G6 location

I used my abdomen for location of Dexcom G4 for 5 yrs, G5 for 1 year & 2 years currently for G6. My abdomen received 1000s of insulin injections before pumping, I have surgery scars & have used my abdomen for 17 yrs of insulin pump cannula placements. I have been considering the use of other locations such as upper thighs & back of arms for the G6. If you have used alternative sites have you noted any changes in readings from the G6?

Mine seems to be equally accurate no matter where I place it. I have found some sites that are prone to excessive bleeding that soaks through the tape (I call Dexcom for a replacement when that happens) but otherwise no issues. Be aware of compression lows if you lie down on your sensor - there are some discussions that explain what those are.

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Hi Henry @Hen51 , you and I have had diabetes for about the same length of time and most probably injected in similar locations before moving to a pump - it is now my 16th year pumping. I’ve only been using Dexcom sensors, G5 and now G6, for less than 4 years.

Up until recently I’ve always situated my Dexcon in my abdomen, About two months ago, I placed a G6 on my right inner thigh and had wonderful comfort and good results for 10 days. The next sensor I inserted into my left thigh, mirrored to where the sensor was in my right thigh, and I felt discomfort the whole time it was there. It failed giving me consistent readings on the fifth or sixth day and then failed on the seventh. I went back to my abdomen and my reading duration and accuracy has been declining. My current sensor is in my right bicep on the back side and has been wonderful in all respects. I intend to put the next sensor in my left arm, but a little more facing in toward my body.

I’ll let you know how that one works.

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Thanks. I’m forced to sleep in recliner. Not much chance of compression.

So long as you’re comfortable and can rest, that’s what’s important. Perhaps placing a pillow to add some space between your sensor and the mattress might help prevent compression while sleeping in bed.

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I’ve only been on Dexcom for a few weeks. My abdomen is scarred, but if I’m careful about placing the sensor between scars, it works great. My Medtronic sensor worked equally well in my abdomen or the back of my arms. Occasionally I’d get compression issues because I sleep with my arm under the pillow. Usually it’s been okay. I use my inner thighs for injections because that’s where the fatty tissue is, but it hasn’t been good for sensors. Medtronic support said legs are a bad place for sensors and to only use abdomen and arms. So I’ve been keeping my pump cannula in my thighs and putting the sensor in my abdomen and arms. That’s worked pretty well.

Dexcom, unlike Medtronic, is only approved for abdominal use, but my trainer said arms should work just as well.

The fact that Dexcom sensors last 10 days (and the adhesive so far hasn’t caused the skin irritation I got from the Medtronic tape) means the area around my last site has time to heal before I need to reuse it.

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Haven’t slept in bed for 4 yrs after falling down stairs.

I’ve worn a dexcom for about 6 years. The g5 I could put anywhere on my abdomen or upper arms and it worked equally. I could get 10 days or more out of those sensors. Upon converting to the g6, I can only use an area 5 or 6 inches from my bell button or it fails prematurely. This is apparently not that common, but I’m not alone with that experience. Hope yours is better and the next sensors are less location sensitive.

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I placed the Dexcom G6 and infusion sets into my abdomen for almost 3 years and developed scar tissue. I was told to leave the abdomen alone for up to one year in hopes the scar tissue goes away. I’ve changed to a shorter infusion set cannula which has been so helpful. I now place the Dexcom into the back of my upper outer arms, but have trouble with bumping my arm against something causing it to bleed. I’m thinking of trying my backside, but am not quite sure how easily it will be to remove or insert. I don’t want to have compression problems which sound common.

I use a transmitter shield in case I get clumsy and bump against something - and an over patch to hold the cover in place. They come in different colors of you don’t want to be so loud and bold😊.

@wadawabbit, @Dennis…Hi–I’m back again looking through the site now that my hubby is Medicare age and this week his endo mentioned he may want to switch to the Dexcom/Tslim combo late this year when his Medtronic 670g is getting close to warranty’s end. She said it is much easier to use (we use iPhones too). While the G3 CGM seems to be consistent in duration, he still has the occasional blood at sensor site, causing immediate failure. Medtronic always has replaced them. The main issue is CONSTANT alarms, requests for BG checks, endless calibrations. The alarms wake both of us every night, usually several times (not necessarily for a hi/low, but for a BG check or yet another calibration). We were waiting for “Project Zeus” sensors to become available, along with the new 770g or 780g, but that seems to be in a perpetual hold mode. His BCBS Advantage supplement WILL pay for Medtronic supplies with the 15% DG copay, but Medicare approves of the Dexcom/Tslim combo, which may end up being cheaper due to longer duration of the CGM and fewer reasons for a finger stick. Anyway, now I’m reading your comments about the G6 failing prematurely, or declining accuracy, no matter where you place it. This gives me pause, as my hubby is built like you (Dennis), with not a lot of options where to place the CGM. My other question is related to the 10-day supposed time limit. The hubby currently uses a SimPatch over his G3 CGM. It has been a dream, and he was wondering if he could use the same type of patch over the Dexcom (his has no “hole” in it). I noticed that some patches allow the Dexcom to show a bit through a pre-cut hole. I could order those, but was thinking maybe it can be completely covered with no issue? The patch is great because clothes don’t snag on it, and the edges don’t peel when sweating or swimming. Perhaps an arm placement would be okay, but there is little fat there and he sleeps on his sides. Any thoughts or concerns about the major switchover after 20 years of Medtronic products? We need to know the correct questions to address beforehand! Many thanks!

I switched from Medtronic several years ago - I was using the “plain pump” and switched before they got their CGM. Dennis and others on the forum can give better comparison of their pump/CGM combo but I’ve never regretted switching. I did get quite a few overnight low BG alerts when I first started on CIQ - that was because we needed to tweak my basal rate: once that was done the alerts became far less frequent and we probably due to a larger than needed bolus for a night time snack.
I personally have not had accuracy issues - thankfully my sensor works equally well wherever I place it. Have @sufficient fatty tissue":blush: which might help.
Some (though not all) accuracy issues are due to compression lows - false lows caused by pressing on the inserton site, they return to normal once pressure is removed (quick and dirty explanation - the topic is well covered in the forums).
I’ve found my sensor stays in place well over the course of the 10 days, but being in the DMV where is hazy, hot and humid in the summer - as well as being a bit on the clumsy side and tending to walk a little closer to walls than I should - I often wear a shield and patch over my Dexcom (definitely when on my arm) - scroll up until you’re stopped by a big splash of pink. They are available in other colors.

The patches are available with or without a strap, through Amazon and eBay. I may have missed something but from what see I all have an opening rather than covering the sensor completely. I understand Dexcom has free over patches as well.
I understand Tandem will let you “try before you buy” - doctor would make arrangements via the pump rep. He might also want to see if he can try a sample sensor to see if there are any issues with the tape. Some people do report sensitivity and have come up with ways to minimize it. Better to find out in advance if you can.

UPDATE: I just removed my pics - I thought I was seeing double as I accepted through the thread and saw they were already included above, so I removed them here to save some space.

Welcome back Stephanie @Stephanie_Y , it is certainly to see you again. Youv’e asked a few questions and I’ll try to respond - let me know if I miss any.

I get the full ten days service from most sensors, and when I don’t, Tandem [an agreement between Dexcom and Tandem when a person uses Control IQ - CIQ] replaces any that fail early. A “bit” of blood does not hinder accuracy or life if the G6 sensor.

I’ve never need any tape to hold on a sensor even with hot-tub use daily; Dexcom supplies over-patches free of cost and has a dedicated web address for requests.

Alarms: In the year and a half since I’ve used G6, I haven’t had any “calibration alarms”. Except for old-man needing toilet disease, I sleep through the night without being disturbed. Occasionally, I will get a low-warning at 85 mg/dl after an evening when my BGL or unusual eating. I have my 9 PM to 9 AM “In-Range” settings at 85 to 145 mg/dl - much narrower than standard range settings.

I used MiniMed pumps, the Medtronic brand-name. for 18 years before mt Tandem t-Slim x2 to go with my Dexcom sensors - the changeover was simple and I found infusion sets exactly like the ones from Medtronic that worked well in my body. A very positive move for me, especially when the Control IQ [CIQ] algorithm that I was expecting rolled out January 2020. Since change 15 months ago, I’ve seen my TIR [Time-in-Range] increase. The Dexcom AGP reports I received today using the international TIR standard my 90=day TIR at 94.8% and 14-day at 96.0%.

@Stephanie_Y As someone who recently switched from 670g to T:slim & Dexcom, I can fill some things in.

First off: Some of those Medtronic alarms are optional. You can go into the settings and turn them off. It helped me a lot. (Sorry I don’t have the pump handy to go through the menus and tell you exactly where. It’s not the most obvious place. But if you dig around, you should be able to turn off calibration alerts.)

That said: It’s been a major upgrade for me. Dexcom is far more accurate and doesn’t require calibration at all. My first sensor was off for the first day, which had me worried. But since then, I’ve had no trouble. I still like to calibrate once a day just to be sure, but sometimes I forget even that, and it’s been fine. Whenever I have calibrated, it’s been right on track. (Except occasionally it’s a little off on the first day. Nowhere near as much as the Medtronic.)

Sensor insertion is easier and less painful. The adhesive doesn’t bother me, and it does stay on. Starting a new sensor is really easy. You just insert it, wait a couple of hours, and you’re set. With Medtronic, I often had blood at the site ruin the sensor or trouble getting the new sensor to start even warming up. Unplug the transmitter. Put it back on the charger for a few minutes to reset it. Plug it back in. Hope the green light flashes this time. Try again. That’s not an issue with the Dexcom at all. I also haven’t had issues with the sensor remaining attached. Moving around, sometimes the Medtronic adhesive would start to go and I’d need to add extra tape. Not with the Dexcom.

Come to that, you can do Dexcom insertion one-handed. No more of that fumbling around with getting the oval tape to go over the sensor plug and then line up the other oval tape so it covers the connection and then add a third party bandage over that just to be sure… Nope. With the Dexcom, you press the applicator against your skin, push the button, toss the applicator, click the transmitter in, and you’re done. Good to go for 10 days. (The one thing I don’t like is that every sensor comes with its own applicator, which means a whole lot extra plastic waste.)

T:slim also has a different algorithm. Like the 670g, Control IQ adjusts your basal rate every 5 minutes depending on your CGM readings. It’s a lot more quiet about it because it implicitly trusts the CGM, unlike the 670g’s constant alerts and requests for confirmation. But, in addition, it can give you a correction bolus once per hour. (Every bolus, whether manual or automatic correction bolus, resets the one hour timer.) So it can keep you in range on its own. 670g will alert you if you’re high, but it’ll ask for a BG reading before it’s willing to give you a bolus. Likewise, the T:slim will factor in your current CGM reading to its bolus calculations by default, instead of you needing to enter a BG reading into the 670g’s bolus wizard.

It’s also got “sleep” and “exercise” settings that change the target range for better control at night (although it won’t give you those extra automatic correction boluses, in order to prevent nighttime lows) or more of a cushion if you’re going to be burning off calories.

I want to say my “time in range” has improved. But that’s apples and oranges. 670g’s “time in range” is actually just time spent in Auto Mode and not a reflection of how much you’re within your target BG range. But my time in range with the T:slim has been around 85%, with an average BG around 140, and a lot less maintenance and attention required.

It’s been nice, too, having everything on my phone. (I know that’s the major difference between the 670g and the 770g.) My data is automatically uploaded for my doctor to review anytime, without my needing to manually connect through a desktop computer. I get my current CGM reading and graph in my phone’s notifications from the Dexcom app, and I get a graph of CGM readings, basal adjustments, and recent boluses on the Tandem app. (Word is they’ll be expanding it in the near future to allow for remote boluses through the app. Just waiting on FDA clearance.) You also get pump software updates when they’re released without needing a whole new pump.

My fingers are happier. The sensor is easier and more reliable. My sugars are better. I wake up much less during the night. It’s been great.

Just know that the process takes a while. There’s a lot of paperwork involved. It can take a month or two from your doc sending the prescription to you getting the new pump. And you can’t use the new pump until you’ve had a training session (currently remote, which I appreciate) to walk you through how to fill a cartridge and input your settings and all that. Because of the pandemic, that’s currently got a one month waiting list. I decided to make the switch in January and didn’t actually get to start using the new pump until April.

Hi @WearsHats. I needed some feedback from my trainer when I first moved to CIQ, and she suggested I use Tandem’s T:Connect app and share with her. I was using my pump to view everything and didn’t think I would have much use for the app once we were finished, but to my surprise it became my “go-to” - and I love using bluetooth so like you I don’t have to do those annoying cable uploads anymore🤪.
Here’s a recent screenshot. The phone graph gives 24 hours but since you have to swipe to see earlier readings they’re not included - and my current number appears at the top but didn’t make it into the shot. However, I believe this one app gives the data you referenced, all in one place. I do have to log into my account to see more history but it’s not a big deal.
One important caveat: when I first got the T:Connect app there was a caution not to use it for treatment decisions. That may have changed, I don’t know - I guess the others have received the cherished FDA approval for that while this one may not. Personally I’ve found everything matches my pump, but do check that out if you consider trying it.

Regarding training before you can use the pump, that’s true but FWIW there is an app called T:Slim Simulator that lets you try it virtually.

Indeed. I use both the Dexcom app and T:connect. Both show graphs of my BG values. Both upload data that my doc can view. But the Dexcom app shows that graph in my phone’s notification bar, which I find handy, and it makes it a little easier to scroll the graph and look at specific readings if I want to go back over what happened while I slept, for example. The T:connect app, on the other hand, gives information about boluses and basal adjustments that the Dexcom app doesn’t know.

I did review training materials and the the T:simulator app before official training. But I was specifically instructed not to start using the pump until I’d had one-on-one training with a human to walk me through everything and make sure I was doing it right. I was well used to using my 670g, I’d watched training videos from Tandem, I’d read through the entire user manual… It still took a couple of hours to go through everything with the Tandem trainer, and it was actually helpful to have her talk me through things like my first cartridge change and to answer the lingering questions I had which weren’t addressed in the user manual.

I mean, the Dexcom graph has less information, since it doesn’t get the basal and bolus data from the pump. The app’s privacy settings won’t allow me to take a screenshot, either.

The sensor takes a reading every 5 minutes, which is then relayed to the pump and the Dexcom app, and the pump relays data to the t:connect app as soon as it gets it. So it’s all up to date. I’ll get the same number in all three places (pump screen, and both apps).

But the Dexcom app has two advantages. The main one is that when I swipe down to view my phone notifications, without needing to open the app, I get the graph and the latest reading. They’re always there, a single gesture away.

The other is that if I open the app and scroll the graph, it will give me the CGM value for any point I touch. I can see on the t:connect app where it was high or low. Above or below the threshold. But when I was running high last night and it stayed above the threshold for a while, was it pushing 250 or was it closer to 200? It’s not always easy to make out on the t:connect graph. The Dexcom graph will give me the exact number* for any reading from the last 12 hours.

*Exact CGM number, which it’s important to remember could be off by 20%. So if your BG is 250, the CGM could show anything from 200-300 still be considered on track. But it’s usually much closer than that. Especially if you’re looking at a gradual arc rather than a sharp spike.

So I just find it handy to have both apps running, even though the pump app has the same CGM data plus the dosage data.

Thank you for the additional info!

@Dennis @wadawabbit @WearsHats … Thank you all for welcoming me back and answering my endless questions with thought and experience. I have passed this all along to my hubby Dale and will urge him to peruse this site. It’s all good information for someone who is seriously considering a switch, and I believe that will indeed happen, based on everything we have read about your experiences! You all are so helpful! Will keep you posted in the months to come!

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Seconding the use of both Dexcom’s Clarity app and the Tandem t:connect app. Of course you want the pump information that the Dexcom doesn’t know, but we strongly prefer the Clarity display. Larger, cleaner, clearer, more detail, and more useful graphics IMO.

Incidentally, if anyone out there is considering the Omnipod versus the Tandem, we also prefer the Omnipod display to Tandem’s (still using both the Dexcom Clarity app and the Omnipod display app together so we can have the insulin dosing data, too). I’m very interested to see how Omnipod and Dexcom choose to handle that when Horizon/Omnipod 5 finally does comes out.