Dexcom

Since starting The Superhero on the CGMS, Dexcom, I get a ton of questions about it. I love sharing our experience with it because as most of you know, I am IN LOVE with Dexie. If there are any questions I do not answer in this post and you want to know more, please comment and ask away!

What is a Dexcom?

Dexcom is our Continuous Glucose Monitoring System. We insert a wire using a long needle into The Superhero (we have only done arm sites so far). The wire stays in place and is attached to the sensor. The needle comes out after Dexie's site is in place. This gets changed out every 7 days. Some people can get an extra week or so out of the sensor with no problems. We have not had this luck yet, not because of the sensor itself, but the tape only seems to stay on for a week. I will be getting some adhesive to help the tape stick longer.

Here is a picture of The Superhero sporting his Dexcom sensor on the first day he was wearing it...

The Dexcom is not the only brand of CGMS out there, but it has the smallest insertion needle and the smallest site on the body. Dexcom also only has a 2 hour warm up period as opposed to 4 or 12 hours (which is what I believe the others are) We also can calibrate when he is between 40 and 400. The other CGM systems have a tighter range in which calibration must take place.

With the sensor attached to The Superhero, it transmits information to the receiver. Basically, the sensor measures the interstitial fluid for glucose and gives out a reading every 5 minutes. This is very similar to checking blood sugar. It has been quite accurate for us thus far. The receiver must be within 5 feet of him at all times. He usually wears a second pouch (made for his insulin pump) and puts Dexie in there. He sometimes wears it in his pocket if he has cargo shorts/pants on. I don't let him put it in his regular pocket because I do not want it to fall out. He really does not mind the second pouch for now. As he gets older this will most likely change.

This is what the receiver looks like...

The picture is a little blurry, but this is the receiver showing a 191 steady sugar level. The arrow is pointing to the right. The arrow gives us the trend. We can see the arrow going straight up with one or two arrows, diagonal up, steady, diagonal down, or one or two arrows straight down. The change in sugar levels between each 5 minute check determines which way this arrow is pointing. If The Superhero's BG level is falling fast, his arrows will be pointing down and his Dexie will alarm. It vibrates first and then if ignored, it beeps. Each reason for alarming sounds different. It took me a few weeks to differentiate between "High BG" (above 240, we have it set at this number) and the "dropping" or "low" alarms.

We still do finger checks on The Superhero. We have to do at least 2 per day to calibrate the sensor. We usually do a few more than that though. We check his finger in the morning when he wakes up, at lunch before he eats, sometimes after his nap, before dinner, before bed, and usually once in the middle of the night. It depends on how he is trending to determine how many times his fingers get poked. So far, Dexie has been pretty accurate most of the time.

Dexie does not talk to the pump. We still have to tell the pump how much insulin to give The Superhero. (I get this question a lot!) There is another version out there that does this now and the Dexcom and Animas (pump) will be able to do this at some point. Right now they are two separate systems.

I do feel that having Dexie is the second best decision (next to pumping) we have made since The Superhero was dx with T1. There are some faults as with any technology. We have had a few failed sensors. They seemed to happen when he was sick with the tummy bug. Not sure if that had anything to do with it or if it was just a coincidence. When this happens, we called Dexcom and gave them the lot number, etc and they would send us a new one right away. We just go with the flow and this does not bother me. We just insert a new one and move on.

So far, we do not have a lot of trouble changing sites. The Superhero is usually ok with us doing it and only throws a minor fit. After it is over he always says, "that's not too bad". I have gotten faster at doing it over time, just like with the pump sites. We do not use EMLA (numbing cream), but I know many families that do. It just depends on you and your kiddo.

I do feel we sleep a little better having Dexie around. I have a baby monitor turned on in his/our room and I do hear the alarms at night. We still get up to check Dexie, especially if we have an off night. Seeing the trend arrows is amazing! Knowing which way he is headed is definite peace of mind.

To get insurance approval (all insurance companies are different) we just had to provide 1 month of BG logs showing at least 3 lows below 50. Our insurance covers 80% and we cover the other 20%. We are paying about $100 per month. (totally worth it!)

My favorite part about Dexie is when we are at a friend's house or the park and I can just look at Dexie, treat, and let him run off. I don't have to check his finger constantly as I would normally when he runs around like a crazy kid. I can see the trend and treat before he gets too low (which is the problem when he runs around like that).

I know my mom feels a lot better knowing she has Dexie when she watches The Superhero. She can easily see where he is and know if he needs a snack or not. She feels a lot more comfortable keeping him now. (and I am sure she will chime in on the comments)

The only thing I can think of that I HATE about having a Dexie, is the fact that we need one. I hate having another thing attached to The Superhero 24/7. BUT I would not go a day without it now! I feel like we were going through Diabetes life with one eye closed before. Having Dexie shows us the WHOLE picture and it is amazing!

If there is anything that I left out that you want to know, PLEASE ask!





Comments/Questions from original blog:

Heidi / Jack's Pack said...

This post was so helpful. Thank you so much for writing about Dexie! I think you've sold it to me! Now I just have to sell it to Jack! :)

March 16, 2010 10:15 PM

Kelly said...

We have the Minilink, and I love it....Maddison, not so much. I wish we could use it every day! It really DOES show the whole picture! I'm so happy you have Dexie for The Superhero!

March 16, 2010 11:45 PM

Wendy said...

I'm getting closer to allowing another CGM in the house...closer, closer, closer....but...not yet. No, not ready yet!!!!!!!!

(turn on soap opera music)

I just don't know (sob) how I'll ever trust again (mascara tears)...

To be continued.

March 17, 2010 12:58 AM

Reyna said...

T....

Thank you, due to your information to me on my insulin pumping post...I went ahead and signed us up to trial Dexie. I just paid for the supplies the other day. I'll keep you updated. Also, Dexcom and Animas are partnered...and are hoping to have a system similar to Medtronics' within the next year. JDRF partnered with Animas for the pseudo-artificial pancreas project (I slapped a link up on my blog in the side bar)...where the pump should "self-adjust" insulin delivery to blood sugar numbers, but NOT to carb boluses...who knows when or IF that will happen, but some cool stuff on the horizon hopefully....HOPE...thanks to all of you...we got a lot of it. xoxo

March 17, 2010 3:09 AM

Danielle said...

I'm so tempted to get one. Charlotte's nights are always so unpredictable. It would be nice to know at least which way she was going!

March 17, 2010 3:38 PM

mommy1 said...

Wow! Great minds think alike! I have been super busy the past three weeks and have been away from blogging! I just posted something similar to this! I love your name. So is the CGM a girl? :)

Amy

March 24, 2010 11:47 AM

Tracy said...

Thank you all for your comments.

Wendy, I love the continuing soap opera. :) (with the dramatic music and everything!)

Danielle, You might be able to try one through your endo. I know our endo is getting 3 to use for her patients to try and for her to figure out what is going on with their numbers.

Amy, I am not sure if Dexie is male or female. :) I think I go back and forth between calling it a he and a she. :)