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Dexcom G4: First Impressions.

I was nervous about receiving the Dexcom G4 because of my issues with the itchy rash, but now that I've found a fix (so far, at least), I was ready to open the package from my partners in San Diego. 

The Receiver.  Very first impressions?  It is SO MUCH SMALLER.  The shape is that of my glucose meter, and I prefer it. Though I never had any issues with The Egg (I sort of have a special, egg-shaped space in my heart for it), I do like a smaller receiver.  It's fly.  (Do people still say that?)  And smaller.  Smaller is better, for me, when I'm trying to carry several other diabetes items at once.  The G4 receiver fits into my meter case, which is very convenient.

It also has a color screen.  At first, I was "eh" about the idea of a color screen, because I didn't see how it would make a difference to me, but for that cursory glance at the screen, it does matter.  Anything "above the line" is yellow, within range is white, and below the line is red.  With a quick glance, I can see how long I've been in, above, or below range.  And having the hypos as red works for me, because it's the most serious issue I face throughout the day.  (Also, it's a nice change from the Seven Plus readout, which looked more like an old school Gameboy, whereas the G4 looks more like an iPod.)

The Transmitter.  The range of the new transmitter is truly remarkable.  I can leave my receiver on the kitchen table and go outside to rake leaves way out in the backyard, and the thing keeps the signal.  I'm still testing how far I can go.  :)  The G4 transmitter is completely different from the Seven Plus in that it's a lot taller, so the profile isn't as streamlined on my body.  Even though the sensor looks almost exactly the same (even though it has some subtle differences, like the gauge of the insertion needle is thinner and therefore more comfortable), the transmitter anchors in with a much higher profile. 


This isn't a huge deal, but it's the most noticeable on-body change for me so far.  I wear my sensors on my thigh, so in regular clothes, it's not a big deal.  But in my gym clothes, which fit snugger against my body, the bulge in my pants is more of an issue.  (And WOW that's a sentence I've never written before but now I can't unthink it or unwrite it so there you go.)

The Alarms.  The alarms are amazing because they are different for low and high alerts.  DIFFERENT.  This has been something Chris and I have been discussing for ages.  Sometimes, when the Seven Plus was alarming, Chris couldn't tell if I was low or high without reaching to the bedside table and clicking the screen alive.  Now he knows what end of the spectrum I'm at just by the alarm.  This is brilliant.  And long overdue, in my opinion.  Also, the alarms can be set to vibrate, soft, normal, attentive (this is where I have mine set, because they're musical), and hypo-repeat.  When I'm low, the notes of the song go from high to low, and the reverse applies for the high blood sugar alarm.  This is such a nice change because I know immediately what kind of issue I'm reacting to, without even needing to click the screen.  (And to that end, it takes an extra second or two for the screen to come alive when I hit the button.  I'm not sure what the delay is about, but it's not as fast as the Seven Plus.)

Battery Life.  Just as a note, I've been wearing the system since Sunday, and I haven't had to charge the receiver yet.  It's not even halfway down in battery life yet.  This is a marked improvement from the Seven Plus, which I had to charge every other day.  Also, it charges through a USB cord, so now I can pack fewer cords when I travel.  Thank goodness, because my suitcase was starting to look like a giant electric spider was trying to escape it, upon unzipping the compartment I store my cords in.

All-Important Accuracy.  So what about accuracy?  The G4 claims to be more accurate, but I can't make that nod yet.  I've only been wearing the new system for a few days, so I don't trust it yet.  We're still in that "getting to know you" phase of our new relationship (even though I've already jumped into bed with it).  I've had some moments I'm really impressed with, like the seven hour block where my meter and the Dexcom were never off by more than 10 points, but I've also had a WTF moment, like when the meter said 188 and 180 mg/dL (double-test), compared to the 64 mg/dL on the Dexcom.  They did catch up to one another about twenty minutes later, but still.  This is what is most important to me, and I'll be writing about the accuracy in more detail after I clock a few more days with the G4.

I want this new system to be exactly what I've been hoping the next generation would be:  fast-becoming a replacement for many of the fingersticks I do throughout the day.  Time will tell.  In the meantime, I remain grateful for technology that serves as a safety net while I'm driving, exercising, sleeping ... living.

[Dexcom disclosure]

Comments

So, I'm hating the case. I look like I'm from the 1980s, wearing a pager. Unlike the "old" Dexcom, I can't give it a cursory glance - I have to unsnap, flip, and then push a button. Yuck. And for the life of me, I can't get the cutouts to align with the down and up arrows and fumble with it.
But I'm loving the more accurate (for the most part) readings. Rock on, Dexcom.

Dude, that case is a nightmare. I've never used any of the Dexcom cases. My G4 lives in a little cloth zipper case for the time being, until some clever company goes all after-market and makes something useful.

Also, "unsnap, flip, and then push a button" is way too close to "slap it, flip it, rub it down, OH NO!" for my exhausted brain this morning. :)

It's nice to hear your comparison from the old Dexcom. I switched to the G4, from the Medtronic CGM and I didn't realize all the differences until I started using the G4. I LOVE the improved accuracy (compared to Medtronic, it's brilliant IMO). I'm hoping to write a blog post on the differences soon!
I'm with you on the delay of the click. It takes a second too long for the screen to "wake up". Oh and the case - didn't even try to mess with it! haha

Your review is exactly on par with what I've noticed so far, and I agree about the case! However, with the enhanced range, I have noticed myself not really "wearing" the device-- I leave it sitting happily case-less on whatever table I'm nearest when I'm home, and when I'm out, it stays in a designated pocket in my purse. Unlike the old system, I don't have to have it as near, so I haven't really felt the need for a case. I did see, though, a picture of someone using a Vera Bradley zip ID case (this: http://www.verabradley.com/product/Category/Wallets-and-Wristlets/Zip-ID-Case/154781/defaultColorVariantId/175963/pc/638/c/0/sc/890/p/154781.uts) to hold theirs, so I may purchase one of those to protect it a bit.

It's nice to read your impressions of it so far. Mine is apparently out for delivery so hopefully it will be here by end of day. I never wore my other Dexcom consistently because the accuracy was so bad between it and the meter so I'm hoping this one will be something I can start using on the regular.

I just got mine yesterday (hooray!!) and so far am loving it. I love how much smaller and slimmer the receiver is. And since I got pink, prettier ;) And I do love that it charges with a regular USB! Huge plus. I didn't even take the charger out of the box since I already have one that I use for my Kindle Fire & work Blackberry. So far mine has been pretty spot on with fingersticks but like you, time will tell on that one.

Unfortunately, we're already getting a second one. The first one has been a nightmare for us (my 8yo is the T1D, I'm the "pancreas"). Extremely inaccurate to the point of being useless, frequent "Out of Range" errors and dropped data even though it is on her waist, and the "up" button occasionally sticks.

Dexcom is overnighting us a new one, but the accuracy better improve. We've had a whole lot of those WTF moments you mention, and it meant that she was sleeping for hours in her 60s while the G4 was saying she was in the 100s.

If this replacement doesn't work, we're asking for a new unit of the 7plus. That has been just awesome for us, accuracy-wise, so I was expecting something even better. Alas, it does seem that the G4 is slow to catch moving sugars for both you and my daughter. Sigh...

I'm having trouble with my son's also. "Out of Range" for 2 hours while he was wearing it. Numbers way off a lot of the time. I'm going to give it a try for a little longer before I ask for a replacement. If that isn't better I will be asking for a new unit of the 7plus also. I was so excited about the G4. I'm hoping I just have a faulty one.

It took my husband to notice the the alarms ARE different on the seven plus. "What does 3 beeps mean?" "What do you mean? It beeps, I check. They're all the same." "No they're not." So I listened. 2 beeps meant high, 3 beeps meant low, and 4 beeps meant super low. (I also had the "dropping quickly" alarm set, which is 3 also) I had worn it for about 6 months before I knew this.

great review

still giggling about "the bulge in my pants" I'm such a kid LoL :)

I cannot wait to get my G4 on! So cool.

Thanks for the review- Dexcom is supposedly coming to Canada soon and I've been considering switching over when it does. I know you tried the Medtronic Minlink for awhile, that's what I'm using now. What is the profile of the new dexcom like compared to the minilink?

My son has the 7+ and I've noticed that after many (~5-6) years of use (with the transmitter mostly on the back of his arms), it doesn't seem to work as well as it used to. Has anyone else noticed this? I wonder if this could help explain why the new ones don't work either-- scar tissue or something after long periods of use?

Thanks for the review. Helps those of us still pondering/waiting for a call back from dexcom.
Not too jazzed about the transmitter being taller. Bean uses her arms (so no worry about pants buldge ;) ) so there's an icreased probability of it getting snagged on stuff.
Only time will tell...

I love seeing all of this feedback on the G4. My SevenPlus has treated me so well in the short time I've had it - but I'm glad to see that progress is happening. I'm excited that even if it isn't a fully integrated system, they could still see the value in making upgrades.

I received my 7+ literally two days before they announced the G4. dexcom is sending me a G4 at no charge but not until sometime in mid-December. I did think the cases it came with were pretty bad. I either keep it in a pocket or an SPIbelt. Thanks for the early review-

Thanks for all the G4 info. Have been using Dex's since the FDA first approved them, but have only one problem with them.
The Seven Plus is much quieter and less likely to awaken me with a low. I have seen no comments on the alarm volume. Can anyone help? The cheapest cell phone can awaken anyone, but this expensive device on which our lives may depend can't seem to do more than a few faint beeps? Has it been improved so it will it will actually awaken a deep sleeper?

Just a minor comment about the color screen. I think the switch was made, because the supply of grayscale lcd screens is decrease/gone. Reminds me when my dad bought his 1st color TV, only because B&W TVs in that size were no longer sold.

I just got my G4 yesterday and this is the first CGM for me. So far so good, but if anyone hears of an after market case/skin that is better then the one provides, please spread the word.

I was wondering, does the needle that goes in you seem any shorter?

Just got an email this morning that my G4 should ship tomorrow! I sure hope it does because right now I'm getting the ??? kiss of death on my Seven+ and I really don't want to change the sensor if my new one will be here in 2 days.

Betty - I stopped using my Dexcom Seven Plus because of the needle hurting so much. I was also having sensor failure issues...but the needle was the problem.

The new G4 has been amazing for me coming from the Seven Plus. The range is great and the insertion (2x now) has been much, much better...the needle is and does seem shorter...so very cool things there!

Now to figure out if I want to replace my Omnipod with..well another Omnipod...or explore new insulin pumps :)

I love the new G4 but the case is awful; big hassle to have to open it (unwrap) and then look. Best solution is to go to BestBuy or Amazon and get a Sony Walkman MP3 neoprene armband case the then easily cut the armband off (U won't even notice they were on. It's a perfect fit with clear plastic fron to see screen and operate the buttons - I got the "Rocketfish" one and I am delighted with the fit and snug ness - perfect for my pocket and to protect the G4.

The warranty on my 7 ran out and I just ordered the G4. When I go low I drop fast and always had issues with the 7′s lag time. So much so that we invested in an alert dog, which is pretty darn accurate. If the accuracy has improved, especially for the hypo alert, I am very excited. I am really hopeful the Animas Vibe will be approved by the time my Ping warranty is up.

I have also had several WTH moments with my T1 3 year old who has been wearing this for 4 days so far. I do not trust it at all so far, and am also not experiencing the long range others have mentioned. It pretty much has to be within 10 feet in open space.

I just hooked up my G4 and I'm waiting for my first calibrations. We shall see about accuracy. As for the case....well....it's nice. But only because I can mount it to my mountain bike's handle bars, like my old Dex's. It's probably more confortable to wear it on my inner thigh and hold it with duct tape, than to use the stock case.

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