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Dexcom G4 or G5?

H

Hawra1981

Member
Messages
7
Type of diabetes
Type 1
Hi all,

This is my very first post here. I need some help please! I am T1 and I am struggling with hypos. Very minor exercising, like riding my bicycle to work etc, would rapidly give me a hypo both at that time and also half way through the night while I am a sleep! I also inject myself at least 8 times a day to keep it under control.. I am on high-fat-low-carb diet.. In short I could say that I have no life... really.. life is a struggle for me due to all the quick changes that take place in my BG levels..

Now my question is: I am considering pushing myself financially and getting either the Dexcom G4 or G5. The quotes I am given by Dexcom are £815 for the G4+ a 4 sensor pack and £680 for the G5 again with 4 sensors. But the G5 transmitter reportedly needs replacement after 3 months (costing £200!!) while the G4 has 6 months warranty/ duration with it. Now, what are your experiences with these? How long has your transmitter lasted for? Which one do you use? And also what about the sensors? How long do they last? I work abroad so I need to self-fund this myself even though it would be really hard for me but I have no option, I want this device because I can set the alert and it alerts me when my levels reach a certain low or high..that is what I need! I also suffer from neuropathy and this worsen's with highs or lows so this device would change my life! I would be grateful for any advice that anyone can offer on how I can save money.. or what my best options are? Many thanks in advance..
 
G4 transmitter normally lasts at least 12 months most find it lasts 14months. G5 I think I read somewhere on the forum it lasts 100 days. Sensors you can restart after the 7 days and most people get about 21 days out of a sensor.
G4 reads about 20 mins behind your actual blood sugar and I think but not 100% sure the G5 is in real time.

Have you asked for a pump? If not do so and go for the Vibe as you can then use the G4 with the pump as it has a built in sensor. Or ask about the Medtronic pump as that has CGM capability as well.
 
Hi @Hawra1981

I second the Vibe insulin pump recommendation, if you're eligible. I love mine

Can I ask how long you've been diagnosed? If you're counting carbs and adjusting your insulin to match? And if some of your 8 injections a day are correction doses?

There may very well be things you can change that will reduce the amount of hypos you're having and give you back your life
 
Hi @Hawra1981 I'm going to suggest that you speak to your clinic about your issues and then try for the SmartGuard capability on the Medtronic 640G as it is probably more useful for you than plain CGM. You can set it to suspend your insulin before you are Hypo and it does a great job of ensuring that you don't have them. I would definitely discuss this whole issue with your team though, as they will listen and tell you what they can do to help.

Have you, for example, done the DAFNE course?
 
hi all, thanks a lot for your replies. The problem is that I work abroad and so I can't go to my clinc as I used to.. and I don't think that they will fund me if I work abroad, right? Now yes some of the doses I have are correction ones, I carb count and I have been diabetic for about 7 years..

I know, I would love a pump but I can't affored that and a CGM together! . Actually I even contacted the Vib supplier but they said they won't sell it to private funders! Not that I can afford it to pay it all at once!! OmniPod is one option but again the monthly cost of the supplies are too high for me.. so I am
left with Dexcom but I don't know which one I should go for? The G5 or the G4? I can't pay £200 for a G5 transmitter every 3 months.. but then again the starting cost of the G4 is a bit too much as well.. thanks a lot again everyone..
 
@Hawra1981 I'asked about the corrections because I wondered if some of the hypos were due to over-corrections (easily done because highs are annoying). I also wondered if you'd done a basal check recently. My basal amount changes throughout the year, maybe 3 or 4 times a year.

I'm not sure about provision of pumps if you're working abroad. I think it would depend on individual circumstances. It's worth investigating anyway.

Keep checking back here for more responses from Dexcom users
 
Hi Azur, thanks a lot for your reply . Well, yes I have tried to readjust the units I inject etc.. I have tried pretty much everything that I have found. Before I travel abroad, I was in contact with my clinic and consultant for this issue very regularly. Apparently I didn't qualify for a pump at that time because I could treat my own hypos and I have never called an ambulance for that reason! This is unfair because I treat my own hypos as soon as I have one in order to avoid calling an ambulance! So basically one has to be good at it and I am not!! I am not suggesting that all pump users have exaggerated their case but just saying that the system is really not too fair as I don't want to call an ambulance if I can avoid it! I think in short, my body is very sensitive to insulin so I need little insulin but frequently to avoid hyper.. if I inject anything more than 4 units of rapid acting , I will have a hypo 3 hours down the line.. and that also means that I cant have more than 40g of carb per meal because I carb count and that is the ratio! Complicated, I know! Sorry to bore you with this. I hope someone can share their experience of using Dexcom soon..
 
You're not boring me at all @Hawra1981 Type 1 is a tricky beast and it's always interesting to discuss people's control methods and issues

I had a similar issue with my breakfast a few years ago. I'd be high afterwards (11 or 12), correct and then go low. I was able to solve this in what seemed like an amazing way by moving my pre-breakfast bolus earlier. I now have a spike in the 6s and have also been able to,reduce the amount of insulin I take for that meal.

I've had Type 1 22 years and I'm still learning ways to perfect control Pre-bolusing is one of my favourite discoveries as the results are so good.

I'm going to,tag @TorqPenderloin for you as he uses Dexcom
 
Hawra1981,

I was diagnosed a couple of years ago now and have heavily relied on CGM's. I also work abroad and travel a lot. I haven't tried a pump, but I would recommend the CGM route as it really helps with 'cause and effect' of blood sugar management.

I first tried the Freestyle Libre, which is very good, but after a while I developed a skin reaction to the sensors. Then at about double the price moved onto Dexcom G5 this time with no complications.

CGM's have really helped me understand the cause and effect of insulin, exercise, carbs and have helped avoid hypo's and have kept my HBA1c numbers down.

For the G5, the transmitter does need replaced after 12 weeks, sensors last for 1 week. In all the total cost for the year is working out at over 4000GBP. This assumes though that you wear them 100% of the time. You may find that after some time your confidence grows and you need them less. It is nice that it works with your phone and you can set up alarms to warn of low blood sugars and potential hypo's.

I'd start with the Freestyle Libre, start up costs are much less and it gives you a good idea whether it is for you. I think the starter pack is about 160GBP and will see you through for the first 4 weeks.

Good luck,

Mike
 

I think your consultant might be misinterpreting the guidelines/criteria for accessing a pump, certainly no one mentioned requiring third party assistance for hypos as any kind of pre requisite to me - visit the input diabetes page for a review of what the criteria actually are - http://www.inputdiabetes.org.uk/alt-insulin-pumps/

I use a dexcom G4. You get ~12 months out of the transmitter. I usually get a good three weeks out of a sensor. You also have to buy a receiver. You can do more things with a G5, transmitter lifespan is limited, but you don't need to buy a receiver. In terms of accuracy, wearability, usefulness etc I've only got good things to say.

As for bolus issues - have a look at bolus timing - http://www.diabetesselfmanagement.c...blood-glucose-management/strike-the-spike-ii/ and maybe "sugar surfing" by Stephen ponder, which probably makes more sense on CGM.
 
Just a quick note on what catapillar said, you don't need a receiver for the G5 (as you can use the bluetooth on your phone) but the folks at dexcom won't sell you the G5 transmitter unless you have one... they keep records of what they have sold seemingly.

I tried to buy without and failed.
 
Hi Mike,

Thanks a lot for that. In fact I didn't mention that I am using the Libre right now and it has helped me. But because often I am busy, by the time that I check, my BG has already reached 3 or less or even 12!! But I want the Dexcom because it alerts me before I reach those kind of levels.. I did try the Dexcom once for some 2 weeks. It was provided by my clinic for a trial and it really helped me to keep my numbers in really good ranges.. tho later the consultant told me that my numbers are very good (didn't see the need to apply for this on the NHS!) but not realizing that it was actually the devise that helped me to keep my numbers in check because I had set the alarm.. anyway now, the Dexcom G4 transmitter lasts for at least 6 months, so wouldn't that make it a better option financially than the G5 for me? Also I have heard that you can "restart" the sensor after 1 week for up to 3 weeks.. so you may be able to save some money there!
 
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Ahh ok thanks. What is better for me financially then? G4 or the G5?
 
Hi again Hawra,

On a personal level I like being able to just use my phone to check levels and leave the receiver at home. I hate the amount of stuff we have to carry around and try to keep it as minimal as possible so I don't have to take a bag everywhere.

I stick to changing the sensors every week to allow movement of sites, mainly because of sensitive skin. I'm desperately keen to avoid the same problems I had with the Libre.

Anyway, hope you find a solution that suits....
 
Thanks a lot catapillar. So I think my understanding is that the G5 is more economical since the transmitter lasts longer. Am I correct? For me, the ability to use it with phone etc (the G5) is not as important as being able to afford it.. so maybe the G4 is a better option for me as I don't want to buy like 4 transmitters a year? I will also have a look at those sites again, thank you, tho to be honest I have done lots of research and have all around the Input side but Thanks again . Please let me know what you think that I should go for, the G4 or G5?
 

I think you mean G4 more economical? Which is probably correct. I think @tim2000s might have some insight on whether you can get away without having to buy a receiver for the G5.

I'm afraid it's pretty individual. G4 v G5 - very much depends on what you want out of it. I have just bought a G5 transmitter today because I want to have a try at using xdrip etc. But if you don't want to do that and are happy with the receiver (I've never been bothered by carrying round the receiver, I just sling it round my neck) then the G4 probably makes more sense cost wise.

PS have you contacted input? It might be worth getting in touch with them if you email they will come back and they are always brilliantly helpful.
 

Hi Hawra,

I'm a bit late into this thread, but having used a G4 for the last year I'm able to share my experience plus detailed costings that I've done for G4, G5 and Libre.

I'm been T1 for 47 years and have been well controlled despite no help from modern technology in the "early days", and as a result I have no complications. I used to have HbA1c around 8% to 7.5% and then 4 years ago decided to get up to date with self management so taught myself carb counting and started bolus doses based on ratios and correction factors. My next few HbA1c dropped into the < 6.5% region so I was well pleased, and I had also dropped carbs from ~140g/day down to ~100g/day and still have enjoyable meals.

So a year ago I decided I would try a CGM, and was aware of the Libre and since it sounded much cheaper, decided to go for that. However Abbott had major sensor supply issues during 2015, so I gave up and went for Dexcom G4, although didn't fully realise what were the main cost and functionality issues at that time. But... I do NOW.

Although I am generally well controlled, I have another, and rare, autoimmune disease called vasculitis, which means inflammation of the blood vessels. This inflammation, like infection, causes my BG to vary day to day, and sometimes I experience rapid BG drops in early morning, and with the G4 Low Alert set to 4, it vibrates and alarms on my bedside table and awakes me every time. I'm OK down to about 3.5, so quick Jelly Baby x2 will soon push me back up to ~6. So for 'me' it is the Dexcom Alarm which totally overrides anything else. I rate the G4 a brilliant tool, not only due to alarm function, but the visilibity to allow me to pre-bolus by up to one hour ahead to reduce spiking.

I have done some detailed costings which I will post next, but in the meantime, if you can make a G4 sensor last for 4 to 5 weeks like I can, then annual cost of G4 and Libre (with no easy alarm option) is about the SAME ...~ £1,300.
 
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Here are the costings and you can see that G4 & G5 are dominated by how long you can make the sensors last. My average sensor life so far is 4.5 weeks, and it seems that many can get between 2 and 4 weeks, and up to 10 weeks in a few cases. My first sensor lasted 8.5 weeks and is my best to date. Keeping good adhesion is key and I use Skin Tac to stick down any peeling edges after a week or so. Plus I use Tegaderm with a hole cut in it to put over the original G4 pad. Also it seems that have good control appears to extend the sensor life.

The costing table assumes the Receiver will in fact last 2yrs, even though it is only warrantied for 1yr. Dexcom incorrectly advised me that Receiver warranty was 2yr in Uk but 1yr in US, which was incorrect. But it means they will run for 2yrs so I've costed it that way.
 

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