Started on Dexcom G6

I’ve been Medtronic insulin pumps and CGM for twelve years. I just got my Medicare Dexcom which is boxed with Medicare stamped on every box. I’m only allowed a 30 day supply, which means 3 sensors and one transmitter. I call to reorder when I start my last sensor, which should arrive before the last sensor is done. There’s no spares no extras. I wasn’t allowed to use my Medtronic CGM records for qualification and the whole process of 4 finger sticks a day started May 1, 2020. As a T1 for 55 years nothing is as helpful CGM is a life saver especially when it can shut off an insulin pump. I’m so grateful and happy to get the Dexcom but no wonder diabetics hoard insulin and supplies. I hoarded my G3 sensors and darn good thing I did. It just constantly annoys me that I have do a whole project plan to get tools I need and use to live.

I will be wearing the 2 side by side to see how it works and compares.

3 Likes

Curious if others have had same experience, since have not heard this mentioned before as MC requirement.

There are ways to extend dexcom sensors, search for restart sensor.

1 Like

As far as I know those are the requirements for traditional Medicare with Medigap. Medicare Advantage Plans apparently work differently. Thank you for directions on restarting. Yes, I extended my Medtronic sensors many times but why for heavens sake should a T1 ever have to? A T1 really needs insulin delivery and be aware of what their BG is at all times just to stay alive. Why are we rationed? Yeah I know we are and that’s how it goes, but really why oh why?

2 Likes

I also heard a bit too late that because Diabetics did so much better with COVID-19 when they used CGM that Medicare didn’t need as much authentication, just a doctor’s prescription. It took a full blown pandemic for Medicare to figure out that diabetics do better all around and their A1Cs most often drop on a CGM. Without a CGM, I’m surfing my blood glucose blind.

2 Likes

I share your frustration with any entity, be it Medicare or suppliers, that restricts fluid access to the supplies we need to keep us alive. They have no idea the dance we do to keep our BGs in check.

Are you aware that some vendors will ship 90 days worth of supplies at a time? That means I receive 9 sensors and 1 transmitter every 90 days. I use US Med but there are some others that also maintain this policy.

My former supplier, which would only ship 30 days of CGM supplies at a time, would have been OK except that they just couldn’t maintain the 30 day rhythm and slipped to 34 then 36 then 38 days. In addition I had to get on the phone, navigate their phone menu, wait on hold just to troubleshoot what the holdup was. I got tired of performing as one of their external business workers!

My last shipment of 90 days of Dexcom CGM supplies arrived after I responded to their text message prompt and we had no further interactions. One text message exchange and the supplies arrived a reasonable time later.

2 Likes

@Terry4 did you have to submit 4 weeks of bg logs, assuming you were already using cgms. ?

I recently started the process to get a tandem pump and the diabetes educator who I met with asked me to get a 4 week blood sugar log together in advance because he thought my insurance (UMR through United Healthcare) would request that and not accept Dexcom reports. Currently dragging my feet on transcribing my old dexcom readings into a fake blood sugar log :joy:

1 Like

@Jane_Vaugh:

If you haven’t actually started your G6 sensor and transmitter and have a backlog of Medtronic supplies, I would suggest you consider NOT starting to use the Dexcom stuff. If you can feeder that start for 30 days, for example, that will automatically give you 3 extra sensors and a 30-day “cushion” on your transmitter life. In that case, once you are “in cycle”, you would always call Dexcom of your supplier when you started your fourth remaining sensor rather than your last remaining sensor. That cushion is extra beneficial when you encounter a sensor failure on your last sensor … much less traumatic if you actually have your “secret stash” to go to rather than waiting for FedEx.

Like most, I don’t understand why there is no provision for an emergency spare sensor, but this is one way to circumvent it without breaking any rules of getting 3 sensors every 30 days and one transmitter every 90 days.

Best of luck on your transition to Dexcom CGM.

Stay safe!

John

3 Likes

I may have done that many years ago when I first started on Medicare. Is that the current Medicare requirement? I have a vague memory of a Medicare rule requiring four finger sticks/day. This would have happened in 2015; my memory is not that good.

It could be that my doctor at the time filled out a form that vouched that I was a T1D, was on insulin, made frequent adjustments to my insulin doses based on my CGM readings, and stuck my finger at least four times per day.

John - I do indeed have a backload of Medtronic sensorS that for the most part I’ll use until I get my TSlim Pump. That will certainly help. I’m trying my Dexcom sensor right now for comparison but will then just use the Medtronic so I have at least a couple sensors extra in case one falls off or something. I’m just whining that I have to do such things to manage my blood sugar and continue fighting the good fight.

Terry - yes May 1 I did 4 finger sticks a day until my endo put it in her notes and was able to access my Medtronic records that showed I used a Contour Next meter. I doubt she counted 4 finger sticks a day but in case anyone wanted to count it was all there.

I’m just disgruntled because for 55 years I’ve managed to stay alive with insulin and in fact beaten all the odds that I would live long enough to go on Medicare and I have to account for my insulin usage and be rationed in my CGM supplies. But I am most grateful that I can get enough insulin and do qualify for a CGM. Far too many T1DS have nothing and are trying to ration their insulin supplies.

1 Like

I have kaiser permanente insurance and they give me 90 days supply. I get 90 days for insulin too.
However several years ago they started reducing the number of vials I would get.
Then at the pharmacy would ask me how many units a day I used. And give me only the amount for 30 days.
Using a pump I waste some insulin so it was really irritating.
I finally started telling them I took 100 units a day just so I could get my insulin.
In reality I dose about 38 and end up consuming 50 with waste etc.
so then they just stopped doing that and just give me what the doctor ordered.
Insurance companies including Medicare are so afraid of fraud that they unfairly stick it to the people who really need the medication.
I really can’t ration insulin. A few hours off of it and I’m into DKA.
Then the insurance company would need to pay for the hospital stay.

No diabetic can safely ration insulin but people who self insure or without access to healthcare are forced to ration their insulin, which often results in DKA and early death. That unfortunately is a whole different discussion than meeting traditional Medicare medical device rules and regulations. Yes we all heard people getting fancy electric scooters that were perfectly capable of walking but who would go through the hassle of using a CGM if they really didn’t need to? The display would be pretty boring if the person didn’t have either type of diabetes. Medicare is a government run health care system for people retired at 65. I shouldn’t expect much logic in the decisions.

Firstly I would keep the two apart at least 6 inches so that insulin doesn’t affect your readings. Secondly, you could restart your sensors to get 20 or more days out of each sensor. It works for me for as much as 30 days

Thanks for the suggestion. My infusion set is on my thigh and I’m wearing the Dexcom 6” from the Medtronic sensor on the abdomen.
The no need to calibrate is quite the game changer plus I can use the Dexcom for meal and Bolus decisions.

I definitely did that with the Medtronic but now it’s better on something that doesn’t need frequent calibration.

No one else seems to have commented on the one thing that sounds shockingly good - “I’m only allowed a 30 day supply, which means 3 sensors and one transmitter.” The three sensors is concerning, but if you get a transmitter every 30 days, that is amazing.

I’ve got extra sensors because of their screwups, but will not have a spare transmitter for years. I was able to get only 100 days out of my first one, rather than the 110 I expected. 1/9 extra per quarter means 9 quarters or 2.25 years from when I started 6/1/20.

Looks like I’ll have to end a sensor session a day early to get over 100.

No. The starter kit had the transmitter. The next two refills will NOT include a transmitter. I only get 1 transmitter every 90 days. Sorry if that wasn’t clear.

I also figured out why traditional Medicare only wants us to have a 30 day supply. The one true thing that’s true for a person of 65 years and older is that there’s no guarantee the person will be alive for the whole 90 days. There would be sensors wasted and additional troubles for survivors.

1 Like

I recently started on G6, after several years on G4/G5. I am VERY disappointed in this product. First, it ALWAyS reads low at the start, and by low I mean ridiculous. Normally, 3-4 hours in, it is reading about 40-45 when my blood sugar is 90-130. I’m on my 5th sensor, and that behavior has been constant. I’ve started now trying to reduce the problem by inserting the new sensor 6-7 hours in advance, so that when I actually switch, it’s only bonkers for ~12 hours instead of ~18. I can’t imagine how they think this thing is good enough for controlling a pump! The even more annoying part is that (despite advertising to the contrary) IT WILL NOT ACCEPT A CALIBRATION during this period, because it will only accept the calibration if it agrees with the reading within some limit. And, even worse, if you try to do a calibration, it stops reading at all until you submit a calibration you agree with. I made the mistake of trying to calibrate it with my first sensor, and wound up attempting 9 calibrations over 12 hours before it finally accepted one and started giving me readings. And the ridiculously complex mechanism for acknowledging an alert is just an abysmal design. On the G5, I could hear the alert, push the button, and that was it. On this thing, I have to open it up, perform 4 actions, and, if I’m not very fast about it, it turns off and I have to start over. The click on the OK icon appears to be especially unreliable. I have to hit it 3-6 times before it accepts the OK. Almost never works the first one or two times. It can take 1-2 full minutes of fiddling to get the alert canceled. There are many social/work situations where that will be very objectionable. Why they didn’t give you an option for use of the button is beyond me (maybe a double click?). The G5 was well designed. This thing is garbage.

Has anything at all changed since you started on your G6? You might also consider talking to Dexcom regarding the lot numbers. Despite best efforts sometimes there’s a problem with a batch of sensors. Call Dexcom support.

thanks. I did call them and they said was a “bad sensor” and sent me another one. But the experience has been quite uniform. Now that I’m doing the early insertion, it’s better, but basically those sensors are designed to read continuously lower than actual. I’ve never seen one reading high, even after calibration. I guess that’s why folks who go from G5 to G6 see their A1C values go up. I’m trying to correct for the bias, but it’s a bit difficult, with the alerts.