FUDiabetes

Recommend how many times you restart Dexcom G6 sensor

@Eric
@docslotnick
I’m using Dexcom G6 with the Dexcom receiver (have Android phone) and have successfully restarted the sensors without any additional software. (I’ll put it below for those who are interested) My question is how many times do you think it’s healthy to restart, as in healthy for my arm (placement). I’ve done a 1 time restart on several sensors i.e. got 20 days out of it, but am worried if longer might start being “bad” for the tissue at that location. Anyone have an opinion?

Here’s the most simple way to restart:

  1. Let the sensor expire
  2. Do not remove the sensor
  3. Use receiver to start new sensor using No Code
  4. Wait 15 min (allow sensor warm up to run for 15 min)
  5. Stop session
  6. Restart sensor with that sensor’s original code
  7. Let it go through the 2 hour warm up and you’re good to go
    Here’s a link to a YouTube video that also describes it:
    https://youtu.be/JlS306O9xco
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Hi Jan,
I will tell you I am not a good resource for this. I will gladly tell you all I know about…things I know about. Things like running, or things like crazy forms of doing insulin and bolusing tricks. And all kinds of things like that.

But for Dexcom, I usually get only about 7 days worth or so, and then it falls off. I don’t treat my sensors well, so they don’t stay on.

So I do not have much experience for things like lengthy sensor wear.

Let’s call @Jen. She does a lot of extended stuff on her sensors. As far as it being healthy for the location, I am pretty sure the version of sensor does not matter. I think Jen uses G5.

But I think she would be a better resource for you on this topic, or any of the other people here who do extended wear.

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As far as I know, the sensor wire does not cause long-term tissue damage from being in, the issue is loss of accuracy because of biofouling / encapsulation from the tissue’s foreign-body response. (A key job of the highly-proprietary sensor wire coatings is to try to make the sensor “invisible” to the immune system.)

This is different from insulin infusion sites, where “scarring” (lipohypertrophy) can be caused by pumping insulin into the same spot for too long.

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@Eric - Thanks, I figured either you would know the answer or you would know who would know!
Just FYI, I am using Skin Grip adhesive patches over the sensor and they’re pretty sturdy and working well for me, but I’m not as active etc as you are. SKIN GRIP Dexcom G6 Adhesive… https://www.amazon.com/dp/B07G9QQJZZ?ref=ppx_pop_mob_ap_share

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@Jan The sensor will last as long as it gives good readings. You know it’s done when the readings start to get squirrelly, and look like a shotgun pattern.

I’ve found on me that’s about 12 days with the G5. I’ve got Medicare and have been able to build up a good supply of sensors, so I’m not worried about burning through them for an extra day or two.

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@bkh - Thanks for your reply. I never thought of it that way, thanks for pointing that idea out. It makes me feel more comfortable doing the extended wear of the sensors.

@docslotnick - Thanks for your experience. So far I’ve actually gotten 23-24 days from the sensors I’ve extended, and it’s just nice to not have to apply a new one. I had one that was a bad bleeder on insertion and it was maybe my 2nd sensor, and I don’t know why, but it gave me quite a scare. Silly really, but I’m a little anxious it will happen again, so extending them seems comfortable.

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I’ve had pretty good luck with data quality and accuracy of G6 sensors extended 2 or 3 times. My last sensor lasted 35 days. Have not really thought or researched much about any effects on tissue - the answer provided by @bkh is probably about as good as we know at this time. Couple of points to add to the discussion:

  • I use the Bluetooth Unpaired method documented by Katie DiSimone who has experimented extensively with various approaches and has found this method to be most reliable. Her entire write-up about this topic is very detailed and worth going through.

  • Using the same code for an extended sensor session does not guarantee accuracy because the sensor is factory calibrated for the first 10 days of use, and internal calibration parameters are functions of the day of use. If you enter the same code and do not calibrate the sensor manually, you are telling the system to use the parameters for day 1, while the sensor is actually on its 11th day. On an extended session, it is better to use manual calibration to improve accuracy. Personally, I do not enter any code for extended session - I just calibrate based on fingersticks (as one would do G5 or G4 sensors). This paper provides more relevant details: Factory-Calibrated Continuous Glucose Monitoring: How and Why It Works, and the Dangers of Reuse Beyond Approved Duration of Wear

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I was paying out-of-pocket for Dexcom for years, so I’d extend sensors as long as I could get them to go. The issue for me was always that the sensor died, never that my body had a bad reaction to it. And i have a pretty long history of reactions to infusion sets and tape and the like, so that fact that Dexcom elicited no reaction is pretty impressive. The longest I got a sensor to last was 46 days, I think. That one did develop a rash near the end, but I think it was because of the tape I used. On average, sensors were lasting me about 30 days (with me putting up with lots of dropouts near the end).

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@dm61 - Thanks for your info. My understanding is that the method described by Katie D is for iPhones and Apple products, which I don’t have. The method I use to restart sensors has seemed to work fine and I don’t even use a third party software or my Android phone.
Yes, I have learned that I do have to calibrate after restarting the sensor, and I check it frequently (probably use more test strips than necessary even with a new sensor). I’m new to CGM so I’m not sure I completely trust it yet. :face_with_hand_over_mouth:

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@Jen - What is your protocol for attaching the sensor since you are expecting long term use? Any special tips to keep it attached?
Are you still doing extended use? I’m thinking that if I can get 1 restart, or about 20 days out of the sensor, then I probably won’t push it. :hugs:

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I’m now using the Libre since my insurance covers it. But I may go back to Dexcom depending on what happens with pumps/looping in the next couple years.

With Dexcom, the built-in adhesive would last me about a week. As it started to peel up, I’d cut away the peeled-up pieces and put a piece of Hypafix tape over top that had a hole punched out for the Dexcom transmitter (I used an EK Tools punch purchased off Amazon that fit the size of the transmitter perfectly). I’d continue doing this as the tape continued peeling up. If it really started peeling, I’d put a piece of Hypafix tape over the entire sensor/transmitter, usually towards the end of 30 days.

If you don’t react to Skin Tac, I’d highly recommend that. You can “paint” it over top of the built-in adhesive and it’ll soak through and pretty much hold it in place without the need for any extra tape, in my experience. Unfortunately, I’m allergic to it and so using it results in the sensor dying within about 24 hours (due to the immune response, I think) as well as a horribly itchy rash that lasts a week or two.

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For what it’s worth, I’ve been using G4/G5 for close to three years. I always put the sensors in the same place and I get about 45 days out of each sensor. And I don’t mean roughly the same place as in “my abdomen” but exactly the same place, to the inch, though I switch from left to right with each new sensor. The tissue still looks and feels as good as new, and I see no impairment in readings from using the same location repeatedly.

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@Beacher - Thanks, that info is really helpful.

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I do not think that’s the case. My understanding is that the Bluetooth Unpaired method applies equally well to Dexcom on Android phones. I do not have an Android phone so I do not know for sure, but I do not see anything in that method that is Apple-specific or that would require any third-party apps.

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I’ve recently had success restarting G6 on my arm after a pretty bad 1.5 years of stomach use (and paying very little to Dexcom for sensors b/c of the high failure rate within 10 days on my stomach! It was the Dexcom technical support who suggested I talk with my endo about trying another location on my body to see if I could have success for more than 5-6 days!).

So my arm is working REALLY WELL. I just had a THIRTY DAY run on one sensor! And I only took it off b/c the adhesive was starting to feel a little gummy. The data was still looking good and consistent. Crazy, huh? I am only using my right upper arm as my damn left shoulder is still frozen and in incredible pain. (Yuck) I get the additional adhesive stickers through Dexcom and apply them when I put the new sensor on each time. You can request them through customer/tech service and they send you a 10 pack. They work very well for me.

Good luck to you! Jessica

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@JessicaD - I use the inside/back of my upper arm too. In fact that was the place the CDE recommended when I went for the CGM training. It has worked well there. I’m on my 2nd restart (3rd 10-day period) on my current sensor. I use Skin Grips which I usually put on when I do the 1st restart. Glad you found a good place for the sensor.

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I find that the G6 loses accuracy at about 15 days - it just stops responding to Bg chanages. (The G5 seemed to last longer, but was less accurate in general.)

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Discussions about the best way to restart a Dexcom session are better understood if the first two digits of the Dexcom G6 Transmitter are provided.

Otherwise it is possible there could be two different conversations going on without realizing it.

This is what I just tried with my G6 2nd restart (with 81xx transmitter). So it is on G6 sensor day 25, still quite accurate. I am simultaneously wearing my last batch of expired G4 sensors, and amazed at how often the G4 and G6 are within 10 points, and meter bg confirms. G4 sensor on day a 12.

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