Thursday, December 13, 2012

DexCom G4: Tips & Tricks

I use the DexCom G4 Continuous Glucose Monitor (CGM).  My favorite places to wear the sensor are the back of either arm and the outside of either thigh.  Runners up are the lower back (think right above the butt on either side) or the stomach as absolute last resort.  If you've never tried a CGM I recommend wearing it in the stomach first (that is technically the only body part approved by the FDA) so you can get the hang of it and then start experimenting with other locations.

The DexCom sensors are only FDA approved for 7 days, I routinely get 10-14 days of good use.  My all-time record is 21 days!  If the sensor is still working properly at the end of your first 7 days, instead of taking it out and inserting a new one, just select "stop sensor" on your receiver, wait a few minutes and then select "start sensor" on the receiver like you normally would.  The receiver doesn't know that you haven't inserted a new sensor.  It will just assume you did and your 2 hour calibration window begins.  It's fun to outsmart the robots once in a while and save some money in the process.

In addition to that tip, here are the steps I take when I insert a sensor.

1. Gather your supplies:


Alcohol wipe, sensor, Skin-tac wipe, receiver, transmitter.
2. Prep the skin by wiping it with the alcohol swab.  Also clean the back of the transmitter with the alcohol swab.

3. After the alcohol has dried, take the Skin-tac wipe and wipe it in a circle motion on the area you plan to insert the sensor.  Make sure to leave a blank space in the middle of the circle for where the insertion needle will stick in (like a donut with a hole in the middle).  You don't want the needle/wire to have to pierce through the sticky residue of the Skin-tac.

4. While the Skin-tac is drying, bend back the adhesive (it always peels in transit), peel off the stickers and place it on the skin.  Smooth out the adhesive so it is against your skin.  Remove the plastic handle thingy so the plunger will work.

5. Tell yourself that it won't hurt and push the plunger in.  You will hear two clicks.  Once the plunger is in, pull back on the round disc thing.  You will hear another two clicks.  This indicates that the wire has been inserted and the needle has been extracted.

6. Use the pincher things on the side of the sensor to release the plunger handle.

7. Snap in the transmitter and press "start sensor" on the receiver.

8. Take the same Skin-tac wipe and wipe it along the edges of the adhesive to really "glue" it down to your skin.  This stuff is super sticky, but since I've used Skin-tac I've never had a sensor fall off.  In fact, I have to use another product called Uni-Solve to get the sensor un-glued from my body.


Finished Product: My skin is as white as the tape.
Removing the sensor
Skin-tac is basically the equivalent of cementing something to your skin, so removing the sensor can be a bit painful.  Ever since I started using Uni-Solve I no longer get a bright, red circle rash where I was wearing the sensor.  I think I was ripping off the top layer of skin along with the sensor tape, but the Uni-Solve makes the sensor practically fall right off.  Goodbye rash and adhesive residue!

*I'm sure Skin-tac and Uni-Solve are sold in a variety of places, but I purchase it on Amazon in boxes of 50.

Great video from Kim at www.textingmypancreas.com showing you how to insert a sensor on your arm: http://www.youtube.com/watch?v=KaN_iPP-wq8

Great video from Kerri at www.sixuntilme.com showing you her take on inserting a DexCom sensor: http://www.youtube.com/watch?v=nb-3TeVS5MQ

48 comments:

  1. Replies
    1. I love that it's helping so many people!

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  2. was about to remove my first sensor (have had it on for a week) and then i read your blog. thanks. quick question: why is the belly an absolute last resort for you? i ask because my trainer said she's never had a call like mine: I find it's really uncomfortable on my belly. should i try an arm? a butt cheek? seriously, i'm laughing, but i'd serious :)

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    1. Lots of people have success with their stomach, I just don't like it there. I've had more success getting the sensor to stay on longer when I use my outer thighs or back of arms. Honestly, just personal preference. Other people have tried upper butt cheek (so you can still sit comfortably), but I haven't tried yet. I'd just say go ahead and start trying different sites until you find what works.

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    2. I like the stomach most because it is most accurate (for me) but I do find the arm to be 5-10%. The arm is really good if youre active (gym...sweaty, working in the heat, etc) because it doesnt get as sweaty and fall off in 5 days. Im gonna try and use the skin tac on my stomach but if that fails, Ill save on the cost of em and keep it on my arm.

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    3. I love my upper butt cheek! (sounds funny) but that is where I put most of my sensor sights, leaving everywhere else for my pump sites.

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  3. oh, and i don't see a video on how to insert in my arm on the textingmypancreas site.

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    1. Click on the YouTube link above, not on her website link.

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  4. katie, i had to remove at day 7 and the new site (once again, other side of belly) did not transmit. i have ??? on my gadget for the entire morning and most of last night. my outer thigh bled and the transmitter fell off. they are sending new sensors, but i'm really bummed out. i guess i'll keep trying, but i can't even get the sites to work...so i'm sad.

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    1. Hello! If you ever get that error, it is probably from the sensor. Just call dexcom and tell them the issues that are occurring. They will replace the sensor for free.

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  5. Thank you for the tips and tricks. I'll look into finding skin-tac over here (Belgium, Europe).

    My sensors last for an average of 30 days. I put it in my upperarm (not in the back, but in front) and I don't feel it sitting there and it's not able to move.

    Good luck!

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  6. Thank you, this was very helpful. I did not want to use this product on my stomach area and wanted to be sure it would work somewhere else.

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  7. Do you stop the Sensor just prior to the starting of the time that it was started last week? Or do you stop the Sensor before the day your time runs out? I know the receiver will tell you that it's time to change the site, but I was just curious when. Thanks for your help.

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    1. It doesn't matter when you stop the sensor. For me, so much of that is dependent on what I'm doing that day. For example, let's say the 7 days is up at 5 p.m., but I know I'm going somewhere right after work, I might restart it at lunch or that morning. Other times, I just let it go until it runs out and then restart it then. Just start and stop when it's convenient to you and your day.

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  8. Did you ever get sore the day after you injected it? I started using it yesterday, i placed it in my abdomen and now today it is sore in my back.. I ve been trying to find someone who knows what could be causing this .. I not sure if it is just my body getting used to the sensor or what.

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    1. I've never felt sore in a different part of my body (i.e. sensor in thigh, suddenly sore in butt or back). I've definitely had the site hurt, feel sore, etc. for periods of time while wearing it. I leave it in if it's accurate and I can tolerate the pain. I don't know why you would feel sore in a totally different part of your body from where the sensor is inserted. Not sure it's a sensor problem if that is what is happening.

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    2. I had pain in my back after using my sensor on my belly too. I moved it to my arm and haven't had any problem there. Good luck!

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  9. Katie - my daughter was on just her 2nd sensor (the first one didn't make it a full week) and we had the surprise of the countdown at the 7 day mark - even though it was still going strong and reading accurately. Unfortunately, I had not seen your blog entry until AFTER that happened. At least we will know what to do with the next sensor! Thanks for putting together this page - it is PERFECT for a new user like my daughter (just diagnosed at Christmas, and received her G4 on April 7). I really appreciate it!

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    1. Awesome! Glad this has helped you. Make sure to call DexCom to report any sensors that don't last the full 7 days. Even if a sensor makes it 6 days, they will send you a free replacement, as it should have lasted a full 7.

      Now, if you're on day 18 and it finally dies they won't help you. ;-) Good luck to you and your daughter!

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  10. Thanks for the skin-tac tip. I've had my Dexcom G4 hanging by a thread for a day now (I'm on day 8) and still working fine, but I'll have to pull it out before I need to just to prevent it from being ripped out while I'm sleeping tonight! Thanks also for creating this wonderful T1D community space!

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  11. So glad to see these comments. Have been on the Dexcom G4 for just a year. I did start wearing it up to 14 days, but never tried beyond. That's my next goal. Also GREAT to read that sites beyond the stomach are OK. I'm getting indentations in my skin from where the Dexcom has been, so I'll be trying the leg/arm next. Thanks everyone!

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  12. We put it on our daughter's tummy and it promptly fell off during the night. Next we tried her arm and used something like Skin-Tac and a big bandage with the center cut out (to put over the sensor) and that seems to have worked.

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    1. My son had problems with allergic reaction and adhesion with the Dexcom. I am now using IV3000 under the site. I cut an opening for the sensor and put the IV300 down first and then place the sensor adhesive over that. It has lasted more than a week with showering every day and also no allergic reaction. We tried skintac but it was just so sticky it was hard to work with. We use uni-solve to remove both his pod and the Dexcom site. With the IV300 we did not need any other adhesive products, no extra tape ect.. So far so good.

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  13. Can you wear your dexcom sensor and transmitter for an x-ray? I called Dexcom and they haven't studied it so they can't tell me anything...

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  14. Yes, I think you can. My wife uses Dexcom G4. We traveled abroad in November/December of 2014 and had not problem going through the security checks at different airports.

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  15. You must remove both sensor/transmitter & Omnipod prior to an MRI, since they contain metal components such as retracted needle, batteries, etc.

    I also want to add that Skin Tac (amazing product!) also comes in a liquid, which I prefer to the wipes - and it lasts forever! I remove the adhesive backing & brush the liquid skin tac - using the enclosed applicator - directly on the adhesive. I wave it around until it dries, then apply to my abdomen about 4 fingers above my waist. This works like a charm as that part of your body doesn't bend or move as your waist does. And it stays on for up to 2+ weeks (during very sweaty workouts too!) or until it can't receive/transmit properly. I've been doing this for years alternating from left to right sides of my abdomen with no problems whatsoever. However, after reading these posts, I will try other body sites now, as well. Thanks!

    Hope this helps!

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    1. My daughter had x-rays again recently, not our first go around, and we NEVER had issue wearing the Dexcom CGM. We always FIRST alert the Dr and verify the location of the sensor with NOT interfere with what they are needing to see but as for having issues with the sensor after...we have had NONE. Some advice...if your going to have xrays (again check with DR. to be sure location won't be an issue...if so, and your prior to xray you can move your sensor to another location prior to xrays). NEVER have and MRI with a sensor....it would not be fun to have it pulled from your body by the magnet!! As for CT scan....again, no issue but check with Doctor and if they are unsure CALL the radiologist or tech prior to service to verify what will or will not be allowed. GOOD LUCK!!

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    2. Putting heavy duty water resitant plaster over sensor 50 mm x100 mm wiil last the entire sensor period and have no negative influence - Just sticks better

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  16. I am interested in using my outer thigh, but nervous as I haven't seen anything online more specific on locations that can be used on the legs. Any suggestions that are more specific?

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    1. Hi Janelle,

      Here is a video I did that shows all the places I have worn the DexCom: https://www.youtube.com/watch?v=dA0fn9Vcrak

      Hope this helps.

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  17. I've been diabetic for 22 yrs, I'm 23. Just got the dexcom and this blog is absolutely amazing. Thank you!

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  18. How often do you calibrate and would it make the Dex more accurate by calibrating more in a 12 hour period?

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  19. Yes, it should. More frequent calibratio├▒s will give give better results.

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  20. I was told by the Dexcom Tech Rep earlier this week that I should only enter BG calibration when prompted to on the screen- to do so more often "confuses" the sensor. Anyone?

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    1. I've used the DexCom for over 3 years now and I will calibrate more than when prompted if I think it's super off, but probably never more than 3-4 times a day. You shouldn't do it obsessively.

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  21. Can I get some ideas or help... I bought some over the counter skin glue type stuff to try and use to see if I would like it. When I put it on my skin where the sticker goes and then around the sticker once it was on... all it's done is made the sticker hard, and not stick... any ideas? Am I doing it wrong?? I wanted to try this first and see if I would like it before I orders skin tac... I hate going through 2-3 sensors in a week... plus it's expensive!!!

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    1. You're applying it like I do, so I don't know why it is only causing the sticker to harden (rather than help it adhere to your skin). You may need to try a different product.

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  22. Thank you for this information! I am 23 and only T1D for almost 3 years. I just got my Dexcom G4 about 2 months ago and was really trying to find somewhere besides my stomach to put the sensor. So when I found this I was so relieved! I was having issues with the ones on my stomach falling off and when I start the Police Academy in January I was worried the tactical pants/belt would make it worse. I think the first spot I will try next is my outer thigh. Once more, Thank you so much for the information!

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    1. You're welcome! Good luck at the Academy!

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  23. Could you clarify a little more on how you know you absolutely must change your G4 sensor? Is it when your readings are consistently off or when your receiver reads "???" I am on day 14 of my very first sensor and am still getting good results, but am confused about how long it will last before I will know for sure I need to change it. Thanks!

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    1. Hello...each sensor will crap out in its own way, but common things are either recurring "???" or, just really funky readings that don't match what is going on in your life. For instance, perhaps you've just eaten a big snack or meal, but your DexCom continues to say you're 55. Or, I've had it where I haven't eaten anything in a while, but it shows I'm in the high 200s. In general, if you just have a few hours or a day or two of your BG tests not matching with the sensor, I'd pull it. Or, if you have the "???" multiple times. If I just get the ??? once, I let it go because often the Dex will fall back in line, but if it happens multiple times I pull it.

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    2. Perfect! Thank you so much for the great advice and blog!

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  24. Although I have seen postings that say that some people have used it for as many as 41 days, my experience has been that the sensor becomes erratic after about 16-27days. I have decided to change the sensor after every two weeks.
    Hope this information.

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  25. After wearing the sensor my skin is really red and raw under the TRANSMITTER. Any suggestions on what I can put on my skin UNDER the transmitter (not the insertion site) so when I take it off after seven days or so it's not red. It takes two weeks or so to heal. I do put a tegaderm under it, but obviously that is not enough to stop the red and irritation. Thank you.

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    1. Kerri over at SixUntilMe.com wrote a great blog post a few years back that might be helpful to you: http://sixuntilme.com/wp/2014/06/25/dexcom-rash/

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  26. This is great stuff thank you! Couple questions, may seem silly but I'm a first time dexcom user. 1. Pants, jeans etc don't irritate or interrupt the sensor? 2. What about during exercise? Running, basketball, any non-water sports, does the thigh location work?

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    1. Congrats on getting a DexCom! 1. Nope, never had an issue with clothing causing the sensor to stop working. 2. The thigh location works in all of those scenarios, but just know that for some people the Dex can lag behind if you're doing super intense exercise. Meaning, Dex might say you're 150, but in reality the exercise has caused you to drop to 60 and Dex is taking a while to "catch up". Just something to keep your eye on as you learn how Dex responds to your body.

      I'll add that sometimes it is irritating to sleep on the side my Dex is inserted because my leg obviously presses into the mattress, but, that would be the case if you wore the Dex in the upper arm as well. Unfortunately, occasional discomfort is part of the deal when wearing all these devices.

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