I am getting hooked up to my first CGMS on Monday. I’ll be using Dexcom.Anyone have any pearls of wisdom for someone starting this device? Tips or pitfalls to avoid?
i managed to get an out of date sensor from the rep and found it really helped to practice with it beforehand and get a feel for what was supposed to happen on each step…
The unit should arrive by fedex today or tomorrow, so I can play with it over the weekend before my training session Monday. Good idea!
I just started using it a few weeks ago, and I LOVE it! I thought the insertion part was a little intimidating at first, because the needle looks gigantic, but it didn’t hurt at all. So, my advice is while the insertion part looks scary, it didn’t hurt me at all. Don’t let it intimidate you. 
It is really easy to use, once you’ve done it a few times. Congratulations!
also. the first time you do it, try standing in front of a mirror or asking someone to follow through the steps with you. This makes it easier to see what you’re doing when you snap in the transmitter. To remove the syringe insertor part, don’t be afraid to rock it gently back and forth - it should come off pretty easily. There are a few youtube videos with helpful tips, i think they were uploaded by members of this site! Good luck!
PS don’t forget to charge the receiver first…
I just started on my Dexcom a little over a month ago, and I went in kinda blindly without doing much research - so I’m still learning about it, but I like it a lot.
My biggest piece of advice - be careful when correcting based on the Dex’s numbers…in fact, I don’t recommend you base the correction on the dexcom’s reading without testing on a normal glucometer first. For me personally, the Dex will be about 20% higher than my actual (finger prick) number when in normal ranges, more than 20% higher when I’m higher than normal, and about 20% lower than my actual BS when low. Due to the discrepancy, I overcorrected the first day I wore the Dex, and learned my lesson quickly.
I’ve had some trouble with the adhesive staying put with my last 2 sites (but not my first few, perhaps due to increased heat + exercise/sweat) so I ordered some adhesive dressing (hypafix) to help it stay on for at least the full 7 days.
I’ve also read that you can wear it longer than 7 days by restarting the sensor without changing sites, but have not tried this yet myself - although I plan to, assuming my skin doesn’t object & the adhesive stuff helps it stay on long enough.
Since you need to calibrate at least every 12 hours, I try to time mine for a little while after I wake up & a little while before I go to bed. But I’ve also noticed that sometimes it gets a little less accurate in the middle of the day, so I’ve begun calibrating then as well, and it seems to be more accurate all day long now. However, I have heard that you dont want to calibrate too often or the Dex can have big accuracy issues, so I plan to keep it at only 3 times a day.
And be prepared for it to act a little wonky now & then…a variety of things can affect its readings: taking blood thinners, heavy exercise, etc. It can be annoying, but it does great most of the time & has really helped me prevent overnight lows & post-meal spikes/perfecting dual-wave boluses with my pump - so its worth it to me.
And I also agree with Erin to not let the insertion needle intimidate you. I’ve been on a pump for a few years now so I’m not used to needles as much, so inserting what appears to be a big needle really got me anxious the first few times - but its not as bad as it looks!
Good luck!
Yay! I think you will love it. If you take tylenol, this will mess up the readings for several hours, so switch to ibuprofen. This is really my only complaint, as I wasn’t informed of this, and I guess failed to think of that when researching (I mean, why would I think of that???) I honestly can’t believe I never had this device before, and love seeing the trends! Oh, and don’t forget to change the sensor and wait until bedtime, b/c then you’ll have to wake up two hours later to enter in your 2 “start up BG’s” to get the ball rolling.
Take care!
I hope you love it as much as I do. I have had one now about 7 or 8 months and can’t imagine not having it. I have found that the stomach area (recommended by the company) gives the most accurate readings the fastest. A diabetic specialist (not a doctor) suggested I try it on the top of my rump, but I find that it gives very unreliable readings there in the first two or three days. Putting it on the stomach is a bit more in the way, but I just have gotten use to it and it gets in synch with my glucose levels faster (it works best in fatty areas). The first 12 hours though are still a bit wonky, and you need to calibrate it a number of times to get it right. Once every 15 minutes for three times after it has been in for 12 hours usually gets it in synch for me. Be patient. It is the glucose trends that are the most helpful as you will still need to always check it against the meter (usually about two or three times a day). Good luck!
Do not be afraid to experiment - I find if I insert night before and start in morning, the Dex tends to do way better day 1 than if I insert and begin new sensor right away.
Maybe not to calibrate when the Dex is way off, it has trouble with rapid swings high or low, so be patient even if it is telling you calibration is needed until trend arrow gets more stable for a reading or two.
Exercise sometimes will wonk mine out - lags a bit more, especially if sugars drop quickly with activity.
Skin-tac applied after you have inserted on the outside of the tape helps a lot. Blow dryer on low for a minute or two after showers helps keep mine stuck for two weeks. And I tape a 3X3 to a 4X4 piece of light gauze over the entire site, it helps a lot for me with clothing rubbing, sweating, etc stay glued for 2 weeks. Mastisol if you are desperate around the edges of the tape. Goo-gone if you need adhesive remover!
Enjoy!
Wow, you all are full of useful information. Thank you sooo much. I AM scared about the big needle. Anyone know what gauge it is? When my blood clotting was off from the lupus just 5 weeks ago, I was bleeding out my pump site and had to use pediatric needles to inject for a week until they fixed my clotting. And I made huge bruises anyway! I have a hematology appointment first on Monday to get a PT INR checked before we stick it in, but I am still scared about bleeding…
Cool! I’m gonna watch this one tonight. I’m at work right now - no youtube access:(
It’s “BLOCKED CONTENT” .
yep, i can’t switch from my broken barely working navigator to the dexcom because the only painkiller i can take is tylenol/acetaminophen
Dexcom is a 26 gauge, I believe.
Great advice so far. I’ve been “Dexing” since March of last year. I took a few month hiatus, and recently just started back up. I have found the Dex to be pretty dang accurate most of the time! Good calibrations are really important, and less is more. I only calibrate when the Dex tells me to. If the CGMS is off more then normal, I will usually try to sit tight and see if it will correct itself. Many times it does, if it remains off…then I will calibrate again.
I definitely recommend getting something to put over the tape. I use Opsite Flexifix. It works great. I just cut out a hole for the sensor. I tried it without tape, and barely lasted two days(with ‘normal’ use).
Good luck!
This discussion has been so helpful, I was going to start the same discussion b/c like Michele, my son, a teen, is starting the Dex on Monday with a training class too! I’m excited to see all numbers and trends, but a little anxious about the insertions, he got a little woozie when we did a 3-day trial with the Meditronic CGM. 26 gauge is so big. He wears an Omnipod and deals with those insertions fine, but his preference is to never wear it on his belly (though can’t blame him because the size of the pod would make it in the way). The Dex is pretty flat and belly is recommended so it something he is going need to get use to. We are happy the CGM is going help us with better control (hope to be in the Flatliners Club soon) and with pre-bolusing b/c he hates being surprised that he has to wait to eat so his BG can come down a little first. Please keep the discussion going.
Addition question, manual says it will need to charge in 3-5 days. Can you do this next to your bed and still get read outs?
We had trouble with irritation when my son applied it to his stomach area, but now he puts it on the back upper arm and it works beautifully. Readings are amazingly accurate, it stays on beyond the seven days, and there is no irritation. His irritation probably was a result of the unit becoming loose after several days, which on his stomach seemed to happen so quickly no matter if he used skin tac when applying it, or hair dryers after showers to dry it. Be aware if you apply it to the arm, find an area on the upper arm slightly to the back where there is some fat, and then apply it VERTICALLY not horizontally as you would do on the belly. We used to apply skin tac to the skin area (stupid us) trying to avoid the spot where the sensor would enter. Now we apply the skin tac to the adhesive on the sensor, which makes it easy to avoid a nickel sized area around the actual sensor needle. It sticks beautifully and stays on so well, and the readings are amazingly close (most of the time) to the Bayer blood sugar meter he uses to calibrate. My son was at first afraid to put it on his arm but now he prefers it there (although he needs help with the actual application if onto the arm). I pinch the area fairly hard as I push down and that makes the needle going in less painful or obvious. He says it hurts very little (my pinch as well as the needle). Good luck with your Dex, we really love it in our house!
Yes, it will continue doing its thing while charging as long as you’re within range (5 feet). I just plug it in & keep it on the bedside table every few nights while I sleep.
So far, so good. But I didn’t put it on myself yet - the nurse educator did it. I get to do it next time. Funny, you’d think being a doctor and all, I wouldn’t be all freaky about the big needle. But I didn’t want to plunge it in the first time myself until I knew what it would feel like going in. It wasn’t bad. I think I’ll manage. Pretty cool so far…
Us too, Dr. Michele, we had our class Monday and it went really well. I did the application/plunger for my son while the educator coached me. He said it was OK, a little less painful than the Omnipod application(half the time he says those dont hurt). On back, to the side above pant line. So off to a good start, stopped 2 lows already, but tonight he finished his workout at 82 going beween steady and falling slow, 15 min. later at 79 and did a BS check he was 59, so there will be a learning curve. Incedently, when we started our workout he was 151 and a slow falling arrow during it. It will be great to know how high he needs be to start workout, no more, no less. Ideally, of course ha ha.
My low alarm went off at 230 am last night. Then this morning I got to watch and see how quickly my sugar climbed after eating gluten free oatmeal. WOW - eye openning! I spiked to 274 in under 30 minutes - got the double arrow rapid rise alarm. By 3 hours from breakfast it was back to 137. I feel like a little kid at Christmas playing with a new toy. I really like this device!