Dexcom gets a positive review for 10-day use
The March issue of Diabetes Care contains a paper about testing the Dexcom SEVEN for 10-day use with adults with type 1 diabetes.The Dexcom SEVEN continuous glucose monitor has been approved for 7 days of use. I usually get 10 to 11 days of use by restarting the sensor after 7 days have elapsed. Your results may vary, so make sure this works for you before relying on it.
Based on the abstract from the Diabetes Care website, it appears that the results on the 10th day are still fairly accurate. Notice how the difference goes down slightly on the 7th day, showing that the Dexcom is more accurate after it's been in place for a few days.
The median absolute relative difference for CGM versus YSI was 12.6, 11.3, and 14.5% on days 2, 7, and 10, respectively (P = 0.63). CGM performed better on day 10 when compared with self-monitoring of blood glucose as compared with YSI.I expect to see more papers like this before Dexcom applies to the FDA for 10-day use of the sensors. The good news is that this ultimately means less sensors changes will be needed. It also probably means that Dexcom will raises the price of the sensors.
I do hope that before Dexcom takes this move they improve the adhesion of the sensors. Mine usually look like they're falling off by day 9 and they rarely last beyond day 11 because they peel off. Have you been able to get sensors to stay in place for longer? What tricks have you used to make this work?
Labels: 10-days, Dexcom, Dexcom SEVEN, research
posted by Bernard @ 2:51 PM
21 Comments:
I am on Minimed's CGM and I wear them for the allotted 6 days. I have noticed that my skin reacts poorly to the sensor after that. It itches and is red, so even though it's still accurate, I feel the urge to take it off. I think this is another case of YMMV.
I rarely get the adhesive to last 7 days. I swear my skin just throws them off.
They haven't been able to figure it out either.
Lots of users on tudiabetes.com have suggested IV3000. They cut a hole in it so the sensor is not covered and put it down over the white, adhesive part that is peeling up. I have to do this with infusion sets if I swim alot as I will get 1.5 days tops if I do not put the IV3000 down to hold it all in place for awhile longer. Make sure the adhesive white part is totally dry when you put down the IV3000 or it will not stick! I found this out the hard way....
I've used IV3000 and tried some adhesive products. But I shouldn't have to do this.
As it is, I work really hard to help it maintain its stickiness. This includes covering it (by hand) while in a shower and drying it immediately afterwards.
I think Kerri is only getting about 3 days out of a sensor due to adhesion problems.
I get six days on average, but SkinTac helps re-secure things that come loose. :)
I have to say. IV300 stunk up the place big time. I use opsite flexfix tape. I cut a small hole in it and put it over the sensor. It is awesome stuff. A roll of the 4 x 11 stuff will last you for many moons. I bought my roll a year ago and am still not near the end.
I talked to a Dexcom rep yesterday about this topic as I am thinking of fighting the insurance company to get one. She said she has folks that wear them even longer but 10 days is fine if your body can handle it. I asked her about the adhesive issue too and I was given a generic "we are working on improvments" speech. She said SkinTac and IV3000 are what most folks use. I agree we shouldn't have to use another product, the darn thing should stay put as it is designed to do!
After about day 7, I cover the Dex sensor with a large bandage and then add adhesive tape to that. Then I watch it closely.
I usually only get around 6 days out of the adhesive... and restarting the sensor only gives me at most 24 hours extra before it fails...
I swear my skin is teflon- as tegaderm and IV3000 slide right off, within a day... I do use IV prep on the edges as they peel up (edges of the dexcom sensor adhesive and any additional dressing)... I also have glued the edges down using mastisol (comes in a little crush-vial thing) but it only can go on the very edges of the sensor dressing- if it gets closer to the sensor/transmitter I find that the sensor becomes even more unreliable...
When I was on the duragesic pain patch- the company sent me some Bioclusive dressings that stuck wonderfully- may try to get my hands on some of those to try them with my 'betes stuff...
Positively giddy about starting the navigator tomorrow (my pain mgt depends on tylenol which really renders the dexcom useless and so basically I walk around wearing a random number generator on most days:-)..although I see some IV3000 in the pack...
I think it really depends on the sensor. Sometimes I have a sensor that is barely good all the way to the end of 7 days although usually my sensors last at least 12. Sometimes I have a sensor that performs perfectly up to 14 days (my personal max) but at that point I am holding the thing in place on my arm with an REI stretchy armband thing and I have to take it off because the glue is all gone.
Anyway, for holding it in place, I don't know what to call it, but I got this armband made out of spandex or something that has a little pocket in in from REI. I think it's made as a place to hold your money when you go swimming or something. It is meant for your wrist, which means that it is nice and tight on my arm. So it fits very well over the dexcom. I also wear this when I go swimming because I don't want people to feel uncomfortable about the cyborg in the pool with them. ;)
Dexcom sucks. The customer service gets worse. The receiver readings are off and almost led me to collapse. Do NOT buy it.
Dexcom sucks. Their customer service got worse. I almost collapsed due to the receiver's false readings.
dimitmant there is no perfect CGM device on the market. For me the Dexcom device works really well most of the time. Sometimes I want to throw it away because of a high or low that it doesn't warn me about.
My advice for anyone thinking about a CGM device is to try as many as you can out for at least a week before purchasing. All of the current CGMs have different pros and cons, just like meters you've got to make sure it works for you.
We are just looking at purchasing a CGM for my diabetic son. We are thinking about the Abbott one. We want one of these as he is a keen windsurfer. I see from one of your other postings that you have worn your Dexcom under a wetsuit, did this work ok? Did you use extra stuff to stick it on? Was it stuck to your abdomen? Thanks
Graeme
When swimming in a triathlon I've worn the receiver in an Aquapac waterproof pouch that's around my neck. The sensor/transmitter is in it's usual place on my abdomen. I don't do anything special to keep it in place. Last year I was in the water for about 25 minutes and it worked just fine.
If I'd already worn the sensor for a week and the sensor edge is peeling, as in the picture, I'd definitely change to a new sensor before going in the water for a long time.
I write a diabetes column for Examiner.com and a reader told me that when he runs, his CGM stops reading after about 10 to 15 min. Then when he stops, it comes back 15 min to an hour later. Have you ever experienced that? Any idea what the reason might be? A biking friend of his had a similar experience. He does not have a problem when weightlifting. It seems to be specific to only certain types of exercise.
Rob
I think the problem that your readers are seeing is due to the rate that their blood sugars are changing. I see this on the Dexcom but not that often.
I think all CGMs use readings from interstitial fluid to calculate what the blood sugar values might be. If the level of glucose changes rapidly it can confuse the CGM. This is also a reason why you shouldn't calibrate your CGM when your blood sugar is rising or falling. After exercise their blood sugar levels probably stabilize and then the CGM catches up.
One way to handle this, for pump users, is to reduce their basal rates about 90 minutes before they start exercising. With less insulin in their system their blood sugars might not be as affected by exercise.
Ask them to check their BG values with a meter once the CGM stops reading. I'll bet the values they get are much lower than the last reported CGM.
Giving this advice feels a little like being the guys on Car Talk. Let me know what you find out.
I have had some problems with adhesive - however 7 days is the max I dare use it. That's if I go that long!! I've used the DexCom CGM for only 30 days and have replaced the receiver, the transmitter, and had 4 sensors fail! Very frustrating. Customer Service has been great - but I'm hoping I made the right choice!
Lorraine, that sounds really annoying especially in such a short space of time. Over the 30+ months I've been using these, I've probably had less than 10 sensor failures.
I hope you figure out what's going wrong so that it works for you. I'm still getting 9-11 days out of most sensors before the sensor or the adhesive gives up on me.
I am starting this month on the Dexcom system & am excited about it. Figured I could weigh in a bit with my experience with my pump insets. When I first started with the pump 5 years ago, I was involved in tournament paintball, and between the motion, snags & sweating I had replaced my inset 3 times in one day! I tried skin tac and a number of other things, but what I think helped most, and the only thing I do now is shave the area clean. I have easily stretched my "spot" to 10 days or more. I typically dont change my location unless I see that Im not getting the efficacy from the insulin at that site anymore. I dont play paintball competitively anymore, but wouldn't be surprised if just shaving and a fresh site that morning would make all the difference.
Steve
Just be careful about overusing an infusion set site. With CGM sites, there's nothing going into your system so they tend to be less reactive.
With infusion set sites, the insulin causes a reaction that ultimately leads to scarring and 'lumpiness'. I've got sites that can take several months to get back to normal after 4 days with an infusion set.
The scarring can cause absorption problems, which is one of the reasons why everyone recommends that you change sites every 3-4 days and try not to reuse them for a while.
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