Disruption in CGM land… Can Medtrum take Dexcom’s crown?

Back in August 2016, I met Medtrum at a JDRF Discovery day. They seemed to be offering a new set of options in the CGM and patch pump world, but none of us had ever heard of them and there was scant information about their products or their pricing.

Scroll forward to April 2018 and it was hard, if you were on Twitter and following the GBDOC hashtag, to miss the fact that they had finally arrived.

After 18 months of meeting healthcare professionals and getting products lined up, here they were, launching their CGM and pump products. It has been perhaps a slightly unorthodox way into the industry, but they’ve made it. As I understand it, their pump products have made it on to the lists available to both Scotland and England & Wales NHS, but I’ve no idea if there are any clinics supporting them yet.

In the meantime, their CGM product is available to the public to buy. Given I don’t have access to the pump products, let’s start with the CGM.

The A6 System is here, and can be ordered direct from the company. You’ll need to call or email them (UK Office number is 01923 312391) and payment is currently only by bank transfer, but they present something interesting.

First up, this is what you get:

An altogether smaller package than that which Dexcom will send to you, and of course a rechargeable transmitter being the key part here.

The transmitter is slightly larger than the Dexcom one, as you can see in the following pictures:

In fact, the dimensions (in mm) are:

• Medtrum A6: 36 x 19 x 11
• Dexcom G5: 33 x 17 x 9

The charging port is the same whole which fits over the sensor contacts, allowing the transmitter to be rechargeable and waterproof to 2.5m. It’s certainly fine in the shower, but I haven’t swum with it to really test it. Charging is easy, and reasonably quick (approximately two hours) but at this stage I don’t know how long the battery will last.

I have noticed the extra height though, as I’ve caught it on doorframes a couple of times. With that note, I should mention that I wear Dexcom sensors off label on my upper arm, like a Libre as I get much longer life out of this location. I therefore currently have the Dexcom G5 on one arm and the Medtrum A6 on the other.

Set up of the system is very similar to that of Dexcom, in that you scan a bar code, connect the transmitter to the sensor and then it warms up before calibrating for two hours.

I did as I do for Dexcom sensors and wore it for six hours before activating it.

The proprietary applicator is much easier to use one handed than the Dexcom, as demonstrated nearly eighteen months ago in this video:

What you’re left with afterwards is much smaller, but the needle is not retracted safely into the device and a small piece does stick out.:

Fortunately, the safety cover for the applicator buttons doubles as a cap for the applicator, but this needs to be put in the sharps bin, sharpish…

The application is straightforward and uploads to the cloud, allowing a follower app (on the iPhone only at the moment). The app can be used with both the patch pump and the CGM, and appears to be able to allow you to overlay both sets of data on one another. Notable in the app is the ability to tell it that you want the sensors to last 14 days. I’m not sure what that does yet, but it raises some interesting questions!

The transmitter stores a number of hours of data and will backfill when it reconnects to the app. I can’t recall exactly how much, but it’s enough to stop at 2am and reconnect and backfill completely at 5am.

In addition, all data is available in a cloud service, a service that Medtrum calls “Easyview”. It looks like this:

And has a wealth of data and reports available to you as a user. It’s also the core for where the Follow function runs from.

Given that there is this “Follow” service, similar to Dexcom share, it shouldn’t take too much to deploy a packet capture app on to an Android phone and work out the Server details and how to log in and access the source data, to provide it to NightScout. Of course, we could also just ask Medtrum.

One useful, and handy feature I discovered by accident is that once you’ve started a sensor and are uploading to the cloud, you can switch phones and the app retains the current state via the cloud. I discovered that when I ran EasySense alongside xDrip+ and OpenAPS via BT Tether on my Android phone, xDrip+ kept dropping BT packets with the Dexcom G5, so I switched it to my iPhone, and had to do no setup. Very handy.

Finally, the pricing. And that’s where Medtrum have really been paying attention.

Sensors cost £35 each. You can buy them as one or as four. Same price per sensor in both cases. That’s CGM sensors at the same price as the NHS pays for Libre. You can see what they’re aiming for.

The Transmitter on its own is a little more expensive, but you can buy a starter set now for £225 which includes the rechargeable transmitter and four sensors. That’s what I’ve done, so that I can bring you a balanced view on whether I think it’s a worthwhile expenditure. In the longer term, there is a question as to whether you’d want to run two transmitters to minimise downtime when charging.

So on an initial starting point, given the product and the pricing, this doesn’t look like a bad deal. The key to it is performance, and that requires some testing. The MARD stated on their website is 9%. Does the system live up to that claim? And importantly, the question for me is, would I be comfortable looping with it? That data is available here.