Medtronic CGM vs Dexcom 4

For those of you that have tried both can you give me a breakdown of how you feel about both systems? I am thinking in June when my Medtronic monitor warranty expires to switch to Dexcom. My main concern is Bethany's skin and keeping the sensor on in the pool. I have a good system in place with the Medtronic which involves lots of opsite. I even use it as a barrier for the small amount of tape on the Medtronic sensor. Bethany has a skin allergy to the Omnipod tape which I manage with cavilon. From what I see in the pics, the Dexcom uses the same tape but I don't think I can use the cavilon for a sensor. Also the tape on the pod inevitablely pulls up on day 3 after lots of swimming and the Dexcom you wear for 7 days. Can you tape over the whole thing like you do with the Medtronic sensor and transmitter? I am thinking that tape won't withstand an active 8 year old who loves to swim.

Thanks for any input you can give me.

 

I have tried both. I am currently back to the Medtronic system.

I think the dexcom is far superior at managing things in real time. But I really missed the ability to scroll back as well as see bolus marks. I found the dex caught highs faster but medtronic was more accurate in the low range. dex could usually pinpoint that I was low but not the actual number. dex caught lows about 5 minutes before the medtronic system. The main advantage and reason we are going to so much effort to have me switch back to it is that the alarms wake me up and I have been sleeping through medtronic alarms lately.

I think based on posts on here I have had an unusually good experience with the medtronic system. The dexcom is much much more comfortable to wear. I didn't know how much the medtronic system annoyed me until I started using the dex.

On my 3rd week of the dexcom (right after switching from the 7+ to the g4) I suddenly developed a very severe allergy to the tape. I was actually with my parents for winter break and my mom got out an epipen It looked like a severe burn in the outline of the adhesive and the entire arm I had it on and my neck were covered in hives. I have had minor reactions to the omnipod but nothing like this. I saw a dermatologist last time I was in NY (my endo really wants me on the dexcom) and she did not think there was a way to manage it without steroids which I am not comfortable using over the long term.

Our current plan is for me to use the medtronic system until the summer. If I am in NY for at least a week we are going to try to remove all the adhesive from the dex sensor and insert it then tape with opsite (which I don't have a reaction to) and then monitor it closely with an epipen and benedryl on hand. If I don't have any reaction I will switch to it. If I do, I am just going to stick with medtronic and hope they eventually get the enlite sensors to us.

I am one of the few people I think who had a negative dexcom g4 experience. I would call dexcom and explain you are concerned about an allergy to the adhesive. They should be willing to work with you. I know my dermatologist spent some time talking to them and we even got samples of sensors to play around with to try to come up with a way to make it work for me.

Sorry for the novel, I hope you are able to to try the dexcom! It really is wonderful and just so much more comfortable to wear.

 

I want to thank you for your novel and taking the time to answer my questions. The allergy to the adhesive as I said is a big issue for us and its what is holding me back. I want to protect my daughter's skin and minimizing scaring. My endo is trying to get one for us to sample before involving insurance. Please let me know how it goes for you. I hope it works!

 

Kind of had the same experience as Meg. Younger son was on Navigator (no allergy), went to Dexcom. It took about three sensors before the allergy fully developed. We owned it by that point. Then went to Navigator for a short time them went to MM CGM. No allergy to that. My older son has no allergy to Dexcom and uses it.

 

My daughter has tons of skin sensitivities, metal allergies, etc. She reacted to the medtronic sensor, but not to dexcom. We thought we saw some signs of an allergic response to the G4 starting, but have been able to mitigate that without losing accuracy by giving her a daily loratadine (allergy med.)

With both systems, the adhesives give her issues - again, she is super sensitive, and not just to those adhesives, but tapes, opsite, tegaderm, IV 3000, etc. We've had decent luck with skin prep before applying any adhesive, and always using unisolve to remove sites and sensors. That, and really good rotation to preserve her skin integrity.

As far as the two systems go - we love dexcom so much more there are no words to describe it. I must be the odd duck - I never use the scroll back feature on the medtronic, and my kid hated the linked meters. So, she enters carbs / bg on the pump through bolus wizard or capture event, but only when she has to. I hated CareLink software, so I download the pump and export it as a csv file. I love the dexcom Studio software - it's very user friendly, and they have a linked button to send your record to technical support if something isn't working right. Customer service has been awesome for us as well. Even though I love their software, I export her dex record and meter record, pulling all three devices into SiDiary. I only do that once every two weeks (used to do it every week, and will if things are going well.) I like having all the info in one place. The dexcom receiver allows you to log carbs, insulin, exercise, illness - so you can log a ton of stuff there as well. Since you can get up to 24 hours on the dex receiver (or a much shorter time frame), I don't feel I am lacking any info on the receiver. Dd says she has plenty of info for managing trends real time.

As far as comfort goes, there's no contest. MM hurt her so much on insertion, and she was forming nasty scar tissue. Dexcom is so simple she can insert herself, and regardless of who does the insertion, it takes us less than 5 minutes. For whatever reason, it seems to read accurately from beginning to end, and sensors almost always last us 12 to 14 days. In fact, I could probably push it out, but I don't want to risk infection. By the end of two weeks, the site looks ishy enough that I don't want to risk it.

My guess is that this is one of the biggest YDMV areas - what works for who, sensitivities to adhesives, etc. That's been our experience, and my child who previously avoided or begged to skip cgm now asks to have it inserted right away. She's 13 and plays competitive volleyball. During tournaments, her coach holds the receiver and it reads her throughout the whole game, allowing us to get skittles to her or reduce basals in the middle of game play. For practice, she puts it in her SPIbelt. I guess we're lucky in that Dexcom alerts her to lows as they're coming on or before she's too low. We've never had it alarm after the fact.

 

Thanks for the responses...so can you use cavilon on the area prior to insertion? I was told not to use it for the Medtronic. Also, can you place tape over the whole thing like the Medtronic transmitter? I would plan on cutting the fabric down and using opsite in place over the remaining fabric. The Omnipod adhesive pulls up only after 3 days of use after swimming often. I use opsite on everything...her pod and sensor. I find its the most durable and waterproof. I have read that you cannot tape over the dexcom somewhere...I think on this board.

 

Watched a YouTube video and discovered the issue with look back on the monitor that I have seen people talking about. This is a deal breaker for me. Bethany will text me from a playdate and tell me "I'm 94 from 98" or something like that which gives me an idea of the rate of her dropping and if she needs juice. Sometimes the Medtronic will beep a low predicted or will have arrows down when the look back numbers are slowing down. I know the Dexcom has directional arrows but do they change to stable the minute the readings start to stabilize or is there a lag? Idk why Dexcom can't keep the numbers in the memory??

 

We switched to the G4 and have stayed with it primarily because the sensor is less damaging to the skin (leaves not mark, in fact). Some other pluses are the sensor lasts up to 2 weeks, range is about 20 feet (vs. 3 feet with the Minimed), and it has a rechargeable battery.

However, when the smaller Enlite sensor comes out (and assuming it has a smaller needle like the G4), we'll likely switch back to MM. The G4 receiver has some major flaws including: Lack of ability to scroll back and view recent numbers; inability to set a high alarm below 120; the alarm beeps once every 5 minutes, hardly often enough to wake a sleeping child; no options for quiet alarms without vibrate, and no display of the ISIG (the input signal level, very useful for verifying confidence level of the sensor).

 

I switched from Guardian with sof sensors to Dexcom 7+ and am now using G4.

I think Dexcom 7+ sensors were more comfortable but not really more accurate than medtronic sof sensors. G4 sensors are more comfortable AND more accurate.

The Dexcom receivers however.... they feel to me like a receiver for dummies after the Guardian. I can get a pretty decent sense of where my blood sugar has been in the pictures- the dots on both the G4 and the 7+ are way clearer and bigger than the squares for the numbers on the Guardian's screen. And on the G4, they're in different colors depending on the number. The rate of change sometimes has a lag and there are arrows but I ignore the arrows and look at the picture.
But the Dexcom just has way fewer things on the receiver. I can't look at time in range or scroll back or set different threshholds for different times of day without changing the alarms every day or set predictive alarms or change the language if I feel like it or set my high alarm to 155 (I can set it to 150 or 160, which is an improvement from the 7+'s 140 or 160).

 

I won't go back to MM.

While I do miss some features of the display (like scrolling back), I'm gaining near perfect accuracy, I'm gaining a sensor that actually reads below 70 and catches lows in a timely manner, I'm gaining a sensor that has alarms and a range good enough to wake me up at night, and I'm gaining - most of all - a rapidly falling a1c in my child.

Also, as far as putting something underneath - there is actually a small window in the inserter and you can line up the cross hairs there to see where the insertion needle will be hitting the skin. we draw a circle on his skin in sharpie and then wipe skin tac around that circle. Then when we insert we are inserting into 'clean' skin. You could easily do the same thing with the barrier tape.

 

Thank you for your post. That helps me with her skin concerns. Do you tape over the whole thing as well? Or just leave it open? I can't use skin tac on Bethany due to allergies and the adhesive is not durable on the Omnipod to last 7 days (it barely lasts 3 days)...the dexcom adhesive looks to be the same.

 

Interesting to read all of these comments. We've been using the MM for 4 1/2 years and it's working well for us (with a bunch of caveats that we've just learned to live with). Our endo is always surprised at how much we like it, says we're among the few who are so positive about it, and says she's prescribing more and more dexcoms. We won't make the move, though, because our dd is adamantly opposed to having to carry or wear a second device - she really likes having it integrated with the pump. Also, now that I read that you can't scroll back through the numbers on the dex I'm thinking we wouldn't like that - we rely on that a lot since dd isn't with us all the time.

 

Supposedly you aren't to tape over it, I'm not sure if it's really a problem or not. We usually need a new piece of hypafix (with a hole cut for the transmitter) around day 4 which then lasts us the rest of the 2 weeks.

Actually - there are a few here who have good luck with MM - Darryl, Hawkeyegirl are two that come right to mind. It makes me wonder why some of us had such horrible luck with MM, but that those that have success with MM, like Darryl and Hawkeyegirl, have such GREAT success.

 

Count us among the ranks of happy MM families. Our endo also continues to be surprised that we are happy with the accuracy and range of the CGM, but we are. I would like a less painful insertion, though!

 

Easier insertion - Dex

We gave up on Minimed CGM integration due to painful insertion. Even with numbing cream etc., we had to hold my 5 year old down kicking and screaming. He would still complain later how much it hurt and that he still felt it. We finally gave up.

With Dex - it is virtually painless. While integration is really neat - I like the idea of the separate device - it looks like an IPOD. This is great for parents of young kids. My son can play basketball - still wearing his pump - while I hold the receiver and check his blood sugar.

Pretty cool.

 

We also had very good luck with the MM, as far as having better glucose control, but it was a lot of work and there were a lot of drawbacks and things that just didn't work - like the alarms.

The MM CGM is great if integration is a deal breaker as it was for us for a long time. And who knows, Sean may very well rebel when he has to take the G4 to school next week (we're on spring break). We too will watch to see if MM ever gets the Enlite through FDA, but we're DONE waiting on MM to release products in the US. Too frustrating!!

 

Integration was our deal breaker when we first started with MM. And that's why we chose it. Initially I was going to allow my son to leave the g4 at home during the day (or tucked into his backpack - which is in the classroom with him). After the first day he just decided to wear it on his belt, during Gym, it's in his bag in the gym. It's been much less of a problem than we both expected. From a kid who was SO adamant that he didn't want 2 things, he's very much enjoying being able to remove it - set it on the counter - and not worry about it at home.

 

That's what I'm hoping for. I've told Sean he can just leave it in his backpack or whatever, but so far when he's carried it he just puts it in the second pocket on his spibelt.

 

We took out the first sensor last night, and I just replaced it a few minutes ago.

Two observations:

First, the site from the first sensor looks great!! I had a hard time finding the mark from the needle. And there's no irritation at all from the adhesive, and it stayed on just fine and probably would have for another week. With the MM we used Tegaderm to keep it on, always had to replace it once or twice during the week, and sometimes had problems keeping them attached. His skin was always red and irritated for days after removing it.

Second, he has now conceded that the insertion is less painful and the sensor is at least no more uncomfortable than the MM. The insertion process is more clumsy at first, but I think now that we've done it a couple of times it's much better than the sof-serter / harpoon.

 

Your post reminded me of the existence of SiDiary, so I downloaded it this morning in the hopes of generating reports integrating CGM and pump data.

I'll be darned if I can't figure out how to get at the CGM data for anything other than a list of readings. None of the graphs seem to have an option for including CGM data.

Perplexed ...