I may have had diabetes for more than three-quarters of my life, but that doesn’t mean that I don’t make silly mistakes with it from time to time.
But I must admit, I still surprise myself on the occasions that I make a slip-up that’s incredibly stupid…and incredibly avoidable.
In life with diabetes (and in general), mistakes are bound to happen…
For example, one morning my Dexcom started alarming, and I thought that I knew exactly why it was sounding off: It sounded like the signature triple buzz of a high alert, so I did what anyone else would do when it’s very early in the morning and not quite time to wake up yet…I ignored it and fell back asleep.
But true to typical Dexcom alarm nature, my sleep was interrupted again by continued buzzing. Rather than pick up my phone to dismiss the alarm, though, I decided to bolus for a couple of units without ever verifying that I was, indeed, high.
Yikes. Can you say rookie mistake?
Fortunately for me, I really did have to get up and start my day within a couple of hours of taking that bolus. Thank goodness I did, because when I got up, I immediately glanced at my Dexcom and was taken aback to see that my blood sugar had not ticked up past my high threshold in the last several hours…it had actually lost reception completely.
Ahh…so that’s what it was trying to tell me. Oops.
Furthermore, my blood sugar was inching below my low threshold – the two units I’d carelessly taken had kicked in, and all I could feel in that moment was relief that I hadn’t taken more insulin.
This story could’ve had a very different ending. I’m still kind of in disbelief that I didn’t just roll over to check my Dexcom and confirm the reason why it was alarming in the first place. I mean, that’s what I do any other time it goes off, regardless of the time of day. I suppose that I was just overly confident in what kind of alarm it was. Coupled with the fact that I was barely awake when this all went down, then it really isn’t all that crazy that this happened…but it doesn’t make me feel any less dumb.
Lesson learned. When it comes to Dexcom alarms, always check them, and never make assumptions.
This post was originally published on Hugging the Cactus on February 18, 2019. I’m re-posting it today with some updates because I recently noticed this post gets a LOT of clicks – this topic is one that many people are curious about it. Read on for my two cents on whether or not bleeders are readers, and note that I haven’t updated this because my experience with bleeders remains the same…
I placed the new Dexcom G6 sensor on my abdomen, hovering my index finger above the large orange insertion button. I pressed it, exhaling as I felt the minute needle pierce my skin’s surface. I looked down, and started to rub the adhesive in circles to make sure it was stuck, when I saw blood. Not just a drop, but a decent-sized pool forming beneath the sensor. Before long, just about the entire surface of the white adhesive was soaked in red.
Yeah, this was going to be a no-go.
It’s pretty rare for me to experience blood at the site of a Dexcom sensor. If I had to put a number on it, I would say less than 10% of my insertions draw blood. An even smaller amount – like, 2% – have caused me to bleed as much I did in the scenario described above. But I know I’m not alone in my bloody sensor experiences – it’s something that many other T1Ds who use a Dexcom have gone through.
There’s a bit of debate, though, that I’ve noticed in the past on Twitter threads and Instagram posts. What to do with a bleeder? Keep it and assume that it’ll read blood sugars normally? Or change it immediately and call Dexcom for a replacement?
Are bleeders readers? Or does it depend?
Do you think that bleeders are readers?
I’m going to go with…it depends.
Obviously, in that situation I described in the opening of this post, I decided that it wasn’t a good idea to keep the sensor on my body. There was too much blood and I didn’t trust that it would adhere well to my body. I didn’t know how long it would take for the blood to stop (only a few minutes, but still), and I couldn’t be sure that it wouldn’t mess up my readings. On top of that, I wasn’t trying to stain my clothing, if I could help it.
So in that circumstance, I did change my sensor right away, and was glad that the second try resulted in a much cleaner, blood-free insertion. I called Dexcom, explained what happened to the customer support representative, and got a replacement sensor mailed to me.
However, just about any other time I bleed upon a sensor insertion, it tends to be a minuscule amount of blood. I usually don’t even notice until it’s time to replace the sensor, and there’s a bit of dried blood left on the site. Other times, I’ll see small beads of blood forming underneath the spot where the transmitter snaps in. And there’s been a couple of occasions that I’ve bled a fair amount and been totally unaware of it until I caught my reflection in the mirror and noticed the blood staining the white adhesive. And in all of those cases, I’ve kept the sensor on for the full ten days, without noticing any discrepancies in my readings.
All that considered, in my inexpert opinion, I think that bleeders usually are readers and that they’re safe to continue wearing. Of course, there will be exceptions, like when there’s just too much blood to salvage the sensor. But every time I’ve kept using a bloody sensor, I’ve had the same amount of success with its functionality…so yes, I think that for me, bleeders are indeed readers.
Before I dive into this post, I want to make it abundantly clear that I don’t know the answer to this question. I’m not judging how anyone reacted during the recent Dexcom G6 outage, nor am I stating that there was a “right” or a “wrong” way to handle the situation. I merely think it’s important to ask ourselves questions like this when things don’t go according to plan with diabetes care/management.
Alright, now that I’ve got THAT out of the way…
Many variations of this graphic have floated around the Internet in the days since the outage. I am not mocking anyone by posting it here; rather, I am using it as an example of ways in which we cope with diabetes difficulties. This example, to me, is an attempt at using humor to deal.
For the last several days, the DOC has been in a bit of a panic. And when I say “bit” I mean “a helluva lot”. That’s because the day after Thanksgiving, Dexcom Follow stopped working. This means that parents/caretakers who rely on the technology to monitor their child’s/loved one’s blood sugar levels were left in the dark. It sparked confusion, outrage, and downright fear, all of which only seemed to intensify over the weekend and into this week when the problem was only partially solved for most users.
Rather than coming together to support one another, the DOC swiftly divided into two camps: The first consisted of individuals who sought to gently remind others that this technology is still pretty new. It hasn’t even been around for two decades. That meant that for many years before then, people with diabetes were doing things the “old school” way, and getting by just fine. Doesn’t this mean that we should all be able to make it through unexpected technology blackouts, knowing that we have our blood sugar meters to fall back on?
The second camp was in a greater fury over the issue. This camp relied on the Dexcom G6 system because those within it simply didn’t know a life without the continuous glucose monitoring technology. For them, the outage was a bit like asking them to Google something without access to the Internet – it’s pretty much impossible, unless you’ve got an Encyclopedia handy. Oh, and it’s MUCH higher stakes, because people who don’t recognize symptoms of low or high blood sugar need this technology to work in order to stay on top of fluctuating blood sugar levels. Let’s not even get into how much is PAID for this expensive piece of medical equipment…one would argue that the high cost of supplies means that the technology should work at all times, no matter what.
If you’re like me, you can see that both of these groups have perfectly valid points. I’ve had diabetes long enough that I didn’t even use – and didn’t see the point in using – continuous glucose monitoring or insulin pumps until a few years ago. I took care of my diabetes the old fashioned way growing up: doing fingerstick checks multiple times per day, treating low blood sugars with 15 carbs then waiting 15 minutes, checking blood sugar levels about an hour after injecting insulin to make sure highs were coming down the way they should. This way of handling diabetes worked for me for a long, long time…throughout elementary, middle, and high school, right up to college.
Then I got a continuous glucose monitor (I believe it was the Dexcom G4) just before starting my freshman year of college. And I haven’t really been without a CGM device since then. It’s changed my life and helped me navigate adulthood with diabetes. Whenever I do experience periods of the technology not working the way it should, it’s infuriating because I feel like it’s not worth throwing away buckets of cash on it in those periods of inconsistency and inaccuracy.
But here’s what I’m wondering, as a result of this Great Dexcom G6 Outage of 2019…do we take this technology for granted?
Do we truly appreciate the times that it works the way it should?
Do we expect too much from something that, technologically speaking, still has a long way to go in terms of working perfectly?
Do we rely too heavily on continuous glucose monitors to provide us peace of mind when, in reality, they simply provide us with real-time updates of our blood sugar levels (i.e., it’s a stream of data)?
I don’t have answers to these questions. I can reflect on my own answers to them; furthermore, I can ponder how and why the DOC gets so divisive in these times where we should try to come together, listen to (and learn from) differing perspectives, and figure out what we can do to best support one another during trying times.
If you’re reading this post and knew immediately what the title was referring to…rest assured that what you’re about to read is not nearly as dramatically violent as The Rains of Castamere episode of Game of Thrones. I just chose the title because it semi-accurately described what I encountered with my CGM at a weekend wedding I recently attended. And because the final season is here in a mere FOUR DAYS and I’m struggling to hold in my excitement/terror/anticipation.
Anyways, the day of said wedding began normally, if not a bit early. I put on makeup and a nice dress, tried (and somewhat failed) to curl my hair, and ate a light breakfast. Somewhere between slipping on my jewelry and singeing my hair with the curling iron, I heard my CGM’s alarm blaring, notifying me that my blood sugar was going up. That wasn’t surprising, since I’d just eaten food. But I was caught off-guard when it stopped alarming after two alerts went off…I hadn’t dismissed the previous two, so why was it no longer making any noise?
I checked the app on my phone and saw “sensor error” on the screen…and said out loud, “NOT today, diabetes,” as I promptly stopped my sensor and ripped it off my body. I didn’t even hesitate to do it because I knew that the sensor was due to be changed that evening, anyway, so I saw no harm in doing it a bit early.
“What?” My partner yelled from behind the bathroom door.
“Nothing, nothing,” I said dismissively, which reflected my determination to just brush this inconvenience away and stick a fresh sensor on my body.
Oh, if only it were that simple…
It should’ve been an easy, routine sensor change; alas, upon pressing the button on the insertion device, I let out a little pained squeak. Sensors don’t normally hurt, but every now and then, I get myself in a sensitive spot. And I definitely did this time around. Before popping the transmitter into the sensor, I noticed a bit of blood pooling underneath the sensor’s adhesive.
Pools of blood as I make my way to a wedding…do you get the red wedding connection now?
Fortunately, this tale has a happier ending than it did for much of the *spoiler alert* Stark family. Sure, my sensor kinda freaked out when it warmed up two hours later and measured blood instead of interstitial fluid, and it took like 12 hours for it to get its act together and display my readings accurately, but…it all worked out in the end. And thankfully, not a single person had any clue that there was a patch of blood on my belly throughout the wedding…it didn’t even stain through my dress.
Oh, the Dexcom G6. You have no idea how much I simultaneously love and hate you. I love you for your painless insertion, increased accuracy, acetaminophen-blocking capabilities, and your sleeker profile. But I effing loathe you for having communication issues with the sensor on days 9 and 10 of wear…that is, if you even last that long on my body. You have serious sticking issues, old pal. Your adhesive tends to be a bit of a ripoff – both literal and figurative.
You see, I was just trying to roll over into a more comfortable position in the middle of the night when you decided right then would be the ideal time to just fall off my arm, prompting me to go from blissfully snoozing to wide awake and angry in less than 10 seconds. Way to go! It pissed me off because it happened with very little effort. I would’ve understood if I had scratched or touched it in any way, but all I had done was flip from sleeping on my left side to my right. Not fair and definitely not the ideal way to wake up.
The ripoff sensor in question.
I wish I could say it was a one-time occurrence, but no, it happened a couple months ago. Again, it was the middle of the night and again, it was ripped off prematurely. I think that in both cases, I still had at least another three or four days of use before it was due to be changed. And even before these two middle-of-the-night ordeals, I had trouble with a freshly inserted sensor that was peeling all around the edges. What the heck is going on with Dexcom G6 adhesiveness?
Maybe this is a sign that I need to start using something in addition to an alcohol swab each time I change a sensor. Perhaps Skin-Tac or more regular usage of Pump Peelz/Grif Grips will prevent future sensor ripoffs. But I still can’t help feeling ripped off, because this never really happened when I was using my G5 sensors.
The small mercy in this situation is Dexcom customer service. Kudos to their team for being understanding and willing to replace my not-so-sticky sensors…but I wish I could say that I had more faith in a G6 sensor’s ability to stay on my body for the full 10 days that it was intended to.
I’ve been lucky enough to have the Dexcom G6 CGM in my life for just over six months now. In that time, many people in my life – both T1Ds and non-T1Ds – have asked me countless questions about my experience with the device. I thought it’d make sense to address some of the most commonly asked questions here, in the hopes that I can provide some insight to those who are curious about the Dexcom G6.
Question: Can the Dexcom G6 be restarted?
Answer: In my experience, no. I cannot get the G6 to restart like I could get my G5 to restart. But take my “no” with a grain of salt, here, because I know of other people who HAVE had success restarting their G6 sensor, making its life extend much longer than the 10 days guaranteed by Dexcom. I have only tried to restart the G6 once, with absolutely zero success, following the process outlined here. My advice to those who want to try to restart their G6 is to do so cautiously, and make sure you’re not trying to do so with the last sensor in your stockpile.
Question: Is it actually safe to take acetaminophen (Tylenol) on the Dexcom G6?
Answer: Yes! I’ve noticed that acetaminophen can be taken safely on the G6. I did not anticipate for it to be unsafe, seeing as it was advertised as one of the big improvements Dexcom made from the G5 to the G6. I’ve taken Tylenol a handful of times without noticing any issues with my CGM readings, but as always, be sure to monitor your blood sugar carefully and perform a manual finger stick check if your symptoms don’t match up with your CGM.
Question: I can’t get my Dexcom G6 sensor to stay put for the full ten days. How do you make it last?
Answer: There’s tons of ways you can help ensure your G6 sensor stays stuck on for the entire ten-day duration. I always make sure that my skin is completely dry before the sensor makes any contact with the site. Avoiding any excess moisture is key in helping it stay put. If I notice the sensor starting to peel around the edges after a few days of wear, then I use a Pump Peelz CGM adhesive to keep it in place. Those tend to work really well for me. In times of serious adhesive doubt, I also use Skin Tac wipes, which basically glue that sucker down. One last tip I recommend is to avoid sites that come into contact with a wide variety of surfaces. In other words, a sensor that’s placed on the abdomen may fare better than a sensor on the leg, because the odds of the sensor getting accidentally knocked off due to contact with clothing or other objects are lesser. You know your own body better than anyone, though, so trust your own judgment when it comes to CGM placement.
Modeling my G6.
Question: Is sensor insertion truly painless?
Answer: For me, G6 insertion has been pain-free approximately 85% of the time. It’s stung slightly a handful of times, but I’ve found that it only hurts when I choose a site that’s not particularly fatty. That’s why I generally stick with my abdomen – either side of my navel – or the back of my arms for G6 insertion.
Question: Is the G6 really that much more accurate compared to the G5, or any other CGM on the market?
Answer: Yes and no. That may not be a very satisfactory answer, but I’ll explain why that’s my belief. Overall, the G6 seems to be more accurate for me than the previous Dexcom CGM models I’ve worn. Are the number always on point compared to what appears on my meter? No. Do I wear the Dexcom CGM to have an accurate picture of what my exact number is at a given moment in time? Kind of, but I also know that this isn’t totally realistic. After all, users of the Dexcom CGMs know that it measures blood sugar levels in five-minute intervals. It can’t give me a clearer picture of what my blood sugar changes are minute-to-minute. So with that in mind, I find that the G6 is really excellent for monitoring trends – seeing how rapidly my blood sugar is falling or rising, or seeing how it changes gradually over time. The patterns are more important to me than the precise numbers; at least, that’s how I feel in my current stage of diabetes management.
I can’t really speak to other CGMs on the market, such as the Freestyle Libre or Medtronic’s CGM. But what I can say is that I’ve heard less-than-stellar reviews about both. It’s important to remember, though, that they’re not meant to be the exact same as the Dexcom CGM. The Libre itself isn’t really continuous and can’t provide users with information until they chose to wave the receiver over the sensor. And as far as I’m aware, the Medtronic CGM communicates directly with Medtronic pumps, and I’m not sure how seamlessly the systems work together.
Bear in mind that when it all comes down to it, I’m answering these questions with my experience, and my experience alone, in mind. Dexcom is and will always be the number one resource to go to with any questions regarding their CGM devices. But hopefully, the information I’ve shared here will at least help someone who is curious about the G6 feel more motivated to seek additional information. I stand by the fact that it has revolutionized my own diabetes care and management, and though it’s far from being flawless, it’s still an invaluable tool to have incorporated into my daily routine.
I don’t understand why the sensor error occurs. But it almost ALWAYS happens on the ninth day: My sensor will work wonderfully and provide me with extremely accurate data, but then BOOM it’ll sporadically stop working and produce graphs like the one above that are virtually useless. Even worse, there’s no telling when exactly it’ll start communicating again with my receiver. The error message SAYS I’ll get data back within 3 hours, and I normally do, but there’s a big difference between going 10 minutes and going 2 hours without any readings.
This device has so many good things working in its favor: longer wear, painless insertion, increased accuracy, compatibility with acetaminophen, slimmer profile. But I’m of the opinion that if something says it will totally function for a certain length of time, then it WILL. The fact that it doesn’t, and that this has occurred more than once to me, is alarming and frustrating.
The only possible explanation I’ve come up with is that maybe the upper arm isn’t a great place to wear the G6. As we all know, Dexcom devices are FDA approved to be worn on one location, the abdomen. However, that hasn’t stopped the cheeky diabetes community from wearing it elsewhere. Besides the upper arm, I’ve seen people with it on their forearms, thighs, and calves. I even know one clever person who chooses to wear it on the upper bum during the summer months to prevent tan lines (hilarious and brilliant, IMO). I choose to wear my CGM on my upper arm most of the time because it’s comfortable there, and I like to give the sites on my belly a break. But maybe it’s time I start wearing it more frequently on my stomach, the “officially okay” site, to see if that prevents these ridiculous sensor error scenarios.
What I’d like to know in the meantime, though, is has this happened to you or anyone you know using the G6? Has anyone pinpointed a cause, and is it worth notifying Dexcom of this issue? I’d love to hear your stories and thoughts – drop a note in the comments or get in touch with me directly!
Last week, I received not one, not two, but FIVE packages in the mail. No, I didn’t go overboard with some online shopping – it was all deliveries from Dexcom to help me get my CGM up and running again.
You might be wondering: Why were there so many packages? In theory, I just needed a couple of replacement sensors and a new transmitter – couldn’t it all go in one box? Well, I wound up getting a little more than just the aforementioned supplies…
Not pictured: another two boxes I received from Dexcom. Not sure why they couldn’t send everything in one large box, but beggars can’t be choosers.
That’s because I had the stupendously (emphasis on the STUPID-sounding part of that word) great idea to power up my old G5 CGM while I waited for my G6 materials. I had a few G5 sensors leftover from before I made the transition to the G6, and to my knowledge, I had a working G5 transmitter. So I followed the procedure to get my G5 going: I inserted a G5 sensor (ouch!), snapped the transmitter into place, and started the warm-up on my G5 transmitter.
But something was…off. The Bluetooth icon was blinking in the upper left-hand corner, and I couldn’t see how much time had elapsed in the two-hour warm-up period. At a loss as to what to do next, I left the receiver on overnight to see if it would ever pick up a signal from my G5 sensor/transmitter, to no avail.
That’s when I made the “fatal error” of shutting the system down and trying to restart it. This triggered the G5 receiver to enter a reboot cycle that wouldn’t stop. Any time I pressed the circular home button, the system would buzz and the screen would light up, as if it was about to start working. After 45 seconds or so, the screen would go black again. There was no way to interrupt this reboot loop – even sticking a paper clip into the tiny hole in the back of the receiver wouldn’t correct the faulty software.
So now, not only was my G6 out of commission, but my G5 was a goner, too.
After a few phone calls to Dexcom technical support, I had answers as well as supplies sent my way. I learned that there’s a known error with the G5 system that causes the reboot cycle to launch. I should have waited longer for the G5 transmitter to connect with the Bluetooth on my receiver (i.e., I should’ve waited for the Bluetooth icon to stop blinking), but it wasn’t necessarily my fault for having a device with a known software issue. I would receive a new G5 receiver because my old one was still under warranty, as well as a G5 replacement sensor. I would NOT get a G5 transmitter, because I’m convinced the battery on the current one is still good, but I was informed that once a transmitter is activated, the battery keeps going until it runs out of juice. Interesting. That means that it could, in theory, stop working any day now, because the transmitter was activated and last used in April 2018.
Hopefully, I’ll never have to get another G5 transmitter because I’ll be able to rely on my G6 from here on out. It gives me comfort to know I have backup G5 supplies, but I’m pretty much married to my G6 at this point. Dexcom kindly sent me the required new transmitter for the G6 system, which arrived on Thursday of last week. I got a return kit for the old G6 transmitter the previous day, and on Friday, my new sensors came in along with a return kit for my defunct G5 receiver.
Sure, it was a lot of packages to sort through in the mail. And it was mildly frustrating that I had to wait two days between getting my new G6 transmitter and compatible sensors. But the most important thing is that I’m now reconnected to my G6 and feeling thankful that Dexcom delivered when I needed it most.
My first month on the Dexcom G6 went by so quickly. The G6 entered my life during a particular hectic period: between a trip to Vegas, my 25th birthday, family gatherings, and work obligations, May was marked by constant activities…which made me that much more grateful to have my G6.
Before I continue with this review, I’d like to note how I got priority access to the G6. Approximately one year ago, I applied on Dexcom’s website to be a “Dexcom Warrior”. Basically, this just means that I filled out a form with my information and some background on my diabetes story. I didn’t expect anything to come of this; if anything, maybe I’d be contacted for someone to write a bio piece about me.
Fast-forward to January 2018: I receive an email informing me that I’ve been selected to participate in a Dexcom marketing campaign. There weren’t too many details other than that a shoot was taking place over two days in Atlanta, Georgia in February and that Dexcom would pay for my flight and hotel if I gave them my time that weekend. I was thrilled to receive the offer and gladly accepted. And I’m grateful I got to have such a unique, fun experience.
I didn’t learn until several weeks later that my participation in the marketing campaign would allow me to receive early access to the G6. In other words, I was going to be one of the first in the world to try this technology. My head is still spinning from that fact, and it’s not something that I take lightly. I understand that I’m fortunate to have access to it, and in return for this special privilege, I am putting as much truth and transparency as possible into my reviews of it.
Onto my one-month evaluation…new observations include:
The whole 10-day automatic shutoff thing bothers me a little more than it did in the beginning. There’s no workaround, so I’ve got to know exactly when my sensor is going to expire so I can have a fresh one on hand. This can be irritating, especially when *life happens* and I forget about changing my sensor.
The adhesive seems to be one thing that has made zero improvement (but it’s not like it’s gotten worse, it’s the same). I think the surface area of it is a little smaller? But it’s held up fairly well for me for the full 10 days. I’ve only had to use OpSite FlexFix tape on it once, and that was on the ninth day.
I am LOVING not having to calibrate the receiver after the two-hour warmup period. My blood sugars automatically start getting recognized by the receiver after the two hours have elapsed, and it’s awesome.
A view of the G6 mobile app.
I’m still experiencing an utterly painless application. I’ve yet to try a site other than my abdomen, though. I don’t think a different site will hurt more, though I’m curious to see if readings are less accurate.
Speaking of readings, I’d say that they’re within the ~15 point range compared to the blood sugars my meter reports. Not bad at all.
The battery on the receiver is kind of weak. I have to charge it at least twice per week, which is slightly annoying. But I also have the G6 app downloaded on my phone, so it’s not a huge deal if the battery on my receiver depletes completely.
The G6 app works well. Aesthetically speaking, it’s clean and modern looking, and very easy to read. It works better for me than the G5 app did, but I had a myriad of issues going on with it that affected my user experience.
I’m pretty satisfied with my G6 experience so far. I’m hopeful for the future – perhaps it’ll be possible to extend a sensor’s lifespan or easily recycle the chunky plastic applicators.
But I’m interested in questions you might have – are you still wondering about something regarding the G6 that I haven’t addressed? Please let me know. I’d be happy to provide insight.
Hugging the Cactus 