[Diabetes-talk] DexCom G5 Mobile CGM system

Mon Feb 15 01:28:55 UTC 2016

What do you mean by extra insulin? With an insulin pump, which is different
from a CGM, you have basal rates set up to deliver insulin throughout the
day, and you have an amount you bolus for meals and corrections.

Bridgit

-----Original Message-----
From: Diabetes-talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of d
m gina via Diabetes-talk
Sent: Sunday, February 14, 2016 5:43 PM
To: diabetes-talk at nfbnet.org
Cc: d m gina <dmgina at samobile.net>
Subject: Re: [Diabetes-talk] DexCom G5 Mobile CGM system

Yes I understood that,
my question is this,
With the machine, do you still need extra insulin.
I am told yes here in town from the one lady I saw.
I am saying no.
Because you folks have never shared that before on the pump.

Original message:
> Dar, the CGM has no connection with taking insulin at all. It's simply 
> a way to look at your blood sugar readings and see the patterns. What 
> you do with the information is still the same. But if you have 
> hypoglycemia unawareness, an alarm with go off when your number is too 
> low and get your attention for sure, or will get the attention of 
> someone else if you can't respond. You can also set an alarm to notify 
> you if you are too high. But the device does not administer insulin in any
way.
> Glad you are doing the walking you are. Keep it up!
> Veronica

> "Guide Dogs, First Hand", Veronica Elsea's classic album is now 
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> To learn more, visit:
> http://www.laurelcreekmusic.com
>                 Veronica Elsea, Owner
> Laurel Creek Music Designs
> Santa Cruz, California
> Phone: 831-429-6407

> -----Original Message-----
> From: Diabetes-talk [mailto:diabetes-talk-bounces at nfbnet.org] On 
> Behalf Of d m gina via Diabetes-talk
> Sent: Sunday, February 14, 2016 1:01 PM
> To: diabetes-talk at nfbnet.org
> Cc: d m gina
> Subject: Re: [Diabetes-talk] DexCom G5 Mobile CGM system

> 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

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