THE STORY OF ONE FAMILY'S JOURNEY WITH TYPE 1 DIABETES AND CELIAC DISEASE.
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Tuesday, February 22, 2011

Dexcom Review -- 2 Months Into the Game.

I wrote about our past CGM experience...and I shared my reservations about trying the CGM again...then I shared a review of our week long Dexcom trial.

If you've been reading Candy Hearts for awhile, then you already know that we completed the insurance process and obtained a Dexcom SEVEN PLUS of our own just before Christmas.  In the time since, I've discussed the Super Bolus and our shark's teeth phenomena.

It's been 2 months now.  Most of the time Dex and I get along okay.  Sometimes we don't.  But, at any rate, here's a few things I've learned:

1) Each sensor is a new ballgame. This is why I can't trust it. I feel like I have to build a new relationship every time we insert a new sensor.  Relationship drama is the WORST!

2) In my opinion, each sensor needs a 48 hour grace period before I rip into it about being unreliable. I think it takes time for it to "settle in" and start doing it's thing.

3) Her arms work better than her tummy. I realize it's only FDA approved for her belly, but I think she has more interstitial fluid in her arms. Not only that, when she lays on her tummy at night, it disperses the fluid under pressure and we end up with crazy overnight graphs.

4) It CAN be calibrated TOO MUCH! I had no idea! We were entering every number, but then I read that you were only SUPPOSED to enter a number if it's more than 20% off (actual BG divided by 5) OR if it prompts you to. The sensors and I are getting along much better now that we've been sticking to that rule.

5) The number is usually useless for rapid swings in either direction. The arrows, however, are not. If she's feeling low, I test and treat just like we did before Dex came along. 15 minutes later, I can retest and, while the numbers might still be inconsistent, the arrows usually point me in the right direction -- double arrows down turns into one arrow down turns into a slanted arrow down, etc... I do feel like I can use the arrows confidently to help me gauge what direction things are moving and whether or not additional treatment is necessary.

6) When placing the sensor (which, btw, I have never done -- Hubby handles all that jazz), it's important to get a good squeeze of fat and lift it as high as you comfortably can (again, we're using arms for Dex) to make sure the sensor doesn't get inserted to deep.

7) There are times that I actually **LIKE** having 2 devices...
** The first was when we took a New Year's Day trip to play in the snow.  It was about a 3.5 hour drive, and I sat up front with the Ping remote and Dexcom receiver.  It was SAWEET!  I could tell what was going on in the seat behind me plus point and shoot the remote over my head to give insulin!  
** I also appreciate being able to keep the remote on the charger at night.  It's SO NICE not to have to rumble around looking for her pump to see the CGM.  A quick glance is all we need for extra reassurance at night.
 8)  Each sensor consistently lasts between 10 - 14 days.  They may go longer, but we remove it when she starts to complain of itching.  We have yet to remove a sensor at the 7 day mark. Thus far, we just restart the sensor, wait for the 2 hour start up period, enter 2 BG's, and press on :)

On a side note, here's where I stand with those reservations I mentioned earlier:

Insurance:  So far, we haven't had a problem.  They approved the system and the sensor refills.  That being said, we haven't actually received our first refill order, so I do have to admit that I'm holding my breath a little.

Real Estate:  We're using her arms exclusively for CGM sites.  She never liked wearing pump sites in her arms, so it seems to be working well for now.  We rotate her pump sites between her bum and tummy and the CGM sites from one arm to the next.

Hypoglycemia Awareness:  She continues to feels her lows somewhere around the 60's.  That being said, her lows do NOT wake her up at night.  She didn't wake up from lows before Dexcom either, so we remain pretty vigilant at night.

Technology Updates: We're eagerly anticipating the Animas/Dex combo, but do not expect to see it anytime soon.  After reading this information, we decided to go ahead and renew her pump warranty and will play the rest by ear.  If we have to pay out of pocket for an upgrade later, we'll cross that bridge when we come to it.  Keeping her current pump under warranty is something that we just didn't want to risk.  As for other pump options, we can't base our decisions on what might or might not be part of the future in pump therapy.  We're happy with Animas today, and will just see where this road takes us tomorrow.

Click HERE to read other CGM posts at Candy Hearts.

PS -- If you have concerns about skin sensitivity and adhesion issues, Lorraine has a great post that addresses those concerns HERE.

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13 comments:

  1. Thanks for sharing your experiences with Dex! We're getting ready to do a 1 week trial in another 2 or so weeks...I'm pretty excited about it, but want to be realistic! So it's great to read about others experiences and get the nitty-gritty on the pros and cons!

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  2. We love ours. It alerted us to a low at the airport at a time we never would have checked. It's invaluable at night and I wake up to the alarms (next to a baby monitor) 99% of the time. Again, it alarms at times I would not have thought she would be low or high and would not have thought to check. Our child is only 2 and doesn't show any signs of being low, even when she is a 45!

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  3. Thank you so much for sharing all of this with us Wendy! It will definitely come in handy for me in the near future.

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  4. Many of those things I would echo. Though we just use the dex sensor on my son's bottom, and only for the 7 days. I like the idea of giving his bottom some time to breathe and heal up from where the sensor was inserted.

    One thing I learned from you: I didn't know we should wait until 20 pts off to calibrate -- though, usually I only calibrate if it's significant.

    Something you might not know: the rep told my cde only to charge it for short periods, like 30 minutes or so. Not overnight. Not sure why. But, there must be a reason!

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  5. Great review! I know many will find this very helpful!

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  6. Excellent review! When we did our trial, our nurse warned us about over-calibrating. We were told only to calibrate twice a day unless the dexcom instructed us otherwise (ie for a sensor error). I didn't know about calibrating if is more than 20% off. I am looking forward to getting ours in the near future. I have been missing it more than I expected!

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  7. We love our dex-com, which we have had for around 8 months now. It's always a little rough the first couple of months with any new gadget, but we would never go back. The number is certainly a "ballpark" figure but, like Wendy mentioned, the arrows are very reliable.

    To clarify for Roselady - only calibrate it if it's more than 20% off (actual BG divided by 5), not 20 points off. And we were also told to calibrate it twice a day, as well - at breakfast and at bedtime.

    Thanks for the great post, Wendy!

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  8. great to hear ur input on the dex! hope to get one soon. head over to my new blog for a giveaway! bethany at - sweetmystery6.blogspot.com

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  9. *Nodding Head* GREAT review Wendy!!! I can honestly say that EVERYTHING you mentioned is also consistant with our Medtronic CGMS.

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  10. Lora -- thanks for the clarification on the 20% thing!!! I didn't catch that error! See...tired D Mama brain -- thank goodness we have each other to lookout for one another!

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  11. We had to learn the hard way about calibrating too much too! Great review!

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  12. VERY informative Wendy. I love it for the car rides and the trending for sure.

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  13. Found your page when surfing. Very helpful- thanks.
    My son is also on a dexcom and thought I would add a couple of extra points that we found during use:.
    1. Only calibrate when reading is stable
    2. If you have trouble hearing reciever alarms at night stick it in a bowl of coins- this increases noise level if reciever is on beep and vibrate mode.
    Wendy Y

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While I'm happy to share our experiences with what works, and what doesn't work, for the management of Type 1 Diabetes and Celiac Disease in our house, please do not mistake anything you read here for medical advice. Decisions regarding your/your child's health care should be made only with the assistance of your medical care team. Use any information from this blog at your own risk.