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Feature	Abbott FreeStyle Navigator®	MiniMed Paradigm® REAL-Time System	MiniMed Guardian® REAL-Time System	DexCom™ SEVEN® PLUS
Photos	Navigator sensor on Monica's arm	MiniMed Paradigm REAL-Time with new, smaller MiniLinkTM Transmitter Photo from Medtronic MiniMed	Guardian REAL-Time System with new, smaller MiniLinkTM Transmitter Photo from Medtronic MiniMed	Photo from DexCom
Availablility	Across the US	Across the US	Across the US	Across the US
FDA approval	March 13, 2008 for adults 18+	Children 7-17 and Adults 18+	Children 7-17 and Adults 18+	March 2006 for adults 18 and older
Communicates with an insulin pump	No	Yes, communicates with the Paradigm 522 and 722 pumps	No	No
Price	Receiver and transmitter: between $960 and $1040 Six sensors (a month's supply): between $360 and $390	$999 CGM starter kit includes MiniLink transmitter and 10 sensors, or Upgrade with the Pathway Program for current in-warranty MiniMed Paradigm insulin pump users. New insulin pump would be handled through insurance coverage and contracts negotiated.	US: $1,339 System + $35/sensor UK: £2750, sensors £235/4 or £565/10	$450 (equipment: receiver, transmitter) $240 (4-pack of sensors that last 7 days each = 28 days)
Insurance Coverage	Insurance covereage is commonplace	Insurance covereage is commonplace	Insurance covereage is commonplace	Insurance covereage is commonplace
Accuracy		Consensus Error Grid: 98.9% A+B MARD (Mean) - 19.7% MARD (Median) - 15.6%	Consensus Error Grid: 98.9% A+B MARD (Mean) - 19.7% MARD (Median) - 15.6%	Clark Error Grid 97% A&B; Median 11.4%; Mean 15.7%
	GluocoWatch Biographer data for comparison: MARD: 17% to 21% Clarke Error Grid A+B: 94% Clarke Error Grid A: 60%
Sensor life	5-day wear indication	FDA approved for 72 hours; users report longer wear times	FDA approved for 72 hours; users report longer wear times	FDA approved for 7 days; users report significantly longer wear times
Length of sensor probe	6 mm	0.5 inches	0.5 inches	13 mm
Gauge of sensor probe	21	23	23	26
Angle of sensor insertion	90 degrees	45 degrees	45 degrees	45 degrees
Insertion Device Available	Each sensor has a disposable inserter	Sen-serter®, manual insertion possible also	Sen-serter®, manual insertion possible also	DexCom SEVEN Applicator
Monitor size	3" x 2.5"	Displays on insulin pump, no separate monitor	3" x 2"	3" x 2.5"
Start-up Initialization Time	10 hours	2 hours	2 hours	2 hours
Calibration	Calibrate at 10, 12, 24 and 72 hours after insertion with no further calibration for the final 2 days of the 5 day wear	First calibration is 2 hours after insertion. Second calibration within next 6 hours after first, then every 12 hours. Will alarm if calibration value not entered.	First calibration is 2 hours after insertion. Second calibration within next 6 hours after first, then every 12 hours. Will alarm if calibration value not entered.	Calibrate every 12 hours, first calibration must have 2 done within 30 minutes of each other. Can calibrate at any glucose rate of change (blood glucose need not be stable).
Transmitter/Sensor or body surface size	2.05" x 1.23" x .43", weight 0.48 oz	Sensor the size of a nickel. Transmitter is 1.4" x 1.1" x 0.3" and attaches to the sensor.	Sensor the size of a nickel. Transmitter is 1.4" x 1.1" x 0.3" and attaches to the sensor.	1.5" x .9" x .4", weight 0.24 oz
Alarms on user-set low and high threshholds	Yes	Yes	Yes	Yes
	Note: In clinical trials, some people never respond to alarms at night regardless of the volume. An alarming device (receiver or pump) that is under covers, a pillow, or underneath a body is almost impossible to hear. If you are considering a continuous glucose sensor, be sure to investigate the device's alarms to see if they will meet your needs.
Displays glucose numbers	Every 1 minute	Every 5 minutes	Every 5 minutes	Every 5 minutes
Displays Directional Trends	Yes, always has directional and rate of change arrow. Can view 2, 4 ,6, 12 or 24 hour glucose graph. Can go back 28 days.	Yes, arrows that display how fast and in what direction, and 3- and 24-hour graphs	Yes, arrows that display how fast and in what direction, and 3, 6, 12 and 24-hour graphs	Yes, always has directional and rate of change arrow. Can display a 1, 3, 6, 12 or 24 hour glucose graph
Displays Rate of Change	Yes, Sideways arrow means dropping at less than 1 mg/dl/ minute. Up or Down arrow means raising/dropping at over 2 mg/dl a minute. 45 degree arrow means dropping/raising between 1 and 2 mg/dl per minute.	Yes, single and double arrows up or down communicates how fast glucose levels are falling or rising	Yes, single and double arrows up or down communicates how fast glucose levels are falling or rising	Yes, single and double arrows up or down communicates how fast glucose levels are falling or rising
Predictive Alarming	Yes, alarm on 10, 20, or 30 minutes before it thinks that you will hit that number based on the current trend. It estimates a future number by using algorithms and vector technology. (One parent has her child's set at 20 minutes notice for highs, and 30 minutes notice for lows.)	No	Yes. Predictive Alerts can be set to warn you 5, 10, 15, 20, 25, or 30 minutes before glucose limits have been reached. Rate of Change Alerts can be set to warn you when glucose levels are changing between 1.1 mg/dL/min to 5 mg/dL/min, in 0.1 increments.	No
Alarm details	Alarms or Vibrates	Alarms (short, medium, or long beep options) or vibrates. Alarms repeat until cleared; can set alarm snooze for low and high glucose level alarms.	Alarms (short, medium, or long beep options) or vibrates. Alarms repeat until cleared; can set alarm snooze for low and high glucose level alarms.	Alarms or Vibrates
Transmitter Memory		Yes, the transmitter stores up to 40 minutes of missed data. Weak signal alarm.	Yes, the transmitter stores up to 40 minutes of missed data. Weak signal alarm.	No - lose transmission, lose data
Transmitter Waterproof	Yes	Yes, IPX8, 8 feet for 30 minutes.	Yes, IPX8, 8 feet for 30 minutes.	Yes
Transmitter Batteries	Watch Battery. Replace every month.	Rechargeable. Non-replaceable. MiniLink Transmitter life about 1 year. $999 CGM Starter Kit includes transmitter and 10 sensors.	Rechargeable. Non-replaceable. MiniLink Transmitter life about 1 year. $999 CGM Starter Kit includes transmitter and 10 sensors.	Non-replaceable. Additional Transmitter is $250.
Monitor Batteries	2 AAA batteries. Replace every 3 months.	No separate monitor required; results displayed on MiniMed Paradigm 522 or 722 insulin pump	1 AAA battery. Monitor alerts when change is needed.	Must recharge the battery every 5 days, charge time 3 hours
Range of Monitor to Transmitter (Factory Stated)	10 feet (reports of significantly greater distance)	6 feet	6 feet	5 feet
Sensor Storage: Refrigerated or Room Temperature	Room Temperature, 6 month life	Storage between 36-80 F without the need for refrigeration. 6 month life	Storage between 36-80 F without the need for refrigeration. 6 month life	Room Temperature, 4 month life
Snooze alarm feature	Yes, 1 hour silence	Yes, customizable for high and low alarms	Yes, customizable for high and low alarms
Built in BG monitor	Built in Freestyle monitor	OneTouch® UltraLink™ meter	No, can use any meter and manually enter	Manually calibrate with any glucose meter
Computer Software	Freestyle CoPilot	Carelink™ Personal Software	Carelink™ Personal Software	DexCom Data Manager® 3 Software
Warranty		6 months on transmitter, 4 years on insulin pump	9 months on transmitter, 1 year on monitor	1 year warranty for receiver and transmitter
Upgrade program		Paradigm Pathway Program	No
Money-back guarantee		30 day return policy for transmitter	30 day return policy for transmitter	10 days if package unopened
Developing Technology	Working on communications with a pump	Closed loop sensor and pump in clinical trials (Yale, elsewhere).		Longterm (about 1 year/outpatient procedure) Implantable Sensor
Official Product Website	FreeStyle Navigator® Continuous Glucose Monitoring System	MiniMed Paradigm® REAL-Time Insulin Pump and Continuous Glucose Monitoring System	The Guardian® REAL-Time Continuous Glucose Monitoring System	DexCom™ SEVEN® PLUS
FDA Approval Links	FreeStyle Navigator® Continuous Glucose Monitoring System - P050020	Paradigm REAL-Time and Guardian REAL-Time Systems P980022/S015	Paradigm REAL-Time and Guardian REAL-Time Systems P980022/S015	STS-7 Continuous Glucose Monitoring System - P050012/S001
Additional web sites and blogs			LifeAfterDx - Guardian Blog	FDA Site for the DexCom STS Photos of DexCom STS in Use My New Friend Dexcom

Selected Scientific Studies About Continuous Glucose Sensors

• Quality of Life Measures in Children and Adults with Type 1 Diabetes: The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Randomized Trial.
• Accuracy of the 5-Day FreeStyle Navigator Continuous Glucose Monitoring System.Free full text available in HTML and PDF formats.
• Subcutaneous glucose sensor values closely parallel blood glucose during insulin-induced hypoglycaemia.
• Impact of Real-Time Continuous Glucose Monitoring on Children and Their Families.
• Use of Continuous Glucose Monitoring in the Detection and Prevention of Hypoglycemia.
• Unrecognised hypoglycaemia in children and adolescents with type 1 diabetes using the continuous glucose monitoring system: Prevalence and contributors. (J Paediatr Child Health. 2006 Dec;42(12):758-63)
• Continuous subcutaneous glucose monitoring in children with type 1 diabetes mellitus: a single-blind, randomized, controlled trial (Pediatr Diabetes. 2006 Jun;7(3):159-64)
• Improvement in Glycemic Excursions With a Transcutaneous, Real-Time Continuous Glucose Sensor (Diabetes Care 29:44-50, 2006)
• Evaluating the Clinical Accuracy of Two Continuous Glucose Sensors Using Continuous Glucose–Error Grid Analysis (Diabetes Care 28:2412-2417, 2005)
• Evaluation of CGMS® During Rapid Blood Glucose Changes in Patients with Type 1 Diabetes (Diabetes Technol Ther. 2006 Apr;8(2):146-55)
• Extended use of a new continuous glucose monitoring system with wireless data transmission in children with type 1 diabetes mellitus (Diabetes Technol Ther. 2006 Apr;8(2):139-45)

For More Information

• Getting Started with Continuous Glucose Monitoring
• FDA Summary of Safety and Effectiveness Data - Guardian RT
• FDA Summary of Safety and Effectiveness Data - GlucoWatch Biographer.
• Clinical use of CSII and continuous glucose sensing – best practice by Dr. Moshe Phillip.
• Sensor Augmented Pumps by Dr. Bruce Buckingham.
• Algorithms for insulin delivery – towards the closed loop by Dr. Dorothee Deiss.
• Clinical perspective for closed loop by Dr. William Tamborlane.
• Steps For Obtaining Case By Case Coverage For Continuous Glucose Monitors (CGMs) from JDRF
• Diabetes Technology & Therapeutics has published a Continuous Glucose Monitoring (CGM) Supplement with free fulltext articles in PDF format including:
  • The Future of Continuous Glucose Monitoring.
  • Continuous Glucose Monitoring: An Overview of Its Development.
  • A Tale of Two Compartments: Interstitial Versus Blood Glucose Monitoring.
  • Continuous Glucose Sensing: Future Technology Developments.
  • Continuous Glucose Monitoring Health Outcomes.
  • Can We Really Close the Loop and How Soon? Accelerating the Availability of an Artificial Pancreas: A Roadmap to Better Diabetes Outcomes.

Thanks to Jennifer White for compiling the original table. Please use our Feedback Form to share updated information or corrections.

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Last Updated: Tuesday October 09, 2012 14:51:34
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