LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Thursday, October 25, 2012

Dexcom G-4 Platinum—quick start or not?

For those of you who don’t already know the basics of CGM, it occurred to me that I’ll be throwing around a lot of new concepts and terms that might confuse you. Like what the eff are all the parts of the system called in the first place?! So here’s today’s super-brief CGM Primer to help you acclimate yourself to the new world (and word) order:

“What, exactly, is CGM in the first place? Good question. A good question with no simple answer. A medical dictionary might tell us that CGM is a high-tech system for frequently checking and reporting on the blood sugar level of the human body, all with minimal input from the user. A lively technical manual might tell us that CGM is a technological ménage à trios of integrated components: A sensor to measure our glucose; a transmitter to make the system wireless; and a monitor to receive signals from the sensor and alert us to changes in our blood sugar.” -- Excerpted from “Beyond Fingersticks: The Art of Control with Continuous Glucose Monitoring” with permission of the author. Who is me. (I asked me if it was OK, and I said yes.)

Now, on to today’s post…

Expeditious. Snappy. Speedy. Rapid. Brief. Fast. Pronto. Lickity split. In short, as advertised, the quick start guide gets you going quickly. Oh. Wait. I misspoke. It’s not a quick start guide at all, it’s a “simple start guide.” I guess any two-sided quad-folded document that measures 14 x 20 inches can’t be classified as quick, now can it?

Oh. Wait again. The complete title is “7 Simple Steps to Start Quick Start Guide.” The title alone took up half the document. Just try to say that five times really fast.

Anyway, the seven-step program to Hooking-up and Heading-out the Dexcom way is:

1) Getting to know your device
2) Setting up your device
3) Setting your alert profile
4) Inserting your sensor
5) Starting you sensor session
6) Calibrating
7) Ending your sensor session

Ummm…. OK, those chapter tiles aren’t exactly going to win the Pulitzer for Letters, are they?

There are also some trouble-shooting tips, a breakdown of the receiver’s display, some calibration “dos” and “don’ts,” a summary of advanced features, and a FAQs section. Apparently, there are only six frequently asked questions. Oddly, all seem to have been asked and answered by lawyers.

Now, I’m all for disguising education as entertainment (I’m frequently guilty of that misdemeanor myself), but I maintain that FAQs are not the way to do it. Still. I’ve seen worse gear guides.

Did I like it? Did I use it? OK. I gotta be honest. I watched the movie before I read the book. Well that’s a lie. I haven’t read the book yet. I watched the movie before I read the Cliff Notes, and I wish I’d just gone straight to the Cliff Notes.

My advice to Dexcom vets: When you upgrade, just use the 7 Simple Steps to Start Quick Start Guide (the 7S³ Quick Guide from now on) to get up and running. For Dex newbies, take 45 minutes and watch the movie. There are some solid basics in there that will help you get your CGM career off to a good start. Oh, and I know this great CGM book you can buy….
But back to the movie new CGMers, it won’t win an Oscar, but it will be worth your time. Actually, you don’t even need to watch it in advance, like I did. It’s designed to be watched in real time with the CGM in your hot little hands. It even has built-in breaks. Go charge your receiver. See ya in five hours.

Speaking of the receiver, you could probably figure out how to operate it by holding it in your lap and pressing its buttons. No movie. No quickie guide. The receiver is pretty well engineered with simple and straightforward controls and menus. The machine is “driven” by a large select button surrounded by a ring of up/down/left/right buttons that eat up about a third of the landscape on the face of the device. It, by the way, is a right-handed device, damn it. Sad. I don’t think it would have taken a team of rocket scientists to have a motion detector like the iStuff does to flip the screen for us lefties. Except for screen orientation, the layout of the machine is ambidextrous.


Anyway, Step One of the 7S³ Quick Guide is the “getting to know you” phase, dedicated to introducing you to the receiver and its constant companions, the transmitter and the sensor/sensor inserter (in Dexspeak: Applicator). I can summarize the content for you: Hi. This is your monitor. Hi. This is your transmitter. Hi. This is your sensor applicator.

Did you just yawn? That’s OK. So did I.

Step Two guides you through the basic setup of the system, and it’s worth looking at.
There are things you’d never know if you didn’t watch the movie or read the quickie guide. For instance, who knew that the transmitter has to be removed from its box and left out in the open air for ten minutes to turn itself on? The 7S³ Quick Guide also helpfully reminds us not the throw away the very expensive transmitter. Don’t laugh. It’s happened. I know at least two people who have done it. (Don’t worry. Your identities are safe with me.)

While the transmitter is taking its air bath, you need to key its ID number into the receiver. I’ve had three Dex 7 Plus units, and all came with the receiver and transmitter mated to each other out of the box. Not the case this time. No big deal, but just remember you need to do it or your first sensor run will be very short (’cause your receiver will never hear a word the sensor and transmitter say to it).

You’ll also need to set the date and time. Mine knew the day, month, and year, but didn’t realize that it had moved to the Rocky Mountains. It’s a simple fix. One I’ll be doing again in the next week or so when we fall back. I hate this biennial time-change thing. I think we should all just spring forward half an hour and forget about it.

The 7S³ Quick Guide also guides you through setting up the CGM’s alarms, of which, realistically, there are four: A high threshold; a low threshold; a rise rate; and a fall rate. There are a few others that deal with loss of signal, calibration, some “snooze” alarms, and more. But this is such an important topic that I think we’ll come back to it another day. Hey, if you’ve got a brand-new G4 burning a hole in your hand, by all means set it up with the factory defaults for now. The alarms can be changed later.

Another subject I’m going to put off is Step Three, choosing an “alert profile.” This is new. And exciting. You have five fully different choruses to choose from, all of whom can sing your blood sugar to you in a different key. Briefly they are: vibrate; soft; normal; attentive; and hypo-repeat. Each has a different volume and different combinations of melodies to keep you in tune with your glucose. I confess I was a little disappointed, as on a beta unit I saw a menu with a sound level called “annoying.” I loved that. But I think attentive is the new annoying, as annoying was nowhere to be found. And yes, if you are dying to know, I find that the “attentive” is loud enough to make me happy—and you all know that too-low alarm volume was my biggest complaint about the CGM from the Other Guys.
The rest of the 7S³ Quick Guide takes you through your first sensor run. But rather than tell the tale from the point of view of the quick start guide, I think I’ll tell you the tale of a real sensor instead.

So, next time: Firing up my first G4 sensor.


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