The Dexcom G6 continuous glucose monitor stands as an indispensable tool for individuals managing diabetes, providing them with the means to meticulously track their blood glucose levels.

This cutting-edge device offers the capability to transmit real-time glucose readings seamlessly to either a smartphone app or an insulin pump. Notably, each sensor boasts an impressive wear time of up to 10 days, ensuring prolonged and convenient monitoring.

Within the realm of continuous glucose monitoring, the Dexcom G6 reigns supreme as the pinnacle of technological advancement. Developed by the eminent diabetes technology firm, Dexcom, headquartered in the heart of San Diego, California, this CGM represents a pioneering innovation. It distinguishes itself by introducing an unprecedented form factor, affording users direct-to-mobile app connectivity, thereby obviating the need for a standalone receiver.

The accolades for the Dexcom G6 don't end there. It has garnered recognition from the Food and Drug Administration (FDA) for its exceptional precision, to the extent that regular fingerstick glucose tests for calibration are no longer necessary.

Even if you haven't personally delved into the world of this influential and widely acclaimed diabetes device, chances are you've encountered it through compelling television advertisements or the memorable Dexcom Super Bowl campaign in February 2021.

This high-profile promotion featured none other than the renowned singer-actor Nick Jonas, a living testament to the efficacy of Dexcom's product in managing type 1 diabetes.

For those harboring curiosity about the Dexcom G6 and its myriad capabilities, rest assured that you've arrived at the ideal destination to gain a comprehensive understanding of this transformative diabetes management solution.

 

 What is the Dexcom G6?

The Dexcom G6, initially approved by the FDA in March 2018, represents a groundbreaking advancement in continuous glucose monitoring (CGM). Notably, it was the first CGM to introduce direct-to-smartphone app connectivity, offering users the option to forgo a separate receiver.

Here's a closer look at what makes the Dexcom G6 so exceptional:

Transmitter: This slim, gray component attaches to the sensor casing worn on the body, effectively serving as the system's brain. The G6 transmitter, 30% smaller and sleeker than its predecessor, boasts a remarkable 3-month battery life. Thanks to built-in Bluetooth connectivity, it transmits glucose data every 5 minutes to a smartphone app, a separate receiver, or compatible devices within a 20-foot range.

No Fingersticks Required: Unlike previous CGMs, the G6 eliminates the need for daily calibration through fingerstick tests, earning it a nonadjunctive designation from the FDA. This means it can be used for insulin dosing and treatment decisions without the backup of fingerstick tests. Remarkably, Dexcom provides the option for manual calibrations if users prefer additional confidence in accuracy.

Disposable Auto Inserter: The G6 introduces a user-friendly inserter design—a plastic, spring-loaded auto-applicator. All it takes is a simple press of an orange button to insert a new sensor, even accommodating one-handed insertions. Sensors are conveniently preassembled into the auto-inserter, minimizing exposure to needles. The disposal applicator piece automatically separates from the sensor upon insertion.

Sensor Code: Each G6 sensor features a four-digit code on the adhesive backing, which must be entered into the mobile app or separate receiver prior to insertion to activate the "no calibration" functionality. Failure to scan or input this code will result in the sensor requiring daily calibrations every 12 hours, as was the case with the previous G5 model.

Extended Wear: The G6 sensor offers a longer wear time of 10 days, compared to the previous model's 7-day duration. It's worth noting that there's a strict cutoff at the 10-day mark, preventing users from extending sensor wear, as was common with earlier versions. While some DIY methods exist to restart a sensor, these are considered "off-label" and not endorsed by the FDA.

Approved for Children: The Dexcom G6 is FDA-approved for use in children aged 2 years and older.

No Tylenol Interference: The G6 addresses the issue of interference from acetaminophen-containing medications (such as Tylenol), a persistent concern in the CGM realm. Special membranes on each sensor mitigate interference from these medications, reducing the occurrence of false high glucose readings.

Predictive Alerts: Users benefit from an "Urgent Low Soon" alert triggered by the G6 when it detects rapidly falling glucose levels, predicting a drop to 55 mg/dL within 20 minutes. This alert, mandated by the FDA, cannot be deactivated, unlike other G6 alerts and alarms that can be silenced.

Customizable Alerts: The G6 allows users to personalize alert preferences based on specific times of the day or night. It includes a "Do Not Disturb" feature for audible or vibration alerts, although important alerts like "Urgent Low" and "Sensor/Transmitter Failure" cannot be snoozed.

Dexcom G6 Mobile App: After a 2-hour warm-up period, the G6 mobile app displays real-time glucose results, featuring color-coded indicators for being "In Range," "Low," or "High." It provides trend direction with a visual arrow and presents a graph showing glucose values and other user-entered data like insulin, carbohydrates, or exercise. The app also offers the option to view up to 24 hours of data when the smartphone is in landscape mode and allows data sharing with up to 10 individuals or healthcare professionals through the Dexcom CLARITY platform.

Compatibility: The G6 app is compatible with both Apple and Android smartphones, although not with all models. Dexcom has a list of compatible devices, and it's important to note that the G6 doesn't yet directly transmit data to Apple or Android watches without the presence of the connected smartphone.

How accurate is the Dexcom G6?

When assessing the accuracy of the Dexcom G6 continuous glucose monitor (CGM), we rely on a standard metric known as the mean absolute relative difference (MARD). In the context of MARD, lower values signify superior accuracy.

Based on clinical data, the Dexcom G6 boasts an impressive MARD of 9 percent, maintaining this high level of accuracy throughout the sensor's wear time. This places it at the forefront of the CGM market, surpassing its direct competitors.

It's important to note that individual experiences may vary. Some users who have used both the Dexcom G6 and the Abbott FreeStyle Libre 2 have reported similar levels of accuracy.

 Dexcom CLARITY Software

Dexcom CLARITY software is an invaluable tool for tracking glucose data trends and sharing reports with your healthcare professionals. This web-based software, provided by Dexcom, is accessible online and via the Dexcom G6 smartphone app, and it comes at no cost to customers.

In the G6 app, simply switch your smartphone's orientation to a horizontal view, and you'll find a green icon with four vertical lines in the upper right corner. Clicking on this icon seamlessly takes you to the Dexcom CLARITY app.

CLARITY offers a comprehensive range of features, including the ability to view your average glucose levels over various durations, generate reports spanning from the past 24 hours to 3 months, and utilize comparison charts to assess your management during different periods. For instance, if you recently transitioned to a new insulin pump, you can easily compare your CGM data from the past month with data from prior weeks or months.

Two particularly popular features of CLARITY are:

1. Time in Range View: This feature displays the percentage of time your glucose levels remain within low, target, and high ranges. While the default "in-target" range is set at 70 to 180 mg/dL, you have the flexibility to adjust the Dexcom CLARITY ranges in Settings to align with your preferred targets.

2. Glucose Management Indicator (GMI): GMI provides an approximation of the laboratory A1C result you might expect based on your average glucose readings from the most recent 12 days of CGM data. While it's not an exact prediction, many find this feature helpful in gaining insight into their standing with respect to the 3-month average result.

Moreover, you can easily grant your doctor access to your CLARITY data. Simply authorize this through the app or the CLARITY website, allowing your doctor to log in at no cost and review your data.

Notably, the use of the CLARITY overview report can be billed to insurance, facilitating reimbursement for your doctor's interpretation and review of your CGM data, whether through Medicare or private insurers. The corresponding billing code, also known as the CPT code, is 95251.

 How much does it cost?

The cost of Dexcom CGMs can be covered by a wide range of private insurers in the United States. As of mid-2022, Medicare also includes coverage for the Dexcom G6.

However, it's important to keep in mind that the specifics of coverage can vary from one insurance plan to another. To determine your coverage and benefits, you will need to check with your insurance provider. Keep in mind that obtaining the Dexcom G6 transmitter and the sensor box requires a prescription, so you will need to collaborate with a healthcare professional before making a purchase.

In the past, Dexcom used to sell its systems and supplies directly through its website until spring 2021. However, the company has now transitioned to working with distributors such as Edgepark for online ordering.

 

Who is the Dexcom G6 right for? 

In a nutshell, the Dexcom G6 is a valuable tool suitable for individuals of all ages dealing with any form of diabetes, including expectant mothers with gestational diabetes. Managing glucose levels meticulously, particularly during pregnancy, is critical.

The advantages of using a continuous glucose monitor (CGM) like the Dexcom G6 are well-established. CGMs offer several benefits:

1. Preventing Severe Highs and Lows: They help individuals avoid dangerous high or low blood sugar episodes, especially those that pose immediate health risks.

2. Guiding Insulin Management: CGMs assist in fine-tuning insulin dosages and act as a safety net to prevent dosing errors.

3. Enhancing Safety: For those who may not sense impending low blood sugar (hypoglycemia unawareness), CGMs provide an added layer of security.

4. Optimizing Time in Range: By providing real-time glucose data, CGMs contribute to better diabetes management by increasing the amount of time spent within target glucose ranges.

5. Educational Insights: CGMs allow users to observe and learn from the direct impact of their dietary choices and physical activity on their blood sugar levels.

Furthermore, CGMs have become more than just medical devices; they are evolving into consumer wellness products due to their significant impact on overall health outcomes.

While CGMs benefit individuals across the diabetes spectrum, recent studies suggest that specific groups, such as teenagers, young adults, and older adults, may particularly reap the rewards. This is likely attributed to the convenience and practicality that CGMs offer in managing diabetes effectively.

Which other devices does Dexcom G6 work with?

In 2018, when the FDA granted approval for the Dexcom G6, it ushered in a new device category known as "iCGM" or integrated Continuous Glucose Monitor. This category is designed to seamlessly connect with various compatible devices, including smartphones, insulin pumps, and other wearables.

Presently, the Dexcom G6 is compatible with cutting-edge devices like the Omnipod tubeless insulin pump and the Tandem t:slim X2 insulin pump featuring Basal-IQ and Control-IQ closed loop functionalities. If you're uncertain whether your device can work with the Dexcom G6, you can easily verify compatibility on the Dexcom website.

What's even more thrilling is that the upcoming Dexcom G7 model promises to introduce advanced features and enhanced integration with automated diabetes management systems, heralding an exciting evolution in diabetes care.

Brand reputation and user reviews

Based on feedback from customer reviews on platforms like the Better Business Bureau and Trustpilot, the overall sentiment towards the Dexcom G6 is positive. Users generally express satisfaction with its ability to assist them in improving and managing their glucose levels effectively. However, several common complaints revolve around customer service, insurance claim processes, and delivery issues.

Many online reviewers praise the Dexcom G6 for its reliability and accuracy. However, some users report occasional challenges, such as transmitters not consistently lasting the full 90 days and sensors failing prematurely before the intended 10-day lifespan.

As a consequence, a frequent grievance centers on the need to invest a significant amount of time in reaching out to Dexcom's technical support, whether through phone calls, text messages, or online channels, to obtain replacement sensors, a process that can take 3 to 5 days.

Users often share valuable tips for optimizing their experience with the G6:

1. Ensuring proper hydration can lead to better glucose data and sensor reliability.

2. Preparing the skin with nasal allergy spray and a medical adhesive wipe before sensor insertion can help prevent skin irritation and prolong sensor adherence.

3. While it's possible to enter fingerstick readings to calibrate the G6, it's not mandatory. Entering multiple readings in a short time frame can confuse the CGM. Waiting at least 30 minutes after signal loss or recalibration attempts can help establish a more stable connection with accurate data.

Personal Experience: Personally, I have found the Dexcom G6 to be accurate and beneficial, particularly when it functions as expected. However, I often encounter sensor failures around the 5 to 6-day mark, resulting in only half of the intended usage period.

One standout feature is the "Urgent Low Glucose" predictive alert, which notifies me when my blood sugar is predicted to drop below 55 mg/dL within the next 20 minutes. This advance warning allows me to take action to prevent a potentially dangerous low.

Additionally, the redesigned auto-inserters have made inserting a new sensor much easier, especially when doing it independently. Compared to the older G4 and G5 inserters, which some users described as uncomfortable, the G6 inserter has received fewer complaints of pain.

However, one drawback for me is the larger size of the new applicator, making it less convenient to dispose of in homemade sharps containers compared to the older, thinner sensor devices.

Conclusion

The Dexcom G6 stands as the cutting-edge CGM solution in today's market, representing the culmination of nearly two decades of continuous glucose monitoring technology development by its experienced manufacturer.

This advanced system provides real-time glucose data, augmented by a suite of alarms and customizable alerts designed to predict and prevent potentially hazardous glucose levels. It empowers users to take a proactive approach to diabetes management.

With its user-friendly design, high accuracy ratings, and compatibility with a range of other diabetes devices, the Dexcom G6 presents itself as a compelling option for individuals living with diabetes.

Nevertheless, it's important to acknowledge that this level of innovation comes with a price tag, and occasional frustrations can arise when the product doesn't meet all expectations.