelo or Abbott Lingo. These mark the primary time a CGM has been extensively out there over-the-counter and not using a prescription, however like all issues that sound too good to be true, certainly there’s a catch?
After spending two weeks with the Dexcom Stelo, it’s an unbelievable product for everybody fascinated with diabetes. However, earlier than you rush off to purchase one, it’s value noting that it’s not probably the most ideally positioned in case you’re a diabetic, particularly in case you’ve used a earlier Dexcom product. Here’s why.
Why an excellent CGM is so invaluable to diabetics
I hear you ask, why would you be fascinated with a CGM? Can’t you simply test your blood sugar by way of a fingerstick measure? The reply is sure, you’ll be able to, however a CGM solves the most important downside with fingersticks: context.
A finger stick studying provides you a single snapshot at that precise second in time, but it surely doesn’t inform you in case your sugar is rising or falling. Crucially, a test very first thing within the morning earlier than consuming — which is really useful by each physician — additionally doesn’t present any info on the day earlier than.
I observed throughout my first few months of finger-sticking that this lack of context meant I used to be usually adjusting meals or medicine in line with a quantity that was old-fashioned inside quarter-hour. My first six months as a diabetic solely led to a slight drop in my common blood sugar regardless of following all of the suggestions, main me to discover alternative routes to trace and measure my blood sugar.
A short have a look at my CGM historical past
To perceive the context round my Dexcom Stelo expertise, it’s value understanding my general historical past with CGMs. For a few years, U.S. well being care suppliers wouldn’t cowl Dexcom CGMs — principally as a result of they required two elements and had been far dearer — so like most individuals, my first CGM expertise was the Freestyle Libre.
First, there was the Freestyle Libre 14-day, then the Libre 2, and at last, the Libre 3. At the identical time, Dexcom was constructing its personal totally built-in CGM answer, and the ultimate end result was a game-changer: the Dexcom G7 (extra on this later).
Having used a complete of 5 totally different CGMs, I’ve observed the important thing info that issues to long-term diabetes care, and whereas the Dexcom Stelo — and Abbott Lingo — provide most of this info, there are little snippets which are lacking. It seems these snippets matter rather more than you would possibly suppose, however solely to folks like me. For most individuals, these over-the-counter CGMs will change their lives, very similar to CGMs have finished so for me.
Why the Dexcom Stelo is nice for most individuals
Before we get into the little issues I’m lacking, it’s value mentioning why the Dexcom Stelo shall be incredible for most individuals. Its core premise is to supply a lot of the Dexcom G7 options at a lower cost with no need a prescription. It makes use of the identical {hardware} and applicator — fairly actually from my expertise utilizing each — differentiated solely barely by software program, packaging, and supplies. Ostensibly, it’s the perfect of the Dexcom G7 at a significantly lower cost, and crucially, with out the necessity for docs or insurance coverage corporations to be concerned.
The latter level is vital: within the U.S., U.Okay., and plenty of different nations, it may be powerful to get a CGM below your native well being plan until you will have a medical want for it. The Stelo resolves this downside, and as somebody who travels loads, we must always finally be capable of stroll into pharmacies all over the world and purchase an extra sensor with no issues. At least, I hope.
The Stelo app is just about an identical to the G7 app. It offers essential context on present glucose numbers — synced straight from the sensor by way of Bluetooth each X minutes — in addition to whether or not it’s trending up or down, previous historic knowledge, and helpful insights. The latter, particularly, units it aside from the Dexcom G7 in each good and dangerous methods.
The key variations between the Dexcom G7 and Dexcom Stelo
I used to be very excited to get caught into the Dexcom Stelo, as adopting that over the G7 would save me 1000’s of {dollars} yearly. It seems, nonetheless, that there are key variations that make the Dexcom Stelo excellent for most individuals however make the Dexcom G7 higher for my particular wants.
Like most cases, knowledge is simply nearly as good as what you do with it. Both CGMs present sufficient contextual knowledge to be helpful, however when you dig into it, you understand the important thing distinction: the Dexcom Stelo is a extra user-friendly model of the Dexcom G7. This means a number of helpful insights on diet and the way glucose works, but it surely additionally means most of the options I depend on don’t work both.
Four years after my analysis, my blood sugar nonetheless spikes closely after meals. I’ve change into accustomed to mentally maintaining a tally of the ultimate excessive level, however whereas the G7 permits me to trace this to 400 mg/dl or greater, the Dexcom Stelo is restricted to 250 mg/dl. Above this quantity, it could actually’t present any extra info. This doesn’t matter to most individuals — and conforms to standard knowledge about how a lot your blood sugar ought to spike two to a few hours after a meal — but it surely doesn’t work for my distinctive circumstances.
Similarly, the Dexcom Stelo doesn’t will let you customise your particular goal ranges and as an alternative asks you to select from two, each of which conform to worldwide knowledge: 70-180mg/dl for diabetics or 70-140mg/dl for prediabetics or these with out diabetes. This suits most individuals’s wants — and goal ranges are one of the simplest ways to trace blood sugar over time — however the capability to additional customise the peak of the graph and see numbers above this arbitrary quantity makes the Dexcom G7 higher at managing diabetes for these with extra unstable sugar readings.
There are additionally no pressing low or pressing high-sugar alerts, the previous being tremendous necessary to me as my physique usually goes tremendous low in a single day when it’s most harmful to take action. The Stelo alerts additionally don’t present the numbers, prompting you to open the app to know. The Dexcom Stelo additionally lacks the house display widget for iOS and the flexibility to sync your Apple Watch on to your CGM sensor.
The Dexcom Stelo is good for all however the nerdiest diabetics
The key motive to purchase the Dexcom Stelo is not only worth, though this performs an enormous half. The Stelo provides wonderful info designed that will help you be taught extra about diabetes, blood sugar, and the best way to management it.
In some ways, the Stelo provides the right entry level into diabetes and glucose monitoring, which is predicted to explode significantly over the approaching years. Unlike Abbott Lingo, it additionally retains the identical terminology used throughout all of its sensors and options, making it far simpler to make the bounce between the totally different merchandise.
Dexcom lately introduced an funding and partnership with Oura, and beginning subsequent 12 months, the Oura Ring 4 will sync your blood-sugar knowledge to assist present a holistic overview of your total well being. This is among the largest and most enjoyable developments in glucose monitoring for years. Whether you employ the Dexcom Stelo or go for the extra superior Dexcom G7, there’s by no means been a greater time to get into glucose monitoring. When you do, I extremely suggest Dexcom.
