Almost all of my safety stock is the result of many years of using Dexcom CGMs. I started back in 2009 with the 7+ model. When the G4 arrived, I soon moved to it. I tried and didn’t like the G5 so I moved back to the G4 until my late move to the G6 when forced by Dexcom shutting down the G4 server.
All of these models prior to the G6, sensor restarts were possible and easy to execute. When a 10-day sensor lasts 20 days on a regular basis and you still order as if you’re using one every 10-day period, you can imagine how your supply shelf grows.
Whenever a new Dexcom model appeared, I continued to use my existing excess supply of the older model while I accumulated the newer model even though I wasn’t using the latest model immediately. You get the idea; I rolled the supply advantage forward for each model change.
I did not break any Medicare supply rules except for telling my supplier I had fewer supplies on hand than I did. I disagree with the “just in time” supply philosophy as we who live with diabetes fully understand that diabetes does not always cooperate. A sensor order gets delayed for any number of reasons and you’re expected to “deal with it.” Which could mean living without a sensor to keep you healthy and safe.
I firmly believe that a system that delivers essential medical supplies should never operate so close to the cliff where only the patient suffers from the shortage. Neither the supplier nor the payer suffers when your supply cupboard goes bare, only the patient.
The supplier and payer each assiduously look after their needs; it’s the patient’s job to look after theirs. We did not set up the rules and the system puts us at risk. If we need to bend the rules a tad to protect our health and welfare, then so be it.
Those of us who use insulin understand well beyond the descriptions in medical textbooks just how dynamic this playing field is. Insulin sensitivity is not a static factor and if you don’t adjust when it adjusts then your blood sugar goes out of range. Being able to confidently counter BG movements knowing that any mistakes (and there will be mistakes!) you make can be mitigated by a good sensor.
In your case, Tom, every time you report a mid-session sensor failure to Dexcom and get a replacement, the number of days of service you received on the failed sensor goes into your safety stock. If you experience several failed sensors per year, you should be able to build up a reasonable quantity of sensors.
Doing this with transmitters is harder now. Back during the G4 days, the transmitter service life was 6 months but did not do a hard shut-down at 6 months. They typically lasted 9-12 months. That “extra time” then accrued to my supply shelf.
Unfortunately, with the G6 transmitter, Dexcom shut that door and designed in a hard shutdown around 110 days. Yet they allow you to order a new transmitter every 90 days. Theoretically, you can gain a 20-day advantage for every transmitter. That could translate to about one extra transmitter per year.
So, there is still enough slop in the system to build up your comfort stock to remove you from the cliff’s edge. Diabetes is hard enough, we shouldn’t add in man-made stresses to make it harder. I will do what’s necessary to protect my health and safety.