*MY* experience with dexcom [Archive] - Children with Diabetes Forums

WillRace

06-23-2006, 05:42 PM

rickst29,

Thanks for getting back with a response so soon. :) I should have figured that the procedure was that simple. I guess that is what I figured in the back of my mind, but I was hoping that the use would be uninterrupted (ie: no 2-hour calibration required). Still great news, and thanks so much for the info.

I really like the STS as well, and have also been wondering what my next A1c will look like. I feel like control has been much tighter. Many fewer lows and as far as I can remember, no severe lows. Even better, no huge rebounds after the lows. The ability to see a trend and act in advance is huge.

I do a good amount of auto racing, which believe it or not, is an amazing workout. Racing requires a lot of concentration and physical effort, which can cause glucose levels to plummet, especially on 90* days where it may be 100* or hotter in the car. Needless to say, I have been worried about getting caught off-guard while on-track. My top priority has always been safety - especially the safety of my fellow competitors, track workers, and everyone else around me. A severe low would not be "safe", and so I have always taken precaution to ensure that would not happen. I've had several race days in the past where I'd have a low, rebound too high, have another low, rebound, etc. Not good.

I recently attended my first race weekend with the STS. I was concerned a bit about the transmitter getting wet (with sweat) under my race suit, but had no problems. I clipped the receiver to the dash next to a bunch of my car's gauges. I can't tell you how incredibly cool I found it to be able to glance over to the gauges and check my oil pressure, water temp, and glucose level. Wow. For the first time ever I could actually gauge the status of the most important machine in the car (the driver) in a moment's notice.

My race weekend result? I spent the first day between 120 - 84. Spend the second day at 110 - 90. Straight as an arrow. Mind you, it is not uncommon for my body to blow through 40-50 carbs during a 40-minute driving stint. I did have the usual creep up to 180-200 after lunch, but I've almost found that unavoidable in everyday life anyway.

I love this thing.

That said, here are some of the strange things that have happened during my time with the STS:

- Like other posts I've seen, I've had a couple of "bad" sensors. The first sensor I used worked fine. The 2nd sensor stopped working after about 12 hours, which was overnight while I was sleeping. I woke to a "disconnect" alarm. I pulled the sensor, installed a new one, and waited for the calibration screen (double-drop) to show up. 4 hours later, nothing. I called customer service. They were great. The woman I spoke with seemed very sincere and apologetic. We walked through another sensor install to make sure I had done everything correctly (I had). This one worked perfectly. I received a package with two free replacement sensors the next morning. In my book, that is great customer service.

- I've had a few strange readings overnight, some showing creeps up to 300 followed by lows. I've woken to find high mis-readings (ie: STS says 198, glucose test shows 92). Recalibration eventually brings the STS and glucose tests into alignment, but it may take a few hours. Also, it seems that these mis-readings usually happen overnight and during the 3rd day of use.

- With regard to the overnight mis-readings, I've found a little correlation between where I place the receiver during the night and its accuracy. Not enough to prove a point, but it seems that the mis-readings occur on nights where I leave the receiver on my night table (next to my clock radio, cell phone, and wireless telephone). Coincidence? Too early to tell.

- I've had the transmitter pop out of a sensor once. This happened last week. I tend to leave the receiver on my desk while at work, and sometimes walk away without it, which can cause missed readings. I noticed a few missed readings in a row last week and thought nothing of it. About an hour later I checked again and found that there were still no readings. I touched the sensor over my shirt and immediately felt that the transmitter was missing. Luckily, the transmitter was caught under my t-shirt at my belt line. Popped it back in and it picked right up again.

- The shower patch is great. I just read a post on another forum where a user had a terrible time with the one they used. I can't comment on their situation, but I can say that I have never, ever, had a problem with the shower patch. I do not have a lot of hair in my belly region (where the sensor goes), but if I did, I would shave. In any event, I've found that the shower patch is excellent. My first shower with the STS installed was quick and careful. I avoided the area of the patch and was in and out as quickly as possible. I hated it. I threw caution into the wind the 2nd time around. I applied the patch, made sure it was secure, and then showered normally. I figured if it was going to get soaked or break, it may as well happen sooner rather than later. To my delightful surprise, I had zero problems. I have not tried swimming with the receiver installed, but am looking forward to trying it out. I don't expect any problems. Unlike the sensor itself, the shower pad pulls off very cleanly. If only they could make the sensor pad's adhesive as skin-friendly as the shower pad

- I've found that the adhesive on the sensor pad can be a pain to remove. The pad peels off, but can leave a bit of sticky residue behind. I took the last sensor off by wetting the area with warm water, which helped a lot. Previous pad removals have left adhesive on my skin that did not wash off even after a few days of showering. Removal of the adhesive required plenty of scrubbing. Next time I'll take it off in the shower.

- The holster needs to be redesigned. It seems that the team that designed the holder did not work with the team that designed the calibration or charge cord. Installing the cord while the receiver is in the hoster is almost impossible. There is an elastic band that partially blocks access to the port on the bottom of the receiver. Worse, the top and bottom pieces of the holster have to be spread apart for the plug to clip into place. If I had three hands, it would still be difficult to to, with two, it is nearly impossible. As a result, I started unclipping the retention strap and removing the receiver from the holster to charge and calibrate. Within a week of unclipping the strap, the stitching that held it in place failed, leaving one end buttoned in place, and the other flopping around. Interestingly enough, the strap isn't necessary, as the receiver fits snugly into the holster and does not fall out without it.

- As soon as I held the receiver for the first time, I thought to my self that I should go out and buy a screen protector immediately, at it seemed easy to scratch. I was right. The receiver/holster took a fall as I was getting out of my car. Unfortunately, it landed face-down on a sandy parking lot, which left a deep scratch across the front. Darn, Darn, DARN!!!! I will try to buff out the scratch with some plastic polish this weekend. If you are going to get a STS, do yourself a favor and pick up a iPod/Palm/Treo style screen protector ahead of time. I wish I had put one on as soon as the STS came out of the box.

I think that is enough for now. :)

I love this thing! :)

selketine

07-01-2006, 11:10 AM

I showed William (age 4, pumping with Animas) the pics from the CWD website of the Dexcom and was explaining it to him and he said "NO WAY"! Turns out it was the inserted that scared him - LOL! I don't blame him - it looks a bit intimidating.

Is Dexcom going to be associated with Animas? I was curious if Animas was working on a CGMS or to be associated with one in development elsewhere.

rickst29

07-01-2006, 09:10 PM

I showed William the pics from the CWD website of the Dexcom and was explaining it to him and he said "NO WAY"! The inserter scares him.
I ***PROMISE*** it's less painful than his current infusion set. Yeah, the gadget looks like a County Medical Examiner's most horrible tool... But the Sensor is, I guess, about 33 gauge: thinner than the thinnest needle you can buy, MUCH thinner than his infusion set.

Here's why it's big:
(1) There's an enormous "wing" (clear plastic) sticking out of the side to keep it from going off until you're ready. At $35 each, you don't want it wasted that way. But it's so hard to pull out, I pull it BEFORE attaching the Sensor adhesive pad to my skin.

(2) It is a 45-degree insert, not a straight-in. And because the Sensor is longer, the Spring is longer too.

(3) There is a big plasticized paper adhesive pad... larger than a typical infusion set, so the base also looks quite monsterous.
-----
I use Ultraflex, which is a short (8mm) straight-in Nylon infuser. But that one hurts, it's a lot wider around. I always look forward to each Ultraflex change with fear and loathing. :eek: For me, the Dexcom Sensor is ABSOLUTELY painless. Each time, I've been surprised-- looks like it's gonna be at least a bit of a stick, and then, all done! NOTHING!

Pulling the inserter back takes strong fingers afterwards. That's weird.

rickst29

07-01-2006, 09:17 PM

You don't have to remove the Transmitter. Last time, after the 3 days expired I thought to myself, "If I leave the Receiver on the other side of the house, 3 walls and 40 feet away (out of range), how's it gonna know that I didn't pull the Sensor"?

Answer: It doesn't. I Left the Transmitter in, left the Receiver on the other side of the house for 10 minutes, ran the "new Sensor" Procedure, and it again gave me "3 more days".

Next time, I'm gonna try it without even moving the Receiver from my pocket. Maybe, as long as the current session is ended (72 hours has passed or you stopped it early on purpose), it'll accept the "new Sensor" right away?

I'll post my result.

selketine

07-02-2006, 02:46 PM

Thanks for the info on the inserter Rick. He uses the Rapid D sets and I'm not even sure what the guage needle is but it is 6mm straight in. He is just 4 yrs old of course so that does make a difference in how he sees things.

rickst29

07-19-2006, 05:40 PM

Heck, you don't even have to take the Receiver out of range at all. When the "Sensor Session is Expired" timer goes off, just press the buttons for "new Sensor, OK?", and "OK!", and you're all done. 3 more days!

My last two Sensors worked for 17 and 19 days respectively. No skin irritation at all, just 1/6 as many little holes. :) And 1/6 as many $$$$. :) :)

Now starting day 11 on this one. :)

Ali

08-04-2006, 02:28 AM

I know you can see trends-but when I have used the sensor it was so out of time with quick changes-when I really need it and so off the mark i.e. said 90 when i was 45 that it gave me little valuable info. I need the info to make changes before I get below 70 and with a 40 point spread in results (between finger and sensor readings) it was not very helpful. i.e. I set it to alarm at 80 but when I checked I was already at 40-way to late to prevent problems and I was feeling it already. It helped some with overnite readings but gave me no new info re after meals etc. Any tips wpuld be great.Lisa. P.S. I also check 10 to 15 times a day and couple times at night. I really need it for exercise and rapid changes when the sensors seem to be the least accurate. I try to stay between 70 and 150 but have many lows. I have a few highs due to pump malfunctions, overeating or some other unknown-hormonal etc.Again nothing was picked up that I would not have checked for anyway. I need something to accurately alarm when my BS hits 70 and 150.

rickst29

08-04-2006, 09:58 PM

Wow, that's terrible, and should almost never happen.

(Any amount of error has SOME probability of occurring, but this amount should be 'ALMOST NEVER'.)

I keep my 'low' alarm even higher, 90, to improve the probability of catching serious lows. But I've never seen mine off by THAT, except during periods of rapidly changing bG. (During rapid changes, treat the Trend, not the value.)

So you could be a little safer by cranking up your low alarm level... at the cost of more False Positives, of course. That's a workaround which I use. But the magnitude of your errors are outside of my experience. Are you sure that you're choosing the BEST POSSIBLE Sensor Sites?

JoeC

08-16-2006, 09:26 PM

Has anyone used the DexCom on the thigh or buttock? I know it's only prescribed to be used on the abdomen, but on a five year old, a Silhouette and a DexCom STS take up a lot of space.

rickst29

08-17-2006, 10:11 PM

Yes, there's a woman on Insulin Pumpers who uses her thigh, but she's only getting about 6 days per Sensor. She EM'd me for ideas to get longer/more stable results from the Sensors.

She's quite short, with very little room between her lowest rib and her hip bones (on her side, which is MY favorite place). I replied that I think upper butt cheeks might be the BEST place for her, because leg muscles (quads) move a lot, creating a very unstable environment for the Sensor. Sounds like that could be your child's best spot, too.

Abdomen is IMO a bad site, because (in my and several other peoples' experience) you really need to keep it a BIG distance from your infusion site rotation pattern to get good results.

ritterfam

08-22-2006, 05:49 PM

joec,

our son is 4. we put the dexcom on his buttock. we use the same area for his cozmo inset sites. we have not had success with this.

we have had the dexcom for about a month. it has worked very poorly and we are looking for solutions. our numbers are frequently off by over 100% (reads 200 and BG is 100) even when numbers arent changing rapidly. If our son is going up or down rapidly, forget it, multiple skipped readings. We skip around 20 readings a day, meaning we have to recalibrate daily. it has not helped us get any more sleep, or helped us avoid any lows or highs.

i just came to this discussion board today. I see that rickst recommends staying a long way from prior infusion sites, even if they have not been used in a long time, we may try the love handle area, because we have been struggling with buttocks. our son is quite thin, so it will be difficult to put the sensor there.

rickst, thanks so much for posting about your experience. how do you know to avoid dexcom sites that are close to insulin infusion site? did you personally experince difficulty? we have been following the manual's recommendation to stay at least 3 inches away from the CURRENT infusion site. we'll put the dexcom site very close to prior insulin infusion sites. could you tell me about your experience with this?

thanks a ton,
ritterfam

rickst29

08-23-2006, 08:20 PM

Hi ritters,

I was about to give up and send the gizmo back before I tried my "love handles". I definitely could not get by with just an inch from older visible infusion sites... in fact, I couldn't get by with placing the Sensor anywhere in my infusion site pattern, even when the vicinity hadn't been used for several weeks and showed no visible scars on the surface of my skin. For me, several Sensors never came up at all.

There's hardly any room on a 4-year old for "love handles" between the rib and hips. But, if you're not using his front for infusion sets, I think that you should definitely try there. And, you might find more room and good results a bit closer to his front (45 degrees to either side, between his belly button and his love handles).

I'm not at all surprise that putting Dexcom on the same "butt cheeks" you use for the Cozmo's Infusion sets turns out to be a TOTAL non-starter.

It's possible that Dexcom simply won't work for your small child. But switching to the front side gives you a much better chance than you've had so far. I think that they really ought to change that manual or put some new hints on their website.

Please post back if it works better... and also post back if it doesn't, inquiring CWD forum members will want to know ;)

ritterfam

08-26-2006, 11:10 PM

rickst, thanks for the info!

just yesterday, we talked to a member of the clinical research team at dexcom. he had a couple items of advice for us regarding use of the device in a small child...

1) insert sensor at more acute angle than 45 degrees, while pinching up. the idea being to keep the sensor in the subcutaneous tissue, away from the fascia layer surrounding muscle. he said if the sensor is touching the fascia, you will get tons of skips and erratic readings.

2) do sensor insertion in the morning, this will decrease skips and erratic readings. we don't understand at all his explanation of why this would be helpful. but he advised we do this.

we had a great day with the device today following the above advice, except for when our son was sitting in the car ( right on the sensor) and now that he is asleep. After he fell asleep, dexcom went haywire (lying on back, right on the sensor).

if we can't make it work on the butt, we may start trying the love handle area.

thanks again!!!

beth and nate

JoeC

08-28-2006, 11:32 AM

Hi RitterFam,

Glad to hear you received some help from the DexCom team and had success with the DexCom. Thanks for the insertion tip.

We just put one on our son yesterday in his upper outer butt cheek. This is new territory in that we have not used this area for infusion site for almost 3 years. It’s been working well. This morning DexCom said 121, fingerstick said 118. (DexCom,Fingerstick): (297,311), (102,108), (175,160), (298,173), (121,118). I believe the 298/173 was due to Anthony laying on the sensor as you pointed out. Within an hour, DexCom was back on track without any calibration needed.

I know it looks like I’m hung up on numbers, but really it’s the trend (especially downward) that are so valueable. Yesterday, we gave a correction when Anthony was 311 (and climbing). After playing around for a while (an hour?), I checked is “guy” (the DexCom) and it said 137. The 1-hour graph told me everything I needed to know. A few minutes later we did a fingerstick and we had the 102/108 paired reading. We gave him a snack and avoided a severe low. That makes it worth the effort.

rickst29

08-29-2006, 06:16 AM

For confirming that upper butt cheeks can work well-- at least when NOT being used for infusion. (I was only guessing.)

As you saw in my very first sentence when I joined this Board (the top of this Thread) -- TREATING THE TREND is the fundamental change which you can make when you have a CGM. Congrats on your success and understanding of the strategy!

(PS... I've been on a software development 'death march' for the last few nights. I finished, but tonight I just can't get to sleep after so many nights of working in a row. So, I dropped in :D )

payam7777777

10-22-2006, 03:49 PM

Anything new?
Just curious to know more.
AND incredibly eager to have one. beyond doubt.

rmccully2000

10-22-2006, 06:23 PM

We've had our 6 year old son on it for two weeks now. There are annoyances and it's not perfect, but I LOVE THIS THING!!! Being able to watch the trends and prevent lows has been the best thing to happen to us since diagnosis 1 year ago.

We've used 4 sensors so far and one was bad. They shipped us a new one overnight to replace it. One ripped off when he fell at the dinner table (slid down the edge of the table and it pulled the sensor up a little).

It pinches a little at insertion but it doesn't bother him once its on. He has only worn it on the tummy so far and he is on MDI so we don't have to worry about staying away from old sites as pumpers do.

It's a little difficult keeping the receiver close to him at all times, especially at home. School is easy because he carries a fanny pack everywhere with his supplies anyways.

We've prevented 3 lows that we would otherwise have missed. It does get off sometimes but we have had good luck so far with Dexcom keeping up with rapid rises and falls. If it gets off, calibration helps get back within 30 points. when its calibrated, the readings are anywhere from 2 to 30 points different than the one touch, but the trends always seem to be right on.

Had some noise at night, but not as many missed readings as I had expected.

Not being waterproof is annoying as the shower patches give him a rash. It doesn't get ruined if it gets wet, you just have to let it dry before getting accurate readings again. I'm going to try IV3000 per another users suggestion.

One thing I didn't expect, Mason also loves this thing and wants to wear it all the time. I think it makes him feel more in control to see where his blood sugar is.

I just filed reimbursement for the sensors and am ready to fight for coverage. I don't want to go back to finger pokes without knowing direction and rate of change. It's like performing surgery without being able to see. Well, not really, but that's how it seems to dose insulin without this information!! :)

Rick, you were so right, sorry if I thought you were a salesperson. I had just had the most annoying experiences while trying to buy a pump with pushy sales people so I was a little suspicious.

And thanks for all your posts, everyone. Your tips on inserting on children seemed to help us get the right angle!!

Becky,
Mom to Mason 6, dx 11/05

payam7777777

10-22-2006, 08:24 PM

;---------------------------------------------------------------------------------------;
; DexCom STS -Pages ;
;---------------------------------------------------------------------------------------;
The DexCom Continuous Sensor
http://www.mendosa.com/dexcom.htm

Dexcom - Transdermal Glucose Oxidase Enzyme
http://www.diabetesnet.com/diabetes_technology/dexcom.php?PHPSESSID=2f94ed1948822e2ede4bcce80a9db 9f2

FDA: DexCom™ STS™ Continuous Glucose Monitoring System - P050012
http://www.fda.gov/cdrh/pdf5/p050012.html

Photos of the DexCom Sensor
http://www.childrenwithdiabetes.com/DexComSensor.htm

How To Buy
http://www.dexcom.com/index.html

Starter Kit
http://www.dexcom.com/html/dexcom_products_sts_starter_kit.html

Sensor
http://www.dexcom.com/html/dexcom_products_sts_sensors.html

SAFETY INFORMATION
http://www.dexcom.com/html/dexcom_products_sts_safety.html

Matt Vogel's
http://www.insulinfactor.com/article_dexcom.html

Gary's
http://mydiabetescgms.blogspot.com/

Diabetes Mine
http://www.diabetesmine.com/dexcom_and_me/index.html

;---------------------------------------------------------------------------------------;
; DexCom -Forum Threads ;
;---------------------------------------------------------------------------------------;
*MY* experience with dexcom
http://forums.childrenwithdiabetes.com/showthread.php?t=781

Another Dexcom blogger...
http://forums.childrenwithdiabetes.com/showthread.php?t=1433

Dexcom battery life
http://forums.childrenwithdiabetes.com/showthread.php?t=1376

DexCom Continuous Glucose Monitor
http://forums.childrenwithdiabetes.com/showthread.php?t=1403

DexCom Experience
http://forums.childrenwithdiabetes.com/showthread.php?t=488

Dexcom DM(TM) Consumer Data Manager
http://forums.childrenwithdiabetes.com/showthread.php?t=1372

How acurate is CBGT?
http://forums.childrenwithdiabetes.com/showthread.php?t=1782

The Beep of the Sensor, the Thrill of Control
http://forums.childrenwithdiabetes.com/showthread.php?t=1375

;---------------------------------------------------------------------------------------;
; Continuous Glucometers ;
;---------------------------------------------------------------------------------------;
The Continuous Glucose Monitoring System
http://www.childrenwithdiabetes.com/d_0j_20n.htm

Continuous Glucose Monitoring
http://www.childrenwithdiabetes.com/d_06_e00.htm

New Advances in Glucose Monitoring (Glucometer List)
http://www.diabetesnet.com/diabetes_technology/new_monitoring.php

Chart comparing Navigator, Guardian RT, and DexCom STS
http://www.childrenwithdiabetes.com/continuous.htm

Here's a few more useful forum threads:

Dexcom
http://www.islet.org/forum/messages/44940.htm

Dexcom continuous glucose meters to ship this month!
http://www.islet.org/forum/messages/42642.htm

Does Anyone Have the Dexcom STS System?
http://www.islet.org/forum/messages/44654.htm

and more:

http://drjekyllandmrslow.blogspot.com/
http://katequest.blogspot.com/
http://www.diabetes-wise.net/

rickst29

10-23-2006, 08:36 PM

Rick, you were so right, sorry if I thought you were a salesperson. I had just had the most annoying experiences while trying to buy a pump with pushy sales people so I was a little suspicious.
Becky, you're RIGHT to be suspicious of anyone who makes glowing reports about costly products on the Internet. Lots of companies (and politicians!) are doing fraudulent Marketing via fake bloggers, and fake forum 'members'.

But if you ask people point blank, "who are you, what is your history, and where do you live?" the fakes will almost always be 'outed': it's WAY too much time and trouble (i.e., MONEY) come up with a complete supporting "life story" when you're just a marketing droid doing fake talk for money.

rickst29

10-23-2006, 08:44 PM

Anything new?
Just curious to know more.
AND incredibly eager to have one. beyond doubt.
Payam, I assume that your post is about Abbott Navigator (since any eager person has been able to get a Dexcom in about 10 days since May).

I've heard no Abbott announcement, although they should have me on a mailing list. (A long time ago, I volunteered for any upcoming study where they could make use of me.) The instant they start taking order forms, it'll probably be posted to Insulin Pumpers mailing list.

These kinds of things often occur at the ends and beginnings of months, rather than partway through. So I'm gonna keep my eyes open on November first. I hope the waits for delivery aren't too bad: On the Minimed pumps, it's been taking MONTHS for some people on IP to get their CGM upgrades.

payam7777777

10-23-2006, 11:12 PM

We're not in the States *sigh* We're in Iran Dexcom not available sooner than 100 years from know :(

rmccully2000

10-24-2006, 12:14 AM

Thanks for being so understanding Rick :)

Payam, I wish there was something I could do to help you with access to new technology. I read on this man's website (http://www.hanselman.com/blog/TheFirst12HoursTheMedtronicMinimedParadigmREALtime ContinuousGlucoseMonitor.aspx) an analogy that I thought was good. It's like fixing a broken speedometer in your car. This technology is going to change everything and I'm hoping it will catch like wildfire and be available somewhere close to you soon.

I have just taken off the latest sensor from Mason because the adhesive was itchy (it lasted 6 days). I was going to give him some time off from the Dexcom since I thought he might want a break. He asked if we could put another one on tonight before bed. I asked him why and he said it made him feel safer. (imagine the sound of my heart breaking,,, sigh). He sleeps in our bed on Friday nights and Saturday morning, I caught him checking his graphs and trends when he woke up. I told him I will do whatever I have to do to keep this technology for him.

Another thing I discovered by analyzing the graphs: He has lunch at school at 11:00 (usually the exact same meal every day!). Shot at 11:45. Then he tests again at 2:00, after recess, and has a snack if under 200. BUT, I noticed a pattern when looking at the Dexcom software. The lunch Novolog peaks at 1:00, with the lowest number, then begins a climb back upward until dinner. I always attributed the highs before dinner to his Lantus dosage. I will watch for the rest of the week, but I think we need to move his afternoon test to 1:00 to catch any lows and add carbs if necessary! This really surprised me.

Oh, and Dexcom caught another low this weekend at the Fall Festival for his school. Alarmed us at 67 and he was 72 on the OneTouch, heading downward!! I asked if his tummy hurt (our only signal previous to Dexcom) and he said no. No wonder he feels safer. Gave him 2 roll of smarties and he was back on his way up!!

I promise I don't work for Dexcom, or own stock (any stock for that matter!) in it, but I love this thing, warts and all.

Becky,
Mom to Mason 6
dx 11/05

Ali

10-25-2006, 12:52 AM

I have read with interest all the info about Dexcom. I am using Dexcom and wondered about the non abdomen area for sensors. I am thin and use a pump and only use my stomach area for the pump. For the sensors where on your thighs do you use? I do not really have fat on my outer thighs and when I injected I used my middle and inner thigh areas. I do not think I could reach my upper backside for the sensors or the back of my arms. Let me know. Also the Medtronics folks talk about taping down the sensor to avoid any movement-any one here do additional taping of the sensor? My sensors so far have not been very accurate. i.e. too off to be of value for alarming lows or highs. I test 10 to 15 times during 24 hours with fingersticks and that is fine as long as the sensor is also accurate. Also the receiver is so big!! It aslways pops out of pockets. Anyone hear of them making a smaller one? Also how have folks found their software? Any tips on using?Thanks for any help. Type one 36years.

payam7777777

10-25-2006, 01:36 AM

Here's part1 of the excerpts i gatherred from here and there about dexcom. A part of it is rickst29's and the rest is other peoples thoughts about their dexcom. Enjoy.

;---------------------------------------------------------------------------------------;
; DexCom -Excerpts ;
;---------------------------------------------------------------------------------------;
which stands for short-term sensor that the FDA approved for 72 hours of usage. Many users, however are already using it longer, saving them money at the expense of accuracy. DexCom is asking the FDA to approve its seven-day sensor.

Two of the first people to jump on the DexCom bandwagon are Aaron Kowalski, director of strategic research projects for the Juvenile Diabetes Research Foundation, and his brother Stephen. Aaron, 34, and his brother, 31, have each had type 1 diabetes since they were 3.

“My experience has been fantastic,” Aaron told me recently. “Today I hit eight weeks of use. After only six weeks my A1C came down from 7.2 to 6.5, and I have no doubt that it can go even lower. The beauty of it is that it was so easy to get there.”

DexCom STS was approved by the FDA on March 27, 2006 and is now available for purchase. Patients will undergo a one-hour training session to learn how to use the injection and monitoring system.

The STS starter kit, which includes a receiver, a transmitter, two sensors and applicators, a carry case for the receiver, and a charger, lists for $800. Additional sensors cost $35 each.

$800 for receiver, transmitter and 2 sensors. $175 per 5 sensors.

$500 plus $35/sensor

transmitter ($250 to replace) and 12 months for the receiver ($500 to replace)

Dexcom Receiver estimated lifespan is only 12 months, and it costs $550. It's rechargeable, but the rechargeable batteries wear out.

72 hours, (applying to FDA for longer), has gone longer in trials

Length of sensor probe 13 mm

Gauge of sensor probe 25 (Both CWD and FDA say it's 25G)

Start-up Initialization Time 2 hours

Calibration Must calibrate with One Touch Ultra -- cannot be entered manually. Calibrate every 12 hours, first calibration must have 2 done within 30 minutes of each other.

I've found Dexcom's readings to be accurate most of the time, but not when my glucose values are changing rapidly, during exercise for instance

Dexcom receiver calibrating with the Lifescan Ultra meter.

I heard a series of loud beeps coming from Dexcom. The receiver screen read "HIGH" with a corresponding BG data point of 400. "This can't be right?" I thought to myself. Besides feeling a little winded, everything seemed fine. I didn't have a meter with me to confirm, but was almost positive I wasn't 400. My friend and I ran down the steps, up again, back down, and headed for home. Ten minutes later, Dexcom was still reading "HIGH" but I felt low. A little shaky and light headed, I ate a tube of glucose tabs and a Clif Shot energy gel. After walking for a few minutes, I felt better and we ran home in fifteen minutes. I immediately checked my BG with a finger stick and it read 87, although the Dexcom still read "HIGH." I calibrated the receiver and within a few seconds, Dexcom read 260. Over the next hour, the receiver stayed in the mid 200's and eventually prompted me to replace the sensor.

waited two hours for calibration

Dexcom starter kit (receiver, transmitter, 2 sensors, receiver charger plug, Ultra cable, belt clip) and a 5 pack of sensors (3 day wear each).

The sensor must be calibrated by plugging in an Ultra meter and doing a finger stick. Apparently, Lifescan is the only meter company that gives public access to their technical specs. The rep assured me that Dexcom does not receive compensation from Lifescan. You must initially calibrate the sensor 2 times and then once every 12 hours.

The sensor is not waterproof. For showering, they recommend covering the sensor with a "Shower Patch" (sold separately, $6 for 10 patches) which sounds like a large piece of IV3000. The patch shouldn't be worn for extended periods of time because the humidity/moisture will interfere with the sensor.

The training and instruction was simple and took about ten minutes. First, I inserted the sensor with ease, after a few practice sessions. I felt a little poke at the insertion site, but it was relatively pain free. Next, I attached the transmitter on top of the sensor with a small breakaway lever. The sensor and transmitter were very comfortable to wear and weren't much bigger than a Comfort/Tender/Silhouette infusion set. The last step was to initialize the receiver and set my high and low BG thresholds. The receiver is an oval device about the size of a cell phone, circa 1998. The sensor has a two hour warm up period and at that time will prompt me to enter two BG readings from my new Ultra meter.

the Dexcom receiver was vibrating and flashing a picture of two blood drops… it was time to calibrate! I did two finger poke BG tests on the Ultra, using two different fingers. I then connected the Ultra to the Dexcom receiver and within a few seconds the calibration was complete. I couldn't wait to start seeing my blood sugar values and trends. The manual said I should start to see readings within 15 minutes of the initial calibration. Fifteen minutes passed, then 30, then 60. I tried two more calibrations, but it still didn't display my BG's. "Wait a minute," I thought to myself, "Something must be wrong here." I called the rep and she said I may have a "noisy site" meaning my body is having a difficult time adjusting to the sensor. She suggested I try another calibration and if that didn't work, call customer service to replace the sensor. Sure enough, the calibration didn't remedy the situation. The nice folks at Dexcom customer service recommended I take out my current sensor and put in a new one. They promised to replace the sensor that didn't work, which was very nice of them. After taking out the bad sensor, I was surprised at the small size of the catheter. The catheter is a tiny platinum wire half an inch long, and has the diameter of a human hair! I put in a new sensor, but this one was a bit more painful and I could slightly feel the catheter. The catheter feeling went away, I waited through another two hour warm up period, calibrated with two pokes, and surprise… my first BG appeared on the transmitter, it was 100! Was I in one of those typical meter commercials with a perfect BG?

After the workout, I felt pretty good, my BG read 92 on the transmitter, but after the finger stick read 62! Well the manual and rep said that there may be a 10 minute delay on BG readings. Due to the intense exercise, my blood sugar must have been dropping rapidly. Next time, I should eat some carbs during my workout. To correct the low and help replace my glycogen stores, I drank a bottle of Gatorade and bloused for about half of it. A few minutes later, my Dexcom was giving a low alert of 65. "Where were you ten minutes ago?" I thought. After a few more minutes, the BG reading rose to 114. I guess this was my first lesson of interstitial fluid versus whole blood glucose values.

Learning from my previous overnight low experience with Dexcom, I set the receiver's low threshold to 90. Over the next few days, I took my bike for two long rides. The nights following those intense workouts, Dexcom woke and warned me of the overnight low before it was too late.

payam7777777

10-25-2006, 01:37 AM

Just before bed, Dexcom said 210 and a finger stick read 205. I gave a correction bolus for the 205 and went to sleep. At 2:14 am, I woke feeling shaky and extremely hungry. It felt like a low, but I thought I should check to make sure. I pushed Dexcom's buttons and the backlit display read 81 with a flat trending graph for the past hour. An Ultra finger stick test read 45, which seemed more realistic. I stumbled to the kitchen, drank a Gatorade (40 grams of carbohydrate), and ate a granola bar (25 gm carbs). I found my bed and fell back asleep. A few minutes later, I was woken up by Dexcom vibrating, beeping, and flashing a "LOW 55" alert. Another Ultra test gave me a 95 reading. Dexcom was a little late, due to the interstitial fluid lag time. The food was obviously working, but the granola bar was probably too much, so I bolused 1.65u of insulin to cover the extra carbs, and slept for the rest of the night.

I will set Dexcom's low BG threshold to 90 or 100. This way, I can play it safe with a slightly higher BG

inserted, initialized, and calibrated a new sensor

The graph looked like a random array of dots ranging from 120 to 250. I must have had a "noisy" site,

After some thorough research, I found that interstitial fluid is a water solvent containing amino acids, fatty acids, enzymes, hormones, neurotransmitters, salts, cellular waste products, and glucose. Interstitial fluid is found throughout the body, bathes the cells of the body's tissues, delivers materials to cells, and removes metabolic waste. Studies have shown that the glucose in interstitial fluid can be used to estimate the glucose in blood plasma. The Dexcom sensor measures interstitial glucose every five minutes through a tiny platinum electrode (about the size of a human hair) under the skin.

Even though there is a strong relationship between interstitial and blood glucose values, these values are not the same, which is why you shouldn't dose insulin or eat carbs without doing a finger stick. When I first put on Dexcom, the rep said I would probably see a ten minute lag between sensor and finger stick BG readings. I have occasionally noticed discrepancies between readings, usually during or after intense exercise, when my BG values are changing rapidly. These experiences have reinforced the importance of not dosing insulin solely based on Dexcom readings.

Due to the ten minute delay, dosing on sensor readings would be just like riding my bike while looking behind, over my shoulder (see picture). Always looking behind gives a lot of information about the past, but gives no information about the present. Without current information, I could run into unexpected obstacles or dangers, especially when conditions are changing quickly. Whether riding bikes or managing diabetes, I need to know where I currently am, in order to make good decisions for the future.

...during my sixth day of wearing the same sensor (I figured out how to extend the sensor life and Dexcom has applied to the FDA for seven day sensor use).

Dexcom helped me discover a post breakfast BG spike.

FDA: The sensor is inserted in the abdomen. After a 2 hour start-up period, the STS System is calibrated with 2 fingerstick measurements taken by a traditional glucose meter. After calibration, the STS System provides a glucose reading and updated glucose trend information for viewing every 5 minutes. The STS System also contains a built-in alarm that can be programmed to alert the user when results fall below pre-set low and pre-set high levels.
FDA: When should it not be used?
* This device is not designed to replace a blood glucose meter. The DexCom STS System must be used with a blood glucose meter.
* Treatment decisions should not be based solely on results from the DexCom STS System. You must confirm with a blood glucose meter before making therapeutic adjustments.
* Symptoms related to low or high blood glucose levels should not be ignored. If you have symptoms of low or high glucose, use your blood glucose meter to check the STS System results.
* You should update the STS System’s calibration every 12 hours at a minimum to ensure device performance. The performance of the STS System when calibrated less frequently than the recommended minimum of every 12 hours, has not been studied.

The FDA approved the DexCom STS for 72 hours of usage. Many people with diabetes, however, are already using it longer, saving them money at the possible expense of accuracy.

Adults, but not children, at home or in healthcare facilities can use the DexCom STS to detect trends and to track patterns. Approval is for the DexCom STS to complement—not replace—regular blood glucose meters.

The DexCom™ STS® Continuous Glucose Monitoring System is indicated for use as an adjunctive device to complement, not replace, information obtained from standard home glucose monitoring devices.

WARNINGS

* This device is not designed to replace a blood glucose meter. The DexCom™ STS® System must be used with a blood glucose meter.
* Treatment decisions should not be based solely on results from the DexCom™ STS® System. You must confirm with a blood glucose meter before making therapeutic adjustments.
* Symptoms related to low or high blood glucose levels should not be ignored. If you have symptoms of low or high glucose, use your blood glucose meter to check the STS System results.
* You should update the STS System's calibration every 12 hours at a minimum to ensure device performance. The performance of the STS System when calibrated less frequently than the recommendation to calibrate a minimum of every 12 hours has not been studied.

The STS System has currently only been tested in adult persons with type 1 and type 2 diabetes. The device has not been tested in children, adolescents or pregnant women.

The DexComn STS Continuous Glucose Monitoring System is indicated for use as
an adjunctive device to complement, not replace, information obtained from
standard home glucose monitoring devices.

Use of acetaminophen-containing medications when the STS Sensor is
inserted may affect the performance of the device.

Warnings
* This device is not designed to replace a blood glucose meter. The
DexCom STS System must be used with a blood glucose meter.
* Treatment decisions should not be based solely on results from the
DexCom STS System. You must confirm with a blood glucose meter
before making therapeutic adjustments.
* Symptoms related to low or high blood gl icose levels should not be
ignored. If you have symptoms of low or high glucose, use your blood
glucose meter to check the STS System results.
* You should update the STS System's calibration every 12 hours at a
minimum to ensure device performance. The performance of the STS
System when calibrated less frequently than the recommended minimum
of every 12 hours, has not been studied.

This thing is amazing! It's like the switch from urine testing to blood testing... I can now TREAT THE TREND, instead of waiting for trouble.

So, even though the ISF numbers are 20 minutes old, the "trend" of the graph is spot on, nearly every time. (Except when you've just gobbled a big pile of sugar tabs: obviously, that 'leap' isn't predicted by the previous trend.)

Dexcom seems to last even longer. I pushed my last one to 12 days, the numbers were as good on the 11th day as they were on the 2nd! (Morning of the 12th was about 20% off, so I replaced it).

That means:
* 1/4 as much expense ($3 per day for sensors, instead of $12 per day as prescribed).
* Far less spares to carry around on trips.
* Much less site rotation required... I'm now planning on using basically FOUR places, because it's over a month and a half before I re-use a spot!
* Fewer stabbings, fewer re-orders.

Zero frustrations, except that it is VERY EXPENSIVE to learn that a site doesn't work. (Don't go anywhere near your "traditional" infusion sites, even if it's been weeks since the last use.)

payam7777777

10-25-2006, 01:38 AM

I would like to have a spare calibration cable (One-Touch Ultra meter), I'll probably order one up.

I just last night replaced the Sensor which I'd been using since before the last post... started June 5, ended June 22, just over SEVENTEEN DAYS!
That's a Sensor cost of only $752 per year, barely $2 per day.
Unlike the previous "12-day" sensor, this one genuinely died... during the last few hours, it skipped several readings, and then just gave up the ghost. I intentionally ran it all the way into the ground.

Extending Sensor Life
When the 3-day timer is up, unclip the Transmitter from the Sensor... leave the Sensor right were it is, undisturbed. Wait a couple of minutes.
Then run the "New Sensor" procedure (get to the 9-hour screen, hold the down button for 7 seconds). When the "Transmitter Inserted, OK?" screen comes up, plug the transmitter right back into the same sensor and clip it down. Confirm "OK" and wait for the double-calibration indicator to come up (after about two hours).
3 more days Repeat as Directed (3x, 4x, whatever)
Understand, of course, that the FDA DOES NOT approve, and also that I WILL NOT BE RESPONSIBLE for any problems which may develop if you use this device in unapproved ways.
Extending Sensor Life UPDATE
You don't have to remove the Transmitter. Last time, after the 3 days expired I thought to myself, "If I leave the Receiver on the other side of the house, 3 walls and 40 feet away (out of range), how's it gonna know that I didn't pull the Sensor"?

Answer: It doesn't. I Left the Transmitter in, left the Receiver on the other side of the house for 10 minutes, ran the "new Sensor" Procedure, and it again gave me "3 more days".
Next time, I'm gonna try it without even moving the Receiver from my pocket. Maybe, as long as the current session is ended (72 hours has passed or you stopped it early on purpose), it'll accept the "new Sensor" right away?
Extending Sensor life, ANOTHER Update
Heck, you don't even have to take the Receiver out of range at all. When the "Sensor Session is Expired" timer goes off, just press the buttons for "new Sensor, OK?", and "OK!", and you're all done. 3 more days!
My last two Sensors worked for 17 and 19 days respectively. No skin irritation at all, just 1/6 as many little holes. And 1/6 as many $$$$.
Now starting day 11 on this one.

I'll post my result.
From my readings, including Dexcom and One-Touch (calibrations and "just-checking" comparisons), I expect that my next A1c will probably be 6.3 or less.

I have reduced by "traditional" bG testing from about 12x per day to about 5x per day, because I don't need it anymore. So, although Dexcom costs almost $5 per day, it saves $5.60 just on the strips (7 @ $.80 each). I have also been using Glucagons at the rate of 5-8 per year. My crappy insurance only pays for one, the rest cost real money. That's another $300-500 per year (Canadian import pricing).

I really like the STS as well, and have also been wondering what my next A1c will look like. I feel like control has been much tighter. Many fewer lows and as far as I can remember, no severe lows. Even better, no huge rebounds after the lows. The ability to see a trend and act in advance is huge.

Like other posts I've seen, I've had a couple of "bad" sensors. The first sensor I used worked fine. The 2nd sensor stopped working after about 12 hours, which was overnight while I was sleeping. I woke to a "disconnect" alarm. I pulled the sensor, installed a new one, and waited for the calibration screen (double-drop) to show up. 4 hours later, nothing. I called customer service. They were great. The woman I spoke with seemed very sincere and apologetic. We walked through another sensor install to make sure I had done everything correctly (I had). This one worked perfectly. I received a package with two free replacement sensors the next morning. In my book, that is great customer service.

I've woken to find high mis-readings (ie: STS says 198, glucose test shows 92). Recalibration eventually brings the STS and glucose tests into alignment, but it may take a few hours. Also, it seems that these mis-readings usually happen overnight and during the 3rd day of use.

I've found that the adhesive on the sensor pad can be a pain to remove. The pad peels off, but can leave a bit of sticky residue behind. I took the last sensor off by wetting the area with warm water, which helped a lot.

I ***PROMISE*** it's less painful than his current infusion set. Yeah, the gadget looks like a County Medical Examiner's most horrible tool... But the Sensor is, I guess, about 33 gauge: thinner than the thinnest needle you can buy, MUCH thinner than his infusion set.

the Dexcom Sensor is ABSOLUTELY painless

I know you can see trends-but when I have used the sensor it was so out of time with quick changes-when I really need it and so off the mark i.e. said 90 when i was 45 that it gave me little valuable info. I need the info to make changes before I get below 70 and with a 40 point spread in results (between finger and sensor readings) it was not very helpful. i.e. I set it to alarm at 80 but when I checked I was already at 40-way to late to prevent problems and I was feeling it already. It helped some with overnite readings but gave me no new info re after meals etc.

I keep my 'low' alarm even higher, 90, to improve the probability of catching serious lows. But I've never seen mine off by THAT, except during periods of rapidly changing bG. (During rapid changes, treat the Trend, not the value.)

there's a woman on Insulin Pumpers who uses her thigh, but she's only getting about 6 days per Sensor.

Abdomen is IMO a bad site, because (in my and several other peoples' experience) you really need to keep it a BIG distance from your infusion site rotation pattern to get good results.

on ... side, which is MY favorite place

our son is 4. we put the dexcom on his buttock.

manual's recommendation to stay at least 3 inches away from the CURRENT infusion site.

I definitely could not get by with just an inch from older visible infusion sites... in fact, I couldn't get by with placing the Sensor anywhere in my infusion site pattern, even when the vicinity hadn't been used for several weeks and showed no visible scars on the surface of my skin.

I'm not at all surprise that putting Dexcom on the same "butt cheeks" you use for the Cozmo's Infusion sets turns out to be a TOTAL non-starter.

just yesterday, we talked to a member of the clinical research team at dexcom. he had a couple items of advice for us regarding use of the device in a small child...
1) insert sensor at more acute angle than 45 degrees, while pinching up. the idea being to keep the sensor in the subcutaneous tissue, away from the fascia layer surrounding muscle. he said if the sensor is touching the fascia, you will get tons of skips and erratic readings.
2) do sensor insertion in the morning, this will decrease skips and erratic readings. we don't understand at all his explanation of why this would be helpful. but he advised we do this.

We just put one on our son yesterday in his upper outer butt cheek. This is new territory in that we have not used this area for infusion site for almost 3 years. It’s been working well. This morning DexCom said 121, fingerstick said 118. (DexCom,Fingerstick): (297,311), (102,108), (175,160), (298,173), (121,118). I believe the 298/173 was due to Anthony laying on the sensor as you pointed out. Within an hour, DexCom was back on track without any calibration needed.

Yesterday, we gave a correction when Anthony was 311 (and climbing). After playing around for a while (an hour?), I checked is “guy” (the DexCom) and it said 137. The 1-hour graph told me everything I needed to know. A few minutes later we did a fingerstick and we had the 102/108 paired reading. We gave him a snack and avoided a severe low. That makes it worth the effort.

TREATING THE TREND is the fundamental change which you can make when you have a CGM.

payam7777777

10-25-2006, 01:39 AM

WARNING
Symptoms releated to low or high blood glucose levels should not
be ignored. If you have symptoms of low or high glucose, use your blood glucose meter to sheck the STS System results.

(1) Dexcom beats Minimed in accuracy/reliability for detecting lows; and (2) Abbott Labs claims to be BOTH Dexcom and Minimed for accuracy. Abbott has also promised to start a price war. Their "Navigator", like the Dexcom "STS" which I own, can be used independently of any particular pump.

Dexcom *is* a lot more accurate than MM in the hypo range, which is where you NEED accuracy. But Dexcom is also really sensitive to water and sweat, keeping the Sensor dry is a big hassle. For me, Navigator's waterproof Sensor offers a HUGE advantage.

Dexcom does have spectacular Sensor life, at least for me: I almost always get 17-19 days from each "72-hour" Sensor. So the cost for Sensors is very low.

For ME, Dexcom is so accurate that I've basically given up traditional testing: I only test when it demands a "calibration" measurement, or (once in a real long while) when I'm suspicious of the reading.

When I "extend the graph" forwards for about 15 minutes, because ISF readings are about 15 minutes "behind" blood readings, it's usually almost dead-on: within 10-15 points of my One-Touch Ultra bG meter. And 15 points doesn't make any difference in my treatment choices: if it says "75" and it was really 90, well, I should have eaten a bit of something anyway. If it says 55 and I was really 45, I'm already doing the right thing (6-8 sugar tabs). And if it says 200, but I'm "merely" 180, still no difference: I need to make a correction Bolus.

And you must absolutely NEVER let the Sensor get wet, it'll show crazy readings (200, 300 points too high) until it dries out. Many people have this "wetness" problem just from sweating.

The Dexcom doesn't have replaceable batteries. You have to buy a new Receiver/Display/Controller module every 12 months or so, at $550 each, when the battery wears out.

You can improve your battery life, VERY DRAMATICALLY, by keeping the battery ABOVE 80% charge state all the time. That's just the way these rechargeable batteries work-- if you run them down too far, they'll die a lot faster. So, if you see the "battery needs charging indicator" on the Dexcom, you should plug it in IMMEDIATELY.

Dexcom has told me that the batteries can't be over-charged. (I assume that either the charger module, or a circuit within the Receiver, checks for the output voltage of the batteries and stops pushing in the DC when the batteries have reached "full" voltage--- just like your NiMH or NiCad charger turning on its green "fully charged" indicator). So, the best thing to do is to plug it in for an hour or so every day-- and if you get a lot of alarms, which use a lot of "juice", leave it plugged in for even longer. Don't even wait for the "needs charging" indicator to appear.

You'll see that the cost doesn't have to be almost $5000 per year-- I'm expecting to spend about $1700, because I don't have to replace the $35 "Sensor" every 72 hours. I get about 18-19 DAYS from each one.

With Dexcom, you do the 3 clicks, hold for 7 seconds, confirm "OK" New Sensor procedure, and it happily uses the same one for the next 72 hours.
I get about 18 days per Sensor (Dexcom). I don't know of anyone else who gets so long, most seem to be running in the range of 6-12 days with both brands. The Minimed "record holder", Nikos from Greece, gets about 15 days with his. My Sensor cost is running at less than $700 per year, not the $4200 PER YEAR which this woman thinks she will have to pay.

With Dexcom, you do the 3 clicks, hold for 7 seconds, confirm "OK" New Sensor procedure, and it happily uses the same one for the next 72 hours.

With both, you're without readings for two hours while it does the 2-hour "warm up before first callibraton" waiting period... obviously, on a Sensor which you've already been using for 3, or 6, or 9, 12, 15 days, this is unnecessary and slightly frustrating. But not really a huge deal, if I'm not confident that I'm OK, I'll just do a finger-stick partway through the warm up.
I'm so addicted to CGM, I loose confidence and perform that "extra" finger stick about 90% of the time. Two hours with no measurements? UNTHINKABLE!

I get about 18 days per Sensor (Dexcom). I don't know of anyone else who gets so long, most seem to be running in the range of 6-12 days with both brands. The Minimed "record holder", Nikos from Greece, gets about 15 days with his. My Sensor cost is running at less than $700 per year, not the $4200 PER YEAR which this woman thinks she will have to pay.

(and frankly, my Sensor is a lot less bother than my Infuser is)

In the studies, Dexcom is a little more accurate than Minimed. But in the real world, Dexcom also seems to be a lot more flakey if you get it wet or sweat around the Sensor.

But Dexcom doesn't have replaceable batteries, that's a pretty big financial advantage for the Minimed system. With Dexcom, you have to buy a new Receiver/Display/Controller module every 12 months or so, at $550 each, when the battery wears out. See my new Thread on this subject.

The "record holder" guy on Insulin Pumpers gets about 14 days on Minimed, I always get 18 or 19 on Dexcom. I seem to be the "record holder" for Dexcom, but some others also get more than two weeks, and most of the MM folk are down in the range of 7-10 days.)

We've had our 6 year old son on it for two weeks now. There are annoyances and it's not perfect, but I LOVE THIS THING!!! Being able to watch the trends and prevent lows has been the best thing to happen to us since diagnosis 1 year ago.

We've used 4 sensors so far and one was bad. They shipped us a new one overnight to replace it. One ripped off when he fell at the dinner table (slid down the edge of the table and it pulled the sensor up a little).

It pinches a little at insertion but it doesn't bother him once its on. He has only worn it on the tummy so far and he is on MDI so we don't have to worry about staying away from old sites as pumpers do.

If it gets off, calibration helps get back within 30 points. when its calibrated, the readings are anywhere from 2 to 30 points different than the one touch, but the trends always seem to be right on.

It doesn't get ruined if it gets wet, you just have to let it dry before getting accurate readings again.

Dexcom is trying to get their transcutaneous system to last 7 days. They're subcutaneous would last for a year.

the short term is designed to last 3 days (much like MM and Abbott Therasense), but Dexcom is trying to get it to last 5-7 days.

DexCom G1 Continuous Glucose Monitor
Features a long-term implantable sensor half the size of a triple-A battery which is placed subcutaneously in the abdominal wall, where it measures glucose levels every 30 seconds and transmits the data wirelessly to a small receiver. Not available yet for sale. More information will be available at ADA in June.

On the call they mentioned the sensor is about 2.5 square cm.

The thing I am most excited about is that they have another, long term sensor almost ready I think. It is about the size of a quarter, pops under the adipose tissue around your waist (in the doctors office) and lasts about 1 year. Whilst this latest 3 day thing is great, the 1 year thing I believe truly is progress.

Dexcom is trying to get the FDA to extend the life of the sensors to 7 days

They told me a prescription is all they need. Is not recommended for kids but if the doctor gives prescription they will sell it.
it needs calibration every 12 hours and the receiver needs to be within 5 feet of the sensor.

payam7777777

10-25-2006, 01:39 AM

I've been doing one of the DexCom trials for 10 weeks. During that time,
I've had about 65% of my sensors work correctly and 35% of them not work at
all. I get frustrated that the calibration doesn't happen very easily and
consistently. It is supposed to take two hours before it requests 2 blood
drops for calibration, but my experience is that it doesn't accept the first
two and I have to do at least two more. I would hope that they're working
to correct the sensor issue and some of the calibration issues.
When they work, it's great information, although we don't have the software
to upload the information to our computers (which I would like so that I
could see the trends over several days). I've had two painful insertions
and many not too painful ones. When I go low it takes longer for it to
reflect the rise after I eat than it shows on my meter. When I'm on the
higher end, it can be up to 100 points off. When I'm between 80 and 200,
it's pretty close (20 points either way -- which the research MD said was
true of most meters).
Since I don't have very good insurance, I'm not sure if I would actually buy
one. The difference is that we don't have any physician support to actually
evaluate the information and change our basals/boluses, etc. If I had my
own and was working with a doctor, then I'd have someone to help me use the
information. I'm glad that I've had the opportunity to test it out. It
gives me great hope for the future of diabetes management.

I'm on my 2nd day with my new STS. I think it works great. The 1st day, the sensor was little off until I put in a few calibration readings from my OneTouch Ultra. I got a false low warning of 80, when my bg was actually 110. It adjusted itself within about 10 minutes of calibration. Today, every reading has been within 10pts of my Ultra.

I had my sensor inserted into the side of my abdomen (ie. love handle). If I would lay on the side with the sensor, I would get a false low reading. This happened once on the couch and when I turned the other way, the readings went back to normal. Last night it happened again and I got a low glucose alarm with a reading of around 50. When I checked my bloodsugar, it was actually 140.

I'm back to inserting the sensor near his belly button. We don't put infusion sets there, and he has a little cushion at that location. I pinch the skin just as I would when inserting a Silhouette in order to keep the sensor in the subcutaneous tissue.

The 2 hour warm-up thing is a pain, like you said. My sensor just quit working last night at the worst time. I went out to have a few drinks with my friends, which is always a time when I like to check my bloodsugar a lot. After my 2nd drink, the STS went from 110 to 400 in the space of about 10 minutes. Then it went down to 80 and gave me a low bloodsugar warning. Then it just stopped giving results entirely. I had to do the new sensor routine and wait 2 hours.
Hopefully we can get these things figured out, because they are really useful when they work right.

We purchased one for our 5 year boy back in May.
Our initial intentions were to use the device periodically for basal/bolus testing, and over night settings.
Didn't use it much over the summer because the STS is not waterproof, and our boy does a lot of pool activities. Now that the swim season is over here in Pennsylvania, we decided to start using it again. We have too many problems with it to be worth the effort and money for the intervals of time that it actually works well. I can't recommend anyone buying it, but then we are using it on a child.
The sensors are suppose to last 72 hours. I have yet to get 72 hours with a sensor without getting the dreaded "early shut-off due to sensor noise" or the "Out of calibration screen". Some adult users have been using them 6 days or more by leaving the sensor in and just telling the receiver you just installed a new one.
Maybe the sensor probe is too long for a child. That could be our problem. The sensors have worked long enough to help us with our bolus, basal, and over night settings.
As a parent, I hoped the device would take a little of the stress away. The stress of wondering where your kids BG was at at any given time. But this device contributed to my stress.

I recently bought this STS system for my 6 year old Emma. It's only been 4 days but I've had lots of problems so far....from no data at all for hours on end to turning off in middle of the night (the tech thought it might be due to too much noise and it shuts itself off). I have this sensor in her bottom as this is the fattiest spot. So far I am so disappointed but will still give it a try...at least until the sensors are used up. I have a friend who's daughter is on this and she loves it. She is able to go 6 days before changing her sensor with no problems. I hope we'll have better luck as the days go by. I too am finding this is adding even more stress to our lives and wonder if I should have done this?

Anyway, took a chance this past weekend and didn't bring an extra sensor. The sensor lasted the whole long weekend in addition to a week before that, for a total of 11 days inserted in my stomach. After removing the sensor, I saw only a tiny red bump, the same size and shape that I've seen after leaving the sensor in for 3 days. There was only a very mild pink area where the adhesive was; very encouraging; averaging that sensor cost over 11 days, that's less than $3.50 a day, very reasonable, at least for my pocketbook.

the charger costs $25, plus $5 for shipping

My DexCom rep told me initially that her batteries lasted five days between charges, but my batteries seem to last a paltry day-and-a-half, MAX. Seems like I'm charging it too much.

I normally need more insulin when I go up into the 300s

Sensor Site After 10 Days, and a New, Flaky Sensor
Ok, so I was somewhat concerned about leaving the sensor in the site for 10 days, given that you're only supposed to do it for 3, and a trial is underway to get FDA approval for 7, but I tried it anyway, risk taker that I am. I will probably end up using them for 7 - 10 days, but no longer. I know some others that are using the same sensor past 10 days, but I'm not going that far.
Anyway, the site looked beautiful: no irritation, only a very slight, almost undetectable, faint hint of redness. The puncture site was almost invisible: except for the tape residue, I would not have known that a sensor was ever there. Looked a lot better than some of my infusion sites after 3 days. I put some Aquaphor over the area to moisturize the skin, inserted a new sensor, and am on my way, probably 7 days this time, although I've had a couple of sensors stop working after 2 days.
Another tip about starting a new sensor session: start it in the MORNING, not the evening, so you can deal with the inaccuracies while you're awake, and not trying to sleep. The new sensor was flaky for a few hours, and woke me up with 2 low alarms, whereas the ultra read 101, and 105.

this sensor has been right on target, except of course, for rapidly changing BGs.

Item Annual Cost
DexCom STS Receiver $550
DexCom Transmitter, 2/yr$500
Sensors, 1/wk $1976
Shower Covers, 1/day $225
Total Annual Costs $3001

How often do you do a fingerstick test when you're on the DexCom?
I see this question occasionally. Since it's only my 3rd week on the sytstem, I find that I am testing more frequently than before I went on CGMS, because (1) I make mistakes, and (2) I also need to get more comfortable with Continuous Glucose Monitoring- sometimes the DexCom can be off up to 40 points from the fingerstick test (I've had successive fingersticks off 40 points from eachother, too, on different hands, go figure that one out), so you MUST do a confirmatory test before you make treatment decisions. CGMS does not replace fingerstick tests, although I have read about some users that are doing this. I do not get that comfort level from CGMS. Here is a sample of my fingerstick frequency over the last 10 days. I'm hoping to cut this figure in half after a couple of months or so:
DATE Number of Fingersticks
Thursday, August 31 15
Friday, September 1 10
Saturday, September 2 13
Sunday, September 3 14
Monday, September 4 16
Tuesday, September 5 13
Wednesday, September 6 12
Thursday, September 7 13
Friday, September 8 17
Saturday, September 9 17

payam7777777

10-25-2006, 01:40 AM

As I've been told, Dex transmitter does NOT like to get wet!

Dexcom STS Only Works With The Older OneTouch Ultra Meter
Not too much of a problem for me, though I do miss my UltraSmart® meter. At first I thought that you could just use the OneTouch® Ultra® for calibration and then the UltraSmart the rest of the day; I was informed that Dexcom, however has to learn each meter that it connects to, and that it uses as much data as you want to give it in it's algorithm to get good agreement between the Dexcom and the meter. Oh well, I'm becoming addicted to the trend data that the Dexcom gives me, and will have to do without the single point analysis that I get from the UltraSmart until Dexcom is able to work with Lifescan to get the download protocol for the UltraSmart, and the new meters, the OneTouch® Ultra® 2, and the OneTouch® Ultra Mini ™.

Things I have learned from using a continuous monitor
1. The type of food I eat makes no difference whatsoever. Wheat bread is not better for my BG than white bread (it just tastes better).
2. Using the elliptical makes my BG go up for 4-5 hours three hours after I stop. It does lower it while I’m exercising, though. (this is the opposite of everything I have ever read on exercise).
3. The BG spike from two ounces of amaretto is negligible.
4. Orange juice used to treat a low wears off 20 minutes later and I’m low again. Whole milk works better.
5. Combo/extended boluses really work. I usually set mine for 50% now, 50% over the next half hour.
6. If I eat breakfast, my BG will go over 230. Always. If I take a lot of extra insulin, I will first go over 230, then go low. Skipping breakfast shows my basal is fine.
7. Stress does not seem to affect my BG at all. Or, my BG is so sensitive to stress that it is constantly affected by the stress of waking up, the stress of driving, the stress of working, the stress of not working….
8. The low BG alarm on the monitor is embarrassingly loud during the day, but will not wake me at night (possibly because by the time it thinks I’m below 100 I’m really below 50). It doesn’t wake my husband either.
9. The best week I have ever seen for BG was during Christmas, when I ate tons of baked goodies, drank lots of sweet booze, was under a lot of stress both at work and home, and did no exercise. Go figure.
10. Even having a continuous readout, doing ten or more fingersticks a day, and going over everything with my CDE once a week does not get me to an a1c of 7.0.
11. Some days, my BG numbers are just completely random. I have not yet tried seeing if there is a correlation to the Dow (Val’s BG went up after hearing news of the dollar’s weak showing against the yen). Don’t laugh, I’ve tried everything else.
12. I work backwards. I can pretty much read what is supposed to happen for the “typical” diabetic and know I’ll be the opposite. This includes exercising (higher not lower), junk food (spikes less than health food), menses (high for 2 weeks after, low the week before), and being sick (runs lower when I’m sick).
13. Decaf coffee raises my BG. A large decaf coffee with ½ cup milk I have to treat like 20g of carbs. Don’t ask my why, that’s just how it works.
14. Just because I can see my BG is high, doesn't mean I can do anything about it.

If it says the sensor is bad, leave the sensor in, and tell the pump you’ve just put in a new sensor. Nine times out of ten that works and the sensor initializes happily and has no problems.

DexCom needs to be recharged every 3-4 days.

And I was really surprised- it didn't really hurt at all- much less than my insertion sets, in fact. What a HUGE relief :)

the main purpose of DexCom is to identify trends in my blood sugar or patterns.

The digestives of my childhood were plain, dry and exactly 10g of carbs each.

I've jumped in the shower forgetting the waterproof cover patch. Oops! Gets you a "shower spike" reading of 380 and above. Sometimes the unit recovers on its own. Sometimes you have to re-initiate it, as if you were starting up with a new sensor.

Three 100-count vials of test strips for the OneTouch meter (necessary for using the DexCom), purchased on eBay for an average of .57 cents each = $171

Despite gaps between the CGM and traditional meter, the DexCom still gives me the line, which means a lot. I'm constantly reminded that no matter what number I get with a fingerstick, I never have any idea which direction I'm going.

http://www.lifescan.com/products/meters/ultra/

WHAT IT ISN'T:
- a magic wand for transforming your glucose control overnight (obviously, our rational minds know this beforehand, but somehow the vague hope lingers)
- an escape from multiple daily fingersticks. You now need fewer, to be certain, but you do need to calibrate the DexCom at least twice a day, and need to take a fingerstick reading anytime anything really happens, i.e. prior to dosing insulin or whenever the DexCom shows a High or Low reading
- an actionable replacement for the conventional monitor (as per above). You have to be careful! So far I've seen up to a 40pt difference between the DexCom and the standard monitor, so you really don't want to dose (especially not stack doses) based on the continuous readings alone -- which the company and the FDA are both very clear about, though it sure is tempting
- a relief from the schlep-and-hassle factor of diabetes. In fact, you now have one more device (complete with cable and case) to carry around with you and fuss about. btw, the DexCom only interacts with the OneTouch Ultra meter at this point, so you're forcibly switched to that model (which isn't bad, as long as you're good at getting a generous blood sample onto the strip all at once... I'm learning)
WHAT IT IS:
- an incredible new way to view and understand your own body's reaction to all the relevant diabetes variables: different foods and physical activities, insulin doses, menstruation, sick days, etc. The trick is to be patient enough to start out by simply observing, rather than trying to react to everything you see on the nifty little CGM screen right away
- the first-ever effective tool for people with diabetes to get reasonable, personalized answers to the following key questions:
* how long does it take until my insulin starts working?
* how long is the insulin active in my body?
* does this differ by time of day? (for example: am I more insulin resistant in the morning than in the evening?)
* what do my favorite meals do to my blood sugar?

you can buy test strips for cheap(er) at places like Costco, eBay and supply websites like DiabetesMall.net without a prescription! So you don't have to rely on your insurance to cough up coverage for more of these essential supplies. Whew, what a relief. Where have I been?

They say the accuracy of the device will improve with the more fingersticks you feed it

It also tells me that I am utterly stable and am safe to drive! Previously if I tested 100, well, I didn't know if I was rising or falling, and I don't feel my lows, so I'd eat before driving. Now if my fingerstick says 100 and my graph is flat or rising, I'm good to go. Same goes with feeling safe to sleep...

The main point to remember is that the Dexcom is not a replacement for fingerstick glucose testing. It's purpose is to show you the OVERALL pattern of your glucose readings, how it fluctuates during the day, how you respond to certain foods or activities, etc.

One thing that helps accuracy is to do a bunch of finger stick tests early on and callibrate every single one.

The fact that the transmitter isn't waterproof really sucks. You're left with the choice of: 1) wear the shower patch and potentially fritz the $250 transmitter, or 2) unhook the transmitter and have to restart the 2-hour calibration process.

I also agree with the poster who said to just keep reinitiating sensors that seem to fail - they generally work after the 2 hour wait unless they've fallen out.

payam7777777

10-25-2006, 01:40 AM

I've had my Dex since June 2, and it's been a life-changing device. I use the sensors for 7 - 10 days. I've had problems with 2 sensors, which Dexcom replaced. For me, it's been more accurate, more durable and much more usefull than I expected.
It handles water better than expected. I run in 100 degree heat, and the sweat doesn't bother it. I swim, using the shower patches. I had one patch open up while I was doing laps, which meant that the sensor and transmitter were underwater for 10-15 minutes before I noticed. I dried off the area, and 10-20 minutes later it was working fine. You can also pop the transmitter out if you need to and pop it back in without restarting a session.

I do find the first day of the DexCom usually is its worst - sometimes I just give up and restart it the next day if it's still off. But I wore my last one for 12 days and for the most part it was within 5 points of a fingerstick except on day 1.

My calibration experience/strategy is much like Val's: expect the first day to be off. I get through the first day with a new sensor by doing some extra calibration and expecting the unit to be off somewhat. On the second day, I do a restart - that way you lose all the noisy values and bad calibration of the first day, and can start fresh. After that, it is usually smooth sailing for somewhere from four to ten days.
If your sensor is acting really flaky, try restarting rather than just chasing the bad calibration with more fingersticks. If it doesn't work well after a restart (and the requisite few new calibration points), and it's been in more than a day, then pull it and start a new one. If it's been less than three days on that sensor, then call Dexcom and tell them to replace the sensor for free. We can put up with some flakiness, but there's a limit!

In fact, I don't get many 'off' numbers at all but interestingly the accuracy actually seems to be its best on days 7+ of the sensor. So much for the 72 hour lifespan!

Eric Jensen (Aug 24) is RIGHT to recommend trying other places... although his success with upper leg is unusual.
For many people, if you put your Pump Infusers in your belly, you WON'T get good Dexcom Sensor performance there. I say that you should FORGET what the manual says ("as long as you're at least 1 inch away from VISIBLE old scars, at least 3 inches from your current Infuser"). Rather, you should be at least 2 inches away from ANYWHERE you've put an Infusion Set during the last year.
The two places I recommend are: Love Handles-- straight down from the armpit, and above the belt, NOT too high and close to the lowest rib. I know there's not a lot of area there on shorter women, only room for about 4 "sites" on each side, but since I get 18-19 good days from every Sensor, I don't have to go near an old location for about 5 months.
And Upper Butt Cheeks: Well above what you sit on, but be sure to be well below the "thin, bony" parts where there's ligaments into your hip joint.
I started out on the belly, and after 2 weeks of frustration I was gonna send it back-- then I tried my "love handles", it's been incredible.
BTW, I have my low/high alarms at 90 at 170... since there's a delay when you're falling or rising quickly, I don't like the thought of waiting until Dex says 70: for me, bG would likely be 55 or less at that point. And going up, even with Dexc set at 170, my REAL bG is often approaching 200 when I get an "unexpected" buzzer. I prefer to keep the alarms tighter.
My results are so good that I've basically given up on finger-stick tests, and hardly ever do a "confirmation check" when the Dexcom makes a buzz. It's ALWAYS been a correct indicator, except for once when I got it wet.

I used the hip area, aka: upper butt cheek ;-), for my last sensor insertion. Got the usual "out-of-wack" sensor results the 1st 24hrs, but since then I've gotten the best results of any sensor to date...and the sensor's still in on day 9+! Like Caro, CGMS vs. blood glucose results are definitely correlating better the longer I keep the sensor in. Unfortunately I'm getting a little bleeding periodically from the site now, so I'm planning to put this sensor out of it's misery and put a new one in before leaving on my business trip Tuesday.

Skip the shower patches except for trips to the beach. I asked DexCom, and they said getting the transmitter wet in the shower will not harm it, but may make the readings off until it dries out. I have seldom noticed this being an issue, and when it is off it's for less than an hour.

the transmitter has to be replaced every 6-12 months because of battery life, and that's a $250 replacement. Then the receiver has to be replaced every 12-18 months for the same reason

For me, the cost of my Dex is going to be about $2000 a year (I'm getting 7-10 days per sensor, despite running and biking in 100 degree heat, and my OneTouch strips are paid for by insurance.) If I were paying full price for either 10 strips a day, or 3-4 per day plus Dex, I think I'd break even.
The real punch line for me is this: my A1C has gone from 7.5 - 8.0 to 6.5, my energy's up, and I can do things I could never do before.

Are you using good Sensor locations, or just whacking your belly (to close to insulin infusion sites)? Their instructions that you can be just an inch away from visible old infusion site scars, and even right on top of invisible ones, were BAD for me. I never got more than 5 days until I switched to my sides, and they were failing even before 3 days until I moved. Now I average 17-18, very consistently. (Personal record is 20.)

I've had my Dex for 3 months now. IMHO, it is a buggy, first-gen product that takes a lot of work and is often inaccurate.
Having said that, I've only had two reactions in three months (as opposed to 1-2 per week). My A1C has gone from 7.5 to 6.5. I can do many things now that I could not do before. I would rather go back to 18th century bloodletting than try to treat my diabetes without my Dex. I've also found the cost to be much less than I expected.

My experience has been that my first 12 hours or so with a new sensor aren't that good, but it settles in well after that. I'm just starting day 4 on my currrent sensor.

Though, as you probably know, once you start to sweat a lot the accuracy of the Dexcom readings goes out the window anyway - hopefully they'll fix that in the next round.

Welcome to the club! I've had my Dex for a little over a month. For me, it's been a life-changing device. My average BS have gone from about 180 to 130. I can run for hours in the Alabama heat, and see what my BS is doing. I've learned more about what really affects my control in a month than I've learned in years of testing 10 times a day and reading everything I can get my hands on.This is clearly a first gen product, with a lot of room for improvement, but, even with the warts, this is the best thing to come along since home BS testing.

Jack put in his 3rd sensor on Saturday. Two hours later he calibrated it (one finger stick from each hand), and started getting readings. But a short while later, he said that he felt low. The Dex showed 146. A finger stick showed 46 - ouch. The rest of the evening didn't fare much better, with huge discrepancies between The Dex and Jack's meter. We have a couple of hypotheses for this: (1) It takes a while after a new sensor is inserted for the readings to stabilize. Jack's heard that it sometimes takes a sensor a day to get the most accurate readings. (2) His BG was wildly fluctuating (most plummeting down) during the period after the calibration. But increased finger sticks & inputting that data into The Dex drastically improved readings.

By 11pm that evening, he wasn't getting any readings at all. Nada for 3 hours. So he restarted his session and the calibration process (yeah, it woke me up at 1am to demand those 2 finger sticks). Since then, it looks like it's been ok.

Believe it or not, our monthly expenses have decreased since Jack's been on The Dex. He was able to use his first sensor for 6 days (the insertion site hurt by then) and his second for 10 days (probably could have gone longer, but the tape holding the sensor came off). Even if we had bought the system at full price, we would have recouped the money in about 4 months. So all in all, a savings!
The Dex (not including transmitter/receiver):
- $35/sensor, 1 sensor/8 days (average) = $131.25/30 days
- $0.90/strip, 2 strips/day = $54.00/30 days
- Total for 30 days: $185.25
Without The Dex:
- $0.90/strips,14 strips/day = $378/30 days
- Total for 30 days: $378

Yesterday it fritzed out on him again by showing him at 384 (yikes). He did a fingerstick to check and that came in at 38 (ouch).

payam7777777

10-25-2006, 01:42 AM

Dexcom users please contact me thru my email: payam7777777@hotmail.com
I need to talk to you.

Ellen

11-04-2006, 10:31 AM

Where did you get these excerpts? Can we have the URL?

payam7777777

11-04-2006, 01:13 PM

Ellen,

Sure why not. Stay tuned to my posts though, i'll post categorized excerpts soon; a must read for ]prospective] DexCom users.

;---------------------------------------------------------------------------------------;
; DexCom STS -Pages ;
;---------------------------------------------------------------------------------------;
Basic Rules of Continuous Glucose Monitoring
http://dexcom.com/html/basic_rules.html

The DexCom Continuous Sensor
http://www.mendosa.com/dexcom.htm

Chart comparing Navigator, Guardian RT, and DexCom STS
http://www.childrenwithdiabetes.com/continuous.htm

Dexcom - Transdermal Glucose Oxidase Enzyme
http://www.diabetesnet.com/diabetes_technology/dexcom.php?PHPSESSID=2f94ed1948822e2ede4bcce80a9db 9f2

FDA: DexCom™ STS™ Continuous Glucose Monitoring System - P050012
http://www.fda.gov/cdrh/pdf5/p050012.html

Photos of the DexCom Sensor
http://www.childrenwithdiabetes.com/DexComSensor.htm

How To Buy
http://www.dexcom.com/index.html

Starter Kit
http://www.dexcom.com/html/dexcom_products_sts_starter_kit.html

Sensor
http://www.dexcom.com/html/dexcom_products_sts_sensors.html

SAFETY INFORMATION
http://www.dexcom.com/html/dexcom_products_sts_safety.html

The DexCom Continuous Sensor
http://www.diabetesmonitor.com/m79.htm

DEXCOM !!!
http://www.medhelp.org/forums/Diabetes/messages/1006.html

My New Friend Dexcom(Very good reading)
http://www.insulinfactor.com/article_dexcom.html

My Diabetes CGMS(Very good reading)
http://mydiabetescgms.blogspot.com/
http://mydiabetescgms.blogspot.com/2006_07_01_archive.html
http://mydiabetescgms.blogspot.com/2006_08_01_archive.html
http://mydiabetescgms.blogspot.com/2006_09_01_archive.html
http://mydiabetescgms.blogspot.com/2006_10_01_archive.html

Dr Jekyll and Mrs Low (good reading)
http://drjekyllandmrslow.blogspot.com/2006_05_01_drjekyllandmrslow_archive.html
http://drjekyllandmrslow.blogspot.com/2006/07/dexcom-versus-other-guys-twelve.html

My Blog??? :D
http://acthoughts.blogspot.com/2006_07_01_acthoughts_archive.html

DiabetesWise (Very good reading)
http://www.diabetes-wise.net/continuous_monitoring/index.html

Diabetes Mine (Very good reading)
http://www.diabetesmine.com/dexcom_and_me/index.html
http://www.diabetesmine.com/2006/06/dexcom_and_me_u.html
http://www.diabetesmine.com/2006/09/dexcom_dm_consu.html
http://www.diabetesmine.com/2006/06/think_outside_t.html
http://www.diabetesmine.com/2006/07/more_dexcom_add.html
http://www.diabetesmine.com/2006/07/thank_heaven_fo.html
http://www.diabetesmine.com/2006/08/upstairs_downst.html
http://www.diabetesmine.com/2006/07/pricey.html
http://www.diabetesmine.com/2006/09/jj_lifescans_co.html
http://www.diabetesmine.com/2006/07/update_minimeds.html
http://www.diabetesmine.com/2006/07/hot_and_gorgeou.html
http://www.diabetesmine.com/2006/05/aace_for_dummie.html
http://www.diabetesmine.com/2006/08/extending_mysel.html
http://www.diabetesmine.com/2006/08/quick_dispatch_.html
http://www.diabetesmine.com/2006/08/beating_the_ang.html
http://www.diabetesmine.com/2006/08/leavin_on_a_jet.html

Life with a Spouse (Good, about her husband Jack)
http://lifewithaspouse.blogspot.com/
http://lifewithaspouse.blogspot.com/2006/07/to-cgm-dex.html
http://lifewithaspouse.blogspot.com/2006_07_01_lifewithaspouse_archive.html
;---------------------------------------------------------------------------------------;
; DexCom -Forum Threads ;
;---------------------------------------------------------------------------------------;
*MY* experience with dexcom
http://forums.childrenwithdiabetes.com/showthread.php?t=781

Another Dexcom blogger...
http://forums.childrenwithdiabetes.com/showthread.php?t=1433

Dexcom battery life
http://forums.childrenwithdiabetes.com/showthread.php?t=1376

DexCom Continuous Glucose Monitor
http://forums.childrenwithdiabetes.com/showthread.php?t=1403

DexCom Experience
http://forums.childrenwithdiabetes.com/showthread.php?t=488

Dexcom DM(TM) Consumer Data Manager
http://forums.childrenwithdiabetes.com/showthread.php?t=1372

How acurate is CBGT?
http://forums.childrenwithdiabetes.com/showthread.php?t=1782

The Beep of the Sensor, the Thrill of Control
http://forums.childrenwithdiabetes.com/showthread.php?t=1375

Dexcom
http://www.islet.org/forum/messages/44940.htm

Dexcom continuous glucose meters to ship this month!
http://www.islet.org/forum/messages/42642.htm

Does Anyone Have the Dexcom STS System?
http://www.islet.org/forum/messages/44654.htm

Dexcom CMS
http://www.diabetesforums.com/monitoring/12804-dexcom-cms.html

Dexcom Update
http://www.diabetesforums.com/monitoring/9107-dexcom-update.html

New DexCom Receiver for sale?
http://www.diabetesforums.com/monitoring/12079-new-dexcom-receiver-sale.html?highlight=dexcom

Dexcom CMS
http://www.diabetesforums.com/monitoring/12804-dexcom-cms.html

Weird trend
http://www.diabetesforums.com/monitoring/12407-weird-trend.html?highlight=dexcom

Dexcom
http://www.diabetesforums.com/monitoring/12237-dexcom.html?highlight=dexcom

We are on the DEXCOM! (5 year old)
http://forums.childrenwithdiabetes.com/showthread.php?t=2153