How to Obtain a CGM
So, you are ready to do a CGM experiment. But how do you go about getting one? Here are a couple of way to go about that:
Rapid RX sells the Freestyle Libre device, which is the one I have always used. There are 3 generations out with their pricing as of this writing:
The Original Freestyle Libre - $89.99
The Freestyle Libre 2 - $87.99
The Freestyle Libre 3 - the newest one! The biggest difference is that it is smaller being the size of 2 pennies stacked together. $99.99
When you go this route, you will download the corresponding Freestyle Libre App which will act as your device reader. As long as you scan at least every 8 hours, you will have continuous data from the app. The App is free and therefore, very basic. It will give you some information like average glucose overall and throughout the day (my average glucose was highest around 3pm consistently!), percentage of time in range, and percentage of time out of range. You can also make notes each time to scan and this will keep a log so you will be able to see your exact glucose number at the time of scanning instead of estimating based on where it lands on the graph. I would scan before I ate, I tried to do it every 30 minutes after eating to make sure I was back to my pre-meal level 2 hours after eating, before/during/after exercise, and then whenever I would feel a symptom such as hunger, fatigue, moody, etc!
Pros: Cheapest option
Cons: Lack of capabilities within App
Levels is an online company that provides the FreeStyle Libre for $199 per sensor or you can sign up for a monthly or quarterly plan. Levels also had their own App. You still need the FreeStyle Libre app I wrote about above, but you can link the apps together through LibreLink so that your data is sent to the Levels App. The Levels App is an additional cost at $50 for a month or $199 for a year subscription.
We used this app for Eric to test out how it would work. We realized how limited the Freestyle App was and wanted to have more capabilities like being able to drag your finger along your glucose curve to see all of your numbers as well as using their scoring algorithm to understand how the body responded to stimulus. We also found that you can actually purchase your own CGM through RapidRX for a lesser price and then only pay for the Levels App. This necessitated some tech savvy maneuvering, but we managed and the Levels customer support was super helpful!
Pros: Can purchase CGM separately and link up to App which has more capability than the Freestyle Libre App
Cons: Requires some tech savvy-ness to get everything linked up correctly.
This is my favorite option, especially because a patient just told me she was able to use the Nutrisense App with the FreeStyle Libre Sensor she purchased from RapidRx! If you do go through Nutrisense to get your CGM, you will need to use THIS link to get a 2 week trial which costs $200. You can also sign up for a subscription HERE. Use code FLOWCHIRO for $25 off your first purchase!
I think the Nutrisense App has the most capabilities and is easiest to use, especially because you do not need to link it up with the Freestyle Libre App. This App is also like a MyFitnessPal in that you can log your food and it calculates your calories, protein, fat, and carbohydrates. The App scores your meals using their algorithm which uses four categories – peak, average, adaptability, and variability.
Not only does Nutrisense grade your response to food, but it also had data on exercise as well which really set is apart from Levels.
Lastly, you are assigned to a dietician in the app who is there for support. Your first month of support with the app is free. They will not hold your hand through every detail, but they can help you understand how to use the app and answer your questions. There is 1 on 1 support available as well which is an extra fee but worth it for someone wanting to really dig in!
Pros: Scores are calculated for activities and meals, data is easy to understand and take action, opportunity to work with a coach for the first month while as you get the hang of it.
Cons: it can be a lot of data and lead to overwhelm!
The last tip I have is to get yourself a glucometer and test strips to do finger pricks here and there to compare to what your device is reading. I used an expired CGM one time that would not read above 50mg/dL! The glucometer can confirm if your device is reading accurately!