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Most continuous glucose monitoring (CGM) systems require you to still do fingerstick blood testing on a daily basis in order to calibrate them. But that defeats the purpose of why people want CGM systems in the first place, which is to minimize the number of shots you have to endure. But one CGM system that doesn't require fingerstick calibration is the Freestyle Libre Pro.

The Freestyle Libre Pro was approved by the FDA for use by doctors to give to their patients in September 2016. But unfortunately, it hasn't yet been approved for consumer use by the FDA yet. So my question is, are there any other CGM systems which don't require fingerstick calibration?

And are any of them FDA approved for consumer use?

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I think its time to update this question: now there are available a couple of options that do not require the calibrations of the CGM through the fingerstick.

  • The Dexcom G6, which it could be seen as the first "real" CGM that does not require calibrations. Dexcom states:

    As a factory-calibrated, real-time CGM system with exceptional accuracy, the Dexcom G6® will be transformative for people with diabetes, who will no longer be required to prick their fingers for diabetes management

  • The Freestyle Libre, which since late 2017 has been officially approved by FDA.
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I am aware of only three available CGMs in the US today: The Dexcom G4, the Dexcom G5, and the Medtronic Enlite. There used to be one more, the Abbott Navigator, but it was withdrawn from the US market about 4 years ago.

The Medtronic Enlite had a very rough start, with many complaints and worries about accuracy, but seems to have stabilized. The Dexcom G4 and G5 are strong and mature systems.

The Enlite requires 3-4 calibrations per day. It can be a bit picky about how to redo a missed calibration. There are no communities of users that I know of where you can find great calibration recipes for the Enlite.

The Dexcom G4 and G5 require 2-3 calibrations per day. Users have come up with fairly sophisticated routines to optimize them and ensure that the actual reading is close to reality -- a good forum to discuss that may be https://forum.FUDiabetes.org . I can provide no proof for that, but I consider that almost all the calibration recipes you get there for the G4 and G5 would work for the Enlite as well - very little is specific to the Dexcom CGMs.

The Freestyle Libre Pro is not a consumer CGM. Its function is really different: your doctor gives you the sensor, you wear it for 2 weeks without knowing what it measures, then your doctor downloads the results. It is a diagnostic tool, not a diabetes management tool.

However, there is another Freestyle available that you may be aware of, the Freestyle Libre. The Freestyle Libre is actually a pretty cool idea, although not quite a consumer CGM either. Essentially, it is a sensor without a transmitter -- and, like the Freestyle Libre Pro, it dos not need calibration either! You need to manually pass a reader over it to read the result. So you can get a result anytime you want, but you do not get a track that you can view like you do with a Dexcom. The difference may seem small but is actually a giant one when trying to manage blood glucose. Nonetheless, the Freestyle Libre, with its much lower cost, is a great tool that fulfills a different need.

Unfortunately, the Freestyle Libre is not available in the US yet.

So, in the end -- there is no CGM that I know of which is present in the US but does not require calibration. If I had to pick:

  • if I had good insurance I would pick a G5
  • if I did not have good insurance I would pick a G4 (it is possible to pay a lot less for transmitters per year with the G4 -- but that is another story).

Good luck!

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    Here's the thing: I have relatives that regularly go to India, so I have obtained a Freestyle Libre Pro with both parts, i.e. both what the patient would use and what the doctor would use. So I'm effectively using the Freestyle Libre Pro as a Freestyle Libre. This is working well for me, and I intend to use it indefinitely unless I find another solution that doesn't require fingerstick calibration. – Keshav Srinivasan Jun 6 '17 at 12:37
  • Nice! I am curious. Why is fingerstick calibration such an obstacle for you? The issue with any CGM is that, for management purposes, it is 12-15 minutes behind, since it operates on interstitial liquid -- so manual fingersticks are often really useful in any case. Are you using the FLP just for data analysis post facto, or for management purposes? – WestOfPecos Jun 6 '17 at 16:11
  • Because I just hate getting shots. So I prefer the Freestyle Libre Pro, which only requires an injection once every two weeks, to doing daily fingerpricks. And yeah, I don't use blood sugar testing to do real-time management of my blood sugar levels. I just check the Freestyle Libre Pro once every 24 hours or so to see a graph of what my blood sugar has been like. – Keshav Srinivasan Jun 6 '17 at 16:24
  • I get it. You don't need insulin, then. I had misunderstood your original use case. – WestOfPecos Jun 6 '17 at 16:36
  • I do take insulin. I take Triceba once a day. I have type 2 diabetes. I don't need to take short-acting insulin to combat real-time surges in blood sugar, so I don't need up to the minute blood sugar readings. – Keshav Srinivasan Jun 6 '17 at 16:48

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