Original Dexcom STS with calibration process. Photo-cred CWD

Pictured to the right: Screen from phone to scan QR code

to allow 0 calibrations

Now I’m feeling so fly like a G6: Once I had heard about Dexcom’s Limited Release program, where only 1,000 customers nationwide were selected to be the first to test this new system, I immediately called to order and became anxious awaiting its arrival. For anyone who is unfamiliar with Dexcom here is a brief history: Dexcom was established in 1999 and their only product is a continuous glucose monitor (CGM). Personally, I have been using a Dexcom CGM since 2006 with their original STS system, a horrible sensor that only “worked” for 3 days (honestly, signal loss was more common than not). With this system, calibrations were über inconvenient as you were required to use an old school OneTouch Ultra glucometer and connect to the receiver with a cable. The insertion with the STS system was also pretty painful in comparison to the G5 insertion. Since the STS system, and during my 12 years using Dexcom, I have experienced the vast improvements of the system: from a 3 day wear to 7 days, ability to enter calibrations, Share capability, FDA approval for dosing, etc. Each improvement has been a remarkable step for continuous glucose monitors and the G6 is by far the most exciting development I have experienced out of all system improvements. For all the facts about the G6 feel free to click and read the G6 Press Release. Now for the real reason you clicked to read this: my personal first impressions on Dexcom G6! The initial setup of the iPhone app was flawless as all my G5 app settings were automatically transferred over with the click of a button. Setting up the new G6 transmitter was exactly the same as G5 by taking a picture of the barcode, no issues there. New to G6, each individual sensor has a QR code and numeric code; scanning/entering this code allows the system to run with 0 calibrations per day as opposed to 1 calibration per day if you do not enter this code. The QR code would not scan through the app however it was only 4 digits so it wasn't the end of the world to manually enter. This has been a common glitch in the new app from what I am hearing. However, working out these kinks is the reason for a limited release, right?

Pictures (left and right) inserting the PAINLESS sensor directly under my G5 sensor. Below is both sensors; G5 on

top & G6 on bottom

Inserting the G6 might be the best thing since the discovery of insulin. OK maybe that was a bit drastic, but the design has made the insertion extremely simple and much less intimidating. I'm pretty sure I giggled like a little school girl putting the inserter on my body. Once I settled down I pressed the button to insert the sensor and felt NOTHING. Before I could blink my eyes the needle was in and out! Had I not stopped to take pictures (you're welcome, by the way) the whole process would have taken a minute.

Side note: I have also been wearing a Freestyle Libre the past 2 months. I decided to simultaneously start my Libre sensor to compare the difference. I also kept my G5 on since it was already inserted; call me crazy but I felt guilty wasting a perfectly good sensor insertion and figured I’d use it to compare. After inserting both sensors (G6 and Libre) I went to dinner with

Sensor warm-up screens for G6 (left) & Libre (right)

Left: Alert that occurs after 2 hour warmup complete Below: Me pretending to be part-

robot with all of my attachments

G6 (left) a few hours in vs G5 (right) a few days in

my parents to celebrate 15 years living with this horrid disease. (Side note: how badass is it that the G6 came on my 15th Diaversary?) Midway through dinner, WITHOUT ANY PROMPTS OR CALIBRATIONS, I received a notification that the warmup was complete & also a high glucose notification (damn appetizers got to me). It was amazing to me that in 2 hours and, again, without prompts the sensor began displaying the data. I swiped my Libre and had an alert that glucose data would be available in 10 hours. I repeat, 10 hours. THIS is an enormous difference and a strong reason why I would encourage Dexcom over Libre. The other reason is the ever important alarms which I have come to love and appreciate as they have likely saved me from experiencing extreme lows on multiple occasions. During the initial 6 hours the G6 data was practically identical to my G5 & finger-stick data, however the next morning my G6 data was slightly off compared to my Contour finger-sticks but were still within the 20% margin of error. Overall, however my data was ON POINT! I collected some data comparing finger-sticks & Dexcom information and will attach it at the end.

One feature new to Dexcom G6 is the “Urgent Low Soon” alarm. This alarm is separate from “Low” and “Urgent Low” as it alarms you if the

system predicts that you will hit Urgent Low (55 or less) within 20 minutes. See photos for the different places you will see this notification:

Day 10 was my first day of disappointments, and not just because my session was coming to an end. I was all set to run the Broad Street 10 Miler in Philadelphia and just before the run started is when G6 decided to give me a reading of “Signal Loss,” the one thing I hate more than seeing

a reading >400. Luckily, I was still milking my G5 (extra tape and all) so I was able to see what was happening during the run. G6 came back intermittently throughout the run, however I was simply disappointed. I was under the impression that G6 would “prioritize the Bluetooth connection” since it is a medical app, yet my watch and G5 connected just fine. Perhaps it’s my phone, but this is something I need to figure out to prevent this “Signal Loss” from occurring at

the most inopportune times. Don’t worry, I finished the run in 1 piece. ☺ The second disappointment of my Day 10 was when it became time to restart a sensor. I heard rumors about a “hard stop” on the 10th day where you would not be able to restart the sensor, but I chose not to believe it. I was guessing that I could restart the

sensor (like G5) just without the code allowing 0 calibrations. Alas, I have the misfortune to officially relay the message that you CANNOT restart your G6 sensor after 10 days; with or without a code.

Despite not being able to use a sensor more than once (thanks, FDA) I would give an overall positive feedback regarding the ease and accuracy of the system. What a world to live in where we will (almost) never have to prick our fingers again! The future IS here! Please note that this is my own personal experience with the sensor.

This next section is for my #wearenotwaiting fam. I have only started Looping a few months ago so I'm still new to this branch of the diabetes world. Nevertheless, I am extremely grateful for the people much smarter than I who shared their brilliance with the world! Anyway! G6 info pulled into Loop through Dexcom Share FLAWLESSLY right after I linked with Apple Health. Actually, Loop pulled BOTH G5 and G6 until I un-linked my G5 from Share. I have confidence the builders will create an offline pathway for the data to sync but in the meantime the most important thing to know is that G6 pulls through into Loop! One issue I experienced with G6 & Loop was during the sensor warmup. When I entered my sensor warmup after my initial 10 days wearing G6, which is was the first sensor warmup without G5 data pulling Loop, Loop kept saying my blood sugar was “5mg/dL.” I mistakenly ignored it at first thinking “oh, this is weird.” However, I noticed later that my basal was appropriately stopped to help increase from a blood sugar from 5. I have also been recently playing around with an app called Sugarmate which showed a blood sugar of 5mg/dL as well. Both apps pull data through Dexcom share and also both link to Apple Health. What doesn’t make sense is why any data was showing in these apps at all, let alone a blood sugar of 5! In my mind, there should be no numeric data pulling through while the sensor is warming up. Hopefully it was a fluke, but a warning to those who use the Loop app to manage their basal rates that you may have to open the loop for the 2 hour warmup.

Thanks to everyone who stuck through to read this! If asked, I would without a doubt recommend the use of Dexcom G6. However, if insurance prevents you from getting one, any CGM will give you benefits. If your insurance doesn’t allow you to get a CGM at all you need to switch your insurance ASAP! If you have any questions you can find me at this year’s Friends for Life conference in Orlando. I’m happy to hang out and answer any questions you may have! -Kenny Rodenheiser

I apologize ahead of time for not collecting more information, but when you trust its accuracy and you don’t have to calibrate, why prick your finger?

Date & Time Contour Next Dexcom G6

4/26 (Sensor started) So excited, that I didn’t check ☺

4/27 AM: 126 PM: 133

AM: 136 PM: 135

4/28 PM: 176 PM: 180

4/29 AM: 93 AM: 99

4/30 (skipped checking this day, whoops ☺)

5/1 AM: 148 AM: 150

5/2 AM: 66 AM: 75

5/3 AM: 107 PM: 70 (post skittles)

AM: 107 PM: 63

5/4 AM: 143 AM: 143

5/5 AM: 133 PM: 138

AM: 143 PM: 130

5/6 (Sensor ended) PM: 73 PM: END