DexCom G4 Platinum: Second Look
Monday, December 3, 2012 at 9:55AM 
Arden modeling her G4 tucked into her pocket.
Arden has been wearing the new DexCom G4 Platinum CGM for every second of the last month. I initially wrote a 'First Impressions' piece about three weeks ago - let's see how things have gone since then.
Sensor Life:
The worst kept secret in the DOC is that the DexCom sensors can be restarted at the end of their seven day life and often gain accuracy as the days go on. The package insert indicates that you have to change your sensor site at the end of those seven days, I am in no way suggesting that you should ignore that direction. I'm merely sharing how we do things... Many times in the past the DexCom 7+ would happily restart twice and would still be going strong as the last bit of adhesive was holding on for dear life. So far we haven't gotten a G4 to a second restart, but I'm not giving up on getting one into the three week range. Having said that, two weeks is really very good.
Adhesive:
Not as long lasting as the 7+. The G4 is not weathering showers like that 7+ did even when covered. I wonder if DexCom changed the adhesive, maybe I'll ask.
Form and style:
The reciever is a huge inprovement in both size and shape. I've heard a few call it 'unsturdy' or 'light' but we don't have that feeling.
The sensor is slightly taller then the last generation. I've asked Arden multiple times if the size change is annoying and she has always answered, "no". Mindful that I don't wear the product I read about what some others have said and I did find a few adults that aren't happy about the increase. Again, Arden is unfazed by the change.
Signal Range:
I have for years been unable to let Arden sleep on the sofa during her sleepovers becasue I wouldn't be able to hear her CGM. Once I even slept on the floor so that she and her friend could 'camp out' in our family room, but that was so uncomfortable that since that day sleepovers are confined to the bedroom. Until last weekend that is. On Saturday night Arden had a friend over to spend the night, she asked just as she always does if they could crash on the sofa, I said yes without hesitation becasue of the G4. Our family room is underneath of our master bedroom and the G4 cruises through walls, floors and ceiling like they aren't there.
As the parent of a PWD this new feature trumps any other and makes the Platinum a winner in my book. Here is my Instagram picture of Arden's G4 sending a signal through the floor of her bedroom and into our kitchen. Kelly and I were watching 'The Walking Dead' on AMC while Arden slept soundly in her bed. In the past, we would have to pause the show while I ran up and down the stairs like a loon. Now we just listen for the beeps.
@ArdensDay on Instagram
The Sensor Wire:
The insertion of the sensor wire seems less painful but the real win of the wire being smaller is that Arden doesn't seem to notice it under her skin anymore while she is wearing it. It the past with the 7+, Arden would sometimes be bothered by the wire if she moved the wrong way.
Pound the Alarm:
The alarms on the G4 are louder then the 7+. Additionally, you can vary them if the one you are using ceases to get your attention. So far the default sounds are waking me from my slumber, though Arden never hears them when she is sleeping. DexCom has samples of the alarms on this page of their site (scroll to the bottom), if you'd like to give them a listen.
Freedom:
With the new signal range comes freedom. In a movie theater I can hold the CGM to give Arden a break. When she gets home she can take it off and roam the house without fear of dropping the signal. Arden sleeps upstairs, we live our life downstairs. I wish you could have heard the lilt in Arden's voice when she gleefully told me, "I just peed without my CGM", she was seriously thrilled that she left her receiver in the kitchen while she used the powder room, thrilled! Connected but frequently untethered is a major advancement in my opinion, it gives back some of Arden's humanity and releases burdens.
Wrap:
I know of a couple people who have experienced build quality issues, for example Stacey's thumb pad fell off. So far we haven't had any such isues, but be sure that I will tell you if we do.
I've always been an early adopter of technology that I believe in. I expect a few bumps along the way and take the chance on something new when I think the chance is a good bet. So far, the G4 has been a terrific bet. Wait until you see the signal range and how it changes your life.
Be Well!
Scott Benner
This post is a follow up to First Impressions: DexCom Platinum G4 which can be found here.
CGM, ConsultYourDoctor, DexCom, Follow Up, review in DexCom Blog
Reader Comments (43)
I feal for you Katie. It's not a cheap item but your right it (WILL) prolong your life. My wife tells me you can't put a price on life. She's right. I do stretch my sensors to 12 days use which comes out to about $2400/yr. at your price of $308 per box. Hopefully the price will come down in the near future.
Thanks and good luck.
I can't get the sensors to last that long. After 10 days they die. Was reading that its possible for an insurance company to cover them based on your personal history (ie: T1D, frequent lows, etc...) has anyone out there ever tried to get something covered based on your personal health history? Can it happen?
Yes you can I get mine covered by my insurance by prior authorization. I have to have a medical for filled out by my doc. I get my because I drop be low 65 and have hypoglycemia awareness.
Rachel's right. I had my doctor also write that I needed one due to frequent lows and not always aware of when this happens. Even though my insurance aproves it I still have to meet my deductable first. Then its covered 80%. Better than nothing.
Meeting my deductible first is out of the question. My deductible is $2,400. With the UHC high deductible plan, every single prescription for my diabetes is free, this includes syringes, chem strips, insulin, blood pressure meds, blood thinner, etc. But they do not cover the CGM. In exchange for the free prescs, I pay 100% for doc visits and labs untill my deductible is satisfied. In a good year, I don't even come close to the deductible. Just the cost of the CGM sensors would satisfy my deductible in 8 months. I am going to try the doctor authorization, here is hoping there is someone at UHC that has a heart. *crossing my fingers*
Right now, you might be thinking, what is this girl complaining about... she gets everything but the CGM free... but you know what... I live in CA, I pay some of the highest state tax there is, I am 31 years old with a decent job, but I still live with my mother because I can't afford to live on my own. Thank you Rachel and Steve for responding to my questions... its hard to find people in the same boat as me.
I just want to say that I am so happy that you guys are having this conversation and that this blog post brought you together. LOVE This!
Best,
Scott
My 8 yr old daughter switched over to the G4 three months ago. I have found the G4 to be more precise than the 7+. I cut two Iv3000s in half and place one on each side of the sensor. Haven't had any issues with the sensor coming off even while swimming in the ocean.
Does everyone who uses the G4 use catheter tape to secure it? I've been using regular medical tape that you can buy at the drug store, and I hate it! Might be one of the reasons I can't get the sensors to last longer than 10 days. Plus my skin is so sensative that after changing sensor locations, my skin stays burned and raw for 4 days after removing the tape. Is there a store I can buy iv3000 at?? I looked online and it seems like it is only available to order.
Katie, I use Coach's Sport Tape which I buy at Walmart. I play alot of tennis and use it sometimes on fingers when I get plisters. I started using it to hold the sensors on up to 12 days and for me it works great and is very inexpensive. I found the sport tape in the aisle where they sell bandaids at Walmart.
Hope this helps.
I'm seriously considering the G4 and was looking for reviews online when I stumbled onto your delightful blog. I'm at the point where they have my debit info and I just have to make the call tomorrow to get the system. I'm so nervous it will be a waste of money :-/ When I first started looking into the G4 I assumed it was as accurate as a finger prick. But now I see I have to "calibrate' it and it still may be inaccurate and that just overwhelms me. I already have the Omnipod so I was hoping this would help me get those basal rates on point! lol And of course help me get a peaceful sleep for once. How do you rate the hassle of calibrating? Making sure its accurate? Basically is it worth it??? Or is it more hassle? I love the Omnipod but it is more of a hassle than simple shots. I still would recommend the Omnipod even though it requires a lot of work because A1C and overall BG's are waaaay more controlled. Sorry for the long post...
Michelle
I have to tell you that my 12 year old daughter is on the G4, I don't know what I'd do with out it now...
It may not always be 100% but it defiantly close 99% of the time. It helps me to get a full nights sleep.
It defiantly gives the tools on where to make changes to basal rates with out the total guessing on which way the blood sugars go. I was very nervous at first, absolutely nothing to be nervous over ..
The insertion is sooooo easy and she said she hardly feels it. Phew
I hope that my post helps! Any questions let me know ill give you my opinion and hers to.
Best of luck making your choice..
Denise
Michelle, Calibrating is for me a piece of cake compared to before. I use to test my sugars 4-5 times a day to make sure I wasn't to low or high. Now with the G4 only calibrating morning and night is nothing. Yeah, it can be off sometimes, but usally it's pretty close and lets you know which way it's heading.
Michelle - The positives FAR outweigh any inconveniences (and they are minimal). I think that you will be quite happy if you decide to try the G4.
Have a great weekend everyone - I LOVE this thread!
Best,
Scott
I've used the seven, the seven+ and now the G4.
I like:
- user interface of the smaller receiver (so many ways in which it's better than the previous models, but the biggest one to me is size and being able to tell what the heck the system is doing)
My notes:
- I wear the sensors on the sides of my body and wear the receiver in my pocket. If I place the receiver in the pocket on the same side I think it's too close and the receiver can't get a solid RF lock. Easy to solve though, I just keep the receiver in my other pocket
- Sensor lifetime seems about the same as the Seven+. I get about 1.5 to 2.5 weeks of use with the last day being moderately inaccurate compared to finger sticks
- "Drift" between finger stick values and the G4 seems a bit better to me. When I do a finger stick I always enter the value and it feels like the G4 retrains itself better.
- The sensor+transmitter pod is a bit taller. At first I was worried this would cause me grief, but luckily all is good. Near he end of one sensor run the extra height did result in my bumping the sensor off (but it was at the end of its life and stickiness)
Steve, I took your advice and ran with it... the first time I used the "Coach" tape, I got my sensor to last 13 days!! It may have even lasted longer but I got tired of wondering where I would be when it finally quit. Also, it doesn't irritate my skin the way all of the other brands did. I figured out why I hadn't tried it before, they don't sell Johnson & Johnson brand in the drugstores I was going to...
What I think is important for people to know, that are trying to decide whether to try the G4 or not, is this... 1. Yes, you do have to calibrate twice a day, 12 hours apart, but you don't have to wait the full 12 hours. I calibrate at 6am when I wake up and around 6pm when I eat dinner. But if you want to calibrate at 5pm, so be it, then it will want another one at 5am the following day... but you could wait till 6am if you needed to. Its not like it will stop working on you... I find the G4 is more accurate when you calibrate it before it tells you to. If you wait longer than 12 hours it seems to lose its accuracy a little bit. and...2. When I first read the brochure for the G4, it talked about having the comfort of knowing what direction your BG was heading with the magical little arrow. My first thought was, yeah right!! I think I even laughed a little. But after having the G4 for 5 1/2 months now, I understand how amazing an arrow can be. Think about it, you would have to finger stick every 5 minutes to have the amount of data that this tiny awesome thing is delivering to you all day and night. And just knowing that it will alert me whether I'm high or low, depending on my own version of high or low is SO reassuring. I don't ever have to wonder whats going to happen next. Mine is set at 70 and 250, when it hits 70, I have time to bring it up before it gets too low, and at 250 I have time to correct with insulin before it gets outrageously high.
Now, how do we get the insurance companys to cover it... I'd be happy with 50%...
FYI: I have my wife insert my sensors on the tricept area of my arm (you know, the flabby stuff) and it not only works well, but is out of the way when I sleep on my side. I had a few issues with my original transmitter (it was replaced by Dexcom with a phone call) and twice the edge of the case broke when sliding the port cover back (again replaced by Dexcom with a phone call.) My wife (such a dear) surprised me with 2 sleeves to wear over the sensor at night to avoid rubbing the edges of the adhesive edges loose. Unbeknownst to me, she measured by upper arm and had them made. Prior to that, I had used a sock that I cut the foot from, and I still use them when I'm playing golf in the heat. Thanks for the tip on the "coach" tape. I'll give it a try. I am able to make my sensors last 2 weeks by using all the tricks to keep it from coming off. Now that I know people have used them longer, I'm going to try for 3 weeks. I am 65 and was diagnosed 3 years ago when my pancreas decided to stop working one day. By the way, if you're not using the pump, may I recommend it to all. I use the Animas One Touch Ping and I wouldn't be without it................................
Where else can I insert the sensor besides my stomach? I see Mike(in the comments above) had help from his wife to stick it in his arm. Dexcom's manual says it's not supported anywhere other than the stomach, but in my opinion if it works for others, I'm game to try it! Was wondering where else others have put it.
Deanna, Arden puts the sensor exclusively near her hip on the top most part of the outside of her buttocks. It's a fleshy part of her body that has a contour that lends itself to the shape of the sensor bed. We change sides at each insertion. Best, Scott
Deanna, my daughter who is 12 wears it only on the top of her buttocks. She also has
Inserted it her self. It may be something for you to try. Let us
Know how it works out.
Update: Hello and wanted to give an update. I put the sensor on my side at hip area and actually seem to be getting better numbers, longer. In my stomach I go 6 days with accurate readings. I'm now on 12 days! I did have to tape it down with extra tape as I would accidentally grab it when reaching for the waistband of my clothes.
Denise, I will try the buttocks area after I give birth since I'm not quite as flexible reaching my back anymore(2 months to go!!)!
Thank you Scott & Denise!