Timothy - Thanks so much for posting this better way to restart Dexcom G6 sensors. My sensor is on my abdomen, so I am able to use a test strip to pry out and wait 30 minutes for it to forget the last session, but it is not all that easy to do. Your new method is much better.
Jay6 - Interesting about how placement could affect if insurance pays. In the US, it is sad Dexcom did not attempt to get G6 certified for arm placement. Given all the TV ads for Abbott’s Libre showing on-arm placement, I suspect Abbott made the effort. And yes, the G7 will be cleared for arm placement, but of course with the integrated transmitter and sensor, they have also taken a big step to block restarts.
Thanks to both Timothy and Jay6 for the posts.
I restart sensors for two reasons: Often with a new G6 sensor, I find during the first 24 hours, it does not give consistently accurate readings. Perhaps 20% of the time, a new G6 sensor is immediately stable, but that leaves me having to do multiple calibrations most of the time the first day of a new sensor. But in general, restarted sensors, when calibrated once, are immediately stable. So restarting reduces problems for me. I only restart once, so I have not tested G6 sensors past 20 days.
Second, in case there were a supply problem (I live in earthquake country), I would like to have some inventory on hand, but my insurance company (US Medicare) will not allow me to purchase ahead. Of course, I still have no inventory of transmitters, but at least there is a chance my current transmitter will cover the supply shortage and I will have some extra sensors during that time.
This post is not clearly stating anything about how a sensor site is approved, what it takes to get it approved, that the FDA has nothing to do with approval on a site, the data for site location is submitted by Dexcom. The FDA review the data and the application and gives a thumbs up or down. The FDA has NO input on site or clinical testing, just the data required for the application to get approved. The clinical testing is done to gather the data on product performance and design, to gather data on the performance, to gather data on how the testing was done and who the participants were. This is all done to submit an application for approval to the FDA. The FDA may ask for more data or clarification, but, with not be involved in changing the application of the product.
Therefore, Dexcom only submitted, for simplicity, the data for the clinical testing done with the stomach location. Was testing done on other locations? Yes, but not enough sampling to be included in the application. Was there a reason for Dexcom not including other locations for sensor sites? Yes, time and money. That is why the data for the Canadian G6 application included the other locations, the data was already available and expanded clinical and could be included.
Is it acceptable to use the G6 in a place other than the stomach? Yes, as per the Canada submission data and YES, off label does not need an agreement between Dexcom and the Endo.
I’ve been pumping for >26 years and off-lable has always been a part of using a pump and most other diabetes products because the submission for a change or modification in an application cost time and money, and the unique application of the products, personal management requirements and the pharmaceutical changes cannot be aded or updated as a part of a submission, the submission would never be completed.
This is all why the FDA has a unique protocols to assessing and approving products, drugs and technology to manage diabetes. If they did it the old way it was done before, no diabetes products would reach the market in time and might be surpassed by newer products during then application approval process.
Timothy thanks for this super clear explanation in layman’s terms, and for this great tip. Unfortunately there aren’t that many engineers that have your ability to ‘downshift’ your brain and explain things for the masses. I had figured out some of what you explained on my own, but it was only a good guess on my part until you confirmed and expanded on my guesses.
Haha any time.
I had a private message from a user who told me my response was too technical, she didn’t understand some of my terms.
So there you go, everyone takes away something different.
Most people on this site are pretty bright and logical thinkers though.
I think I remember an old cartoon description of how dex works. I’ll look it up.
Like @Mayumi I’m confused about the sensor code/transmitter SN thing. I use the iPhone app, and I don’t have any way to manually enter a different transmitter SN. The app gets the SN from the pairing process, which picks it up automatically. Is this a Tandem thing? What am I missing?
ETA: ack, yeah, I see that you’re referring to using the pump interface, not the app. I don’t think there’s a way to do it in the app.
Are you doing this with the sensor stopped? I believe that a new transmitter serial number cannot be entered until the old transmitter SN is un-paired and a new SN re-paired.
The path I use to get to that point, when a sensor is active: Settings>Transmitter>Pair New>Stop Sensor. This leads to a new transmitter pairing screen and the manual keying in of a new transmitter SN.
Yes that’s it. The menu is greyed out if the sensor is active.
But available when it is stopped or completed.
I was able to restart both with my pump and my phone on 2 different occasions.
@Timothy@Terry4 Thanks for the clarification, which may be helpful to others as well as me, since you can’t see the option until you’re actually in the process of changing your sensor. I’d certainly never noticed it before.
But you also answer my main question, which is that this IS essentially unpairing and re-pairing the same transmitter as an alternative to prying it out and sticking it back in, which is awkward when it’s on your arm. It doesn’t sound like there’s a downside to it, though sometimes pairing can be finicky too.
I haven’t had a problem pairing. But the transmitter ID is long. On my pump I need to enter it twice. On my phone just once.
Worst case is you delete all the old IDs in your Bluetooth settings and start fresh.
I’m curious, too. While I’ve used Dexcom sensors for the last 12 years, I’ve never lost a wire. I do visually check every sensor I remove to verify that the wire remains.
Recently, I used a removed sensor and tugged on the business end of the wire and was startled with how little force was required to pull it out of its mounting position that passes through the two round black sensor contacts.
I’ve never had a sensor/transmitter assembly accidentally scraped off of my body. I’m thinking that this is the situation where a wire could get left embedded in skin tissue with the transmitter holder/sensor connection point becoming separated without the user’s awareness.
At the time of an accidental sensor/transmitter scrape-off, I think it would be the rare person with the presence of mind to immediately check on the wire location, do a close visual examination of the previously installed position and then extract the wire that may protrude from the skin.
What I fear most is any sensor wire that becomes embedded below the skin could travel and create secondary complications.
Even if it got stuck under your skin, it would be easy to pull out.
If it really got under there, it would just stay. It wouldn’t travel.
It’s not in your blood stream, there really isn’t anyplace for it to travel. Maybe a centimeter max.
You would just deal with it like a splinter
It’s the spring-loaded transmitter that pins that sensor filament in place. In theory, it can’t come loose so long as the transmitter is securely installed. I suppose failure is always an option, though.
For the average user, it’s not a problem. It’s those of us who have learned to pop the transmitter out for restarts that really have to worry about it.
I’m always ridiculously protective of the sensor when the transmitter is out.
She [the doctor reviewing x-rays] was stunned by the results and was wondering why it’s on the inside of my arm. THE SENSOR WIRE MIGRATED.
I know this is anecdotal but I’ve read similar accounts over the years. This is likely a rare event, not one that could be used for a scientific trial, if there were ever any financing for this kind of study.
