Actually Using the Dexcom G6

Disclosure:  I received my Dexcom G6 as part of the initial PR roll out, once it was approved and available.  I am also part of the Dexcom Warriors program.  But my supplies all go through insurance and my deductible is gross.  For more on my disclosures, click here.  

I wasn’t home when my Dexcom G6 kit arrived at the house, but the timing worked out perfectly, as I was on a work trip and scheduled to arrive home the day that my G5 transmitter was supposed to crap out at the 90 day mark.  I landed at 10.30 pm on a Saturday, the G5 transmitter died at 11 pm that same night, and I popped the G6 on for the first time the next day.

INSERTION:  It did not hurt.  THIS MATTERS A WHOLE BUNCH because despite my appreciation and respect for the previous iterations of the Dexcom sensor, that shit hurt to put in.  The needle was intimidating and the mental hurdles were justified because 50% of the time, I’d deploy the needle and have immediate, stinging-pain regret.  It always hurt.  Always.  Sometimes a lot (like the ones where I’d put the needle in and hot pain would radiate from the site, and I’d rub around it in effort to shake the nerves of my skin into submission) and sometimes a little (like when it would pop funny going in but feel fine a second or two later), but always.

But the G6 is a completely different insertion device.  It feels like an ear piercing gun (from what I remember) and you press the big, orange button and the sensor shings in without much issue.  It’s still a needle going into my skin but it didn’t feel like a big deal.  I will go back to my G5 in order to use up those sensors (I refuse to waste – they are pricey), but I am not looking forward to using that old insertion device.  The G6 is superior in every damn way.  It’s a huge step forward and can almost (ALMOST but NOT YET) be called painless.

WEARABILITY:  The transmitter is much thinner and less bulky than the G5 transmitter.  The profile is less noticeable underneath pants and dresses. (I’m most comfortable with my transmitter on my thigh.) The slimmer profile is harder for my son to grab and use as a rung to climb me.  The G6 transmitter is similar to the G4 one from years ago, only with a more streamlined edge, so it’s less cumbersome overall.

Stickiness isn’t excellent, IMO, though.  My first sensor yawned off my skin after four days (the edges started to peel and then it was jostled and gave up), so I’m on my second sensor already.  I put some Opsite Flexifix tape on the edge of this one as soon as it started to peel, so I’m very hopeful that 10 days will be doable this round.  But I plan to grab a few StayPut tapes to ensure stickability, because I do not have time for droopy sensors.

NO FINGERSTICKS:  Man, the whole not needing to calibrate this thing is pretty awesome.  Mostly because I hate calibrating.  I love CGM technology and all that it provides, and while fingersticks were my gold standard for decades, I feel like I’ve been recently liberated.  I hate pricking my finger.  I’ll do it whenever necessary but I am grateful that diabetes management has begun to leave pricked fingers in the past.  I’m excited for it to be tabled permanently.

(That said, it is a weird thing, not to calibrate.  The little red drop of blood summoning my attention?  Gone.  The reminder that popped up on my phone every damn day and nagged the shit out of me?  Gone.  I don’t miss it.  Nope.)

ACCURACY:  I chose not to restart a new G5 transmitter and run it at the same time as the G6.  Yeah, I was curious about how those numbers would compare, but I couldn’t justify the waste of a sensor of any kind.  So I’ve only been watching the G6 pitted against my glucose meter (the Accu-Chek Guide that comes as part of the excellent MySugr bundle), and results are very consistent.  As I mentioned, my first sensor came off after only four days, but I’m now about 10 days into using the G6 in general and it’s very, very solid.  I test once or twice a day (out of habit) and I’ve only had one number that was off (I was 106 mg/dL on the G6 and my meter said I was 155 and then 148 mg/dL, rapid-respectively).  All of the other checks have been creepily on point, even the G6 moment that claimed I was 66 mg/dL only I didn’t have a single low symptoms and yet my meter confirmed me at 65 mg/dL.  Win for the G6 there.

COST:  It is jarring to think that I can’t restart these sensors.  I know there’s a safety concern (no fingersticks for the G6 has tougher regulatory hurdles) and that there’s also a business case (no one has confirmed that but how can you deny that), but from a cost perspective, it makes hoarding supplies harder because you have a hard stop at 10 days.  I wasn’t able to restart my G4s and G5s for ages because of the skin reaction I had to the Dexcom adhesive, so the ability to extend the life of the G5 still feels new and super appreciated.  A firm 10 days – no restart – with the G6 is weird.  It makes me feel vulnerable, knowing that my supplies have to meet my demand with precision.  I’m thankful that my insurance covers what I need at the moment, but everything changes so quickly these days, so a sense of access continuity isn’t really a sure thing.

ACTUALLY USING THE DEXCOM G6:  Downloading and using the app was easy because it felt familiar.  The graphs look a little bit different but they are essentially the same.  There’s this new feature where a low blood sugar that’s on the horizon has its own alert now, and that’s kind of nice as it lets me get out ahead of a nasty low even quicker than before.  A more comfortable insertion process makes wearing and using a CGM less painful and also makes the process of swapping out a sensor more tolerable.  With this iteration of the Dexcom device, I’ve seen huge steps forward in comfort and wearability.  I’m hoping steps that are just as big will be taken in terms of access and affordability, making this device the supported standard of care instead of just for people who can afford it.

The biggest change is that I am not pricking my finger and yet despite the lack of calibration, the data seems even closer to that of my glucose meter.  Seeing that confirmed with each random fingerprick increases my trust in this new version of Dexcom.  And when I think back to the Dexcom STS with the shower patches and the three day sensor life, I am reminded of how far this technology has come.  Here’s hoping all this crap eventually talks directly to my pancreas so I can just go to the beach and forget about all this diabetes bullshit.

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