Yesterday I met with the Dexcom representative and actually bought the unit.
The 'system' (receiver, transmitter, charger, cables, software) was $375, and the first 5 sensors cost $175. Total cost $550.
Officially the 5 sensors will give me values for 15 days. However I'm currently wearing a sensor that I first started on Monday and it's still working fine. So if I get an average of 7 days per sensor I have enough for about 5 weeks.
Now there are definitely aspects of this device that I don't like. But when it works it gives me great results. For example, if I'm about to drive I can look at the value and if it's stable and between 120-160 then I feel comfortable getting into the car without testing.
Next week I'll start the paperwork with Aetna and see how much of this I can get covered. I'll post on that as the process unwinds.
I agree with the Dexcom representative that Dexcom is committed to CGM devices, that's all they do right now. Whereas Minimed is really all about pumps, and they use the CGM device more as an accessory for the pump. I know this is over simplifying things, but the pricing models are very different.
I'll post more about this decision later. I'm rushing off to an all day Code Camp at Microsoft.
I found a very useful slideshow that compares the Dexcom and Minimed devices. It's written by John Walsh and Ruth Roberts authors of the excellent book Pumping Insulin. You can find the slideshow on the Diabetes Mall forums.
I need to point out that I also decided to buy some shares in Dexcom. Despite my interest in seeing the company do well, I'll continue to be upfront about the pros and cons of the system.
Yesterday I met with the Dexcom representative and actually bought the unit.
The 'system' (receiver, transmitter, charger, cables, software) was $375, and the first 5 sensors cost $175. Total cost $550.
Officially the 5 sensors will give me values for 15 days. However I'm currently wearing a sensor that I first started on Monday and it's still working fine. So if I get an average of 7 days per sensor I have enough for about 5 weeks.
Now there are definitely aspects of this device that I don't like. But when it works it gives me great results. For example, if I'm about to drive I can look at the value and if it's stable and between 120-160 then I feel comfortable getting into the car without testing.
I agree with the Dexcom representative that Dexcom is committed to CGM devices, that's all they do right now. Whereas Minimed is really all about pumps, and they use the CGM device more as an accessory for the pump. I know this is over simplifying things, but the pricing models are very different.
I'll post more about this decision later. I'm rushing off to an all day Code Camp at Microsoft.
I found a very useful slideshow that compares the Dexcom and Minimed devices. It's written by John Walsh and Ruth Roberts authors of the excellent book Pumping Insulin. You can find the slideshow on the Diabetes Mall forums.
I need to point out that I also decided to buy some shares in Dexcom. Despite my interest in seeing the company do well, I'll continue to be upfront about the pros and cons of the system.
Update: I had posted the wrong location for the comparison slideshow. You can find the presentation here. Sorry.
What a difference a day makes (Dexcom trial continued)
Sunday was a really trying day with the Dexcom. In the middle of the morning, the Dexcom decided that my blood sugars were rising - fast.
I tested and they were on the high side, but the values were actually stabilized. Now I was at church without the large cable, so I couldn't synchronize the meter and the Dexcom receiver. So I watched the Dexcom values climb through the 300s until it just said HI, meaning over 400.
Once I got home I did the synchronization and the Dexcom responded with an X, meaning that the system was out of calibration. I tried calibrating several time and even reset the sensor. I never got another reading out of the Dexcom for the rest of the day on Sunday.
I e-mailed the representative and she mentioned that taking some medications such as acetaminophen can cause problems. I had taken some that morning and that may have been the cause of the problem. Unfortunately this was not something that was mentioned during the training on Friday.
So on Monday I put on my second (and last) sensor. This time I did it after showering so that wouldn't cause problems. And it's been working really well ever since.
I'm hoping that it will last until Friday.
It looks as if I can't get the software before this Friday. This makes it very hard for me to evaluate the overall system. So I'll probably spend most of my visit on Friday experimenting with the software itself.
I decided to change the High and Low settings on the receiver to 180 mg/dL and 90 mg/dL respectively. This way the receiver will buzz me before I hit levels that concern me. This will give me more time to take corrective action.
One thing that I've found from wearing the Dexcom for just a few days is that my dawn phenomenon starts to kick in around 3:30 AM. This is much earlier than I ever expected.
So I've adjusted my basal rate to start 30 minutes earlier and give me an extra 0.5 units at that time. I'm taking it very slowly so I don't end up over-correcting. Here's hoping that tomorrow morning I remain under 180!
I guess my summary for today is. When this thing works it's fairly good. I like the results and the visualization, they're very powerful. I don't like the packaging, the user interface, the loooooooooong cable, the need to use 2 glucose meters. When it doesn't work it's incredibly frustrating, especially because the sensors are $35 each.
Being a technology geek, I took to the Dexcom fairly quickly. I didn't feel the need to press the button every 10 minutes to see what was happening to my blood glucose levels. But I was able to use it last night to see where the levels were going.
And I was woken up around 3 AM because my blood glucose had crossed the 200 mg/dL High level that I'd set. I was able to see how the numbers had been cruising up that way for over an hour. After I corrected and went back to bed, I woke up with a glorious 145 mg/dL at 6 AM.
Later in the day I was able to watch my levels rise up to over 300 mg/dL sometime after a larger than usual breakfast. And also catch then plummet below 80 mg/dL after a strenuous afternoon cleaning out the goat shed. Whew.
Here's a picture from a short time ago. Click on it to see it larger. It shows the frustration that can happen when the receiver moves out of range of the transmitter. See the three dashes on the upper right? It's not getting a reading at the present. After I started writing this post it picked up the signal again and all is good.
Newbie Impressions of the Dexcom
Here are my first impressions of the Dexcom. These are some of the reasons why I see this as a V1 product. I'm sure the Dexcom folks will have a newer version before too long, and I hope they'll fix these issues. Please bear in mind that I think a lot about user experience, so I tend to think about aspects of the device that may not bother others.
First of all, for the device to work it needs to be synchronized from time to time with a OneTouch Ultra meter. Now I already use a OneTouch UltraSmart meter, but I can't use that to synchronize. The only meter that's supported is the Ultra. There is no means to hand-enter values for this purpose.
This is a fairly big barrier to entry. It increases the Total Perceived Pain of Adoption that Pip Coburn mentions in his book, The Change Function.
Another minor nit here is that a cable is provided solely to connect the Dexcom receiver and the Ultra meter. This is something that you will need to do several times each day. The cable is over 6 feet long. But the receiver can't be more than 5 feet from you, and your meter is probably going to be right beside you. Why doesn't Dexcom provide a smaller more portable cable? How about something less than 12 inches in length.
The receiver itself is very large. It's a sealed unit that must be recharged with a provided transformer. According to the manual a full charge takes about 3 hours and will last about 5 days.
I compared the size and weight of the receiver against my Minimed 512 insulin pump and the details are below.
Unit
Dexcom Receiver
Minimed 512
Weight
2.875oz. 85 grams
3.75oz. 110 grams
Height
2.25 inches. 5.71 cm
2 inches. 5.1 cm
Length
4.25 inches. 10.8 cm
3.25 inches. 8.3 cm
In summary, the Dexcom won't win any awards for compactness. It's a little lighter than my pump, but it's bulkier all round. And forget the carrying case that's provider. That substantially increases the bulkiness. Besides which, where are you going to strap this? With a cell phone on one hip and, for many likely Dexcom users, an insulin pump on the other, there's really nowhere else to hang a large bulky black object.
Having a shower is a real pain. I used one of the shower protectors that I received. And I had one of my usual short showers (less than 3 minutes from start to finish). But I still managed to get water between the transmitter and the sensor. Which caused the readings to go crazy. So that I got the big black X in the receiver screen meaning that it had gone out of calibration.
I dried the transmitter off. Tried waiting for about 20 minutes with no luck, and had to reset the receiver as if I had inserted a new sensor. That meant a 2 hour and 15 minute wait until I was receiving readings again. You can see all this in the picture above. The ever-higher readings, followed by a big gap, followed by readings again.
When it's working the entire system has been very enjoyable so far.
I've requested a copy of the software from the Dexcom rep, because I don't think I can really judge the system without seeing what the software provides. Currently I'm frustrated that it's hard to use the screens combined with the receiver to see what was happening (for example) at lunch time today.
To my mind, the inability to go back in time longer than the previous 9 hours is a big weakness. I'd love to see what happened the day before, or maybe a week ago. I'm hoping that the software will make up for this in some way.
I'll try and post more on the Dexcom in a few days. If you've any questions, please ask.
I spent an hour or so today at my endo's office being trained on using a Dexcom.
This was almost like a small Tupperware party. There were six of us with diabetes in attendance and the Dexcom support person was there, plus a CDE from the office itself.
Now I think I've had diabetes for a long time (35 years in September). But one person there has had diabetes for 52 years, and another for around 42 years. None of us were spring chickens - and yet we were all trying on this device for the first time. So kudos to Dexcom for organizing this and giving us an opportunity to try one on.
I find it interesting that this fairly leading technology was being tried on by a number of older adults (I'd guess 38 to 65 years). That says something for what folks with diabetes will do to keep themselves under control.
I'll post a blog later with a picture. So far, it's been very informative. I had a chance to eat lunch and watch my readings dip from the insulin and then rise from the food. At present I'm hovering around 180 mg/dL.
So we have a good friend that we affectionately call Uncle Roger. And this last Christmas, Roger came round and gave us an innocuous looking game called Blokus.
Wisely, we didn't open it for a few days. Then a few days before Christmas itself, we opened this Pandora's box of a game.
Since then, we've played this game too many times to mention. We had family staying with us over the New Year. We played all evening until around 11:30 PM. Then we stopped to cheer in the arrival of 2007. Off to bed and we were around the table playing again by 10 AM the next morning.
We ate breakfast while playing Blokus. Ate leftover lunch and played. Different people came to the table (it's a 4-player game) and played. Different teams paired up and played. Our girls both hold their own when playing against their geeky parents.
So...
If you're looking for something to while away those long winter nights. And you enjoy board games with really simple rules. And you don't mind being frustrated. Then this is the game for you.
And if you're interested, here's a picture from this evenings game.
I've been reading your blogs without actually acknowledging it in my blog roll on the right.
So I finally exported all the links from Bloglines and updated my template. They're meant to be in alphabetical order, though I may have made some mistakes.
Whew. That's a lot of folks writing about diabetes and other things.
They're all good blogs. Drop by and read one of them today.
Update Thanks to Chrissie for reminding me that I hadn't added her blog to my list (sorry Chrissie). If I've left a comment on your diabetes-related blog and you don't see it in my blogroll, please leave me a comment and I'll fix it.
Spring. When a young man's thoughts turn to fund-raising bike rides
Oh no, I hear you say. It can't be that time again.
Well it is.
I had a lot of fun in September of last year taking part in the Bike the Miles event to raise money that supported Dr. Faustman's work at Mass General Hospital.
The ride itself is on Sunday, September 9th. It will be starting in Danbury, CT. If you want to ride with me, we could make a D-Bloggers team!
This time I'm starting sooner and aiming to raise a huge amount of sponsorship.
"How much sponsorship?", I hear you say.
Well why not click on my fund-raising page now and find out. Go on, just one click is all it takes. I'll be here when you get back.
And hey, if you hurry you might be my first sponsor. And I'm going to need lots of them.
Here's my promise (this is a bit like public radio fund raising), I'll stop mentioning it on my blog once I hit my target. And this year, I won't be revising the target amount.
Wish me luck. Tell your friends and family. I have no shame.
Updated to add information about the date and place.
I just read this press release that the FDA has approved the Medtronic CGM for use by Teenagers and Children. And I'm sure that it will be helpful for younger folks with diabetes.
That's good news for Medtronic sales I guess. Perhaps it will enable Medtronic to work out the kinks and improve the product. And I do hope it will push medical insurance companies to start covering these devices.
The Diabetes Technology Blog is focused on using technology to life better with diabetes. I review: blood glucose monitors; continuous glucose monitor; blood sugar meters; diabetes software and living with diabetes.
About Me
Name: Bernard Farrell
Location: Massachusetts, United States
I was born in Ireland and now live in the US.
I have had Type 1 diabetes for over 35 years. I struggle with my blood sugar, the same as most people with diabetes.
I wear a Cozmo 1800 insulin pump and a Dexcom SEVEN CGM to track my blood glucose levels. I also take Symlin to help control my post-meal blood sugars.
I'm blessed by God, and every day brings the possibility of a cure.
