Dex Com G4 Stand alone versus Medtronic Enlite CGM on my son

Diabetes Technology Glucose Monitoring
1

My warrenty is up on my son's Animas Ping so we are shopping for a new pump since my son gets a horrible Dexcom Rash. (It looks like a chemical burn).

Currently my 8 year old is wearing two CGM sensors. His Dex G4 and the Medtronic CGM with enlite sensor borrowed from the hospital as a trial.

I am testing his blood with both the ping remote and Medtronic Contour glucometers at the same time.

My son's A1C is 6.0 tested just last week.

I will be posting my results. So far, here are my comments.

I have been using the DEX G4 since FEB/2014 on him and I love:

*the large range so I can have the DEX G4 remote on my nightstand and he can be 20 feet away in his room.
*the bright easy to see screen
*the fact that it vibrates first and if you don't acknowledge, it will alarm.
*the options for the alarm sounds.
*the sensor does not hurt him upon insertion
*that I could get more than 7 days out of his sensor (until he became sensitized to the glue)

As for the accuracy of both you'll have to stay tuned.

I have been using the Medtronic for 3 days and so far I don't like:


DISCLAIMER: There was a lot of blood upon the Enlite 90 degree insertion so perhaps it is not working well.


*The screen is not colorful, it looks green/black and is harder to read, and the screen is smaller than the Dex G4.

*It seems like the darn thing was alarming all of the time. I would shut off the alarms for 3 hours at night so my son could fall asleep.

*Couldn't shut off the alarm for the pump suspend so he woke up anyway despite a false low. So I shut off the pump suspend feature.

*Finally shut off the predictive alerts as it would show 4 something and he was actually 7.1 on the ping and 6.1 on the contour...... thus the darn thing alarming all of the time.

*I never know what his number is because he is wearing it around his waist. Unless I go over and bother him and dig it out of his spibelt I never know his number when I am curious.

*My son is getting anxious about it alarming all of the time and he is asking me to shut off the sensor.

K, so I ask myself, what is the use of buying the Medtronic CGM if I shut off the pump suspend and the predictive alerts and every and all alarms for 3 hours at bedtime?

I thought, maybe I calibrated too much so I reset the existing sensor to pretend it was a new sensor and after a perfect morning calibration with no food....... the next alarm that went off was a false low. GRRRRR!

I am buying another $65 sensor tonight to give it a second chance. Maybe its the blood in the sensor.

What I hate about the DEX G4: The Dexcom rash is so bad that my son's skin melts and oozes yellow gunk after 4 days. I tried Tegaderm, Bioclusive and IV 3000 under the Sensor. Ive tried Cavilon Spray, just using soap and water instead of alcohol, Ive tried iodine. Tried skin prep. The only thing that he is not allergic to and that works is using a Johnson and Johnson Tough pad that I bought off of Amazon.ca. It only stays on with warmth. If you go into a cold pool you can count on the whole thing falling off. I inject right through the toughpad. I get a good 4 days out of the tough pad before it starts peeling a bit. On day 4 I put Hypafix tape over top with a hole cut out for the sensor.

So I am limping along trying to make the Dex work and reluctant to buy the Medtronic CGM just yet. I wish there was another stand alone CGM because I don't want to give up my Ping remote.

Thankfully Dex has given me two sensor replacements when the thing fell off after a day and a half.

Stay tuned for my opinion on the accuracy.

2

"A horrible DexCom rash" - uh,I'm sorry about your son's problems, but what does this have to do with a Ping??

3

Since our Animas Ping warrenty is up, we are taking the opportunity to try out another pump with a CGM other than the DEXCOM which my son is allergic to. In Alberta Canada, the government buys children pumps for free.

4

There is in the European market a third sensor company. It’s sensor is nearly as accurate as Dex. Can you have a dermatologist work on the skin problem? Can you try “skin tak”? I show myself using it in my longest video at YouTube/DiabeticAaron for the insulin pump because it keeps the sight from infecting as quickly. So many frustrations but the a1c must feel rewarding.

5

Can you use Skin Tac to try to keep the tough pad stuck down? Might be worth a try.

Do you use anything else to hold the sensor down? Opsite Flexfix (with a hole cut our for the transmitter) works really well particularly together with Skin Tac. Better than Hypafix. Also, why wait till day 4 to use the hypafix? I would try it from the start.

Good luck

Joel

6

We have tried skin tac but the "acid" on the Dex G4 leaks through.

7

He gets a rash from Opsite Flexifix as well. I wait until day 4 to add the Hypafix as then it is touching my son's skin a less number of days. I think I have solved the problem about the peeling tough pad. The hot bath seems to make it peel. If he is on day 1-4 I make him shower or not put his arm in the bath. Too bad the tough pads are discontinued. I have ordered DuoDerm extra thin just to try it out and it is not peeling at all. It is too big so I am still looking for something that will work better but it is a good temporary solution.

8

Ok. So from my little experiment I have determined the DEX to be more accurate. I was getting false lows from the Medtronic CGM. The Medtronic CGM and Dex were minimum two points apart the whole time with the Medtronic CGM being always lower than the DEX. There were times when the Dex was two points higher than the poke and Medtronic was bang on and there were times where the Dex was bang on and Medtronic was two points lower.

In the end my son ended up getting a rash from the Medtronic CGM so there was no point to switch CGMs. The predictive alerts did not help much because my son fluctuates between 4-10 many times a day depending on activity and the predictive alerts were ringing all of the time. I found that if I did nothing the blood stayed in range anyway. It was only helpful at night when the bg would fall or raise slowly. The 15 min warning allowed us to correct earlier. My son's A1C was 6.0 this past summer. Medtronic is coming out with a new CGM with a different glue so we'll check that out when it is in Canada.

Still seems to me that as a parent of a T1, Dex G4 is superior whereas for an adult managing their own T1, Medtronic may work just as well. Kids with their growth hormones and recess and gym make kid's BGs fluctuate too much for the predicitive alerts to be as valuable. It may be more valuable in an adult with T1
9

Kerri Sparling of Six Until Me has had a lot of allergy problems with the Dexcom. Here is a link to her posts addressing that issue: http://sixuntilme.com/wp/?s=dexcom+rash

It sounds as though you have already tried many of the things she'd tried.

I got a horrible rash with my last sensor. 3 or 4 days later it was still red and sore. It was the first time that I have ever had that problem. Interestingly, I usually use sensors on my arms and legs and never have problems. But because I've been having Dex problems lately, this sensor was on my stomach so that I could be honest with Dex techs about where the sensor was located.

Good luck figuring this out. I would never go back to Medtronic after using Dexcom, but if each sensor sore and itchy, I guess I would look for alternatives.