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.

17 Comments

  1. Dan

    Great post! Love the fact that you weren’t just blindly positive about every aspect of the G6 like most of the sponsored ‘ambassadors’. A good detail I hadn’t heard anywhere else is that you can set different ranges at different times of day, which is very useful because I miss this feature from my Medtronic pump and it’s one of the deficiencies of the T-Slim. The use case you mentioned, having a tighter high range at night, is exactly what I’d want to use it for.

    • I am really glad to hear that, thank you. I spoke with AMSL at length and would never have taken the product if I could not be honest in my feedback.
      I think the ranges can be customised for any time of the day, I only used night time as an example.

    • HI Dan, thanks for your comment. From what you are saying the T slim only has one basal profile available not others? Assume it has a temporary basal function though? Id welcome your response? Thanks

          • Yes — there’s the ability to add multiple basal profiles on the T-Slim. What you can’t do is set the threshhold for CGM alarms to be different values at different times of day. You can do this on the Medtronic – one of the few things I’d say is better about Medtronic than T-Slim. For example, you might be happy to go higher than 11 during the day because you know you’ll be eating and with a reasonable carb load, it’s impossible for the insulin to act fast enough and keep you below 11. However, at night when you’re not eating, you might want a tighter range – i.e. stay below 9, and get an alarm if your BGLs go above that so you can correct in the middle of the night. The T-Slim currently can’t do this; the CGM alarm threshholds can only be set to the same values 24/7.

            Hopefully Control IQ will make the need for this a thing of the past though..

  2. Frank L

    I have been using the G6 the second day it was available in Australia – I have been on the waiting list for a while…

    I have found it to be extremely accurate, so no need for calibration, and the alerts work really well.

    It really suits me, I have not had a hypo since I have been on the G6 giving the useful features of the alerts.

    The user interface on an android phone (Samsung) is easy to use and navigate.

    It is about time it was released in Australia since it has been available in the US for years. Can’t wait for the G7 (the much slimmer version of the G6).

  3. Hi, I have read your post first this morning when my brain isn’t quite working but again now and Im so pleased you posted it. Living with Type 1 as we all know can be tough but its so useful to have a review of the new Dexcom sensor as it works so differently from the Medtronic one which quite honestly (is a pain in the bum)! I should get a new pump and sensor in December this year (UK based). I look forward to not having to calibrate 4-6 times a day, ah relief ! Your real thoughts on how it did and didn’t work really helped, thank you. Keep the posts coming, I see them every morning when I wake up (take that as a compliment)

  4. Rick Phillips

    Frank, I use the Medtronic 670g but I am excited to someday try the G6 or G7. Unfortunately the main complaint I have with it is the amount of rubbish it produces. I think the diabetes big idea for the next 5 years is figuring out how to reduce waste. In this case the G6 is almost over the top.

  5. Denise

    Hi Frank thank you for your honest review of the g6. I am currently using the Medtronic Guardian Sensor and I have had so much trouble with it losing transmission with my iPhone 11. Have you had any trouble with the g6 losing communication with your mobile? Thanks, Denise

  6. Richard

    Hi Frank
    Thanks for your review of the G6. I currently use the G5 and am interested if you tried, or believe that you could re-set the sensor at the end of it’s 10 days, like the G5.
    I tend to reset each G5 sensor about 3 times and get 23-24 days reliable use before I have to replace it, largely because of the cost of the product.
    Do you think this would be possible on the g6?
    Cheers and thanks in advance.
    Richard

    • Richard

      Hi again,
      I think I answered my own question here by this further web search which indicated that:

      “10-day Wear (No Restarts!): This may be the most bittersweet of all — the fact that the water-resistant G6 has a hard shutoff at 10 days, compared to the previous generations labeled for 7-day wear but could be extended for days or even weeks beyond that by restarting the sensor. That’s not easily doable with the G6, despite a few scattered reports otherwise. Dexcom has actually designed the new thinner transmitter to be snapped into the sensor differently than prior generations. The little tabs that held the G5 transmitter in place within the sensor bed are gone, so this new G6 transmitter can’t easily be removed from the sensor bed without taking it off your skin first. The sensor bed actually bends downward in order to remove the transmitter, making it pretty near impossible to take off the transmitter and re-attach it.

      This inability to restart is a big deal for many out there. I tried to restart my first and second sensor unsuccessfully — both leaving the transmitter on and also trying (unsuccessfully) to take it off the sensor bed while it was still stuck to me. At the 10-day point, when the sensor shut down, I told it to restart without entering a new sensor code (agreeing that calibrations would then be needed, like with the G5). But despite a short glimmer of hope, when the G6 started the two-hour warmup, it declined the restart about 30 minutes later and demanded a new sensor. ImI sure DIY’ers will keep trying to fkfigu out ways to back the G6 by removing the transmitter, in restsrt attempts…TBD what happens there” https://www.healthline.com/diabetesmine/first-impressions-dexcom-g6

      The end result of this is that the G6 will be a complete thumbs down for me as an unsubsidised cost of these products is completely exorbitant. Probably a discussion for another forum, but now that the distributors have access to a subsidised market in Australia their monopoly sales volumes will have exploded, with no drop in price for unsubsidised customers – bad form AMSL!!! However, with the lack of competition we are hostage to whatever they charge!

      Thanks
      Richard

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