Dexcom G6 - no calibrations and other questions

This may sound like I’m living in ancient times by those of you in the Northern hemisphere, but I still use the Dexcom G5.
I also receive my supplies fully subsidised by the NDSS (National Diabetes Subsidy Scheme). The fully subsidised CGM is only available to those under 21, or who have a concessional status. (That is linked in via the Australian Govt income support, whom I receive a disability support pension through.)

Even though the G6 has been in Australia for a couple of years, it has not been available to me, unless I also used the Tandem T-Slim. A pump is well beyond my financial reach, so I’ve happily used the G5.
I have received notification that as of 1st March, G5 supplies will no longer be available in Australia, and I will automatically be switched to the G6. I’m happy about the slimmer profile, but I do have my concerns.

The calibrations that I do with the G5, are often out by a mmol or more. Now, I know that is within the allowances, but it makes a big difference when injecting insulin for me. I’m concerned about the fact that calibrations are no longer required with the G6.
If you have seen some of my other posts, you may be aware that I have a medically induced Generalised Anxiety Disorder, and I’m worried that this is not going to help me in that regard.

Does anyone have any experience with their G6 being out? Or whether you do fingerstick tests anyway?

I currently use 3 diabetes apps :roll_eyes: because none of the apps has all of the features I want to use, so I could record using the notes section in one, which is what I do when I calibrate now, so I can show my HP’s how out it is.

Another question I have is, is the G6 app better than the G5, and in what way?

Thanks in advance for your replies :blush:

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You can use the G6 in “no code” mode which does require calibrations (2 a day for the first few days, once a day thereafter). I find this to be more accurate than using it in “code/no fingersticks” mode (each sensor comes with a code).

I think it’s better mainly because you can edit event entries.

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Hi @SBee
I calibrate my G6. I think it is much more accurate that way.

There is a right way to do it, and a wrong way!

Do not enter the sensor code when you start the sensor. Whenever you start a sensor, it gives you an option to either enter the 4 digit sensor code which is on the sensor label, or not enter it. Choose the no-code option.

The Dex receiver or app will then warn you, “Okay you are not entering a code, that means you will have to calibrate. Do you understand?”

After that, calibration with the G6 is very much like the G5. Except it is twice in the first 24 hours, and then only once every 24 hours after that.

I think it is more accurate with calibrations. If you don’t calibrate, it never knows if it is very far off.

The main thing is to NOT enter a sensor code when you start the sensor. If you do enter a sensor code, calibrations don’t work very well.

Please reach out if you have any questions!

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I am not sure what you are basing this claim on. Perhaps this has been your personal experience, but it has not been mine. And the one thing I am sure of is that personal experience with a device can not simply be generalized without further supporting facts.

Yes, human beings think that if something is true for them then it will be true for everyone else. Everywhere. Always. It’s part of the nature of being a human being. But if anyone should know that this is not actually how the world works, I expect it would be a person coping with diabetes. :roll_eyes:

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@SBee Can you let us know what apps you use? I’m always looking for what & how others use apps.

I never used G5, so can’t address differences w/G6. But ref finger sticks, most of the time with G6 I check w/finger sticks once or twice the first day and apply a calibration its quite a bit off (20 pts+ with a G6 relatively flat line). Its 50/50 if day one is wonky and sometimes the last day or two…seems to happen every few sensors, though it might be site dependent as well. As I’ve said before: A man with one watch “knows” what time it is; a man with two watches is never sure! Same approach with BG readings! However, I trust my Contour Next One meter more than G6 most of the time; with it I can easily test twice if I question it and if they’re reasonably close I trust it’s accuracy! I only question the G6 once in a great while (6-7 weeks?). It seems every time I get to be very comfortable with the G6, a sensor/tranmitter goes stupid/wrong/off sufficiently to make me begin establishing trust again.

I too use multiple apps. I use the G6 app, Sugarmate app, and MyNetDiaryD (Diabetes version of the MyNetDiary). The G6 app is open all the time in order to feed data to the Sugarmate app. The Sugarmate app is what the Dexcom app should have been (from my perspective), providing all the data one could hope for (BG average, standard deviation, coefficient of variability, % in range, GMI, TDI, TDBasal, TDBolus, etc., and is selectable by the user). It also serves as my primary data storage/display of carbs eaten, gets feeds from Apple Health (exercise, et al), device changes, etc. MyNetDiary is for counting carbs (yes, I’m terrible at estimating carbs, so use this), fat & protein tracking (for possible additional bolus for them), plus I can load recipes into it (can import from most websites and be accurate), and can share it with my wife, who is great about using it for logging meals. Lastly, I should mention the Omnipod PDM/app, hoping to get everything on my phone with the O5, so only one device. While its still a different app, with the O5 phone app it may be I can stop having to have the G6 app open and just use the O5 app (not sure about this).

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@Eric, I know you and some others have said to not calibrate if you enter a code. I’ve never had a problem with doing both. I usually manually enter the code, because, anecdotally, using my camera hasn’t worked well; not that it doesn’t work, but I’ve gotten more wonky G6 results (though I know it shouldn’t make a difference how the code is entered). My experience is that it takes the calibration and the displayed BG mediates between its determined BG and my calibrated entry, ending up about the middle between the two. That one entry seems to make the G6 much better, though once in a while, I’ll need to calibrate once more and hour or so later. Most of the time, after that the G6 is with in “tolerances” of my Contour Next One meter readings.

Perhaps I’ve just been lucky….though that’s not my norm, by a long shot! Usually, “if it weren’t for bad luck, I wouldn’t have any luck at all!”

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I would definitely try one with the code and see if that works for you, before going the complete “nocode” route. My son gets excellent results with no calibrations. Honestly the last time he calibrated a sensor was a couple of years ago. But if you are one of the people whom the nocode doesn’t work well in, then calibrations it is. The G6 is quite a bit more accurate for us than the G5 was.

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Discussions with Dexcom.

Discussions with Dexcom.

I am sorry I disappointed you. But at least I attempted to answer the original poster’s question and provide some direction, instead of just going on about how someone else didn’t do a good job with their post.

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I fingerstick a lot anyway just because if I’m in a dynamic bg situation, any generation of the Dexcom hasn’t always kept up as quickly as I need for dosing or treating decisions.

But I am generally very happy with it. Day 1 tends to give wonky data. When the transmitter is nearing the end of its battery life, I get wonky data. Otherwise, it’s good for me!

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Placement of the sensor matters. I was having bad accuracy problems the first 12 hours. I moved placement from my abdomen to arm and the accuracy improved 100%. So if you have accuracy issues, try moving to another location.

I use the sensor code and rarely find a need to calibrate. But I think a lot of the depends on your body and how it reacts to the sensor.

It depends what’s going on, but I test way less than before.

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Could we approach each other with curiosity before eye rolls?

“Can you tell me more?” or “Why do you think so?” are helpful questions.

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Thanks for your replies @Eric @CatLady @TomH @jim26 @T1Allison @Chris. I now know more than I did yesterday, and this is why I love coming here to exchange ideas and knowledge!

I’m really pleased that I can still go the calibration option. This morning my g5 was over 3mmol/l higher than my fingerstick, which is why I was concerned. I’m still a couple of weeks off of being able to order g6 supplies, but that will give me more than enough time to get my knowledge base up a bit higher.

@TomH, I use dexcom, because my endo and team have access.
Xdrip, because I like the prediction and appearance, plus I can then have nicer watchfaces that aren’t all about diabetes.
Diabetes:M which I always used to use as my diary long before I got a CGM, and it also has an extensive food database and you can add your own foods. There is also a carb calculator, but I have questioned their calculations when it tells me to have insulin when I’m having a really low hypo, their response was that it was in line with the regulations for their European country, Bulgaria. They did switch to a subscription based app (I think there is still a free version though), but because I’ve been using it since they developed it, I was able to pay for an ad free license way back when and because the features that come under the subscription, aren’t things that I’ll use, I’m not needing to go in that direction

Thanks again for your help!

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I’ve never calibrated a G6. I use fingersticks in the first 24 hours because it can take up to that time to get in sync, though typically it’s something like 8 hours. I never tell the G6 the results. It is off by more than 1mM in my experience, but only outside the range 100-140mg/dL, which is 5.6-7.8, it’s pretty damn accurate within that range. This is relative to the Contour USB test strips (assuming they are called that in Australia); other test strips read different.

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I used G5 for a few years and have used G6 for about 2 years. Over the long run my experience has been the G6 is more accurate than the G5, at least the G5 calibrated by “me”. Although I tried to follow best practices, I would occasionally throw the G5 off with a poorly timed calibration. So no more of that with the G6. As far as the app goes, it seems to pick the signal up quicker than the G5 app although that might just be a function of having a newer phone.

I am in the third (or fourth, fifth…?) camp regarding calibrations. I enter the code, rarely calibrate and am overall satisfied with G6 accuracy after the initial 24 hours. During the first 24 hours and when BG is suspect (coming out of low or high) I will check with a fingerstick and base my treatment decisions on that fingerstick (but not calibrate). But if I check and confirm that my BG is steady in range and the G6 is off by more than I would like, I calibrate. But not during the first 24 hours.

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I switched from the G5 to the G6 about 2 years ago. I always use the G6 sensor calibration value. I also always check the sensor accuracy several times a day just to make sure. Some sensors are pretty bad and it would be crazy not to verify the accuracy. Most of the accuracy failures are false lows. So in summary I feel it is ‘false advertising’ to say that an accuracy check is unnecessary. If could also be very dangerous since I have also witnessed false, high readings. My A1C values are always in the 5.4 or 5.3 area so accuracy is very important.

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I use the G6 with the sensor code, and calibrate probably more than necessary. But, that’s just the “scientist” in me coming out. :laughing:
I never make a treatment decision without a finger stick. Again, that’s just me.

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Since cgm’s lag your blood glucose by 15-20 minutes, I usually only calibrate a g6 when I first wakeup (most stable, no carbs on board, no insulin on board, no influenced values from exercise, etc). I use the contour next meter so have I have trusted values provided to use to calibrate. I more often have to calibrate the g6 as it nears the end of life

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My type 1 diabetes also gave me severe anxiety. Before CGMs, I tested as many as 20 times a day and would be seized by the sense that I was having a severe low and was about to lose consciousness at unexpected times throughout the day that would sometimes spiral into full blown panic attacks. I still have anxiety but it is much better. Sometimes looking at my blood sugar reading from my Dexcom does what fingerpick testing used to do for me: avert the anxiety spiral.
I have no idea whether this would be of any help to you, but I trust my Dexcom G6. Like jbowler, I do not trust it much during the first 8-24 hours, but for the next 9 days I mostly just let it do its thing. I can’t say whether I’m less anxious because I trust my Dexcom or whether I trust my Dexcom because I’m less anxious.
To whatever extent possible, maybe you would benefit from trusting your new CGM? Trusting may not mean you go days without using test strips. You may still want to test each time you make a dosing decision. It might mean knowing that sometimes it’s off but that even when it’s off it will often go back to being more or less right and that it will help you in important situations (like when your blood sugar is dropping quickly.) Maybe you can notice that it’s off and do nothing about it in terms of calibrating. In my experience, my Dexcom is generally accurate, especially about trend arrows.
Don’t know if that’s of any use to you. I certainly don’t have the anxiety cure, but CGM has made my life more comfortable even though CGM is not always perfect.

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@TTnyc
What a great description of anxiety and how the CGM can help.

I also have anxiety, Generalized Anxiety, but it really is especially about medical/health issues having 2 chronic diseases, T1D and RA.

I still test BG every time I make a treatment decision, but I agree that trusting the CGM arrows gives a lot of reassurance. I do still tend to get anxious when the Dexcom acts wonky, but then I can finger stick to see what’s going on. Having those 2 “supports” is reassuring. I use a lot of test strips the day I start a new sensor, but once it settles in, I’m like you, I can relax and let it do its job.

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A similar thing happened to me yesterday. I started having a panic attack but perceived it as having low blood sugar. I didn’t whip out my cellphone because I didn’t want to disturb what was going on. Eventually I told my wife I was having low blood sugar and left the room. Outside I could instantly see I wasn’t; about 120 on the G6 and stable but I couldn’t figure out why I felt the way I did. It took me a while until there was a break and other people came out who I could talk to before I realized what was happening; I stayed outside until I had calmed down.

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