Dexcom Vs Libre

Libre by Abbott was launched at the end of September and there are a lot of questions on how this would compare to Dexcom.  I outlined 3 key differences between Libre and Dexcom.

These are:
1.  Technology
2.  Diabetes market
3.  Business structure 

In summary, (spoiler alert) the short term winner is Libre, but Dexcom wins long term, unless Abbott makes some specific changes.

First, there is the matter of technology. Libre uses NFC technology.  This is near field communication (NFC) and works only when two devices are close by. This means that the sensor that’s on the skin and the receiver that actually shows the glucose numbers have to be close to each other in order to see the sugars. You have to wave the receiver over your sensor each time you want to view your sugars.

Dexcom uses bluetooth technology. This means that the two devices are always connected.  This is analogous to your bluetooth headphones, speakers, or your phone to your car.  Your phone does not have to be near to change the song on the bluetooth speaker across the room.

Dexcom’s advantage is the ability to have alerts for sugars as they happen. Your phone will alert you if your sugars are too high or low. This is very crucial for patients on insulin.  You need to know when your sugars increase or decrease right away instead of hours later.  Because of the NFC technology, the receiver will not know when the sugars are critically high or low.

We live in a world of instant gratification.  We want information and we want it now. Bluetooth gives us that.

Technology winner: Dexcom

Second, the diabetes market is the market of patients that each sensor will be appropriate for.  Dexcom has been ideal for patients that are on insulin, with or without the pump.  However, Libre is for all patients with diabetes.  Maybe not that ideal for those taking insulin because of the alert feature, but the market share for Libre is much larger.  About 70% of the 30 million patients, or about 20 million patients do not take insulin.  This is the potential reach for Libre and it is double that of patients taking insulin or insulin and oral medications.

Libre will change the way we manage the patients not taking insulin.  Libre will be the one responsible for destroying the glucometer market.  Why check your fingers when you can use the Libre?

Also, currently, the guidelines do not support to measure sugars all the time in the patient that is not on insulin unless risk of high or low sugars.  You have to consider what long term implications Libre will have on these guidelines.  Will they change and adapt to more sugars.  Can we do more because we have more data?  We shall see.

Diabetes Market winner: Libre

Third is business structure.  I like to call it culture.  The culture of Dexcom has always been to share, share and share.  They have opened up their marketing, hardware and software to integrate with other insulin pump companies, software companies and are always looking to share their data.

The contrast is Medtronic and their long inability to share with other insulin pump or software companies.  Dexcom can share because they only make a CGM and do not make a pump.  Looking at Libre, they are made by Abbott, a very large pharma company which is usually very slow to adopt and partner with others, especially smaller companies.

Going forward, the future will be created by the smaller companies and their ability to create partnerships.  These partnerships will lead to true innovation and the future we are looking for.

Business structure and long term winner: Dexcom

Summary

Libre will change the way we manage patients that are not taking insulin and it will totally destroy the glucometer market.  This is short term.  In order for Libre to come out ahead, Abbott needs to start sharing their data with everyone, get an iphone app (which i hear is coming soon)

Long term, Dexcom will create a system that is similar to Libre.  They will need to lower cost and make it easier for patients to use and get rid of the calibration that is currently required.  All of which they are working on.  This will allow them to compete in the same diabetic market space as Libre.  But the bluetooth technology and the ability to share and look for partnerships will make Dexcom the clean winner long term.

Photo shown is the Dexcom G6, this is dexcom working their way into making things smaller.  Along with this, they will go away from the need to calibrate.  Stay tuned, diabetes just got more exciting.  (as if it wasn’t crazy before)

What are your thoughts?
Do you think all of this will change the way we manage patients?
Do you think this will make your life easier as a patient?

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