DisclosureI have a relationship with Dexcom that includes receiving my continuous glucose supplies at no cost.  More details are outlined here on my disclosures page, but please know that the bias I’m bringing to this is pretty significant, not simply because of the working relationship with Dexcom but also the fact that this CGM has been part of my diabetes care plan since 2006, so I’m in deep for a dozen different reasons.  If you have any questions, feel free to reach out.

I received the G5 update about a month ago and didn’t put it on until a few days ago.  There are two reasons for that, the first being that my G4 transmitter was working just fine.  No battery issues, no signal problems.  It felt wrong to yank the transmitter and ditch it, particularly when you take the cost of these products into account.  The second reason was because the G5 transmitter was a higher-profile (literally) piece of technology, sticking up a few extra millimeters higher than the slimmer profile G4.

But a few weeks later, I did ultimately give the G5 a go, and am currently using the G5 Mobile platform now.  These are my first impressions of the system (still on the first sensor, so not even seven days into things).

Getting Started.
Setting up the system took me longer than I had anticipated, but I suspect it is because I spent a lot of time updating my G4 receiver to work with the G5 system.  I had to download software to my receiver, install updates, etc. and that took a while.  That, and once my receiver was updated, the screen wasn’t the black background with mellow colors, but was instead this BRIGHT WHITE OMG SCREEN that I could have used as a flashlight for my whole neighborhood, no problem.  Once the receiver was updated, I promptly stuck it in the bathroom cabinet because no.

Moving on to the mobile app, I needed to download the free Dexcom G5 app.  That was quick and easy, and walking through the set-up steps took a minute or two, including pairing the phone with my transmitter.  I put on a new sensor and the G5 transmitter and kicked the system on.  Two hours later, it was ready for calibration.

The G5 App.
I don’t mind the set up of the app, especially with all the white space, because it allows me to see what I need to see, without clunking up the visuals with a bunch of crap.  Entering blood glucose values is quick, with a confirmation screen asking “Are you sure this number is correct,” making it harder for me to enter the wrong number.  (I would almost-screw up calibrating my G4 receiver all the time because the wheel always wanted to CONFIRM when I was trying to CANCEL.  The app helps me not do this.)

And thankfully, the colors remained the same.  (This may seem like a little detail, but it makes me crazy that the Animas Vibe shows BG colors differently than the Dexcom receiver does.  Not a deal breaker, but certainly an annoyance.)  The numbers were circled in yellow for highs, red for lows, and stayed gray for in-range results, with a little arrow nub on the side of the circle to indicate trends.

The Pigeon Needs a Hotdog.
The little nub, though, looks exactly like the Mo Willems pigeon, which is something I noticed during a low blood sugar last week (and now cannot unsee).  Whenever I check my blood glucose on the app, I think about how the pigeon would NOT want to drive a bus because he’s low, or maybe he should wait to eat a hotdog because he’s trending high.

Dexcom G5. Looks like a cute little pigeon who wants a hotdog until you realize, "Fuck – I'm really low." #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

I do like the way the graphs look, but I must admit it took me a full day to realize that I needed to tip my phone screen to the side in order to see more than three hours worth of data.  (One fun bit:  each dot represents a BG value, and if you run your finger along the line, you can see each individual reading, with color coding in play.  This was fun.)

Some Pros and Cons.
But nothing is perfect, and there were some titchy moments.  (Like the fact that the G5 only works on iOS at the moment. That’s a post for another day, and hopefully one that Dexcom can write.) I hate when the transmitter doesn’t do its job, causing the receiver to throw out those three frigging question marks.  The app is updated to include FOUR question marks now, begging the question WHAT IS THE FOURTH QUESTION?!  Since putting on the G5, I have only had a transmission gap once, but it happened overnight and kept me from correcting a high, so it did make me frustrated.  I hate the overnight beeps, but I need them to stay on top of my numbers, so the thing has to beep when beeping is necessary.

The alarms are loud, but only if my phone is not silenced.  I very rarely have my phone on silent, but for people (like my husband) who prefer to have the phone vibrate instead of ring, this could be a problem.  Also, the alarms require you to unlock the phone and open the app to see the actual blood sugar value, which is a little annoying.  But I see two sides to that:  I would not want my BG broadcasted to anyone who looks at my locked phone screen (privacy), and I also don’t need to know my actual BG when the low alarm is going off (jelly beans).

The Apple Watch app is actually better with the G5, because before I was using SHARE (and following myself) in order to see my values on the watch.  Alerts are similar on the watch.

Also, I don’t mind using my phone as the receiver.  It’s very nice to have one less thing to carry around (which is why integration with the pumps is awesome; more on that in a few minutes), and I always have my phone on me, so the mobile need didn’t feel like an intrusion.  So far.  Ask me again in a few weeks if this is still cool.

A note on SHARE:  SHARE still works on the G5, and I’m still sharing my data.  My husband, the aforementioned “keeps his phone on silent” guy – see all the alerts on his phone exactly as he did with the G4 transmitter, and he didn’t need to download anything new to keep up with the new technology.  That was a nice mark in the “seamless” column.

And battery life – THIS was my top concern when switching over to the G5.  I am paranoid about the battery life on my phone (whoa), and I was nervous that the G5 app would suck the life out of my phone’s battery.  It’s only been a week so far, but I haven’t had any discernible issues.  I have an iPhone 6s and the battery life is good, and I haven’t noticed the Dexcom as a drain yet.  This is something I plan to watch closely, and an issue that will crop up more when I’m traveling instead of home.

The Real Question:  Integration??
The wrench in the whole thing, though, is integration.  Both the Animas Vibe and the Tandem t:slim are paired with the Dexcom G4 technology, but now the Dexcom team has pulled ahead once again with the G5 upgrade.  What does this mean for current pumpers who are in integration purgatory?

I spoke with Bridget Kimmel, Senior Manager, Communications at Animas Corporation, checking in on options for current Animas Vibe users and future adopters.  (Details on my relationship with Animas are found on my disclosures page, too.)

“The Dexcom G5 Mobile can be used as a stand‐alone CGM system with the Animas Vibe insulin pump, however the CGM values will not be integrated into the Animas Vibe insulin pump,” Bridget said.  “CGM values will only be displayed on a compatible smartphone and/or the Dexcom G5 Mobile receiver.”

But as an Animas user, I wanted to know what was next in terms of integration.  Currently, I use my G5 system as a stand-alone, like she said, and then my Vibe as an insulin delivery device.  I pressed Bridget about what’s might be coming.  She realized the response was unsatisfying, but she reinforced their commitment to patients needs.  “The Animas team is not able to reveal future development plans, but emphasized that current and anticipated patient needs are the team’s top priority. Animas is committed to developing integrated solutions that are meaningful and relevant for people living with diabetes, and the team will share more information on the product pathway as soon as they are able.”

I also talked with Aymeric Lecanu-Fayet, Director of Marketing at Tandem Diabetes Care, about how Tandem is handling the new Dexcom G5 Mobile.

“Dexcom launched the Dexcom G5 Mobile system a couple of weeks before Tandem launched its Dexcom G4 Platinum integrated t:slim G4 Insulin Pump.  Those two new products give users more options on where they want to see their CGM data.  The Dexcom G5 Mobile features the most accurate CGM algorithms along with the ability to use ones phone to see and share data.  On the other hand, the new t:slim G4 Pump displays CGM data from Dexcom’s previous G4 sensor. The conversation we have with our customers is ‘Where do you want to see your CGM information?’ Do you want the convenience of seeing your Dexcom CGM data along with your insulin delivery information right on the home screen of your  pump?  If so, go with the t:slim G4 Pump. But if you want the CGM data on your mobile phone and want to share it with others, or want to use the latest CGM algorithms, then, go with the Dexcom G5 Mobile and either the t:slim or t:flex Pump depending on your insulin needs.”

And about an upgrade path?

“Tandem is working closely with Dexcom on integrating with their new G5 system and the future G6 platform.  The new t:slim G4 Pump and Dexcom G5 Mobile unfortunately are not compatible because they use different technology to process and transfer data.  We are always looking for creative solutions to bringing new products to our customers and we provide frequent product development updates during our quarterly calls.”

These responses are somewhat frustrating because it seems like these companies are struggling to match the pace of Dexcom’s development and approval process.  But they do highlight options that people with diabetes have, and I love options.  For me, integration is not the biggest deal and I’d prefer using products I like instead of simply using matchy-matchy products.  (See also:  I wore a Medtronic pump and a Dexcom CGM for several years because that was the tech pair that fit my needs at the time.)  I hope there is more information and less frustration in the coming months for PWD who prefer integrated systems.  For potentially breaking developments, I’d recommend tuning in to the Tandem investor call tomorrow and also following the press release page from Animas.

Going Forward.
So far, the G5 is a good fit for me, but I’m sure frustrations will crop up over time.  For example, the new transmitter claims to need replacement every three months.  And it’s still bigger than the old one.  And what if my phone suddenly eats all its battery life in effort to keep up with my blood sugars?  All of these tech-specific problems may bubble up over time.

But the fact remains that the data from my Dexcom is truly a game-changer for me.  Seeing my blood sugars real-time has influenced everything, for the better, in my diabetes life.  So I might bark about battery life or complain about body real estate from time to time, but I am grateful this technology exists.

And let’s end this monster of a post with that sentiment:  We are lucky to have access to CGM technology.  And I hope to continue to have access to it, even when I’m a senior citizen with diabetes.  To ensure access, we need to raise our voices.  Please visit the JDRF CGM Medicare Coverage site to message your representatives, and you can also shout from the Diabetes Patient Advocacy Coalition site.  Why both?  Well, if you were tapped on the shoulder once, you might be able to ignore it.  But being tapped on the shoulder repeatedly will get you some attention.

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