Dex

The Dexcom G4 attached sitting pretty on my abdomen.

So, I’ve been trialling the Dexcom G4 CGM using an integrated Animas Vibe pump. This is week 7 of the trial and I am gutted that I only have one sensor left before I have to hand it all back.

To say that I love this CGM is an understatement. Actually, let me back up a minute. I love CGM full stop. Since being introduced into Australia about five or six years ago, I’ve used CGM sporadically. And there have been periods where I’ve used it full time. I love this technology for the information it provides me and the way it helps me fine-tune my diabetes management. It makes me feel safer about living with a condition that takes great delight in throwing a curve ball. Frequently. (Actually, I have no idea what a curve ball is. Sporting analogies and me = pffft. But I digress….)

But this CGM has blown me away. I’d heard great things about the Dexcom/Animas integrated system when I was in Berlin at the Euro Bloggers Summit at EASD last year. I hadn’t seen the system in real life, so it was great to hear from real people about everyday real living with it. Really. Overwhelmingly, they loved it.

Knowing that it was on its way to Australia, I couldn’t wait to see it in action for myself, so I was thrilled when I was asked to trial it for a couple of months.

Here’s the good stuff:

  • The accuracy is incredible. This is, of course, the biggest criticism of CGM. The lag time drives people nuts. We all know that it’s not about the actual number, it’s about trends. I get that. But to have a CGM with less lag time means that what we’re seeing is far closer to what is actually going on. The biggest difference I’ve had between the Dexcom and my meter has been 2.5mmol/l. That, my dear friends, is bloody impressive!
  • I can calibrate it at any time, no matter what my BGL is doing. Heading up, up, up or plummeting? Doesn’t matter – calibrate and away I go!
  • The alarms are sensible. I adore the ‘BGL dropping too fast’ alarm which has allowed me to catch more hypos that I can count. Love it, love it, love it!
  • Did I mention the accuracy?
  • The colour screen on the pump (or receiver if that’s what you are using) is brilliant. Honestly, I thought this was a bit of a gimmick until I actually realised how much easier it is to read the screen in low light, bright light, at the movies, when I wake up in the middle of the night and can barely register anything etc.
  • The sensors are meant to be used for 7 days. I got thirteen days out of the first one – which fell out because I didn’t use anything to reinforce the tape; 17 days out of the second and third died today on day 20.
  • And, oh, I know, the accuracy.

What don’t I like? Well, not much. I’m not overly keen on the inserter for the sensor. It looks like a giant syringe and the automatic spring-loaded bit doesn’t kick in until the needle has already made contact with the skin. I have absolutely no needle phobia whatsoever, but I wish I’d been told to push the plunger hard so as not to feel the tip of the inserter needle hit my skin before the automatic part does its thing.

The tape definitely needs reinforcing if you’re planning on getting more than 7 days out of each sensor. But, a quick Facebook post out to the DOC and I was using Opsite to secure the little thing to me. No problems, now. (Although, I was going to consider toupee glue as an option thanks to this blog from the clever and funny Scott Johnson.)

The cost. More on that in a minute.

The alarms don’t wake me up. And they don’t wake my husband up either. I have the pump on vibrate during the day, but at night turn on the sounds. Unfortunately, even when turned up as loud as possible, I still sleep through (a couple of mornings of three plus hours of 3.5mmol/l can attest to that).

I have a decision to make – my pump is out of warranty and it’s time for me to upgrade. I’ve been pumping for 12 years now and have tried every pump on the market (whether as a trial or as my own). The only feature that I insist on is that the pump must have CGM integration as an option, which obviously narrows the choice down to two pumps.

The main negative with the Dexcom is the cost. According to AMSL (distributors of Dexcom and Animas) the introductory cost of the transmitter is $595 and a box of four sensors is $396. However, a fifth sensor is thrown in. Prices rise by about 10% after the introductory offer ends on 1 April 2013 at which time, a box of 4 sensors (plus bonus one) will be $440 – $88 per sensor. Even if I manage to stretch out each sensor to two weeks, it’s still expensive – more expensive than its competitor.

My worry is that Dexcom is going to be priced out of the market. I know that the sensors are absolutely not this expensive overseas, so it is disappointing that the Australian consumer is getting slugged such a premium price. I understand that we’re a long way away and I also understand that there are distribution costs. But I still think that the cost we’re being charged is exorbitant and, frankly, that pisses me off.

But the accuracy really has blown me away. And made me realise that when it comes to diabetes management tools that this is, without a doubt, the most important consideration. I have one sensor to go before the trial is up and in that time will decide whether I can budget for the extra costs of this system. In my mind, it is worth it. I just need to decide if I can do with a couple of fewer pairs of boots this year to fund it.

Disclaimer

I have been on a trial sponsored by AMSL, distributors of Animas insulin pumps and Dexcom CGM in Australia. As part of the trial, I have had use of an Animas Vibe pump and a Dexcom G4 transmitter. I was also supplied with 4 sensors for the Dexcom and a limited number of consumables for the pump. I have no arrangement with AMSL to write about my experiences on the trial or review the devices. I’m just doing it because I’m happy to share my experiences of this new device on the Aussie market. Feel free to ask questions and I’ll answer them if I can. For information about this product, contact AMSL on 1300 851 056.

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