So, I just got off the phone with Dexcom, and I have a G4 plantinum on the way! I’m so excited! Any tips/tricks for a first time CGM user?
Congrats!!!
A few tips from my experience:
-Do not expect that the Dex will replace your finger sticks.
-Best to calibrate when your blood sugar is stable (i.e. not after exercise or after eating)
-Do not over calibrate. Calibrate when the system tells you to and in situations where the number from your meter is +/- 20% from your Dex reading.
-You can absolutely get more than the FDA approved 7 days out of each sensor. Most Dex users do. For example I get 20-30 days on average out of my G5 sensors (which are the same as G4).
-Be patient with it at first. Just like any new device/treatment there is a learning curve.
Best of luck and I’m confident once you get the hang of the Dex you will not want to be without it like the majority of the users.
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Thank you!
When keeping it in that long, do you ever get any irritation at the site?
luckily I do not. The only reason I take out is when the numbers get wonky and if the adhesive is just not holding on any longer.
Just curious as to why you went with the G4 instead of the G5…
I’m new to all of this, and the thought of something attached to me 24/7 scares the crap out of me. I guess in my head it was better to go with something that had been out for a while. Maybe by the time the G6 comes out I’ll be ready to try the newest diabetes technology! 
My skin is very sensitive and I find opsite flexifix great for long term use, sometimes I cut out a doughnut and go over the dexcom adhesive pad, occasionally I cut out an oval and go right through it.
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just got 32 days out of a sensor. That’s the longest I’ve gotten out of one on G5.
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So when you stretch a sensor (and I guess also the transmitter?) like this - do you just keep buying your regular monthly amount and stockpiling for when you haven’t met your deductible yet next year? Is that how people make this affordable at the beginning of an insurance year?
I do it for 2 reasons. First if a site is giving good readings consistent with my finger sticks, why change it. But the main reason is that I pay out of pocket, Medicare doesn’t cover CGM, so it"s coming out of my purse. I think a lot of people don’t have insurance coverage for CGM. My last transmitter lasted 13 months. Receiver still going strong after 15 months.
I don’t mean to answer for Mike but many of us like to work up at least a small excess of supplies to deal with the vagaries of the supply chain. For those of us that use insulin, we can quickly see how vulnerable not having it, even for a little while, makes us. We see our supplies as absolutely needed for life. When we can stretch the service of a CGM sensor or transmitter then we can store up for a rainy day.
We all know that life can deal us setbacks. But some of these setbacks can carry a much bigger punch if we haven’t planned for these contingencies. We or our spouse can lose a job and kill our access to needed health care and supplies. A problem with the manufacturing process can create temporary shortages and threaten our well-being.
I always round up my expected need to manage just these uncertainties in life. Of course life is much less dramatic in countries that provide access to health care to everyone. We are not so fortunate in the US so a healthy habit of “putting by” supplies can help ease the stress of diabetes.
I get my sensors every 3 months regardless of how many I have used. Obviously, as @Terry4 notes below, it’s nice to stockpile a bit. I am very, very fortunate with my insurance. This stuff is DME for me which is covered at 100%.
If you plan to use a sensor for longer than seven days (or even just for seven), make sure it’s very clean in the spot you place it. You also may want to look into something that protects your skin from the adhesive from the sensor. I put on a Tough Pad, because even when I was using another CGM, the sensor site would get itchy a few days BEFORE I wanted to replace the sensor.
My second piece of advice depends upon whether you’re pumping. If you are you won’t need it.
If you aren’t pumping, you may be unused to having something on your stomach, so be mindful of where you place it. Get used to knowing where it is pretty vigilantly at first. Over time, you will naturally know not to sleep on that side at night. It generally doesn’t matter for me because I sleep on my back.
Thanks Timbeak48.
I did briefly try the Omnipod insulin pump. Due to my extreme insulin needs, however, I had to switch to a U500 insulin to get the most out of the capacity/lifespan of a pod rather than burning through pods. That meant dosing 30 minutes before meals instead of just before meals. That just wasn’t workable for me, and I wasn’t getting as good of control. Now that I’ve switched from Gabapentin to Topiramate for my fibromyalgia my insulin needs have dropped considerably (10U at night on my Lantus and nearly half my mealtime bolus! Yeghads!) but I don’t think I’ll go back.
I did experience some of the issues you talked about. I ripped pods off twice when wearing them on the back of my arm - once when taking off a shirt and once I caught it on a door frame. I had one at the small of my back and realized that it just wasn’t comfortable in many chairs outside of those in my house, etc…
I also found out that the insulin in the pod shouldn’t be exposed to higher temperatures, which meant either curtailing my nightly very hot baths, or wearing it above the waterline, which was a shame as the outer thigh was a very convenient and comfortable spot. Is that sort of thing at all a concern with the Dexcom, other than the heat/long soaking possibly affecting the adhesive? I do enjoy a dip in the hot tub after swimming for an hour.
CGM should be arriving today. My question is, when is the best time to put it on? I plan on getting it all hooked up tonight after dinner, but how long after eating should I wait?
G5? You need to calibrate it with 2 blood sugar readings after 2 hours, so it all depends on when you plan to go to bed.
Clean the skin well with alcohol before applying the sensor in order for the patch to stick better.
After inserting a sensor, you will need to wait 2 hours until you are prompted to do the first calibration which requires 2 bg meter readings. I would recommend starting the sensor in the morning, before breakfast, for two reasons: (1) in my experience, initial calibration is particularly important. Any calibration is best done at the time when bg has been flat - not moving up or down - for at least 15-30 minutes. This is more likely to be the case in the morning before a meal than after any meal during the day. I also wash my hands with warm water and soap preferably before any calibration, but especially so for the first calibration. (2) the sensor tends to be more noisy and may produce some erroneous fluctuations in bg readings during the first day of use, especially during first several hours. I prefer to be awake during that time. Resist the temptation to over-calibrate during the first day - just beware of possible errors in bg readings, and let the sensor settle.
I agree with @Dragan1 about starting a sensor session in the morning. In addition to the reasons he listed, the sensor reading may read erroneously high or low and the attendant alarms could be a nuisance while trying to sleep. Understand that the system may not track well in the beginning and you need to let it find its way into alignment with your fingerstick meter. After the initial two fingerstick numbers required after the two-hour initiation period, I will not feed it another calibration number unless it is more than + or - 20% from the fingerstick number and the directional arrow is flat.
Have fun. A well tracking CGM is one of the more significant breakthroughs in diabetes technology. Like any technology, however, understanding your numbers and trends and responding appropriately to them is the key to making it work well. In the beginning, just becoming aware of how your BGs move in response to food, insulin, and exercise can be a real eye-opener.
I’m also considering going onto the Dexcom G4, but haven’t made the leap yet.
I suffer from a sometimes steep morning rise, so from what you’ve written it seems like the morning might not be the best time for me to calibrate? I can go up about 30-50 points within an hour of getting up if I don’t immediately eat and dose with Novolog. I can put off eating by taking a small amount of Novolog, and sometimes do that if we’re going to go out to eat so that I’m not facing a big rise before I even get to breakfast. Would that be steady enough?
My Endo and DE do a week-long test and they make it seem so simple, but the calibration thing sounds way more complex. The DE has you come in on a Monday to put the Dexcom on, then takes it off on Friday. For some reason I’m getting the impression that there may not be a whole lot of calibration going on, that they’re just looking for raw data and not really worrying about alarms and all that. If that’s the case, then the week long trial wouldn’t do me much good as far as determining if I want to actually buy one of these or not.
I take long hot bubble baths every night, and I’ve never had it affect my omnipod or dexcom.