I'm curious since I'm going to try and get one in the next few months, but are the Dexom alarms louder than those on pumps?

I woke up at 6:00 to my pump alarming that it was empty. Turns out it had been alarming for 3 HOURS and I slept right through it. Went to bed having corrected at 7.7 (139), but three hours of no insulin and I woke up to 21.3 (383) and moderate-large ketones. UGH.

I'm thinking if I had a CGM it would have alarmed as well that my BG was on a rapid climb, and might have woken me up. Same thing with lows. But only if it's louder than my pump. Then again, I put my phone across the room and even on silent, the vibration of the alarm will wake me up. So maybe I'd do the same with a CGM.

I've also slept through pump alarms buried under blankets at night. Your story is exactly why I don't like the idea of integrating the CGM into the body of a pump.

The answer to your question is that the Dex alarms are louder but more importantly they're more likely to be heard if you put them somewhere without muffling their sound. In fact, to naturally amplify the Dex, just place it into a ceramic cup or short glass on your bedside table.

It would be nice if the pumps could calculate the time and date when the pump will empty. I've done some guesstimates that aren't always accurate enough. This is the kind of thing that computers do well. I'm surprised the pump companies have not incorporated this feature yet.

I do usually wake up to the CGM vibration. The problem comes when your BG gets too low or too high and your senses are dampened. In the end, a timely alarm is sabotaged when buried below nice comfy layers of warm blankets.

Yeah, I don't want them integrated, either. I think being able to keep the CGM in a more accessible/convenient location than the pump would be great. The whole reason I got the Ping is that I can bolus from the remote without having to get my pump out. I'd like the same flexibility with the CGM.

I think the most annoying part about missing the type of alarm that I did is how slowly my BG comes down after a period of missing insulin. Three and a half hours later ketones are completely gone, but BG is still 16.7 (300). It's interesting how if I'm high from carbs and correct I come right down, but if I'm high from missing insulin it takes hours.

My pump also gave an occlusion alarm when I first bolused with it, which I figure is just from insulin sitting in the tubing in the infusion set (contact detach) for three hours with no movement. Subsequent boluses worked, but my site is also feeling irritated, so I'll change it if I don't come down soon (just annoying as I just put it in yesterday before dinner).

I thought of another Dexcom question. Since I'll probably be paying for this out of pocket, and I heard sensors expire quickly (is it six months or something?), are they still accurate after they expire?

Jen, on your Dexcom question, I think you meant the transmitter instead of the sensor. The transmitters are guaranteed for 6 months but many people get more service out of them than that. My first one lasted 9 month. Yes, I found them just as accurate after they exceeded the warranty period. Be aware that once you get the low transmitter battery alarm, your transmitter will die in about a week.

Your body's slow BG correction response to a gap in basal insulin is interesting. I've noticed the same thing. I've been experimenting with using a temp basal of +200% to correct high BGs. I've had some good results but I don't know that it's faster than a correction dose.

What I like about it is that once I start to see a downward trend on my CGM then I cancel the temp basal and I don't overcorrect. It seems like a more milder and gentle way to correct and I don't have to commit to a correction dose size at the outset. I usually set the temp basal period to 3 or 4 hours with a plan to cancel when the BG is trending down and has dropped below my upper target limit of 140.

This method requires active monitoring and might be hard if you need to pay attention to other things, like your job duties!

Rereading your question, I'm thinking that you really did mean sensors and not the transmitter. Yes, the sensor expiration date is 6 months from the time you receive them. I've used them up to a year later with good performance.

I have noticed a worrying trend these past few months. I used to get consistent 14-day wear from Dex sensors. I now seem to start getting significant data drop-out at 10 days. Dex only guarantees their sensors for 7 days. I'm hoping I just have an "off" batch but it does raise the thought in my mind that the sensors may have been purposefully degraded to better suit their business plan. I'm withholding my judgment for the time-being.

I'm also considering trying to place the next sensor on the back of my arm as some users report extended good performance at that location.

Hi Jen,
there are options on the Dex4 for the alarms, that range from vibrate, low beeps, normal beeps, and 'attentive'. I use attentive, which has the loudest, most obnoxious sound, due to some hearing loss, so that's the best option for me.

Here are details from the online user guide.

• For the soft, normal, attentive and hyporepeat profiles the following alert
sequence will occur:
• The first alert is vibrate only.
• If the alert is not confirmed in five minutes, the system will
vibrate and beep.
• If the alert is not confirmed in five more minutes, the system
will vibrate and beep louder and this will continue at the same
volume level every five minutes until confirmed.

I ended up moving my site as at 4.5 hours I was still 14.5 (261) and my site was quite irritated (also looked/felt irritated upon removal). So hopefully that was contributing (although I did do an injection) and I will come down soon! I used Band-Aids to stick down the new site which I know will get irritated in about 12-24 hours, so we'll see how long the new location lasts.

Thanks for the information about the Dexcom. I did mean sensors (as I'd hate to buy them at $85/each and then have them expire before use), but the information on the transmitting is also useful. I wonder why all the equipment expires so incredibly fast. Definitely not good for those of us who have to pay for it ourselves. The expense is the primary reason I haven't jumped on this immediately; I have to save up first!

I am a tad worried about how irritation might affect me with the sensors and trying to wear them for two weeks, given the issues I'm having with infusion sets. Once I'm done my master's degree (six weeks!) and have more time, I plan on seriously looking into solutions for the allergy issues, so hopefully by the time I get the Dexcom I'll have come up with something.

Thanks, MegaMinxX. I just placed a sensor on my upper arm. I hope my experience mirrors yours.

This used to be how the Cozmo was (escalating alarms if they weren't responded to), but the Animas just has one setting, which obviously doesn't work even on loudest (and I don't think it has a sound + vibration option, which would be nice).

I've found that with my Dex on vibrate, when its under my pillow directly under my head it vibrates the whole bed and the sound of the vibration is amplified about 100 times. I don't plan to sleep with it immediately under my head, thats always an accident, but an accident with the bonus of making sure I notice at the first hint of an alarm that there's something going on. And, Other Half doesn't notice that the "whole bed vibrates", so its possibly just that it vibrates my head and pillow and in a mostly-asleep state I think that feels like the entire bed. Even if my head isn't directly on it though, I think there's only been a couple of specific instances where I wasn't the first one to notice the alarm and wake up to deal with it.

I regularly sleep through pump alarms, but I think thats also in part because I don't figure there's anything "legitimate" that my pump has to tell me when I'm sleeping whereas the Dex very much does, and I respond to it a lot better. I do, and will continue to keep all pump alarms on quiet though, because 90% of the time its not telling me something that I deem useful at that particular moment.

I read somewhere that heavy sleepers were being advised to put the receiver in a glass drinking glass along with a metal spoon so that when the Dex vibrated it would rattle the spoon in the glass and that should make enough racket to scare/wake anyone up.

How scary and such an important question. I'm glad you have a source here at TuD for input from a lot of folks with varied experience!....Blessings, as ever...Judith in Portland