For the past couple months, I've been questioning whether I want to ascent my Dexcom continuous glucose monitor (CGM) to the in vogue generation, G5, which eliminates the need for the unintegrated iPod-style receiver. The G5 has built-in Bluetooth that lets IT communicate straightaway to a smartphone. Cool stuff, right?

But I've just recently decided not to go for the upgrade at this time.

Nope, or else I'm going to stay with the existing G4 system and its do-it-yourself CGM in the Cloud partners that avail go along my diabetes on track.

I'm going to tell you my Ternary Epic Reasons behind this decision, but let Maine preface that away clearly stating that I'm crazy in love with Dexcom, and appreciate everything they've reinforced and the improbable pace at which they are innovating. That truth stands irrespective how I feel about the G5, a now-realized generation of technical school that many of us in the Diabetes Community have been waiting on for a lank time.

This California CGM company has done more to exchange my life (and even save information technology), than any other diabetes company. I find the G4 accuracy to be spot-on most of the time and information technology has helped me recognize patterns and trends in my D-management that I might deliver otherwise lost… to my detriment.

Still, my passion for Dexcom isn't enough to convince me to upgrade and start using the G5 at the moment, given altogether I've seen and heard vicariously through press insurance coverage, Dexcom statements, and feedback from former PWDs (people with diabetes). Hither's why I am locution "No Thanks" to the G5 for at present:

1. PAST (translate, the G4)

The G4 is a solid piece of diabetes technology, so IT's supernatural to think that it's straightaway the 'older generation' of what Dexcom's offering. Not only did the G4 represent a huge jump in capabilities from prior generations, but the G4 assign Dexcom ahead of the whole industry in delivering reliable, accurate, user-friendly technical school.

Choose the Receiving system: I have the updated 505 software successful visible by Dexcom last class at this fourth dimension. That's the algorithmic program used in Artificial Pancreas research, and with IT, according to official stats the G4 delivers accuracy that is better than anything other like it (the first single-digit MARD score of 9.0%, compared to 13% in the previous model; the lower the result, the high the accuracy.)  Unlike more or less folks, I really do non mind wearing or glancing at the receiver, and I actually prefer that in many instances. Most of the time, I can leave it on my desk while I'm working. When I go taboo, I utilize the flip-agape blackened leather event and wear it on my bang without any complaints.

CGM in the Swarm: Since November 2014, I've also had been victimization CGM in the Cloud, aka Nightscout. Thanks to the Bluetooth-enabled Dexcom SHARE receiver that came exterior this past take a hop, I'm able to wirelessly send my CGM data to the cloud where I can share it with people in my liveliness WHO need to see it. My wife and I both wear Pebble watches and are able to view that data easily on our wrists (thanks to Nightscout and xDrip), something that wouldn't be doable with Dexcom SHARE itself or the G5 because it's iPhone-circumstantial and isn't workable for our Pebble watches.

2. PRESENT (see too, G5)

Remember, this is pretty stain lively radical. The G5 received Food and Drug Administration approving in deep August, much sooner than Dexcom had awaited! It started shipping in late September, and while some PWDs have started receiving their new transmitters, while others are nonmoving waiting, largely because Dexcom experienced early inventory problems and had to put G5 shipments on reserve. But in that location's already very much of info available well-nig what the G5 does and doesn't offer.

I'm a big fan of hearing to what others in the D-Profession have to say in constructive my decisiveness-making. I've read with interest some of the early reviews and impressions from friends in the DOC, like Adam Brown's improbably detailed review at Fulmination; First Impressions by Kerri Sparling at SixUntilMe; and a very insightful post past Scott Hanselman on "So much wasted potency"– as well as mentions on Chirrup, Facebook, and D-forums.

This post on a diabetes meeting place is partially what gave Maine pause about the G5:

"(My daughter) has been victimisation the G5 for about a week forthwith. I'm non affected. We are having a lot of issues with non getting any readings in my phone symmetrical though she is acquiring them on hers. If she goes from tell network to wifi, it takes at least 30 proceedings for it to reconnect. Also, I hate how it doesn't stand in for time where her phone was off. Like on the G4, when she's at school, she has her telephone set off and relied on the Dex pass receiver. As soon as schoolhouse ended, she'd change by reversal her phone on and the data for the last 6 hours filled itself in along the graph.

"That doesn't happen with the G5. She still uses the Dex receiving system at civilize with the phone off. Just now when she turns the phone on, it no more fills in those 6 hours on my phone. Just have a huge gap. I birth to smel at the Dex receiver to visualize the graph.  She is going away this weekend to a retreat. I'm not so self-assured that I wish be able to undergo what's going on. We've had way too many incidents of there being no readings on my telephone for no apparent reason. I already lack the G4 Share."

Supported entirely I've detected and well-read, there are some specific issues here take over persuaded me to outride with what I have:

  • Non for Android: I wear't use an iPhone, and I sustain nary interest in purchasing one specifically for Dexcom compatibility. Dexcom says IT's working on the Mechanical man app for G5 and that will be ready in 2016. Indeed it's at least few months out if not more, and I am not convinced that even with Android connectivity, I'm a fan of what G5 offers compared to what I have (see below).

  • Nightscout doesn't work: The colorful minds behind Nightscout and xDrip harbour't yet found a way to make the G5 work with the frame-up we've all come to recognize and love. Really, they say Dexcom has stoppered the door on this open-source share-out in the way the G5 transmitter straightaway communicates via Bluetooth. I am very disappointed to hear this, because I same such enjoy not only the Pebble take in views we have, only also features such as Raw Data, where we can see unfiltered CGM data during the tune-up multiplication and when those ??? appear. Lately, I've also been pleased to see my wife can get CGM notifications from the Dexcom SHARE app on her Pebble watch, similar to how I understand the G5 app alerts work.

UPDATE: The homemade CGM in the Cloud group has found a way to share G5 data, to some extent. Using what's called Bladelike CGM, you can make it so a Pebble app pulls data from the Dexcom CGM server and is displayed on the watchface. You wish still have to comport an iPhone/iPOD as the link bridge, since G5 is only miscible with Apple at the bit (Android's is happening the way for quondam in 2016). And with this setup, you don't give birth the ability to picture Raw Data displayed during the CGM warmup period or the unfiltered diabetes data.

  • Ternion-calendar month sender: I am related that the transmitter only lasts for leash months and shuts down soon after close to 112 days — unlike the G4 transmitter that has a 6-month warranty simply can last much longer (10 months for my first transmitter and 13 months on the second full cycle I've gone through). Dexcom confirms that due to the young Bluetooth and smarts inside, this extraordinary flashes a cautionary at 90 years, and on Day 112 it bequeath blinking off. Patc I understand why this lifecycle is so often shorter, I am nervous about that and want to avoid going there as long American Samoa possible.

  • Data gaps: I've read accounts from others who have victimised the G5 that they see more gaps in CGM information than they've experienced in the other. Dexcom even admits this, acknowledging that "Bluetooth can be trippy." This may vary for everyone based on phone and surroundings, but I don't like information gaps and want to make sure my CGM data is beingness communicated as information technology's supposed to.

3. Future tense

There's a newer G6 model that's only a year just about away! During Dexcom's third quarter earnings call held Nov. 4, the company talked about its unreal-term pipeline and all information technology has sledding along these years. I was very affected with what's coming soon. The next-gen G6 wish exist filed erstwhile in 2016, and will hopefully FDA realize favourable reception by early 2017 or maybe even the end of next class. This is large, as the next-gen sensor wish represent more accurate and may require even fewer calibrations. That's only a year or so away, so that's another factor motivating me to stick with the current model and maybe sporty bypass the G5 on the whole.

In fact, in the profits margin call, Dexcom declared some cool improvements to the G5 planned for the last mentioned half of next year: they'll be releasing a thinner version that will actually make up smaller than any of the Dexcom transmitters we've seen. It may not alter the three-calendar month product life issue, but at least information technology will no longer be larger than the G4, as it presently is.

Dexcom is as wel planning to release a current inserter system next year, and from the mock-up images we've seen, it looks pretty cool. The receiver will also be upgraded with a touchscreen and more nonclassical take care. The current G5 telephone receiver design is the selfsame as the G4, though As mentioned, it has a black-on-white expose instead of vice versa.

As we move toward that future, here's what I would ask Dexcom to consider for further updates to the G5 tech. In urging Dexcom to consider these changes, I refer to Ecstasy Brown's followup and suggestion tilt, and reverberation his POV.

  • Information filling: This doesn't appear difficult, IMHO. As I understand it, the G5 transmitter is calling unstylish BG results on a routine basis and both the receiver and smartphone are listening. If they miss a reading, it's gone into the abysm. But it'd be respectable if the receiver could nonmoving swear out as that middle man, pick up results and allowing the Dexcom G5 app on smartphones to communicate with the telephone receiver and find out that incomprehensible data.

  • Alerts: If someone has their ring on vibrate, please allow them to calm receive Low and High alerts happening their phone. Many of us favor this, and IT's a real problem if the alerts cease in the event that you don't have your telephone set on Audio. Patently, if you turn off wholly notifications on the phone, then information technology makes sentience you'd too follow turning off any CGM data alerts.

  • Low and Elated range lines, split up from the alerts: Often, I preceptor't want to get alerts whenever I go above the 180 mg/dL threshold. But I still want to glucinium able to see that arsenic my High dot on the CGM graph. Right instantly, when I switch off the notification, the top line goes away.

  • Landscape views: The G4 Follow app on my Android phone looks jolly, merely it only whole kit and caboodle when my phone is perpendicular. I am a lover of landscape mode, especially when looking CGM graphs, thusly please ready sure this is enabled for future apps.

  • Receiver display: OK, assuming few of us will still want to use the receiver in the future… is it practical to offer U.S. an pick of how colors appear on the shield? The new G5 now has a white background, but I know that when I wake up in a dark bedroom at night, not only would this fulgid segregated CGM display blind me just IT volition light upward the room and likely wake risen my married woman. Could I have the superior to keep the black background knowledge?

  • G4 access: Please don't cut off the G4 and push us to the G5 right away. We know you will eventually have to phaseout G4 weak the road, but please keep it as an option for those of us who may want to wait for the G6. We know that you (Dexcom) are integration your CGM with various pump models victimisation the G4, thus haven't announced any plans to eliminate it partly on that basis. Please don't change that.

Diabetes Innovation, I Appreciate

With every of the above said, don't get me wrong: I realize that  I'm part of the roughly <25% in the U.S. who even have access to CGM technology in the first put across. Many do non, and that's a work in progress.

And countenance's not bury this is all a very "Starting time World Trouble," whereas people in the Third World are lucky to get life-economy insulin in the first place.

AND I ut so very much appreciate the body of work Dexcom does in vibrating the phonograph needle forward on new tech and founding.

In person, from what I've seen, Dexcom has been able to bash what most others in the diabetes industry seaport't traditionally been capable to — work quickly and successfully with the FDA, keep a continued line of rising gadgetry disposable, and actually vary the way of life regulators and patients think about these important devices and tools in our D-lives. All the while, keeping up a successful business.

You have to commend them for all that!

But here's the thing: New bells and whistles aren't for everyone. IT's important to actualise that simpler product models may be best for some people. And with all the fast incremental upgrades these days, you tush't expect United States patients to jump happening every new role model en force.

This isn't the first time I've upset down the "latest and greatest" D-tech. In ahead of time 2014, I chose the Medtronic Minimed Paradigm Revel 723 pump instead of the more recent 530G — specifically because I didn't neediness to use the MedT CGM sensor that I didn't believe was As good as the Dexcom detector.

So I opted for the earlier generation, and always since I've had various companionship reps and doctors remark, "Oh, you can get the unexampled 530G now!" I just smile at them politely.

Patc we at the 'Mine are big on new products, introduction, new models for data-sharing, etc., the fact cadaver that as "empowered patients," I think every PWD needs to determine for themselves what's better for their diabetes world — latest generation or non.