Dexcom G4 PLATINUM - Start Up questions

Hey everyone,

I have searched through the site and found a lot of good information, I have tried to keep track of it, so I apologize if I ask a question that has been answered recently, but I am hoping someone can help me out.

First I got the CGM because I am T1, and got my A1C down to about 7, and then it shot back up, finger sticks were averaging 120ish so something is going on that I can't see there.

My first question would be the pain of the insertion of the sensor, is there any more than what I would get with my pump? I have tried the MM CGM in the past, and really thought they were trying to use a whale gun on me with that thing.

Second everything I read says to use the stomach, however I read that you can use your thigh, upper arms, and buttocks as well. Has anyone lately used these alternate sites and received good results?

And last, does anyone have any tips for using this CGM? I am really desperate to get my A1C lower to avoid issues later in life, I have not made up my mind if I will wear this 365 days a year or if I should just do it in spurts to make sure things are going well. Any advice on this?

In advance thanks for all your help and answers!

Hi there. I really love the Dexcom. I tried the MM CGM in the past, too, and thought it was much more painful than the Dexcom. While the inserter of the Dexcom looks a little intimidating, I don't think it is any more painful than a regular shot or pump insertion. In fact, I would probably say it hurts less, most of the time.

I've used both my stomach and the back part of my arm, and had good results with both. I think if you put it in a really muscle-y spot, it will hurt more, but if you stick to fattier tissue, it should be fine, with good results.

The thing that is important to remember about CGMS is that since they take readings from interstitial fluid, they will be about 10 minutes or so behind a finger stick, so don't expect them to be 100% accurate in one moment. I think people get disappointed when they want to use them in place of a meter or something. They are much better to help you see trends overtime. But, that being said, I find the new G4 extremely accurate compared to the last generation Dexcom. It's especially accurate in the low and "in range" ranges, and a little less accurate for the higher ranges, but that's just my experience. Every body's bodies are a little different. I really recommend it though, it has helped me get my A1C in much tighter control!

I also have used MM CGMS in the past, and then Dexcom (Seven+, and now Gen4) for the past 2.5 years.

The Dexcom Gen4 is by far the best, and none/very little pain on insert. I would say the same or less pain then my MM Quicksets.

Dexcom is officially 'approved' for stomach only, but I have great results using only my arms and thighs. In the US, with FDA rules, Dexcom can only reference using the stomach. But there are many users who have posted here, with success using arms/thighs.

As for full time or in spurts, I think that's an individual choice, maybe based on expense. With the new Gen4, I usually get 14+ days for each sensor, while some change it every 7 days, as recommended.

If your readings average 120, but A1C is not in line with that, I wonder if you are doing BG checks mostly before meals ? If so, try doing some 1-3 hours after meals to see how high you might be spiking, that would result in the higher A1C. That's were the CGMS is very helpful. It was eye-opening for me to see how different foods raised my BG, and I soon eliminated foods that spiked me too high/fast, that I had not known before.
For many, breakfast cereals, breads, pasta, processed-foods often cause very quick rises after meal. Some can handle them by bolusing earlier, and waiting 15-30 minutes before eating.

You might be able to get a trial of Dexcom, check your local reps or health care team.

I love my G4 Dexcom too! Think I'd give up a pump before I'd part with my Dexcom. I've tried arms and thighs and didn't get good results so i'm only using my torso - stomach area. Yes, it does hurt a little bit...but I'll tolerate a bit of 'pain' because this piece of technology is pretty incredible, it's saved me from some bad lows. I now would feel lost w/out it; every time I have to wait the 2 hours for calibration, I feel anxious. It's very accurate but there is a lag time. Someone from Dexcom (a local rep) can help you in terms of settings, etc...


Thanks for the info, I am hoping to use the CGM as a road map, I know I can't get rid of the meter which as diabetics we all wish we could do I am sure =) but I think it will show me where I am going wrong, or missing something. I never knew that it was 10 to 15 minutes off until last week after reading some more on them. It makes sense once I read it, but I think a lot of people including me thought it was more real time!

Thanks again for the info, I got my unit yesterday, and am going to try starting today, I have to get over the inserter, although I complain about the MM jet pack for my pump so I should be happy with having some control =)

Thanks again!


Thanks for the information, I was reading about the arms and thighs as well, but am always scared to go off the map unless I have someone that has good results with it. If its the same or less pain as the MM then I am going to be good. With those I only get one in about 10 that makes me want to scream for a second but over all they are pretty good too.

My readings were all over the place, I normally do it before the meal and then 2 hours after a meal, and was still doing really well. My endo that I go to was downloading my pump and meter and was at a loss as well. I agreed to do the dexcom because I need to get the A1C down, I was headed for the right direction I was at 7.4 but then I jumped to 7.9 three months later. Even with a diet change I couldn't win, well I did lose 10 pounds which is awesome but the A1C was still a mystery. I am hoping the dexcom can show me what my body is doing. I have been reading that there are some cases where the body will store massive amounts and release it at random times, not sure if this is true or not, meeting again with the endo today and will be asking him.

As for the unit I got it through my insurance so I got it yesterday, I maxed out my deductible and out of pocket this year with back surgery so this was free of charge for me which made it even more of a push towards doing it.

I am only reluctant to have another thing on me, but it's for the best. Thanks for your insights!


Thanks, I am glad to hear its working for you, and thanks for the info on the arms and thighs. I can tolerate a little pain, just not a ton of it =) but like you said its technology that is pretty incredible so it's well worth it.

I had a low last night that if my wife wasn't awake I would have been in trouble. I am going to start today, and hopefully get the great results you all have seen from this thing! Thanks for your input, I will be reaching out to Dexcom for someone local too I always forget about that option to get help. Thanks!

Glad to report, got it going today, little to no pain, the pain I did have was because I was too stupid to go quick =) now working on calibrating it and getting going, thanks again everyone!

Hi Damon,
great to hear you have started ! Since you have used MM CGMS before, I think you will quickly get used to it.

Hope your trainer told you to avoid Tylenol, as it can interfere and give wacko readings.

Here's a link to a good discussion, in case you didn't see it before.

tips for dexcom

Thanks, I didn't get a trainer =) I had to figure this out on my own, but have been reading and asking questions. Thanks for the heads up on the Tylenol, hopefully I can use Aleve with it =)

Thanks for the link!

please remember that it may take a day or two to get calibrated correctly. also, never correct or dose off your dexcom, it does have a lag time, especially when bolusing. i set my low at 90 during the day, when i'm bolusing, that way when it alerts me i'm dropping too fast at 90, I'm probably already at 60. i find it's pretty much accurate when I'm just on basal, during the night, etc...because i'm typically not rising and falling from a bolus. BTW, I still take tylenol on the dex, sometimes it effects numbers, sometimes not but it only lasts for a few hours...


Thanks I had the low set at 55 I think I will up mine to 90 because that makes a lot of sense. Today I had a low at the grocery store I knew it was coming on because I could feel the shakes and the other symptoms of it that I normally get. I looked and was still at 85 but when I tested I was well below that. So being at 90 will be a safe guard for me. Trying to run my sugars as tight as I can. And I promise you I won't replace my meter with it or make decisions with it, I know it's just a tool, but a cool one at that.

Just wondering how high do sugars go after eating normally? I am trying to figure out if what I am seeing is right or not. I ate, and bolused and I believe it went to 190 for a about 45 minutes and started to decline. Since I never had "real" time looks at what is going on, I wasn't sure how high is normal and whats a concern.

well, this is what's freaked me out too, we can see our blood sugars rising and quickly. I totally freak out when I see arrow(s) up and rising and sometimes will do a small bolus. I can actually start feeling when i go high before it hits the CGM so I know i'm starting to rise. I'm trying to avoid any highs like that, depends where you're starting from/at. Do you prebolus? I also see sometimes I'm dropping after I bolus and before I actually start eat. This too has messed me up a bit because I'll eat right away and then end up being too high because I didn't prebolus. It will take a while to get used to. At first, I was checking BG's more because of the Dex..but after a while you'll kind of figure it out. I set my high at 160. I'd suggest too to maybe set all the alarms too, so you'll be alerted at just the one up and down arrow.


Thanks for all the good tips, I started to do pre-bolus, I was always told not to do this. I have always been told if you do that and you don't eat you could be in trouble. But I figure I can do 1/2 before and 1/2 after or something if I don't know for sure.

Today I have pre-bolus'd each time and my levels are so good its not even funny. I have been amazed, by having the dexcom this little time and your tips, I feel energized that I can get the A1C down farther than I ever imagined.

Thanks so much!!

Hi Damon - that's great news . Sounds like you might be interested in the flatliners group ! Lots of good tips and support on ways to avoid the spikes and fast drops, that become more obvious with the help of CGMS.


Good advice MegaMinxX. Also, getting a CGM on a trial basis has become quite common in recent months.
I'm approved for the new G4 but I'm holding off on delivery because I still have 6 extra sensors from Dexcom 7. Using them before getting the G4.
When to a terrific diabetes seminar in Bellville, MI. yesterday (5/18)where in addition to talks on various subjects there were many vendors in attendance. The point is many of those I spoke with are forecasting huge added expense coming soon due to Obamacare. I'm sure they are not all wrong.
Get as much of your needed supplies as you can before July 1, 2013.

you're very welcome! :)