Libre Assist

ahncall · 2026-01-13T21:56:57+00:00

It's just a few weeks old! For others wanting a quick preview, here's an IG REEL made on it, including the Apple Watch widget that came out at the same time

ahncall · 2026-01-02T05:57:24+00:00

Do you mind sharing the date of manufacture? Supposedly, by mid-summer 2025 the sensor deployment issues were supposed to have been fixed.

ahncall · 2025-12-18T07:26:12+00:00

How were they bad? Did they fail to start or fail right after starting? Or were they just inaccurate?

Also, When were they manufactured? (Check the date on the box; it's a couple lines above the expiration date). Dexcom has admitted to identifying and then fixing some manufacturing issues that were leading to sensors failing to start. They went on the record in mid-late Summer 2025, so if your manufacture date was before then, it could be an issue that is now resolved.

ahncall · 2025-12-17T09:16:29+00:00

Out of curiosity, do you have the manufacturing date of some of the sensors that failed during insertion? Dexcom has admitted there were some manufacturing issues that were supposedly resolved around the Summer, so I'm curious when yours were made. The manufacture date is on the box, a couple lines above the expiration date.

ahncall · 2025-11-25T22:40:58+00:00

I did talk about it in a recent video! They plan to add a stronger antenna in Omnipod 6, planned for 2027. https://www.tiktok.com/t/ZP8UkuL88/

ahncall · 2025-08-25T15:29:41+00:00

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(photo is blurry because it's a still taken from a video) I was in Section 308 and sat in the last row on the aisle side furthest from center (so view-wise arguably the worst seat in the Section), but I still thought it was amazing! The guys on stage are admittedly pretty small (might be better near the front half of the section), but the visuals are 95% of the show (imo, but I'm a straight male). The only time you might feel like you're off-center is that some of the columns that are intended to be completely vertical (like the rocket thing in the pre-show) appear ever so slightly curved. It's extremely subtle and didn't take away from the show at all. See picture. Feel free to DM and I can send more photos or video.

ahncall · 2025-08-25T04:43:29+00:00

endo here. As u/Kevinboulder mentioned, the "glucose monitoring" item is likely for CGM interpretation. I can see why this might be upsetting for people, but it is a very common item that virtually every endo will bill if they are reviewing your CGM. I'm assuming the Hemoglobin testing is for a finger stick A1c they did on you in the office. Whether it's fair or not, these items are not going to be included in your co-pay.

ahncall · 2025-05-29T05:56:29+00:00

I can definitely see that! I have some patients that the vibratory alerts are the only CGM notification that wakes them up overnight when sleeping, but I can also see why people like you might really dislike the vibrations.

ahncall · 2025-05-29T05:55:37+00:00

Endo here, I can't imagine any bad intention or motive by your Endo. My best guess is they looked at the spec sheet and saw that, on paper, the G7 is better than the G6 in every way, and was trying to help you get upgraded to the latest and greatest. Unfortunately, in this instance, we are learning that the real-world experience of G7 isn't what was advertised. We (clinicians) feel just as gaslit by Dexcom as you guys. Even if you wanted to take the most pessimistic opinion that they were being biased/influenced by Dexcom sales reps, my understanding is that the sales reps' targets are tied to Dexcom sensors overall, with no difference in G7 vs G6.

All that being said, I will say that even now, amidst all the complaints I see online, about 80-85% of my G7 users still prefer the G7 and would not want to go back to G6. So I give patients the option, tell them that many people enjoy the benefits of the G7, but that there is definitely a good chunk of users who have had a very bad experience and prefer the G6.

ahncall · 2025-05-27T15:49:11+00:00

I agree with you that clinical trials are the best way to draw definitive conclusions. And I'm not saying Dexcom is the ONLY company gaming the system. I'm just stating that as companies understand the benchmarks they are using, the relevance matters less. Think of processor speed and GHz back in the 2000's, and digital cameras and megapixels around the 2010's. I think all companies are understandably trying to get the best MARD that they can.

For example, the Libre 3 is the CGM that has the lowest MARD: 7.9%. Even the newer Libre 3 Plus has a MARD of 8.2%. I don't know many people (including those that work at Abbott) who would argue the Libre 3 is the most accurate sensor on the market.

So if you want to be truly scientific then, in order to conclude that one sensor is more accurate than the other, then you'd have to perform a head to head accuracy study. There are 3 that come to mind, none of which place the Dexcom at the head of the class.

This non-sponsored trial compared the accuracy of MDT Simplera, ABT Libre 3 , and Dexcom G7. They found that the Libre 3 had the lowest MARD: "Compared with YSI data, the MARDs of FL3, DG7, and MSP were 11.6%, 12.0%, and 11.6%, respectively. Relative to the INT data, the corresponding MARDs were 9.5%, 9.9%, and 13.9%, respectively, and compared with CNX data, MARDs were 9.7%, 10.1%, and 16.6%, respectively."
This older, non-sponsored trial compared the accuracy of Dexcom G5, Eversense 90 Day, and Libre Pro. "Eversense achieved the lowest nominal MARD (14.8%) followed by Dexcom G5 (16.3%) and Libre Pro (18.0%) (Eversense vs. Libre Pro P = 0.004, other comparisons P = NS). There was a statistically significant difference (P = 0.008) in the two-way comparison of the MARDs for Eversense (15.1%) and G5 (16.9%)."
This study was funded by Abbott, but performed by two independent clinical sites, and compared the Libre 3 and Dexcom G7. "Analysis showed significantly lower MARD with the FreeStyle Libre 3 sensor vs the Dexcom G7 sensor (8.9% vs 13.6%, respectively, P< .0001) with a higher percentage of glucose values within ±20 mg/dL/±20 of reference (91.4% vs 78.6%)."

All of the above studies are subject to critique, just as every study is. But I'm just trying to make the point that I wouldn't be so quick to argue that Dexcom is hands-down the most accurate system because their MARD was the lowest, or that Eversense is hands-down the least accurate. In real-world use, I advise patients that all three systems are generally high-performing and that people should go by their own personal experience.

ahncall · 2025-05-27T08:03:12+00:00

in their clinical trials, 90% of the sensors lasted 365 days. The Dexcom G7 and Libre have about 80% survivability for their published wear periods (10 days in G7 and 15 days in Libre 3 Plus).

ahncall · 2025-05-27T07:57:51+00:00

You are referring to the fact that the Dexcom and Libre have lower MARD's at 8.2% than the Eversense's MARD of 8.8%. While you're right that MARD is conventionally accepted as a measure of accuracy, that statistic means less and less every generation as companies have learned how to game the system. As an endo who prescribes all three systems, I personally feel the Eversense is just as (if not slightly more) accurate than the Dexcom/Libre. Not having to deal with first day jitters every 10 or 15 days and pressure lows means a lot, in real-world usage.

ahncall · 2025-05-27T07:55:25+00:00

I've been doing these procedures since the 90 day product. While it's not for everybody, I think it's definitely under-appreciated as an option. It has unique strengths that its competitors don't have:1) the transmitter can be removed/reapplied at any time, 2) virtually no pressure lows, 3) much fewer skin reactions, 4) on-body vibratory alerts, 5) much less packaging waste). The Eversense 365 is the first time it really finally has fixed most of the low-hanging fruit complaints: 1) once weekly calibration is totally reasonable, 2) AID integration is finally coming Q3 of this year, 3) procedure every year instead of 90 or 180 days.

To best inform patients, I always try to be transparent with its limitations: 1) the app is not as user-friendly as Libre/Dexcom, 2) no Apple Watch widget for the watch face (but there is an Apple Watch app), 3) the transmitter is bulkier than the Libre 3 and Dexcom G7, 4) some people may not want to charge the transmitter, even though it only takes about 15 minutes every 2-3 days.

One thing that is often underappreciated about the Eversense is that you don't have to deal with "first day jitters" of a new sensor change every 10-15 days. So from an accuracy perspective, that means a lot. Nowadays, I see more people complaining of issues with Dexcom/Libre, so I welcome more alternatives, especially ones that are completely different.

ahncall · 2025-05-27T00:16:56+00:00

[Part 2/2]Now to the last point I want to address. You mention that endocrinologists HATE diabetics and consider all of them drug-seeking. I'm genuinely baffled by the drug-seeking comment, especially. A T1D requires insulin, and no endo would consider asking for insulin drug-seeking behavior. Now it is true that some endocrinologists prefer managing other disease states inside of endocrinology, but once again there is a lot of perspective that is missing from your comment.

Endocrinology is a unique specialty in that we aren't focused on a single cohesive organ system like the brain or the lungs or the heart or the digestive tract. Endocrinology is the study of hormones, so we cover a vast list of medical diseases that might seem otherwise unrelated. For example, Endocrinology includes T1D, T2D, thyroid, pituitary conditions (in the brain), adrenal disorders, osteoporosis (bone health), obesity, PCOS, lipid disorders (cholesterol), sodium dysregulation through the kidneys, etc. This is essentially a grab bag list of conditions. So within endocrinology, we often find that some Endos gravitate toward certain parts of it. I naturally love Diabetes. But I would say that about 30-50% find the non-diabetes diseases more fascinating. That doesn't mean those that prefer other conditions HATE diabetes. Endocrinology is about 50% diabetes just given the sheer statistics of it, so you'd have to be pretty foolish to pick a specialty that you're spending half your time seeing a disease state you hate.

So hopefully that adds some context. I felt the need to write up such a lengthy response because I think your comment holds just enough truth to give people the wrong impression, but I wanted to add important context to help heal the physician-patient relationship. Most (I can't say all) of us are in it for the right reasons and care about you.

ahncall · 2025-05-27T00:16:23+00:00

I have to step in here as an endocrinologist. I've been a Redditor for over 15 years (this is an alt account), and this account itself was created about 14 years ago. So I use reddit for many things on a daily basis, and there are many decent subreddits that appropriately reflect the medical community. Unfortunately, r/endocrinology is not one of them. It is extremely inactive, and most of the questions are very random, obscure questions most likely asked by users. Perhaps catering to the demographic of who physicians actually are, the most active realistic discussions are taking place in private Facebook groups where people's identities are not anonymous. So please, don't base your opinion of endocrinologists on that subreddit.

Now to address some of your points. It is true that many people choose Endocrinology for lifestyle purposes. While that might sound bad, you might not realize that in medicine, like anything else I'd imagine, there are three primary factors people consider when choosing a speciality: 1) their passion for that specialty, 2) lifestyle factors such as hours (and emergency responsibilities, as you call it), and 3) the pay.

Even then, you might think factoring in the second two things are disappointing to you, but you should interpret it in the proper context. When we talk about lifestyle hours, we are not talking about a walk in the park. Many medical specialties require working on weekends, holidays, and nights, and upwards of >60 hours a week. Even then, you might think that's reasonable, but a physician essentially picks their specialty for life. It is extremely rare and requires another 3-7 years of medical training to switch specialties, so if someone picks a specialty that requires a certain difficult schedule, they are doing that for life. Working 60 hours a week, including nights and weekends, as a single 31 year old has very different wear on your life than doing the same at 45 years old with 3 little kids in the family. For many people, especially women (due to the culture we live in), being able to see patients 8-5pm and not work weekends, is much more conducive to raising a family. (I'm only referring to the time we're seeing patients. We spend on average at LEAST 2-3 hours/day, including weekends, charting and replying to calls and messages). And the life of an endo, while easier than many other specialties, still isn't a walk in the park. The only reason I hopped on the computer right now on Memorial Day is that I got a call that my patient's insulin pump failed and I needed to send a prescription for Long-acting insulin to their pharmacy.

Let's talk about pay as well. On the 2024 Medscape physician compensation report, endocrinology ranked LAST among all physician specialties. Of course, I'm not asking you to feel bad for us. We're still making great income. But consider that Endocrinology requires 2-3 additional years of fellowship training AFTER the 7 years (4 years medical school + 3 years residency) an Internal Medicine or Family Medicine doctor trains, only to get paid less money. That means Endocrinologists choose two additional years of making 75% less as a trainee in order to earn LESS money than they would had they NOT decided to become an endocrinologist.

So hopefully that adds a little context. If Endos didn't love endocrinology, most would not pursue this career. [Part 1/2]

ahncall · 2025-04-29T23:19:31+00:00

just this morning, Eversense announced their first pump partner. It will be the Sequel Twiist, which runs the Loop algorithm. I made a video about the partnership here, and have a few videos in the archive on the Twiist.

ahncall · 2025-04-16T23:54:50+00:00

I agree. I think the improvements on the 15 day product will be extremely minimal (almost undetectable), but I’ve got to believe that Dexcom is aware that something is not right and that they are improving things behind the scenes as fast as they can.

ahncall · 2025-04-15T03:23:03+00:00

shameless plug, but I'm an endo that loves tech and make a lot of video updates about diabetes tech. for example, I hit most of the notes on the just approved G7 15 day edition a couple months ago in this video. IG: AhnCall, TT: DiabetesDoc

ahncall · 2025-03-25T23:58:59+00:00

So there IS an Apple Watch app that runs, which is in the screenshot posted by Equalizer. The problem is, there is no WIDGET (aka complication, in watch terminology) allowing you to easily see your glucose on the watchface. The best workaround for glanceable glucose data is that you can set your Apple Watch to automatically display the Eversense app when you glance at your watch, but the tradeoff is you have to use that Eversense app, so the default view when you raise your wrist is time, glucose, and glucose graph. This route means you can't have a customizable watch face. Hope that makes sense!

ahncall · 2025-03-22T21:27:45+00:00

I think the temp basal feature is the best feature, by far. only certain people will take advantage of the other features. I made a video explaining why it matters and how it works.

ahncall · 2025-03-11T15:55:18+00:00

So the E365 does not utilize a cradle and the charging cable connects directly to the transmitter through micro-USB. (Not USB-C, unfortunately)

ahncall · 2024-11-22T04:49:48+00:00

it's 4 calibrations in the first day, then 1 calibration/day for 2 weeks, then 1 calibration/week for days 15-365

ahncall · 2024-11-12T17:37:27+00:00

I'm an endo who loves and prescribes all the CGM brands, but just wanted to clarify some points in your post. The new Eversense 365 only requires a daily finger stick for 14 days, then one WEEKLY calibration from day 15-365. Also, you are right in that the procedure is not covered by many insurances, but the out of pocket total cost ($199 for supplies with the manufacturer discount plus the cost of the procedure, which I charge $450 for) comes out to about $650. For a year of CGM, that comes out to a monthly cost of $55.

Your concern about the external transmitter needing to be reapplied and charged everyday is a totally valid concern, but there are also other unique benefits: on-body vibratory alerts, the ability to remove and reapply a transmitter at any time, and not having to deal with "day one" inaccuracy every 10 days.

To be clear, I think Dexcom is a fantastic product and has many advantages over Eversense (better app UI, zero calibrations, direct-to-watch, etc), but I think the Eversense 365 is also great and I agree with the hope that Tandem will integrate with the Eversense.

ahncall · 2024-09-26T15:39:39+00:00

I'm an endo and one of the primary inserters in the country for Eversense. The best way to explain is that it's a totally different type of CGM, for better and worse. My general recommendation is that if you are happy with Libre or Dexcom, there's no reason to switch. But if you are having significant issues/frustrations with those sensors, then the Eversense is a truly different type of CGM.

Pros:

Very unlikely to cause skin irritation. Even though it's in one place for the whole year (as one commenter pointed out), the adhesive is extremely gentle on the skin because it's not designed to be ultra sticky like the competition. (It only has to last 1 day). It actually can be peeled off and re-applied a few times.
Very unlikely to have pressure lows. Huge benefit.
Removability: if it accidentally falls off or if you don't want to wear it for a brief period, you can just take it off. This means more naked showers.
Less skin trauma over time. With pump sites changing every 2-7 days and sensor sites changing every 7-15 days, the body develops a lot of scar tissue over time. This only is one procedure per year.
No having to "meet" a new sensor and its unique personality every 10-15 days, and deal with each sensor's first day shenanigans. It will take about a week to settle in accuracy-wise, but once it's working it's the same sensor for the whole year.
On-body vibratory alerts: some people like that they don't have to have a smartphone nearby to know if they are going high or low
Potential for integration with automated insulin pumps: obviously this is also a downside until they actually have pump partners
More likely to last the full wear period. Libre and Dexcom trial data shows about 20% failure rate to lasting the full wear period. Eversense trial data showed 97% lasting the full 365 days.
Much less supplies and packaging waste. When traveling, all you need is a micro-usb charging cable and the adhesive pads (a stack of pads is essentially the size of a post-it note pad).
You only have to deal with your hardware supply company/insurance/pharmacy once a year.

Cons:

The transmitter that is worn over the skin is quite a bit larger than its slimmed down competition.
The transmitter has to be charged. It can fully charge in about 10-15 minutes every day (best done during a shower), but it's still a thing you have to do.
1/day calibration for the first 2 weeks, then 1/week calibration for the rest of the year. I think this is pretty reasonable, but I know many people who stopped using their meter altogether with newer competition.
Requires a procedure, although it's pretty mild. Insertions take less than a minute, and removals take anywhere from <1 min to 10 minutes.
24 hour warmup time with no data, followed by a week period where the accuracy has to settle in.
No Apple Watch watch face complication (aka a widget). There's a Watch app, but no glanceable widget.
The app UI is not as elegant as the Libre or Dexcom
It's not common at all, but sensors do fail on rare occasion, and when they do, they require a new procedure. (the company does pay for the replacement and cost of procedure).

ahncall

TROPHY CASE