Testing the Dexcom G6 CGM: Setup

I have written many times before how I have been using the FreeStyle Libre “flash” glucose monitor, and have been vastly happy with it. Unfortunately in the last year or so, Abbott has had trouble with manufacturing capacity for the sensors, and it’s becoming annoying to procure them. Once already they delayed my order to the point that I spent a week going back to finger-pricking meters, and it looked like I might have to repeat that when, earlier in January, they notified that my order would be delayed.

This time, I decided to at least look into the alternatives — and as you can guess from the title, I have ordered a Dexcom G6 system, which is an actual continuous monitor, rather than a flash system like the Libre. For those who have not looked into this before (or who, lucky them, don’t suffer from diabetes and thus don’t spend time looking like this), the main difference between these two is that the Libre needs to be scanned regularly, while the G6 sends the data continuously from the transmitter to a receiver of some kind.

I say “of some kind” because, like the Libre, and unlike the generation I looked at before, the G6 can be connected to a compatible smartphone instead of a dedicated receiver. Indeed, the receiver is a costly optional here, considering that already the starter kit is £159 (plus VAT, which I’m exempt from because I’m diabetic).

Speaking of costs, Dexcom takes a different approach to ordering than the Libre: it’s overly expensive if you “pay as you go”, the way Abbott does it. Instead if you don’t want to be charged through the nose, you need to accept a one year contract, for £159/month. It’s an okay price, barely more expensive than the equivalent Abbott sensors price, but it’s definitely a bit more “scary” as an option. In particular if you don’t feel sure about the comfort of the sensor, for instance.

I’m typing this post as I opened the boxes that arrived to me with the sensor, transmitter and instructions. And the first thing I will complain about is that the instructions tell me to “Set Up App”, and give me the name of the app and its icon, but provides no QR code or short link to it. So I looked at their own FAQ, they only provide the name of the app:

The Dexcom G6 app has to be downloaded and is different from the Dexcom G5 Mobile app. (Please note: The G6 system will not work with the G5 Mobile app.) It is available for free from the Apple App or Google Play stores. The app is named “Dexcom G6”

Once I actually find the app, that is reported as being developed by Dexcom, I actually find Dexcom G6 mmol/L DXCM1. What on Earth, folks? Yes of course the mmol/l is there because it’s the UK edition (the Italian edition would be mg/dl), and DXCM1 is probably… something. But this is one of the worst way to dealing with region-restricted apps.

Second problem: the login flow uses an in-app browser, as it’s clear from the cookies popup (that is annoying on their normal website too). Worse, it does not work with 1Password auto-fill! Luckily they don’t disable paste at least.

After logging in, the app forces you to watch a series of introductory videos, otherwise you don’t get to continue the setup at all. I would hope that this is only a requirement for the first time you use the app, but I somewhat don’t expect it to be as good. The videos are a bit repetitive, but I suppose they are designed to help people who are not used to this type of technology. I think it’s of note that some of the videos are vertical, while other are horizontal, forcing you to move your phone quite a few times.

I find it ironic that the videos suggests you to keep using a fingerstick meter to take treatment decisions. The Libre reader device doubles as a fingerstick meter, while Dexcom does not appear to even market one to begin with.

I have to say I’m not particularly impressed by the process, let alone the opportunities. The video effectively tells you you shouldn’t be doing anything at all with your body, as you need to place it definitely on your belly, but away from injection sites, from where you could have a seatbelt, or from where you may roll over while asleep. But I’ll go with it for now. Also, unlike the Libre, the sensors don’t come with the usual alcohol wipes, despite them suggesting you to use it and have it ready.

As I type this, I just finished the (mostly painless, in the sense of physical pain) process to install the sensor and transmitter. The app is now supposedly connecting with the (BLE) transmitter. The screen tells me:

Keep smart device within 6 meters of transmitter. Pairing may take up to 30 minutes.

It took a good five minutes to pair. And only after it paired, the sensor can be started, which takes two hours (compare to the 1 hour of the Libre). Funnily enough, Android SmartLock asked if I wanted to use to keep my phone unlocked, too.

Before I end this first post, I should mention that there is also a WearOS companion app — which my smartwatch asked if I wanted to install after I installed the phone app. I would love to say that this is great, but it’s implemented as a watch face! Which makes it very annoying if you actually like your watch face and would rather just have an app that allowed you to check your blood sugar without taking out your phone during a meeting, or a date.

Anyhoo, I’ll post more about my experience as I get further into using this. The starter kit is a 30 days kit, so I’ll probably be blogging more during February while this is in, and then finally decide what to do later in the year. I now have supplies for the Libre for over three months, so if I switch, that’ll probably happen some time in June.

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