Hi everyone,
I’m WWGirl and my boyfriend who is a Type 1 is getting a Dexcom 7+ tomorrow. He tried the Minimed CGM last year and stopped after the sites where he inserted would keep getting inflammed. We are really hoping Dexcom will work better!
I’ve been reading through many of the posts here and it has been so helpful to know much more about it than is on the company website and to hear actual experiences.
Do you all have any tips before we get the training from the person we meet tomorrow which will make things go smoother in the long run? The boyfriend tends to be a little impatient (I would definitely be as well with everything he puts up with due to diabetes) and I really want this to succeed! So it would be great to know anything which can make things run better initially.
Thanks very much,
WWGirl
The Dex has a much smaller insertion needle and sensor than the Minimed does so hopefully that will help. Also, the Dex adhesive is different which may also help. Since he’s used to the Minimed he may be surprised to find that the Dex doesn’t require any extra adhesive although many of us tape them on to make them last two or three weeks. If he’s had inflammation issues in the past though I’d suggest just using them for the recommended 7 days the first couple times to see how he’s reacting. My biggest piece of advise is that you want a moderately fatty area to put the sensor into, to little fat and there’ll be no tissue for the sensor to get readings from but to much fat and I find the readings are pretty far off. Good luck with it and thanks for being on here supporting your boyfriend!
I’ve been using the Dex for about three months and it’s awesome for giving direction. Once you do it once or twice it’s really easy to insert and I haven’t had many issues. One of the biggest benefits for me is carrying it (in a plastic bag) while running and riding to manage food while training/racing.
I would suggest paying close attention to the instructions for inserting the sensor. It it not the most intuitive process and the adhesive patch is easy to fold on itself. It is also easy pull the ring that withdraws the insertion needle too soon. When I started using Dex I sat with the instruction manual in front of me for the first month or so when I was changing sensors. Now I can do it with my eyes closed.
I love my Dex CGM and would not want to give it up, but I will also be the first one to tell you it is not perfect. I occasionally get incorrect readings, so I always double check with a finger stick before taking action, especially if I don’t feel the way I would expect based on the Dex reading.
Brad said it perfectly, WWGirl. Remember that the Dexcom is always a good indicator of BG levels, but in case of any doubts DO use a fingerstick to make sure what the actual BG is. You might find some big differences at times.
I’ve been using this device for 14 months now, and am very very happy. It had a very positive impact on my lifestyle. But like all things it must be learnt and understood, so your boyfriend impatience might not be helping there… don’t rush to conclusions too quickly!
Ciao, Luca
Also can your BF use CHG wipes (Hibistat)… or is he sensitive to those as well…
I found if i prep with a hibistat/choraprep before any adhesives/barrier wipes… I dont get the inflammation as bad as if i dont… Its also a bit of a more smoother insertion once you get the hang of it… Only gotcha is the acetaminophen restriction but i thought it was a lot easier to insert than the MM and a lot less painful/bleeding
“inflammation” at the skin surface, or pus from the actual probe?
I almost never have a problem with the actual wire insertion; maybe 1 out of 10-20 times, it will go through a tiny blood vessel and die from “blood poisoning”. (For me, that’s about once per 6 months.) But I have a lot of experience with putting them in. His first few attempts might not be perfect.
I have a great deal of trouble with reactions to adhesives, including the adhesive on the Dexcom pad. He might want to use a more gentle tape underneath the Dexcom pad for “help”. Opsite FlexiFix is a good one, so you might search for the word “Flexifix” and then read all about it the Threads and Posts which come back. (Those Threads are full of other good things to use, too.)
But I only use FlexiFix to hold the tape edge down better- I put a strip on top of the Dexcom pad edge, about one inch wide. For me, that’s not a critical product. The one which is critical for me, preventing horrible skin lesions, is called “Skin-Prep”. That’s NOT!!! “I.V. Prep”, that’s something else entirely. (Even though the packaging is almost identical.) Skin-Prep protects skin from chemicals in the adhesive, and it protects adhesive from salty sweat in the skin. That’s what I use for skin “infammation” – without it, for me, the site is itching badly after just a couple of days, and it’s gone red and painful underneath.
With Skin-Prep, I could go a lot longer than two weeks with no discomfort or funny looking spots. The Sensor dies first. As with “Flexifix”, you can learn about it by searching on “Skin-Prep”. And maybe “SkinPrep”, too. There’s an important trick with Skin-Prep: you need to get the target area completely dry before you set down the Dexcom Sensor pad. If it’s even slightly wet, it won’t work right.
Both are mail-order items, available at only a few places. Your trainer will cover everything else, inclduing this reminder: always make sure, absolutely sure, that the Transmitter is “clicked” into the Sensor’s retainer arms on BOTH sides! It can often run with one side loose, for a while, but it won’t last long. A loose Transmitter also constitutes an infection risk. (Even though it’s probably only a small one, in most situations.)
He’s probably going to love it. I do! I tried MM for a few days, and never got accurate readings. (That was a really long time ago, however.)
Good advice from Luca and Brad. The system isn’t perfect, but quite frankly neither is One Touch. Always fingerstick before taking action or doing something like getting into the car for a drive, and test again if the fingerstick is materially different from what the Dex says. I’m going on 18 months now with the Dex and I’ve had my share of bad sensors and bad readings, but overall I’m very happy with it and would not consider going without it. I’m 45 and have been type 1 now for 30 years.
Thank you all for replying! It was awesome to get almost instant feedback. I’ll summarize the tips:
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Fatty area for insertion
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Pay attention to instructions for inserting sensor
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Double checking with finger tests
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Don’t rush to conclusions
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Check for loose transmitter
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Keep target area dry before sticking sensor pad on
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Prep with Hibistat
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Opsite Flexifix adhesive under / on top of dexcom adhesive
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Skin-Prep (Rick, I think it was at the site of the insertion, but I need to double check with the boyfriend)
Jake, Rick thanks for the last 3 suggestions. I am going to look more at the relevant threads on how to deal with sticking and prepping (good to be prepared though we are not at that stage yet!). One issue is that we live in Israel, so it will take some time to look into equivalent products here - international shipping on ebay and other sellers does not tend to be good.
Thanks once again - we will meet the trainer in another half hour or so.
WWGirl
WW, you’re a careful reader. Good job!
I have 3 comments on this post. First, I want to make sure that you understand Flexifix is ultra-thin, ultra-flexible tape. (not an adhesive.) It’s so thin that it needs removable film on BOTH sides. You can’t handle it after the second layer is removed; you peel away that thin, clear layer with green grid lines AFTER you’ve put the sticky side down on your skin. The first layer is a thicker layer of white paper/plastic, just like the adhesive-protector films on infusion sets. It’s labeled “Remove First.” And be ready for sticker shock. It costs A LOT. But in the long run, it’s cheaper than similar products which come in single-unit packages, such as IV-3000: You’re getting a roll of 10 meters, and it will last for years.
The last issue with FlexiFix: If BF might want to cover the entire Sensor, then the 4" wide size is the one to get (not the 2" size). The length is just about perfect for the Dexcom Sensor pad, extending on to your skin by about 1/2" past the two ends. If you choose to use only a 1" strip across the upper side of the oval, then the 2" can work (you just cut lengthwise instead of across) … but the 4" works for both alternatives, that makes it better. Unfortunately, most online stores sell 2", so it will be a bit tougher to find.
Skin Prep: This goes on my skin, underneath ALL of the tape area. (That’s the Sensor pad and the FlexiFix edge-protecting tape.) I also have to use it under my infusion sets. One wipe covers a really big area, and you want the wipes – the spray goes on in lumpy droplets, much more messy. This one will be extremely hard to find, you will probably be paying a very high shipping charge with a USA vendor.
Now, I have a new comment, and it’s going to be very long and detailed: Hibistat. Yuck, very bad for skin. It’s just another skin-drying 70% alcohol pad, like I.V. Prep wipes, but slightly “improved” by the addition of CHG. It’s good if you’re far away from a cleaning sink (in the woods, at the beach)… but there are better, cheaper, and MORE EFFECTIVE ways to clean the Sensor insertion area. Besides- their insert has specific warnings about of allergic reactions, isn’t that a problem you’re trying to AVOID ??
CHG, “the pink stuff”, is very effective as an oral anti-microbial agent, because it keeps working for several hours. After dental work, microbes keep trying to re-establish their presence from nearby places they live – nasal cavities, throat, and so on, so it’s widely used. (In my house, we actually use it as an oral rinse each night.)
But the Dexcom Sensor site is a completely different environment: You punch the wire into a site which is supposed to be completely sterile, and after you’ve snapped the Transmitter in place, it’s sealed. “Little buggers” are unable to penetrate the sterilized zone, unless you’ve done something badly. Dexcom insertion constitutes a simple surgical procedure at the skin surface – much more like an ER Medical Doctor stitching up an accidental cut, and much less like getting a new crown put into your filthy mouth. (“filthy” from a biological perpsective, of course.)
I’ve never seen an ER Medical Doctor use “the pink stuff” for such a procedure. In the USA, and other places I’ve been, they’ll clean and flush out the wound as well as can be done, then they’ll use “the orange stuff” – Povidone-Iodine solution (“PVI”, rather than “CHG”). In the USA, the brand name is “Betadine”, but nearly everyone everyone buys generic (PVI 10% solution).
There’s no “flushing out the wound” on undamaged skin, of course. But, at home with good supplies and running water, here’s what I do: (1) lay out clean (NOT-YET-USED after washing and drying) towels and washcloths. Get the hairdryer down and plug it in (for drying the Skin-Prep later). Get the Sensor package and clean scissors, NOT-YET-USED from being run through the dishwasher. I open the PVI bottle, poo a tiny bit into a glass dish. Scrub my hands first, and use a tooth brush to get under my fingernails. Throw that washcloth on the floor, then use a fresh washcloth to scrub the Dexcom site. (That’s a ‘Skin-Gone-Red’ level of scrubbing; you need to peel away all of the loose, flaking skin with bugs in it.) The “Dexcom site” is the entire area under tape, including Flexifix. Now I open the Dexcom package, remove the plastic shooter “guard” piece and peel the paper backing, set it down sideways (adhesive pad vertical, in the air) on a “virgin” section of towel. I also get a couple of q-tips, using my RIGHT hand. Dip the untouched end of the first q-tip into the PVI and wipe it on the target area – not over the entire area, just in the vicinity of the wire puncture site. (About 2cm diameter.) It needs to stay wet for about 30 seconds to be sure, so I reload the q-tip a couple of times. BTW, the other q-tip is only a spare.
Then I open the Skin-Prep, grabbing the pad from the foil package into my LEFT hand. I turn on with hair dryer, with heat, and hold it in my RIGHT hand, pointed at my upper leg underneath the target site. I wipe Skin-Prep sideways, covering the entire area to be taped. I immediately tilt the hair dryer upwards, into the wet area, to dry it off. (The angle, from below, helps to keep the Skin-Prep protectant in place while it dries. Without the dryer, gravity makes it run towards the bottom of the wet area.) The skin prep pad has wiped off all of the PVI color, but that doesn’t matter now- the PVI has already done it’s job. I stick the Sensor down and gently push the Dexcom tape in all the way around – BEFORE shooting in the Sensor (one hand pushing tape down, the other hand holding the “shooter assembly” level. Then the shot-in and removal…
Then I put the Transmitter in, and make sure that I get TWO clicks. Then I do Flexifix over the whole thing, trimmed to cover about 1cm past the Dexcom pad edges. In your case, he’ll want to make the Receiver execute “Start Sensor” right away. For me, Dexcom readings are much less reliable during the first 12 hours, so I’m usually still running on the “old” Sensor… with my “other” Transmitter, while the new Sensor gets an extra 12 hours of “warm-up time”. (I’ve actually got two Transmitters, and the “old one” still works pretty well.)
Use of “PVI” and “Skin-Prep” is not approved by Dexcom: Skin-Prep leaves a genuine film on your skin, and Dexcom doesn’t have time or money to waste on obscure experiments like this. But they’ve never had any effect on Sensor lifespan or accuracy for me, and I feel that the combination creates a more sterile site than Dexcom’s relatively simple procedure does. I feel that 70% IPA is a nearly useless disinfectant. But I am not a Medical Doctor, or Nurse, I don’t have any license to practice medicine (of any kind). My “feelings” and “opinions” are totally unqualified, and so you should verify with an MD before using my procedure.
Rickst29, I’m impressed by your dedication to proper sterilization procedures. I’ve been using my Dex since September and my procedure is 1) wipe site with an alcohol pad, 2) wait about 15-20 seconds for site to dry, 3) stick on Dexcom and smooth out the wrinkles in the adhesive pad, 4) insert sensor. Usually around day 8 or 9 I then take some tape and tape the sides of the adhesive pad down to try to get two weeks out of my sensor. I’m sure your method is much more sanitary but I don’t think I have the patience or time to follow it every time I need a new sensor. 
More people are allergic to PVI than CHG… BOTH are more effective than an alcohol pad since alcohol pads are a bacterostatic not disinfectant… Also who wants the staining of PVI (and using alcohol to clean or remove PVI is another can of worms)…
Neither is GREAT for your skin… (does tend to dry it out)…
But if your prone to infection or irritation, starting with a sterile and clean slate makes for a safer infusion/sensor area… The thing with the CHG/Alcohol pads (combined/hibistat)… is that they DONT stain the area, and are convienent to do a set change in suboptimal conditions and have antibacterial and antimicrobial properties.
As you said, your not a doctor/nurse, and as I will say… YMMV…
But there are different ways to get the same outcome.
Yeah, I have to agree with Rebecca here. Maybe I am just very lucky, but the adhesive that comes with the oval pad on the Dexcom sensor works great for me, and gives me no irritation whatsoever.
The only thing I do, since I always squeeze two weeks from a single sensor, is to use a 3M Tegaderm tape model 1624W cutting a rectangular hole in the middle for the transmitter, and applying it covers the oval tape with just enough Tegaderm tape.
The Tegaderm allows me to keep the oval pad always perfectly attached to the skin, worst case it’s the Tegaderm that gets wrinkled, and should that happen I simply peel it away and put on another one. Much cheaper than a Dexcom sensor! 
Ciao, Luca
Here is the latest:
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The Dexcom seems to be functioning reasonably with regard to measuring - the readings are not too far off - except once yesterday. After BF played basketball his sugar was rising (it always does this - going upto the middle to high 200’s) and the Dexcom over estimated it for some time. During the day the readings are not too far off.
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The adhesive on the pad started to come off after he played basketball - maybe he sweats a lot. We are trying to tape it with some medical tape we have. The first kind we tried stayed put all day but came right off after his frisbee game in the evening.
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No redness or inflammation yet. We are crossing fingers though because with the Minimed it only appeared in the second week. (Rick, BF does not remember if the redness and inflammation was at the site of the sensor insertion, but it did spread all over his abdomen.)
BF asks to say: THANKS EVERYBODY FOR YOUR HELP!!!
Thanks, Jake! I assumed that PVI didn’t have serious allergy issues, because the instructions on my bottle don’t list it (and Hibistat’s insert does). I could look up Betadyne in my PDR, see if it does have a warning… but I believe you, and won’t bother.
Skin-Prep’s principal “carrier fluid” is mostly alcohol, and as I described, it does wipe away the stain. But the pad is sterile at the start, and I wipe it on from the PVI area outwards into the scrubbed-until-red skin area. The hairdryer completely dries my Skin-prep in less than a second, so the alcohol doesn’t have time to do much of anything except it’s drying action.
So I’ll back down on my Hibistat screaming, thank you!
After the tape starts to fail at the edges, you’re in trouble-- the Sensor mounting begins to slide around, just a little bit, and the motion pulls and pushes on the wire. The wire needs to stay motionless inside his body. That’s why the high-end tapes, FlexiFix and Tegaderm (which I forgot tho mention), are so popular with the Dex users here. IV-3000 isn’t to bad, either, but Smith+Nephew makes both FlexiFix and IV-3000. And they’ve got a good reason to be making and selling two different things: In some applications, one works better than the the other. In this application, the more flexible “FlexiFix” is superior – especially for active people who move a lot.
hmm. active people. Did you just say “basketball”?
There are ways to “patch” failing tape. The paint-on adhesives, e.g. Mastisol, work pretty well. (Applying Mastisol to a Dexdcm pad is tricky – search “Mastisol” to find instructions I;'ve written elsewhere.) But unlike Flexifix tape, Mastisol dries into a rock-hard layer of glue – from what you say, his skin will almost certainly react badly if he uses Mastisol. So go with Luca Bertagnolio’s way instead-- new and better tape, covering the Dexcom pad and extending about 1cm beyond the edges.
When my pad edges begin to look even a tiny bit bad, I add a Flexifix doughnut in Luca’s way. I do that on about 1/3 of my Sensors; the rest last for the whole 14 days using just the Skin-Prep and Dexcom pad.
The failing edge was probably sweat-induced, and IMO the best product for that is Skin-Prep. The thin layer of “protectant” works in both directions, keeping salty sweat from ruining the adhesive at the same time as keeps the adhesive’s chemicals from causing IR. The alternative is to use a “better” taping pad underneath the Dex, with a tiny “doughnut hole” cut into it for the wire insertion site. The large piece of “better” tape sticks better than Dexcom’s pad, and it prevents sweat from reaching the Dex pad. Lots of people do this, although I need Skin-Prep. (For me, ALL of those alternative pads cause bad rashes unless there’s Skin-Prep underneath. And once I’ve put skin-prep underneath, there’s no need for the layer of “helper” tape anyway.)
Tried to reply earlier, but lost my connection. I think that you may want to give mastisol a try. Like BF, I began using the Dexcom recently (on 3rd sensor.) The last sensor lasted for 15 days thanks to mastisol. But the significant thing to BF’s situation is that I have sensitive skin and had a bad reaction after trying to tape my first sensor when it began to peel. Next time I tried applying mastisol when the edge began to lift - just by peeling it up enough to get a q-tip under that was soaked with mastisol. This allowed the sensor to stick for 15 days and it remained reliable throughout! Upon removal, my skin looked good as new with only a vaguely visible line of mastisol- no redness. I think that I could have just left this to slough off, but I used a citrus solvent to remove it which then caused a bit of irritation, but that lasted for only a day or two before returning to healthy-looking skin. Just keep experimenting and you’ll find a procedure that suits you. Glad to hear another guy has a woman like you to help with motivation- my loving wife got me started on the Dexcom and I’m looking forward to seeing how it affects my A1C. Keep at it!