Friday, November 9, 2012

G4 and More (Post 2 On CGM)

The 2012 DexCom G4 Continuous Glucose Monitor


After writing this blog post and waiting several hours for the initial DexCom G4 receiver to charge, my oldest daughter gamely lined herself up for the first ever "Naturally Sweet Sisters G4 Insertion" (sounds very official, doesn't it?).

First words out of her mouth...

"Wait!  I thought you said it was a different needle!  That is the SAME!  It's going to hurt." 

Then, my quick cover of, "No, it IS different.  The DexCom people just aren't very clever  at packaging design.  They used up their creativity on the actual receiver and decided that the sensor would just be the same."



The "Old" DexCom Seven Plus Insertion Device for the Sensor



The "New" DexCom G4 Insertion Device for the Platinum Sensor - Does It Look Different To You?

Yes, those words did not fool anyone, least of all my daughter.  Rolling her eyes, she lined herself up for the poke and braced for the expectant pinch.

Click, slide, snap.  Done!  In the same series of steps as the DexCom Seven Plus, the needle is deployed, the collar pulled up and the insertion device quickly rocked out.  In seconds, the sensor is snapped into place and the receiver activated for start-up. 

Oldest daughter commented (before I could ask) and wryly said, "Yep.  Still hurts."

For the record though, I still think it hurt less.  She didn't cry or even mention it later.  Usually, a CGM site will cause a stinging sensation, that slowly lessons to a throbbing sensation and eventually, just a sore spot.  One that no one can touch or even venture near.  Today, it was either excitement for her new G4 or less pain than usual because after, nothing was said.

I am going with less pain because when things really hurt, there is no being quiet about it.

Another new feature on the new G4 is a reduced calibration time of only 2 hours (compared to about 3 on the DexCom Seven Plus).

The calibration start-up defines the time in which the sensor starts up and begins to "sense" blood glucose readings.  You have to wait that time before actually using the receiver.  When the time is up (measured on the receiver with a mini pie-chart graphic), you will be requested to enter two blood glucose readings.

We used that time to watch the enclosed instructional CD (for those smarties reading this, yes, we watched it after we did our insertion - but you should plan on watching it after opening the box, especially if you are new to CGMs).

The CD walks the viewer through basic set-up, insertion, calibration, start-up and ending a session.  I requested that the girls watch it with me as they will be the ones handling the CGM care while at school.  Both giggled at the term "fingerstick" which is used liberally throughout the video (and I can't always explain the humor of 9 and 11 - year olds but they thought it was hilarious!).  However, through the laughter, I did notice that my oldest daughter played along with her receiver just as the instructor in the video demonstrated on hers. 

If you have used the DexCom Seven Plus, the majority of features are the same.  The biggest difference is the full color display.  Both the graph and the blood sugar display as red when low, yellow when high and gray for in range blood glucose levels.  Alert levels can be set as can features to allow for sleeping in past normal wake up times.

After our allotted two hour wait time, the receiver buzzed and requested two blood glucose readings (or for the annoyance of my daughters, two fingersticks!).



Even though I was bracing myself for a crazy blood glucose number (it always happens when you are about to take a picture), she actually came up with two really good ones - it helps that it is about 8:50 EST and well past our dinner hour.




To enter the blood glucose reading, much the same as the DexCom Seven Plus, the DexCom G4 simply highlights the "ENTER BG" button and using arrows, scroll up or down to your number and select the middle button to confirm.  The process is fast and efficient and for kids, no big deal. 

On the G4, calibration (entering a blood glucose reading) after initial start up is only needed once every 12 hours.  Simple and really, no big deal.



In fact, as my daughter was entering the numbers from her readings, I had to ask her to slow down so I could snap this picture. 


The only downside to having such great blood glucose is that she is about to head to bed.  To the world at large, type 1 diabetes does NOT sleep.  This 95 mg/dl on her CGM can quickly spell disaster if we leave it alone.

Here it is;  Drum Roll please........

The number one reason that I love having my kids on a CGM is that once the sensor is in place, I can identify the trends of where their blood sugar is going; up, down or flat-lining.  Tonight is a little bit too early in the CGM start-up process and I can't yet see where she is headed because there is simply not enough data.  To safely put her to bed, I will have to give her some fast acting carbs or turn down her basal rates to ensure that she won't fall lower, which she may or may not.

If this were tomorrow or even later in the day, I would have a much better grasp of the direction she was heading just from looking at her graph and possibly even avoid having to do anything, except to check her blood glucose later in the evening.


And if you ask oldest daughter her thoughts, with an impish grin, she would tell you how excited she was to be able to bring her Pink I-Pod Nano to school tomorrow. 

Yes, she means her new DexCom G4 CGM - she is just hoping to fool a few of her friends!



As we continue on our journey this week with our new G4s, I will update the blog with more real life reviews from the Naturally Sweet Sisters.  Stay tuned for youngest daughter's review (she is a vocal one - so DexCom beware!) and her thoughts on the G4.  Already, she is wondering why hers still has not arrived.   She has some serious CGM envy tonight!

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