Medicare/Dexcom October G6

I spoke with someone at Dexcom today. I asked if we would be switched over to the G6 at some point this year. His answer was October and if we don’t like them we can switch back to the G5 either by informing Dexcom ordering department, or getting an Rx from the doctor for the G5. If all that is true, that eases my mind. I’ll TRY the G6, but I want the option to go back if it doesn’t work out. Sounds like that will be doable.

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I think you’ll be very happy with the G6. If Tandem had their act together and got the X2 in your hands, the G6 is a no brainier. With the Medtronic pump it doesn’t matter really. Use whatever you want young Padawan, the world is your oyster.

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I am quite concerned about the G6 because it appears Medicare patients have had implementation delays due to technical as well as production issues. One of the technical issues I have heard is that the G6 does not work well for patients with a low BMI. My BMI at 18.5 would certainly be considered low and I would work hard to try to find a place on my body to make the G6 work, but if it won’t work, I am really happy that I could remain on the G5.

I didn’t notice any difference between them except the G6 has a lower profile. I’m 6 foot and 160 pounds. I’m not convinced this Medicare delay is due to production. I think there are other issues going on behind the scenes that neither Medicare or Dexcom want made public.

So your BMI does not appear to be an issue at 21.7.

I’ve never paid any attention to my BMI. I don’t understand why the G6 wouldn’t work the same as the G5. Like I said, the only difference I noticed between them is the profile.

CG114:
A family member of mine has a similar BMI with T1D and has issues with Dexcom if dehydrated, otherwise no issues. It’s more sensitive to hydration in the arm versus abdomen or upper buttocks. Same experience with G5 or G6.

I have issues with Dexcom readings too if dehydrated, but my BMI isn’t 18.5; I only use my arm for Dexcom.

I know I’ve read articles about athletic individuals using Dexcom too. Here’s a link for one of them on their site, there’s others too:

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On the Medicare G6 issue, a Dexcom rep advised me that the issue with Medicare is because of Medicare’s issue with using a phone as a receiver. That was a few months ago though, so good to hear it’s projected for October.

Also I agree, the G6 is better, both because of the easy insertion and also because it works with tslim X2 to suspend insulin when low.

As soon as G6 is available to me on Medicare, I will do my best to make it work. I am really happy, however, that if I can’t make it work due to hydration/BMI and or other technical issues Dexcom is addressing, I will be able to switch back to the G5 until solutions are found to make the G6 totally functional. The G5 is certainly not perfect but works fairly well most of the time when you learn to deal with its periodic temperamental flaky moments.

I believe it was recently stated that Medicare w/G6 will no longer receive strips.
Certainly possible I misinterpreted.
As always, everybody has their own decision tree.

Based on various people’s responses, it does sound like the G6 has higher “randomness” (???) in how well it works for somebody. Certainly being dehydrated is always an issue but that was so in the G4 and G5 as well. Very low BMI seems to have fingers pointing at it. The reality however IMHO is you have to try it to know. Not ideal but other than that it is (IMHO again) simply guesswork trying to know in advance whether the G6 will work for you or not.

The G6 works well for the vast majority of people.
But if you happen to be some of the ones for whom it does not work well then … That is really the only thing that matters for you.

We use the G6 to drive the Basal-IQ on our X2, such that we expect the G6 to be delivering data readings which are less than 10 points difference from our Contour Next One meter readings once we are 12 hours past G6 warm-up. Not worrying about the times of rapid change bit when levels are relatively stable.

The 30/30 rule that Dexcom has for the G6 is something I consider entirely unacceptable. If the Dex was just barely within 30% for us there is no way I would be allowing it to drive any algorithm.

The G5 had/has a 20/20 rule. I like Dexcom but think it was a very ■■■■■■ move for them to go from 20/20 on the G5 to 30/30 on the G6. As I said, luckily for us we are usually within single digits difference between the G6 and the Contour Next One meter when relatively level blood sugars. Obviously there is a cgm lag when blood sugars are rapidly changing.

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According to a convo I had with dexcom support the differences experienced by some is due to the angle and length differences between the G5 and G6 filaments. They said it’s subtle but accounts for issues for those with BMI. I don’t if the explanation is the FULL reason for G6 issues for those with BMI.

I had a bit of trepidation about it, too—I was happy with the G5 and there were some bad reports out there. But I’m SO glad I did.

  • I thought the accuracy was only going to be marginally better. It is WAY better, to the extent that I’m hardly doing fingersticks at all anymore. Never had that level of confidence with G5, good as it was.
  • I thought the insertion gadget was silly and too much like the Medtronic Guardian 3 “Serter” thing. Wrong. It works really well, and makes it MUCH easier to place the sensor in harder to reach spots like the back of the arm.
  • I thought the “No calibration” thing was a trivial improvement—been sticking my fingers for decades, big whoop. But not having to calibrate after starting a new sensor is HUGE. For instance when I dislodged my sensor just as I was going to bed t’other night, and didn’t have to worry about waking up at stupid-o’clock to calibrate the replacement sensor.
  • Session extension: a bit more complicated, but once you figure it out it’s n.b.d.

Worst thing I’ve heard is people not being able to get the full 10 days from sensors. Never been a problem for me, but that might be a deal breaker if you run into it. No way to tell without trying as it seems to have something to do with individual physiology/body chemistry. I have had one sensor that went cracker-dog for the first 2 days, well past the initial settling-in period, but I did the restart routine on it and it was fine after that.

ETA: on the no-calibration at sensor start, there are all kinds of times when knowing you’re going to get your chain yanked in two hours plays hob with doing a sensor change. I ran into this all the time with the G5. Making sure I wasn’t going to be in the middle of a performance or some other non-interruptible activity two hours hence from insertion was frequently a cause of consternation. Such a relief to be able to just go ahead and change it and not have to worry about that any more, really makes it so much simpler.

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100%

I agree with just about everything you said here!
Also, on the 10 day issue. With using the standard issue setup, I only got 10 days a couple times.
I then started using skintac before putting the sensor on, and I consistently go 14 days (last one went 21 days, but I did use the free dexcom patch for the last 3-4 days.)
The skintac makes 14 days easy for me. I have some edges curling up a little, but not enough to worry about. So I am happy!

Have u ordered the free dexcom patches? that should stop the edges from curling. i use them on every G5 sensor; they hold the sensors fast.

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I hope that the October date is correct. Of course each of us will be limited by the last time we received a transmitter. So for me, November will be the earliest start date.

My philosophy with Dexcom these days is that I will get G6 when I get it. Every time stuff like this goes on at Dexcom, different reps tell different people different things. In general I am happy with G5 and because I am Looping, I am doing OK without Basal IQ. However using an Omnipod is much more expensive for me than using my Tandem pump.

Once I start getting G6 supplies, I will probably use G5 for an extra month or two to accumulate a stash of G6 sensors. I have enough G5 supplies to go several months. I plan to go back to my Tandem pump once I start on G6. But as I increasingly am doing well with Loop, maybe I won’t. It’s nice to have a choice.

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I’m in a better mental place than some other folks because I don’t really care if/when I get a G6. Why? Because I MIGHT like it, but then again I might NOT like it. I’m not waiting for it excitedly like a kid waits for Christmas. :slight_smile:

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Well thanks Dave44, now I want the one I ordered yesterday like a kid excitingly waiting for Christmas, :grin:

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I have ordered the free patches, yes.
Thing is, I really don’t like anything more than absolutely necessary when it comes to tape, patches, etc.
I just want the original adhesive to work like promised and not have any other issues. Kind of like the G5 USED to do!

I asked about this in a conversation I was having with a supervisor in the San Diego office. She did say that Dexcom did in fact change the adhesive on the G5 and the new not released yet G6. Due to enormous backlash they are in the process of changing it back. The inane recorded message that plays while you’re on hold is rather insulting. Dexcom is literally blaming the user for not following the correct procedure when inserting the sensor, because it’s certainly not on them for applying no adhesive on the sensor to begin with.

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Agreed!
And while I understand that they may have been trying to get an adhesive that fewer people had reactions to, they really should have made sure it at least WORKED!

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