[Diabetes-talk] DexCom G5 Mobile CGM system

[d m gina]

With wearing this device, do you still have to take extra insulin?
I ask because my diabetic coordinator says I still would have to do two 
different insulin shots.
Being confused I don't want to keep adding more insulin at the cost of 
$400 for five pins.
That seems quite out of reach for anyone.
I am told the price was because my insurance needed to have me pay what 
they want for the start of the year, even though I pay a co payment on 
a monthly bases.
I am walking a treadmill for an hour for five or six days.
When the summer gets here, and there is no snow then I can go back to 
my mile and a half walk that I do with my dog.
Glad this is working for you.

Original message:
> Hello Ed and all interested in CGM, pumps and accessibility,

> Fair warning, this is a lengthy post...

> Ed - I am also using the DexCom G5 Mobile system(G5 stands for fifth
> generation), and have been since it first became available as an upgrade to
> the prior system late last year. I am late in providing an update to this
> list, and for that I apologize. The DexCom G5 Mobile is quite a breakthrough
> in terms of accessibility over their previous DexCom G4 Share system.

> As you describe, nearly all aspects of the day-to-day use of the system,
> including setup and calibration can be managed by someone who is blind. I'm
> glad to hear that your A1C has fallen into a healthier range since you began
> to use the CGM. Mine did also, and in general, the statistic I've heard
> reported is that on average, a person's A1C will lower one full point when
> using a CGM consistently.

> Hang in there with pulling the plastic covers off the adhesive. In the
> beginning I had some issues as well, but now very confidently handle
> applying the sensors to my skin. I've included at the end of this email a
> lengthy description of how I go about putting on my sensors.

> Not being able to detect a low blood sugar before it is dangerously low is
> known as hypoglycemia unawareness, and if your insurance covers CGM use,
> having hypoglycemia unawareness gets you automatic approval for use of the
> CGM. CGM can truly be a life saver, and I know both my wife and I sleep much
> easier now.

> Now, in terms of the Medtronic system, they are marketing the Minimed 530G
> (I think the G stands for Guardian). This is a combination insulin pump and
> CGM system. It still requires you to have two items inserted under your
> skin, the canula for the pump and the sensor for the CGM, but the pump unit
> handles both the display and input for both the pump and the CGM. The
> feature that sets this pump and CGM system apart is that the pump pays
> attention to the CGM readings, and when the CGM indicates you are going low,
> if you do not respond, it automatically turns off the pumps basil insulin
> delivery for up to two hours. This is the first time ever in the US a pump
> has been approved that takes data from a CGM and makes a decision for the
> human wearing the pump. That in and of itself is a landmark accomplishment.

> In terms of accessibility, They offer a system named Minimed Connect, which
> can be used in conjunction with an iPhone or iPad app to display information
> about the Minimed 530G pump and CGM on your phone. By the way, I believe one
> must purchase the Medtronic Connect system to have the iPhone app display
> the CGM and pump information; for DexCom the system connects to the iPhone
> at no additional charge. I spoke with another blind person who uses it. It
> does have a few advantages over the DexCom G5 Mobile system if you use a
> pump, because the Connect app lets you get information from your pump as
> well in an accessible form. I use a pump, and I always have to ask others to
> tell me how much insulin is left in my cartridge, how much insulin is still
> active in my body since my last bolus, and what my pump battery level is.
> With the Minimed Connect system, the blind person can now access that data,
> along with the CGM current reading, right from the iPhone app. The
> availability of the pump information on the app is a first, as far as I
> know, for any pump.

> That being said, just from the CGM pperspective, the Minimed Connect falls
> way behind the functionality available via the app for the DexCom g5 Mobile
> system. As I said earlier, the Minimed Connect app only lets one view the
> data from the app; you cannot interact with the pump or the CGM via the app.
> So, with the DexCom G5 Mobile, you can use the app to start and stop your
> sensors, enter your twice-daily calibration values, set all your individual
> alert levels and sounds for your high and low thresholds, and you can even
> enter your diabetes-related activity into the app, such as how much insulin
> you just took, how much carb you just ate, how much exercise you just did,
> and other items such recording that you are ill.

> All that data, in conjunction with the blood glucose readings from the CGM,
> can help you and your diabetes health team determine how to best adjust your
> particular carb to insulin ratios, basil levels on your pump, etc.

> On the Minimed system, all the functionality I just described for the DexCom
> has to be entered on the Minimed pump system, which is absolutely not
> accessible.

> Another advantage of the DexCom system is that all you need to carry with
> you is your iPhone. The DexCom sensor you wear on your body transmits the
> information directly to your phone. On the Minimed system, you have to carry
> another small device with you, named the uploader, which is about the size
> of an automobile key fob. The Minimed transmitter on your body first sends
> the information to the uploader, and it in turn sends it to the phone. So,
> it is small, but the uploader requires charging, and it is one more item to
> remember, and potentially to forget.

> Finally, a wonderful advantage of these new CGM systems is that they also
> automatically send the blood glucose data to the CGM company (either DexCom
> or Medtronic) where it can be viewed by you or your doctor. The web-based
> DexCom product for viewing your data, identifying blood glucose trends, and
> tracking how you re doing is called Clarity. As I said earlier, the
> Medtronic name is Minimed Connect. DexCom offers Clarity for free.

> So, when I see my endocrinologist, she can call up my data from the DexCom
> site. I do not need to have my CGM uploaded to her PC in her office, nor do
> I need to give her my blood sugar logs. For better, or worse, my life as a
> diabetic is available to her, in living color.

> Of course, there are many privacy safeguards in place. Your physician can
> never see your data unless you provide them access, and you can limit how
> long they have access. If you provide your doctor ongoing access, for three
> months or six months, for example, they can log in and see your data even
> whenyou are not at the office. And, the clarity system also let's you simply
> email a report to your doctor.

> I hope that soon, everyone on this list that can take advantage of a CGM can
> start using one. . I'm encouraged that at some point Medicare may start
> covering them.

> All the best,
> Tom Ley
> What follows next is a description of how I put on a sensor.


> How I put on a new DexCom G5 Mobile sensor without sight
> First, I find that often, the sensors come out of the large sealed plastic
> coverings such that the adhesive oval area is curled downward, so the
> adhesive is not flat. I make sure I bend up the oval shaped adhesive area
> all the way around until it is flat again.

> The covering over the adhesive is made of two pieces, each piece covering
> half of the adhesive. The two tabs you pull on are right next to each other,
> in the middle of one of the long sides of the oval.

> I usually start off by holding the sensor by the adhesive area with the
> fingers on my right hand, holding on the right side of the adhesive area.
> When I hold it like this, the bottom of the adhesive area is facing me, with
> the long body of the sensor that contains the inserter kind of falling back
> and down away from me to the right.

> Then I find the tab for the left half of the adhesive with my left hand, and
> making sure my right hand is only grasping the right side, I pull the tab on
> the left side toward  me and down to remove it. Lacking another hand, I
> usually put the piece I just removed between my lips to hold it until I'm
> done.

> Then, I very lightly grasp the now exposed sticky adhesive part with the
> tips of my left fingers. I grasp the smallest part I can, about in the same
> place the tab was that I just removed. And, I can now let go of the sensor
> with my right hand.

> It is important not to get the adhesive stuck to your clothes or anything
> else. I hold it away from my body. I might say also that I always stand when
> I put on a new sensor.

> Now, I use my right hand to find the tab for the other half and pull it
> toward me and down until it separates. I then hold this one between my lips
> as well. I'm sure it would make for some humorous watching if anyone videoed
> me while I was doing this!

> Now, the entire adhesive is exposed, and I'm holding on to the adhesive with
> my left fingers, but just the smallest part is sticking to my fingers. Now,
> I grasp the body of the sensor inserter with my right hand, and very
> carefully unstick mhy fingers from the adhesive. If done carfully, none of
> the adhesive will be sticking to itself, or anything else.

> Next, I carefully use my right hand to maneuver the sensor to the place on
> my abdomen I plan to insert and touch the adhesive to my skin. Then I
> qquickly run my finger over the adhesive to make sure it is well attached
> all around.

> Hope this helps!

> Tom




> _______________________________________________
> Diabetes-talk mailing list
> Diabetes-talk at nfbnet.org
> http://nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
> To unsubscribe, change your list options or get your account info for 
> Diabetes-talk:
> http://nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/dmgina%40samobile.net

-- 
--Dar
skype: dmgina23
  FB: dmgina
www.twitter.com/dmgina
every saint has a past
every sinner has a future