[Diabetes-talk] DexCom G5 Mobile CGM system

Mon Feb 15 03:28:43 UTC 2016

Hello,

The device doesn’t dispense any insulin. It just monitors your Blood Glucose wirelessly. It doesn’t actually do anything but that.

I hope that helps.

Ed
> On Feb 14, 2016, at 2:00 PM, d m gina via Diabetes-talk <diabetes-talk at nfbnet.org> wrote:
> 
> 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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> 
> -- 
> --Dar
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