My son’s Dexcom 7+ arrived, but we can’t get in for training for several weeks. I’m not sure we’re going to wait that long before getting started. We’ve read the manual, watched the tutorial, watched videos of insertions of the sensor. What else do we need to know if we want to get started?
Thanks!
I never had any training for the dexcom, and with the help of my husband, we figured out how to use it just fine. We did the same as you, read the manual, watched the DVD, etc. It's pretty easy to figure out. I'd say just go for it! My doctor actually told me that a lot of people don't get the training and just start on their own because it's pretty easy to use. My only piece of advice is that the inserter seems a lot more intimidating and scary than it actually is. In my opinion, the faster you press the plunger, the less it hurts, but that's just me. Good luck! Hope it all goes well.
If you're comfortable with the pump infusion sets, then I think you'll do fine with dexcom w/o in-person training.
If any sensor doesn't work well, you should be able to get a replacement from Dexcom. Dexcom says to wait up to 3 hours if you get ???, as sometimes the ??? will disappear, and then work fine. I've had a few with ???, some that resolved, and others that I got replacements for.
I met with a local dexcom rep for a trial sensor before I purchased dexcom. I inserted the first 'trial' sensor, while she watched, but I think I could have done it without her. But I also had experience using MM CGMS. So when my own dex arrived, I didn't have any additional in-person training.
I did have problems with my 2nd or 3rd sensor, and I got the dreaded ???. I called dex support, and they agreed to send me a replacement. Once I knew a replacement was coming, I took out the old one, and that's when I realized I hadn't locked down both corners of the transmitter, which probably caused the problem ! The 'twisty' thing doesn't always work well (for me), so I use my fingers if needed to get the 2nd corner snapped in.
I agree, best to get a good fast push on the plunger ! It's not 'spring' loaded.
Good luck !
Just remember the numbers aren’t very accurate for the first 24-48 hours. Also remember the interstitial fluid is 10 min behind your finger stick readings. If my BG in the am is off by more than 50 I’ll add in another BG reading into my Dex and it helps to get the readings closer together.
Good luck!
Honestly, I wouldn't wait.
If you're kind of savvy, I can't think of a reason not to try it out. Use caution, and if you finger test anyway, where's the harm?
My training for my CGM was pretty poor, and the girl doing it was inexperienced. She seemed surprised that I hadn't already started using it.
The best advice I can give is to only calibrate with a finger stick test when stable.
I'll sometimes have a lousy glucose reading when the CGM is demanding a test, and I just tell it to hush up while I get myself to a more level/stable ground.
Meaning, not just after meals, not in the morning, etc etc.
Before when I would enter in that reading anyway (not being aware enough of that delay in time between the CGMs reading and my actual blood level), thus completely throwing off the validity of the reading as my glucose may have still been rising or falling, zeroing in the CGM to a false number that it then happily continues to track.
Molly has it right too. I'll put in a new sensor the night before I switch it on. They have a tendency to be a bit twitchy before they're thoroughly 'wet'.
I've always found 12 hours to be enough for my minimed CGM to see it testing accurately.
Breaddrink- I agree it was helpful for the Minimed CGMS to insert the sensor 12 hours or so before starting it, to let it 'wet'.
But this is not necessary for Dexcom sensor. Dexcom is a bit less accurate the first 24 hours, but it's usable, and trends are usually accurate. I start it immediately after inserting sensor, and then enter calibrations 2 hours later when prompted.
Dexcom says you don't have to be 'stable' to enter calibrations, but I agree it does work best when you do. I also calibrate when dexcom is off by 20%, as suggested by dexcom support. Usually within 5-10 min, the dexcom reading is adjusted to be close to what I entered.
When my meter reading is far off from my dexcom, I'll do another meter BG. It's been a surprise to sometimes find consecutive meter BGs to be quite different. So I'll do 1 or 2 more meter BGs to find a consistent number. (making sure my hands are clean).
Great tips, thank you! We have the sensor inserted and are in that 2 hour start up mode.
The manual says to insert the sensor on the abdomen. I think of abdomen as stomach, but technically, it’s the whole mid-section of the body. Do you put your sensors on your back, hips, upper buttocks, etc. or do you stick to the stomach? My son would prefer not to have his on his stomach, but that’s where we put this first one.
Better call your insurance company to make sure they approved it. I got mine on Thursday and learned it hasn't even been filed with insurance and was told it could take 30 to 45 days before it gets approved. I sent it back on Saturday because of this.
Thanks. Ours was approved. Sorry you had a bad experience!
I started in the stomach too, as recommended, and did ok. But then found I prefer my thighs and arms.
Check out the Dexcom group, there are several discussions on locations.
Here's a neat video for arm insertion on a young boy. I do mine in the opposite direction, with needle going downward, as I didn't have good results going up.
http://www.youtube.com/watch?v=Z5x4M9kg-BY
You've probably already calibrated now, but when you do those first 2 meter BG checks for calibration, it's best to get 2 readings that are within 5-10 points. So I don't enter the calibration until I've done at least 2 meter checks.
Thanks. We actually watched this video before getting started.
We have calibrated - he was 88 & 86 with his finger sticks with no insulin on board, so I think was right where several folks recommended he be for calibration.
I just joined the Dexcom group and will scroll through some of the older posts for ideas.
Thanks!
Glad your experience is being better than mine. Good luck with the dexcom.
It works for me almost anywhere - abdomen, buttocks, love handles, thighs, and my favorite place- lower part of upper arm. It's only FDA aproved for abdomen.
Have you seen the threads on making the sensors last longer?
I strongly recommend Opsite Flexifix around the edges of the sensor tape. The stuff stays on forever and prevents the adhesive from gradually pulling up at the edges.
Congrats!!
Thanks for yur response. From what I’m reading, it seems like the abdomen is an FDA issue and has nothing to do with efficacy on other parts of the body. That’s really good to know.
We use SkinTac for pump sites, but we didn’t use anything for the sensor. I read not to use IV3000, so I figured SkinTac probably wasn’t a good idea either. I have some FlexFix and will give it a try - thanks for the suggestion. Do you use a square of Flexfix and cut out the middle for the sensor or do you cut strips of Flexfix to put around the edges?
The sensor has enzymes on it, and shouldn't pass through anything like Skin Tac.
I cut strips, some folks cut a hole for the sensor. The other thing you can do is apply a small amount of Skin Tac around the edges after it's in. Personally I think the flexifix works best ;)
I was trained to only do one finger stick, but to put the number in twice for calibration. I've been doing it that way for 2 1/2 years now.
What a brave little boy in the video!
Thanks for all the help. One more question…
The manual says we will need to calibrate at least every 12 hours. If we enter a bg at another time, will that stop the receiver from prompting for a calibration? For instance, before dinner, the Dexcom said 206, but the finger stick showed 130. We went ahead and entered the 130 value even though we had a few more hours before calibration is needed. I don’t want the CGM to ask for a calibration in the middle of the night, so I’m wondering if we enter a value with the bedtime finger stick, will that satisfy the machine for another 12 hours?
Thanks!
AustinMom - I did just like you and inserted the Dex CGM as soon as it arrived. I read the manual and watched a few videos online. You probably have already read this but it's a mistake I made a few times and learned the hard way. Never make a treatment decision (adding insulin or food) based only on the Dex reading, especially in the first 24 hours or so. It's always a good idea to do a fingerstick to confirm a high or low reading that might require an insulin correction or eating some emergency glucose.
While the Dex is still a relatively inaccurate device, it has given me countless accurate warnings and helped me to make timely corrections. I've worn a Dex sensor almost continuously since September 2009.
Yes, the bedtime finger stick will reset the calibration clock. Even if you go more than 12 hours, the DEXCOM will still report values. They just want a calibration at least every 12 hours to make sure the values it's reporting is in the right ballpark.
Best of luck with the DEXCOM. It's been a life changing piece of technology for me.
Alan
You did the right thing to enter the 130, even though it wasn't asking. This falls in the > 20% off range, and Dexcom says to enter a calibration. This happens more often the first day or 2.
If that was at 6pm, then dex would prompt for next one at 6am. But you can always enter more calibrations than 2/day, so yes, you should calibrate again before bedtime.
The first day, it's best to do more than 2, and I often do every meter BG on day 1. The receiver is 'learning' and getting reference points to compare to. Once it is reading accurately, you can actually go longer than 12 hours, by just ignoring the prompt for calibration. It does not alarm for calibration, and will continue to give readings w/o calibration.
When you entered the 130, did it 'correct' itself and get closer to 130 ?