A Review of Dexcom G6
Full disclosure: I have entered into a sponsorship agreement with AMSL Diabetes. AMSL have provided me with a three-month trial of the Dexcom G6 Continuous Glucose Monitoring system, with one of the sponsorship expectations being this blog post. Because AMSL have sponsored me, their regulatory team has reviewed this post for the purpose of ensuring compliance with regulations governing the distribution of medical devices in Australia. All words and opinions expressed here are my own.
After many months of anticipation, the Dexcom G6 Continuous Glucose Monitoring system has finally hit our shores here in Australia. This newest iteration of the Dexcom features a slimmer profile, 10-day sensor wear and no requirement for calibrations with a finger stick. I’ve been using the system for 20 days now, having recently completed my second sensor.
Application: There was an important first step where I had to input a code printed on the back of my sensor into the G6 app on my phone, in order for me to proceed without the need for any calibrations.
The sensors now come encased in a one touch insertion device. I was admittedly a little nervous about this. I prefer manual inserts where I can, as it gives me a lot more confidence that everything has gone in correctly and I haven’t bruised my precious real estate. That being said, insertion was so much simpler and quicker than its predecessor. All I had to do was stick the sensor onto my skin, remove the safety lock and press the orange button.
What I’d most like to see improved here is the ability to reuse or recycle the large plastic insertion device.
Transmitter: The G6 transmitter sits on top of the sensor and sends blood glucose readings to the Dexcom G6 app on my phone every five minutes via Bluetooth. The transmitter features a much slimmer profile than the G5, and I definitely noticed an improvement while I was sitting on the couch or laying in bed. Transmitters are a costly component of running a CGM, and I would have liked to see this last longer than three months.
Sensor wear: I’m always wanting to get more out of my diabetes gear, so it’s good to see that G6 sensors are now approved for 10-day wear. Although as someone who tries to line most of my diabetes tasks up with the weekend, 10 days is admittedly inconvenient. Saturday, next Tuesday, the following Friday…
The sensors stuck well enough for me over the 10 days. My first sensor showed more signs of wear and became loose around the edges towards the end. I also received one sensor error on days 7, 8, 9 and 10. This occurs when the G6 app stops receiving readings for a short period of time. My second sensor stuck better than the first, and I didn’t receive any sensor errors here. External adhesives can also be used to secure the edges if needed.
Dexcom G6 app: The G6 app was really easy to set up, with step by step instructions guiding me through pairing my transmitter and inserting and starting my sensor.
There are the usual alerts which can be customised to notify you when your blood sugar is high or low, rising or falling. My foolproof alert is the tone ‘High.’ As much as I can’t stand that sound in the middle of the night, it never fails to wake me up so that I can correct and avoid waking up high.
One new feature is the urgent low soon alert, which will give you a 20 minute warning when blood glucose is predicted to fall below 3.1mmol. It feels like your Mum nagging you to do something about it, even though you’ve already been told. Not necessarily a bad thing…
As someone who does often adjust my target ranges at night, another feature I really liked was the alert schedule. In the G6 app, I was able to create a customised schedule between the hours of 11pm and 6am with a tighter target range than my default schedule. I am being a little easier on myself right now, but I’ll definitely try this some point.
Accuracy: I’m still adjusting to the way that the G6 behaves. The trend arrows feel more immediate than what I was used to on the G5. I feel like I see the impact of a meal or activity more quickly on my CGM graph. I’ve had to adjust my behaviour a little in order to avoid being too reactive to trend arrows. It’s also left me questioning how effective my pre bolusing has been.
I started checking my blood sugar in the morning and evening, in line with my usual G5 calibration schedule. Almost all of my meter results were within 1mmol of the reading on my G6. I’ll also add that I’m paranoid about checking my blood sugar on clean hands. Generally, I found that my G6 reading was on the higher side of my meter reading.
Overall, I found the accuracy to be excellent. I’ve only calibrated the system once over the past 20 days, which was in the first 24 hours of a new sensor. For the most part, I didn’t feel the need to calibrate this system because there was rarely a time where it didn’t feel accurate.
Another time I found accuracy to be superb was when my blood sugar was dropping. In my experience using G5, I expected less accuracy when I was comparing my meter with a diagonal trend arrow. But the G6 was spot on.
Verdict: I went into this trial sceptical that the Dexcom G5 could be bettered, however the Dexcom G6 has definitely exceeded my expectations. As someone who would be paying for this product out of pocket, I’m still undecided as to whether I would continue using this beyond my trial. However, it is a step in the right direction to see G6 priced considerably lower than G5.
Dexcom G6 is currently available to purchase in Australia from distributor AMSL Diabetes – www.amsldiabetes.com.au. AMSL are currently working with the government to get G6 listed on the NDSS, however there is no confirmed date as of yet.
Footnote from AMSL: If your glucose alerts and readings from the G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions. Always read the label and use only as directed. Read the warnings available on amsldiabetes.com.au/resources before purchasing. Consult your healthcare professional to see if this product is right for you.