Dexcom 9496 Spread Spectrum Device User Manual Part 1

Dexcom, Inc. Spread Spectrum Device Part 1

Contents

User Manual Part 1

User GuideCONTINUOUS GLUCOSE MONITORING SYSTEM
IMPORTANT CONTACTS AND NUMBERSEmergency Phone Number: ______________________________________________Your Healthcare Professional: _____________________________________________Your Receiver Serial Number: _____________________________________________Your Transmitter Serial Number: ______________________________________________________________________________________________________________Dexcom® Technical Support/Patient Care Team: _______________________________Dexcom Website: ______________________________________________________Nearest Hospital: ______________________________________________________ ___________________________________________________________________1.877.339.2664dexcom.com
1Dexcom G5 Mobile System User GuideTable of ContentsPart 1: Getting StartedGlossary 5Chapter 1 - Beginning Your Dexcom G5® Mobile Continuous Glucose Monitoring (CGM) System Journey 91.1 Introduction ............................... 91.2 Self-Paced Resources ...................101.3 Your Dexcom Account ....................12Chapter 2 - Indications for Use and Safety Statement 152.1 Introduction ..............................152.2 Important User Information ..............152.3 Safety Statements .......................162.4 Overview of Safety Statements ..........172.5 General CGM System Warnings .........202.6 Calibration Warning and Precautions ....202.7 System/Hardware/Software Warnings and Precautions ...............................22Chapter 3 - Risks and Benefits 293.1 Risks ......................................293.2 Benefits ...................................30Part 2: Let’s G5®! The BasicsChapter 4 - What Is the Dexcom G5 Mobile CGM System? 354.1 System Description ......................354.2 Safety Statement .........................354.3 The Dexcom G5 Mobile CGM System ...364.4 What’s New to the Dexcom G5 Mobile CGM System? ............................384.5 System Information ......................394.6 System Components .....................394.7 Smart Device Overview ..................48Chapter 5 - Set up Your Display Devices ... 495.1 Introduction ..............................495.2 Safety Statement ......................... 495.3 Why Different Monitoring Methods? .....505.4 Dexcom G5 Mobile App ..................505.5 Dexcom G5 Mobile Receiver .............63Chapter 6 - Starting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session 696.1 Overview .................................696.2 Safety Statements .......................706.3 Prepping for Sensor Insertion ............726.4 Choosing Your Insertion Site .............756.5 Inserting Your Sensor ....................766.6 Attaching Your Transmitter ..............806.7 Loose Sensor Pod ........................816.8 Starting Your Sensor Session ............ 826.9 Receiver Bluetooth® Tips ................866.10 Sensor Session Warmup .................90Chapter 7 - Calibration 917.1 Introduction ..............................917.2 Calibration Overview .....................927.3 Safety Statements .......................937.4 When to Calibrate ........................957.5 Calibration Prompts ......................967.6 Preparing for Calibration ............... 1007.7 Ready? Set? Calibrate! ................. 1007.8 Calibration Errors....................... 106Chapter 8 - Ending Your Sensor Session and Transmitter Session 1098.1 Introduction ............................ 1098.2 Safety Statements ..................... 1108.3 Ending Your Sensor Session ........... 1108.4 Remove Sensor Pod and Transmitter .. 1248.5 End of Transmitter Battery ............. 126Part 3: Next Steps - Getting the Most out of Your Dexcom® CGMChapter 9 - Home Screen, Rate of Change Arrows, and Errors 133Table of Contents
Dexcom G5 Mobile System User Guide2Table of Contents9.1 Introduction to Home Screens ......... 1339.2 Safety Statements ..................... 1339.3 Overview of Home Screen ............. 1349.4 Rate of Change Arrows ................ 1469.5 Error Messages ........................ 147Chapter 10 - Daily Events Affect Your Glucose Trends and Patterns 15310.1 Introduction ............................ 15310.2 What Is an Event? ...................... 15310.3 Entering Events ......................... 16210.4 Viewing Events ......................... 170Chapter 11 - Sensor Glucose Alarm and Alerts 17311.1 Introduction ............................ 17311.2 Safety Statements ..................... 17411.3 Alarm and Alerts ....................... 17511.4 Alarm and Alerts Screens .............. 17711.5 App: Alarm/Alert Recommended Settings ................................. 18311.6 Receiver: Default Beeps and Vibrations ............................... 18411.7 Clearing Alarm/Alerts .................. 188Chapter 12 - On the Go With G5: Customizing Your Alarm and Alerts 19112.1 Introduction ............................ 19112.2 Safety Statement ....................... 19212.3 Changing App Alarm and Alerts ....... 19212.4 Changing Receiver Alarm and Alerts .. 204Part 4: Everything Else G5Chapter 13 - Warranty: The Fine Print 21513.1 Introduction ............................ 21513.2 Receiver Warranty Information ........ 21513.3 Transmitter Warranty Information ..... 21713.4 Dexcom’s Obligations Under the Limited Warranty ................................ 219Chapter 14 - How to Take Care of Your Dexcom G5 Mobile CGM System 22114.1 Introduction ............................ 22114.2 Basic Maintenance ..................... 22214.3 Storage ................................. 22614.4 Checking App and Receiver Information ............................. 22714.5 System Disposal ....................... 228Chapter 15 - On the Go With Dexcom G5 Mobile CGM System: Getting Through Security 22915.1 Introduction ............................ 22915.2 Going Through Security ................ 229Chapter 16 - Need Help? You’re Not Alone! 23316.1 Dexcom Technical Support ............ 23316.2 Patient Care Team...................... 23416.3 Sales Support Team .................... 23516.4 Corporate ............................... 235Chapter 17 - Technical Information 23717.1 Device Performance Characteristics .. 23717.2 Product Specifications ................. 27517.3 FCC Requirements ..................... 283Chapter 18 - Troubleshooting 28518.1 Introduction ............................ 28518.2 Safety Statements ..................... 28518.3 Troubleshooting ........................ 287Chapter 19 - Symbols on Package Labels 299Part 5: Sharing Is CaringChapter 20 - Dexcom Share™ 30320.1 Learning About Dexcom Share ........ 30320.2 Dexcom Share Overview ............... 30720.3 Risks and Benefits ..................... 30920.4 Safety Statement ....................... 31020.5 Setting up Dexcom Share .............. 31320.6 Using Dexcom Share ................... 32320.7 Dexcom Follow™ App .................. 32820.8 Troubleshooting ........................ 330Index 333
• Glossary • Getting Started• Indications for Use and Safety Statement • Risks and BenefitsGETTING STARTED
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Glossary 5Dexcom G5 Mobile System User GuideA1C Blood test used to diagnose type 1 or 2 diabetes and to gauge how well you’re managing your diabetes. The A1C test result reflects your average blood sugar level for the past two to three months.Accessory Device A device that connects with and extends a smart device. Such a device requires the smart device connection for full functionality. Examples are a smart watch or a Bluetooth headset.Also see the Apple Watch and Smart Watch entries in this glossary.Alternative Site TestingUsing a blood sample from non-fingertip (alternate) sites such as the palm, forearm or upper arm for meter readings.Do not use alternative site testing to calibrate the Dexcom G5® Mobile CGM System, only use fingerstick measurement.App A self-contained program or piece of software designed to fulfill a particular purpose; an application, especially as downloaded by a user to a smart or mobile device.The Dexcom G5 Mobile App was developed as a display for continuous glucose monitoring.Apple Watch A specific smart watch that is compatible with iPhones only. The Apple Watch is considered an accessory device as it requires an active connection with the iPhone to have full functionality. Also see the Accessory Device and Smart Watch entries in this glossary.Blood Glucose (BG) ValueBG is an abbreviation of blood glucose. Blood glucose value is the amount of glucose in the blood measured by a BG meter.Blood Glucose Meter/Meter/BG MeterA blood glucose meter is a medical device used to measure how much glucose is in the blood.(Continued on next page) Glossary(Continued on next page)
GlossaryDexcom G5 Mobile System User Guide6(Continued on next page)(Continued on next page)Calibration Calibration is a comparison or measurement between your meter’s fingerstick BG values, and the sensor’s interstitial fluid glucose readings. Although blood and interstitial fluids are similar, glucose concentration is higher in your blood. Calibration allows alignment between your sensor and meter readings.When you calibrate, you take a fingerstick measurement from your meter then enter the value into your receiver or smart device. The system uses that value to verify the sensor glucose reading is on track.Continuous Glucose Monitoring (CGM)Continuous glucose monitoring (CGM) systems use a sensor inserted under the skin to check glucose levels in interstitial fluid. A transmitter sends sensor glucose readings to a display device.Users must confirm glucose levels with a BG meter before making a change in treatment.Contraindication A safety statement outlining specific situations where the Dexcom G5 Mobile should not be used because it may be harmful to you. The risk of use clearly outweighs any possible benefit.Hyperglycemia High blood glucose. Same as “high” or high blood sugar. Hyperglycemia is a characterized by an excess of glucose in the bloodstream.It’s important to treat hyperglycemia. If left untreated, hyperglycemia can lead to serious complications.The default high alert in the Dexcom G5 Mobile CGM System is set to 200 mg/dL. Consult your healthcare professional to determine the appropriate hyperglycemic setting for you.
Glossary 7Dexcom G5 Mobile System User Guide(Continued from previous page)(Continued on next page) Hypoglycemia Low blood glucose. Same as “low” or low blood sugar. Hypoglycemia is characterized by a low level of glucose in the bloodstream. It’s important to treat hypoglycemia. If left untreated, hypoglycemia can lead to serious complications.The default low alert in the Dexcom G5 Mobile CGM System is set to 80 mg/dL. Consult your healthcare professional to determine the appropriate hypoglycemic setting for you.Indication A condition making a particular treatment or procedure advisable. How, for what purposes, and under what circumstances you should use the Dexcom G5 Mobile CGM System. Indications let you know who should use the Dexcom G5 Mobile CGM System and when.IP The International Electrotechnical Commission (IEC) is a nonprofit, non-governmental, international organization created to produce safety standards for electronics. One of the safety standards it designed is the Ingress Protection (IP) Marking which classifies and rates how protected an electronic device is against dust, water, accidental contact, etc.IP ratings are numerical, with the number based on the conditions the electronic device comes across.An IP22 rating lets you know your electronic device won’t allow you to stick your fingers in it and won’t get damaged or be unsafe during specific testing with water dripping down.Jailbroken The removal of limitations and security measures set by the manufacturer on a smart device. The removal poses a security risk and data may become vulnerable.Do not use, install or run the Dexcom G5 Mobile App on a jailbroken smart device. The app may not work correctly on a jailbroken smart device.Landscape If your smart device is oriented sideways.
GlossaryDexcom G5 Mobile System User Guide8Sensor Session The seven day monitoring period after inserting a new sensor. During this time frame, your glucose is being monitored and reported every five minutes, with data being sent to your display device(s).Smart/Mobile DeviceA smart/mobile device is an electronic, mobile device that can wirelessly connect to networks over Wi-Fi or a cellular data connection (3G, 4G, etc.).Examples of smart/mobile devices are smartphones and tablets. Smart Watch A watch that communicates with and extends a smart device. These devices typically require a smart device connection for full functionality. An example is the Apple Watch.Also see the Apple Watch and Accessory Device entries in this glossary.Today View A feature found on iOS smart devices used to quickly access information from any activity or from the lock screen. Access by swiping down from the top edge of your device.Warning A safety statement letting you know the following feature has important hazard information. Describes serious and life threatening circumstances of using the Dexcom G5 Mobile CGM System, their consequences, and how to avoid the hazard.mg/dL Milligrams per deciliter. The standard unit of measure for glucose readings in the United States.Portrait If your smart device is oriented vertically.Precaution A safety statement regarding any special care to be exercised by you or your healthcare professional for the safe and effective use of the Dexcom G5 Mobile CGM System.RF Radio-frequency transmission used to send glucose information from the transmitter to the receiver or smart device.Safety Statement A statement of the intended uses of Dexcom G5 Mobile CGM System and relevant warnings, precautions, and contraindications.(Continued from previous page)
9Dexcom G5 Mobile System User GuideBeginning Your Dexcom G5 Mobile Continuous Glucose Monitoring (CGM) System Journey1.1 IntroductionWelcome to the Dexcom G5 Mobile family!We are excited you chose us to partner with you in your journey to manage your diabetes. As a continuous glucose monitoring (CGM) device, the Dexcom G5 Mobile CGM System allows you to break free from constant fingersticks. But how do you use the Dexcom G5 Mobile CGM System? What are its features? Do you need to avoid anything? Where do you even begin?This chapter is the first step to answering these and many other questions. After this chapter, you will be able to:• Describe different training resources• Locate tutorials about using the Dexcom G5 Mobile CGM System in your diabetes management• Find Dexcom G5 Mobile System’s step-by-step instructions• Recall how to use the User Guide• Explain why you need a Dexcom® accountWe have numerous resources available to help you to get the most out of your Dexcom G5 Mobile CGM System. Between our self-paced training resources and our friendly and knowledgeable Dexcom customer support teams, help is always available.First Things First - Learning How to LearnKnowing about the Dexcom G5 Mobile CGM System is your first step in creating a successful CGM experience. Before using it, learn about it.You have numerous self-paced resources, helping you get to know the Dexcom G5 Mobile CGM System:Chapter 1Getting Started:Beginning Your Dexcom G5 Mobile Continuous Glucose Monitoring (CGM) System Journey
10Dexcom G5 Mobile System User’s GuideBeginning Your Dexcom G5 Mobile Continuous Glucose Monitoring (CGM) System Journey1. Tutorials2. Quick Start Guide3. User GuideNo matter which resource you select, make sure you review them prior to using your new CGM system.1.2 Self-Paced Resources Tutorials Along with step-by-step instructions, our tutorials illustrate how real-time CGM can assist in your daily diabetes management. The following is a list of tutorials and how to access them.Online TutorialsFirst Steps With Your Dexcom CGMDesigned for those who have never used a Dexcom CGM. This tutorial covers what to expect in your first week and includes links to step-by-step videos on how to insert your sensor, calibrations, ending a sensor session, etc.Next Steps With Your Dexcom CGMJust finished First Steps or already familiar with how a CGM can benefit you? This tutorial covers looking at trends and introduces some advanced features including our reporting tools.Accessing Online Tutorials:From dexcom.com homepage, click Support, click Training.Once you have viewed the online tutorials you should be pretty comfortable with what CGMs do and how the Dexcom G5 Mobile CGM System can help you. Offline TutorialsYou don’t need to be tied to the Internet to view our instructional tutorials, they’re also available offline.Accessing Offline Tutorials:USB Card in the receiver package.
11Dexcom G5 Mobile System User GuideBeginning Your Dexcom G5 Mobile Continuous Glucose Monitoring (CGM) System JourneyWritten Mobile ResourcesQuick Start Guide (QSG)The Dexcom G5 Mobile Quick Start Guide compliments the tutorials by proving the same step-by-step instructions in a booklet form or within the app.One of the great things about the QSG is you can use it in conjunction with the videos, taking notes as you go!Accessing the QSG:Booklet in the receiver package.Both the tutorial and the QSG give you brief look at the Dexcom G5 Mobile CGM System. But what if you want more detailed information? User GuideYour Dexcom G5 Mobile CGM System reference book! This user guide gives you the most extensive overview of the system detailing features, important safety information and so much more.To download an ebook of the user guide or request a printed user guide, visit dexcom.com/guides.The Dexcom G5 Mobile User Guide is grouped into six separate parts:Part 1: Getting Started 1. Glossary 2. Getting Starteda. Learning how to learn about the Dexcom G5 Mobile CGM Systemb. Registering at dexcom.com3. Indications for Use and Safety Statement 4. Risks and BenefitsPart 2: Let’s G5®! The Basics1. Introduction to the Dexcom G5 Mobile CGM System2. Choose and Set up Your Display Device(s) 3. Initiating a Sensor Session: Inserting the Sensor & Transmitter 4. Calibration 5. End a Sensor Session
12Dexcom G5 Mobile System User’s GuideBeginning Your Dexcom G5 Mobile Continuous Glucose Monitoring (CGM) System JourneyPart 3: Next Steps - Getting the Most out of Your Dexcom CGMOnce you are up and running, how you can maximize the Dexcom G5 Mobile features:1. Reading Trend Graph Screens and Recognizing Trends2. Events 3. Alarm and Alerts4. Sounds for Alarm, Alerts and System MessagesPart 4: Everything Else G51. Warranty2. Dexcom G5 Mobile CGM System Maintenance3. Travel Tips4. Customer Service Contacts5. Technical Information6. Troubleshooting7. Package Label and Product Symbols At the end of your Dexcom G5 Mobile System User Guide, Part 5, is the user guide of a new Dexcom G5 Mobile System feature: Dexcom Share™.Part 5: Sharing is Caring1. Dexcom Sharea. What Is Dexcom Share?b. Setting Up Dexcom Sharec. How to Use Dexcom Shared. Your Followerse. TroubleshootingPart 61. Index for Dexcom G5 Mobile System and Dexcom ShareHow to Use Your User GuideAll chapters in the Dexcom G5 Mobile User Guide are laid out the same way:The beginning of each chapter lists what you’ll be able to do after you have finished, after that, any applicable safety statements you need to know, followed by the chapter’s content. At the end, there’s a recap of what was covered and what’s in the next chapter.1.3 Your Dexcom AccountYou’ll need a username and password to set up the Dexcom G5 Mobile App and for reordering.
13Dexcom G5 Mobile System User GuideBeginning Your Dexcom G5 Mobile Continuous Glucose Monitoring (CGM) System JourneyIf you haven’t already done so, go to dexcom.com and set up your own account. Or, if you prefer, the Dexcom G5 Mobile App walks you through creating your log in credentials as part of your initial app set up.SummaryNow You Can:• Describe different training resources• Locate tutorials about using a real-time CGM in your diabetes management• Find Dexcom G5 Mobile System’s step-by-step instructions• Recall how to use the user guide• Explain why you need a Dexcom accountWhat’s Next?Now you are familiar with how to use this user guide and where to go for help. Throughout the user guide you’ll see color-coded boxes containing Safety Statements. The next chapter, Indications for Use and Safety Statement, lists all Safety Statements along with how to read and interpret them. Next you’ll learn about when and how to use the Dexcom G5 Mobile CGM System safely.
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15Dexcom G5 Mobile System User GuideIndications for Use and Safety Statement2.1 IntroductionWe want the Dexcom G5 Mobile CGM System to be a valuable tool in your diabetes management. Like any system, there are steps to take to get the most out of it. As excited as you are about getting started, did you know if you just took Tylenol®, maybe you should wait? Did you know taking Tylenol is contraindicated?In this chapter, you’ll learn about some key areas that might prevent you from having the best CGM experience, or, if you’re not careful, might even harm you or the system. You’ll even learn what a contraindication is!2.2 Important User InformationEach part of your system has instructions including indications, contraindications, warnings, precautions, and other important user information. Please review the instructions for each part of the system in this user guide before using any of the Dexcom G5 Mobile CGM System. This chapter is important to read. It helps you use the Dexcom G5 Mobile CGM System safely and covers:• What is a Safety Statement? ○Telling the difference between an indication and a contraindication ○Explaining why warnings are so important ○Defining precautions• How to read a chapter’s Safety Statement• Overview of Safety StatementsLet’s start with definitions, look at a Safety Statement example used throughout the User Guide, and then review the Safety Statements broken down into the system’s components.Safety StatementA Safety Statement is a brief statement of the Dexcom G5 Mobile CGM System’s indications, relevant warnings, precautions, or its contraindications (when to avoid using it). The Safety Chapter 2Getting Started:Indications for Use and Safety Statement
Dexcom G5 Mobile System User Guide16Indications for Use and Safety StatementStatements are meant to keep you and the system safe while using the Dexcom G5 Mobile CGM System: 1) Indications How, for what purposes, and under what circumstances you should use the Dexcom G5 Mobile CGM System. Indications let you know who should use the Dexcom G5 Mobile CGM System and when. Indications are the who, what, and why of the Dexcom G5 Mobile CGM System. 2) Contraindications Contraindications let you know when not to use the Dexcom G5 Mobile CGM System. If used during these situations, you may hurt yourself or the system, the risk of use clearly outweighs the benefit. 3) Warning Important hazard information: Describes serious or life threatening circumstances to stay away from while using the Dexcom G5 Mobile CGM System, their consequences, and how to avoid danger. 4) Precaution Special steps you need to take while using the Dexcom G5 Mobile CGM System, preventing minor or moderate injury to either you or the system. 2.3 Safety StatementsThis user guide presents Safety Statement two ways:1. In this chapter’s Overview of Safety Statements ○Lists all Safety Statements ○Includes a section reviewing how the statements are formatted2. Within a chapter ○Lists only those statements applicable to the chapterChapter’s Safety Statements Each chapter will list all applicable indications, contraindications, warnings, and precautions. Some chapters will have multiple Safety Statements; others have none. Safety Statements are located towards the front so you can keep them in mind as you learn about that chapter’s topic. The same statement may be repeated throughout the user guide. It’s important to recognize which factors could prevent the system from working correctly, or even harming you.
17Dexcom G5 Mobile System User GuideIndications for Use and Safety StatementWithin chapters, each color coded Safety Statement is in a box, broken down into four sections:1. Type of statementa. Bold and color-coded ▪WARNING-Red ▪PRECAUTION-Blue ▪INDICATION-Green ▪CONTRAINDICATION-Purple2. Do’s/Don’tsa. An action you should or should not takeb. Italicized3. Whya. A statement of the potential harm4. Consequencesa. What could happen if you don’t follow the instructionsThe following is an example of a chapter’s Safety Statement and how to read it.WARNINGDo: Calibrate at least once every 12 hours.Why: Calibrating less often than every 12 hours might cause inaccurate sensor glucose readings.Consequences: Missing severe low (hypoglycemia ) or high (hyperglycemia) Alarm or Alerts.Since this is a WARNING, you know it covers important safety information. Italics are the Do/Don’t steps to follow: Calibrate at least once every 12 hours. Below the italics is a statement explaining Why you need to follow the steps: Calibrating less often than every 12 hours might cause inaccurate sensor glucose readings. And finally what happens, or the Consequences, if you don’t: missing a severe low (hypoglycemia) or high (hyperglycemia) glucose event.2.4 Overview of Safety StatementsThis section provides a review of Safety Statements containing the same elements described above (type of Safety Statement, an action, a statement of potential harm, and consequences) listed in a narrative, not boxed, format. Here you’ll learn what indications
Dexcom G5 Mobile System User Guide18Indications for Use and Safety Statementand contraindications are and what to do to keep you safe and the system in proper working order.Safety Statements are broken down into two major categories. First, general CGM system Warnings—reviews warnings and precautions you take with most CGM systems—and second, Hardware/Software Warnings and Precautions list warnings and precautions specific to the Dexcom G5 Mobile CGM System components.Indications and ContraindicationsIndications What are the Dexcom G5 Mobile CGM System indications? Well, in technical terms, the indications are:The Dexcom G5 Mobile Continuous Glucose Monitoring (CGM) System is a glucose monitoring system indicated for detecting trends and tracking patterns in persons (age 2 years and older) with diabetes. The system is intended for single patient use and requires a prescription.The Dexcom G5 Mobile CGM System is indicated for use as an adjunctive device to complement, not replace, information obtained from standard home glucose monitoring devices.The Dexcom G5 Mobile CGM System aids in the detection of episodes of hyperglycemia and hypoglycemia, facilitating both acute and long-term therapy adjustments, which may minimize these excursions. Interpretation of the Dexcom G5 Mobile CGM System results should be based on the trends and patterns seen with several sequential readings over time.In Layman’s TermsBut what does that mean? Indications are the who, what, and why of the Dexcom G5 Mobile CGM System. WhoThe Dexcom G5 Mobile CGM System is a single patient use device (meaning you can’t share the components with others) for people 2 years or older with diabetes.WhatThe Dexcom G5 Mobile CGM System is a prescription-only glucose monitoring device. Dexcom G5 Mobile CGM System tracks your glucose patterns and detects trends. Working with your home blood glucose (BG) meter, the system is meant to complement, not replace, your BG meter.
19Dexcom G5 Mobile System User GuideIndications for Use and Safety StatementWhyThe CGM system’s trend and pattern information, its glucose Alarm/Alerts, combined with your meter’s actual BG value, can help you manage your diabetes.By identifying low and high glucose level periods, the Dexcom G5 Mobile CGM System allows you to take action when needed and create long-term management strategies with your healthcare professional. Using trend information to see your highs and lows helps you stay inside your target range. The Dexcom G5 Mobile CGM System’s trend and pattern information is based on a series of sensor glucose readings taken over a period of time.Work with your healthcare professional and create a game plan on how to best use your trend and pattern information in managing your diabetes.ContraindicationsContraindications let you know when not to use the Dexcom G5 Mobile CGM System; you may hurt yourself or damage the system. Remember, if used during certain situations, the risk of use may clearly outweigh any potential benefit. Within the chapters, contraindications are in purple boxes. MRI/CT/ DiathermyRemove the Dexcom G5 Mobile CGM System (sensor, transmitter, and receiver) before Magnetic Resonance Imaging (MRI), Computed Tomography (CT) scan, or high-frequency electrical heat (diathermy) treatment.The system hasn’t been tested during MRI, CT scans, or with diathermy treatment. Magnetic fields and heat could damage the components, stopping sensor glucose readings or Alarm/Alert notifications. Without sensor glucose readings or Alarm/Alert notifications, you might miss a severe low or high glucose event.MedicationsTaking medications with acetaminophen (such as Tylenol or Excedrin® Extra Strength) while wearing the sensor may falsely raise your sensor glucose readings. The level of inaccuracy depends on the amount of acetaminophen active in your body and is different for each person.
Dexcom G5 Mobile System User Guide20Indications for Use and Safety Statement2.5 General CGM System WarningsWarningsWarnings outline important hazard information, describing any serious and/or life threatening situations, their consequences, how to avoid danger while using the system and how to protect the Dexcom G5 Mobile CGM System from harm.Review Training MaterialsThoroughly review the training materials included with your Dexcom G5 Mobile CGM System before using. Incorrect use could lead you to misunderstand system information or might affect its performance and you might miss a severe low or high glucose event.Treatment DecisionsThe Dexcom G5 Mobile CGM System does not replace your BG meter.When making treatment decisions, such as the amount of insulin you need, only use your BG value. Don’t use the Dexcom G5 Mobile CGM System sensor glucose readings because readings can be different from your BG value. If sensor glucose readings are used in determining treatments, it could result in you missing a severe low or high glucose event.Don’t Ignore Low/High SymptomsIf your sensor glucose readings don’t match your symptoms, measure your BG with a fingerstick. You may miss a severe low or high glucose event.Who Shouldn’t UseThe Dexcom G5 Mobile CGM System was not evaluated for the following persons:• Pregnant women• Persons on dialysisDo not use the Dexcom G5 Mobile System in critically ill patients. It is not known how different conditions or medications common to the critically ill population may affect the performance of the system. Sensor glucose readings may be inaccurate in critically ill patients.The system’s accuracy hasn’t been tested in people falling into these groups and sensor glucose readings may be inaccurate, resulting in missing a severe low or high event.
21Dexcom G5 Mobile System User GuideIndications for Use and Safety Statement2.6 Calibration Warning and PrecautionsCalibration is the process of making sure your sensor continues to be accurate. Your sensor doesn’t automatically know what your glucose levels are—you have to teach your system what a given BG value is by entering in a KNOWN glucose value from your BG meter.WarningCalibrate on ScheduleCalibrate at least once every 12 hours. Calibrating less often than every 12 hours might cause sensor glucose readings to be inaccurate, resulting in you missing a severe low or high glucose event.PrecautionsBe Accurate, Be QuickEnter the exact BG value displayed on your BG meter within five minutes of a fingerstick.Entering the wrong BG values, or waiting more than five minutes before entry, might affect sensor performance, resulting in you missing a severe low or high event.Significant Glucose Rate ChangesDon’t calibrate when your BG is changing at a significant rate: more than 2 mg/dL per minute.Look for rate of change arrows on your display device screen and don’t calibrate when you see:• A single arrow, pointing up ○Rising 2-3 mg/dL each minute• Two arrows pointing up ○Rising more than 3 mg/dL each minute• Single arrow pointing down ○Falling 2-3 mg/dL each minute• Two arrows pointing down ○Falling more than 3 mg/dL each minuteCalibrating during a significant rise/fall of your BG may affect accuracy of sensor glucose readings, resulting in you missing a severe low or high glucose event.Fingerstick OnlyOnly use fingerstick measurements from your BG meter for calibration.
Dexcom G5 Mobile System User Guide22Indications for Use and Safety StatementAlternative site BG values from your arms, palm of your hand, etc., may be different and less accurate than your fingerstick BG values. Using alternative for calibration might affect sensor performance, resulting in you missing a severe low or high glucose event.Prior to Initial Calibration: Data/Alarm/AlertAfter starting a new sensor session, until completing your initial calibrations you won’t receive any sensor information such as readings, Alarm or Alerts. Without these, you may miss a severe low or high glucose event.Continue to take fingerstick measurements during a new sensor warmup period. Now that we have reviewed common CGM Safety Statements, let’s focus the Dexcom G5 Mobile CGM System components. 2.7 System/Hardware/Software Warnings and PrecautionsIn this section, you will learn how to safely use the Dexcom G5 Mobile CGM System’s hardware and software. Some sections have either Precautions or Warnings, others will have both.Sensor/Sensor Pod Warnings and PrecautionsWarningsSensor Breaking OffOn rare occasions, the sensor wire may break or detach from the sensor pod. Within 24 hours of experiencing a broken sensor wire, please call our 24/7 Technical Support department, toll free at 1.877.339.2664 or toll at 1.858.200.0200. If a sensor wire breaks under the skin with no portion of it visible, don’t remove it. Contact your healthcare professional if you have redness, swelling, or pain at the insertion site.PlacementDo not insert the sensor component of the Dexcom G5 Mobile System in a site other than the belly/abdomen (ages 2 years and older) or the upper buttocks (ages 2 to 17 years). The placement and insertion of the sensor component of the Dexcom G5 Mobile System is not approved for other sites.If placed in other areas, the Dexcom G5 Mobile System may not function properly.
23Dexcom G5 Mobile System User GuideIndications for Use and Safety StatementStorageDuring a sensor’s shelf life, store it between 36° F-77° F. While you don’t need to keep your sensor in a refrigerator, you can as long as the refrigerator is between 36° F-77° F. Never store sensors and/or sensor packages in a freezer. Storing the sensor incorrectly might cause the sensor glucose readings to be incorrect, resulting in you missing a severe low or high glucose event.PrecautionsExpiration DateDon’t use expired sensors. Before inserting, always check the package label for the expiration date using the YYYY-MM-DD format. If past the expiration date, don’t use because the sensor glucose readings might not be accurate, resulting in you missing a severe low or high glucose event.Sensor PackageDon’t use sensor if its sterile package has been damaged or opened. Using a non-sterile sensor might cause infection.Clean and Dry Before UsingBefore opening the sensor package, wash your hands with soap and water, then dry. If your hands are dirty while inserting the sensor, you may contaminate the insertion site and get an infection.Before sensor insertion, clean the skin with alcohol wipes to prevent infections. Don’t insert the sensor until the cleaned insertion site is dry, and free from any lotions or perfumes.If your insertion site is not clean and completely dry, you run the risk of infection or the sensor pod not sticking and falling off. Sensor PlacementChange the site where you place the sensor with each new insertion. Using the same site too often might not allow the skin to heal, causing scarring or skin irritation.Sensor placement is important. Make sure the area you place your sensor won’t:• Be bumped, pushed, or squeezed• Have scars, tattoos, or irritation Insertion in these areas might affect sensor performance, resulting in you missing a severe low or high glucose event.
Dexcom G5 Mobile System User Guide24Indications for Use and Safety StatementAvoid injecting insulin or placing an insulin pump infusion set within three inches of the sensor. The insulin might affect sensor performance, resulting in you missing a severe low or high glucose event.Transmitter Warnings and PrecautionsWarningsInspect TransmitterIf your transmitter is damaged or cracked in any way, don’t use it. Damaged components could create an electrical safety hazard or malfunction, which might cause electrical shocks.ChokingThe transmitter is small and may pose a choking hazard. Don’t put it in your mouth or allow children to play with it. PrecautionsReusable: Don’t Throw AwayWhen ending a session, don’t throw away the transmitter. The transmitter is reusable and can be used in multiple sensor sessions. Keep using it until the system notifies you the transmitter battery is about to expire.Don’t Share Your TransmitterNever share your transmitter with another person. The Dexcom G5 Mobile CGM System is a prescription-only medical device and is meant, or indicated, for your use only. Your transmitter is tied to your readings. If used by someone else, your reports, Alarm and Alerts, etc., would be wrong, resulting in you missing a severe low or high glucose event.System PrecautionsNext are precautions for the receiver, transmitter, sensor and the system. PrecautionsUse Correct Transmitter, Receiver, and SensorDifferent generations’ transmitters and receivers aren’t interchangeable with each other. The Dexcom G5 Mobile CGM System’s transmitter and receiver are not compatible with the Dexcom G4® PLATINUM CGM System’s transmitter and receiver. The Dexcom G5 Mobile CGM System won’t work if you mix receiver and transmitter components from different generations, resulting in you missing a severe low or high glucose event.
25Dexcom G5 Mobile System User GuideIndications for Use and Safety StatementYou can use a Dexcom G4® PLATINUM Sensor with the Dexcom G5 Mobile CGM System. Before using the sensor, make sure the sensor label says “Dexcom G5 Mobile/G4 PLATINUM Sensor,” or “Dexcom G4 PLATINUM Sensor.”System AccuracySystem accuracy may be affected when your glucose is changing at a significant rate such as during exercise or after a meal. Significant glucose rise/fall rates:• Rising 2-3 mg/dL each minute• Rising more than 3 mg/dL each minute• Falling 2-3 mg/dL each minute• Falling more than 3 mg/dL each minuteReceiver and Smart Device PrecautionsThe Dexcom G5 Mobile Receiver and your smart device share some warnings and precautions.PrecautionsCommunication RangeDo not separate the transmitter from the receiver or smart device by more than 20 feet. The transmission range from the transmitter to receiver or smart device is up to 20 feet without obstruction.Types of obstruction differ and not all have been tested. Obstructions can include water, walls, metal, etc. If your transmitter and display device(s) are more than 20 feet from each other or are separated by an obstruction, they might not communicate, resulting in you missing a severe low or high glucose event.Water is often the biggest culprit in reducing the communication distance between the transmitter and display devices. Take special care when swimming, getting into a pool, bathtub, shower, etc.Setting Alarm/Alert NotificationsWhen using both a receiver and a smart device, you must set your settings separately in each. If you set up one device and then use another, you might not get an Alarm or Alerts, causing you to miss a severe low or high glucose event.Using an accessory device (like a smart watch) might override your smart device sounds. Alarms or Alerts might vibrate or be heard on the accessory instead of your smart device.
Dexcom G5 Mobile System User Guide26Indications for Use and Safety StatementAfter connecting any accessories, make sure that the smart device settings allow you to continue receiving Alarms or Alerts on the smart device.Is It On?If the receiver or smart device is turned off (Shut Down), it will not display sensor data, information, Alarm or Alerts. Make sure they are turned on; otherwise you won’t get sensor glucose readings or Alarm or Alerts, causing you to miss a severe low or high glucose event.Smart Device WarningsNext are warnings for just your smart device.WarningsSmart Device SettingsThe Dexcom G5 Mobile App can’t override your smart device’s internal settings. Also, accessory devices (like a smart watch or other wearable smart devices) might override your smart device’s Alerts and Alarm.To receive Alarm or Alerts you must:1. Make sure Dexcom G5 Mobile App Notifications are turned on in the Setting’s menu.2. Verify app hasn’t been shut down.3. Turn Bluetooth on.4. Turn off Do Not Disturb (if available on your smart device).5. Restart app after device is restarted.6. Set Volume at a level you can hear.7. Do not close app, always run app in the background.8. Make sure accessory devices do not override your smart device settings.If your settings are incorrect, you might miss a severe low or high glucose event.Dexcom G5 Mobile CGM System Alarm/Alert vibrations aren’t any different from other vibrating apps on your smart device. Medical device apps, like the Dexcom G5 Mobile App, don’t have any special priorities over your smart device’s features. Dexcom G5 Mobile App notifications or alerts may sound or feel the same as notifications from another app. The only way to know is look at the screen.Can’t Hear Your Alarm or Alert?An Alarm or Alert can’t be heard through your smart device’s speakers if headphones are plugged in. Make sure you unplug your headphones when you are done using them, otherwise you might not hear an Alarm or Alert, causing you to miss a severe low or high glucose event.
27Dexcom G5 Mobile System User GuideIndications for Use and Safety StatementReceiver Warning and PrecautionWarningDon’t Use Damaged GoodsIf your receiver is damaged or cracked, don’t use it. This could create an electrical safety hazard or malfunction, causing possible electrical shocks.PrecautionKeep Receiver DryKeep the USB port cover on the receiver closed whenever the USB cable is not attached and do not submerge in water.If water gets into the USB port, the receiver could become damaged and stop displaying readings or providing alerts; you might miss a severe low or high glucose event.CautionU.S. law restricts the sale of the Dexcom G5 Mobile CGM System to sale by or on order of a physician.SummaryNow You Can:• Define a Safety Statement ○Explain the difference between an indication and a contraindication ○Describe the importance of warnings ○Describe what a precaution is• Correctly read a chapter’s Safety Statement• Provide an overview of Safety Statements by categoryWhat’s Next?In our next chapter, you will learn about the risks and benefits of using Dexcom’s G5 Mobile CGM System.
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29Dexcom G5 Mobile System User GuideRisks and BenefitsWhen using any medical device, there are risks and benefits. In this chapter, you’ll learn what they are, helping you decide if Dexcom’s G5 Mobile CGM System is right for you.First, let’s review some possible risks.3.1 RisksThere are some risks with using real-time CGM.Not Receiving Alarm/AlertsIf you aren’t getting your CGM Alarm/Alerts, you run the risk of not knowing you are having a severe glucose low or high. Some hardware issues preventing Alarm/Alerts:• Alert function is turned off• Transmitter and display device is out of range• Receiver or smart device isn’t showing sensor glucose readings• Receiver or smart device battery is dead• Unable to hear Alarm/Alerts or feel vibration• App not running in the background• Smart device is in Do Not DisturbSee Troubleshooting or recommended settings in Chapter 11 for more information. Sensor Glucose Reading Different From Meter’sThe sensor glucose reading can be different than your meter’s BG value. If the sensor’s glucose reading is higher than your meter’s BG value, you may miss a Low Alert. As an example, your last sensor’s glucose reading was 82 mg/dL, whereas your BG value shows 78 mg/dL. If your Low Alert is set at 80 mg/dL, you won’t receive an Alert because the sensor glucose reading is 82 mg/dL.Chapter 3Getting Started:Risks and Benefits
Dexcom G5 Mobile System User Guide30Risks and BenefitsIf you’re not receiving an Alarm/Alert, and not taking fingerstick measurements, you may be unaware of low or high glucose levels. Sensor Insertion RisksInserting the sensor and wearing the adhesive patch might cause infection, bleeding, pain or skin irritations (e.g., redness, swelling, bruising, itching, scarring or skin discoloration). The chance of this happening is low. The Dexcom G5 Mobile CGM System uses the same sensor as the previous CGM system—the Dexcom G4 PLATINUM. The Dexcom G4 PLATINUM System clinical studies and compliant data showed slight redness and swelling occurring only in a few patients.During Dexcom’s G4 PLATINUM System’s clinical study, no sensor wires broke however there is a remote chance sensor fragments could remain under your skin if the sensor breaks during normal wear. Sterile broken sensor wires don’t pose a significant medical risk. If a sensor wire breaks off or detaches and remains under your skin, contact your healthcare professional and call Dexcom’s Technical Support toll free, 24/7, at 1.877.339.2664 or toll at 1.858.200.0200 within 24 hours. Those are the risks, let’s now review the benefits!3.2 BenefitsDaily habits impact your BG levels. With the Dexcom G5 Mobile CGM System, you can track how your exercise, carbs, stress levels, medication, or illness, influences your glucose levels. Knowing Your TrendsWearing the Dexcom G5 Mobile CGM System on a consistent and ongoing basis helps you manage your diabetes. Providing sensor glucose readings every five minutes, for up to seven days, the Dexcom G5 Mobile CGM System helps you detect trends and patterns. Trend information reveals where your glucose is now, where your glucose is heading, and how fast it’s changing. Understanding your trends allows you to take proactive action, helping you avoid dangerously low or high glucose values.Using Dexcom Share (see Part 5) allows friends and family, your Followers, to monitor your glucose activity, adding another layer of support and peace of mind.
31Dexcom G5 Mobile System User GuideRisks and BenefitsHelps in Your Diabetes ManagementThe Alarm/Alerts features (see Chapter 11) keep you aware of your glucose levels. Alerts notify you when your glucose goes outside your target range or is rapidly falling or rising, letting you to take action before you get too low or too high. The Urgent Low Alarm lets you know when you are dangerously or urgently low, going below 55 mg/dL. By taking corrective measures, you lessen the time spent in your low/high range, while increasing time in your targeted range (Garg S. Z., 2006) (Battelino T, 2011). Real-time CGM can help improve your A1C as well as improve the quality of your glucose control. If you are at or below 7%, using a CGM such as Dexcom’s G5 Mobile CGM System, helps reduce hypoglycemia (Tamborlane, W. V.,2008).Lowering your A1C, increasing your time in your target range while decreasing time in low/high BG range is believed to reduce your risk of diabetes related complications (Ohkubo, Y. 1995).In some cases, patients perceived an increase in their quality of life and peace of mind when using real-time CGM. (Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. 2010)What’s Next?You’ve read the Safety Statements, reviewed the risks and benefits; now let’s take a look at Dexcom’s G5 Mobile CGM System!References:Battelino, T., Phillip, M., Bratina, N., Nimri, R., Oskarsson, P., & Bolinder, J. (2011). Effect of Continuous Glucose Monitoring on Hypoglycemia in Type 1 Diabetes. Diabetes Care, 34(4), 795-800.The Diabetes Control and Complications Trial Research Group. The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus. The New England Journal of Medicine, Vol. 329, No. 14. (September 1993), pp. 977-986.Garg, S., Zisser, H., Schwartz, S., Bailey, T., Kaplan, R., Ellis, S., & Jovanovic, L. (2005). Improvement in Glycemic Excursions With a Transcutaneous, Real-Time Continuous Glucose Sensor: A randomized controlled trial. Diabetes Care, 29(1), 44-50.Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. (2009). The Effect of Continuous Glucose Monitoring in Well-Controlled Type 1 Diabetes, Diabetes Care, 32(8), 1378-1383.
Dexcom G5 Mobile System User Guide32Risks and BenefitsJuvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. (2009). Sustained Benefit of Continuous Glucose Monitoring on A1C, Glucose Profiles, and Hypoglycemia in Adults With Type 1 Diabetes. Diabetes Care, 32(11), 2047-2049.Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group (2010). Quality-of-Life Measures in Children and Adults with Type 1 Diabetes. Diabetes Care, 33(10), 2175-2177.Ohkubo, Y., Kishikawa, H., Araki, E., Miyata, T., Isami, S., Motoyoshi, S., & Shichiri, M. (1995). Intensive Insulin Therapy Prevents the Progression of Diabetic Microvascular Complications in Japanese Patients with Non-insulin-dependent Diabetes Mellitus: A Randomized Prospective 6-year Study. Diabetes Research and Clinical Practice, 28(2), 103-117.Tamborlane, W. V., Beck, R. W., Bode, B. W., Buckingham, B., Chase, H. P., Clemons, R., ... & Xing, D. (2008). Continuous Glucose Monitoring and Intensive Treatment Of Type 1 Diabetes. The New England Journal of Medicine, 359(14), 1464-1476.
• Introduction to the Dexcom G5 Mobile CGM System• Initial Set-Up• Starting a Sensor Session: Inserting the Sensor & Transmitter • Calibration • Ending a Sensor SessionLET’S G5! THE BASICS
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35Dexcom G5 Mobile System User GuideWhat Is the Dexcom G5 Mobile CGM System?4.1 System DescriptionNow it’s time to get an overview of the Dexcom’s G5 Mobile CGM System. After this chapter, you’ll be able to:• Explain the Dexcom G5 Mobile CGM System • Describe options to view trends• Locate your historical readings• Recognize system components• Explain each part’s function4.2 Safety StatementIf you’ve used the Dexcom G4 PLATINUM CGM System, you might still have its transmitter or receiver. While you can use the sensors across the different generations (look for “G5 Mobile” or “G4 PLATINUM” on the sensor’s package), you can’t mix the transmitter or receiver between the two systems.WARNINGDon’t: The Dexcom G5 Mobile CGM System was not evaluated for the following persons:• Pregnant women• Persons on dialysisDo not use the Dexcom G5 Mobile System in critically ill patients. It is not known how different conditions or medications common to the critically ill population may affect the performance of the system. Sensor glucose readings may be inaccurate in critically ill patients.Consequences: The system’s accuracy hasn’t been tested in people falling into these groups and sensor glucose readings may be inaccurate, resulting in missing a severe low or high event.Chapter 4Let’s G5! The Basics:What Is the Dexcom G5 Mobile CGM System?
Dexcom G5 Mobile System User Guide36What Is the Dexcom G5 Mobile CGM System?PRECAUTIONDon’t: Never mix Dexcom G5 Mobile’s Transmitter or Receiver with Dexcom G4 PLATINUM’s Transmitter or Receiver.Why: The Dexcom G5 Mobile CGM System’s Transmitter and Receiver are not compatible with the Dexcom G4 PLATINUM CGM System’s Transmitter and Receiver. The Dexcom G5 Mobile CGM System won’t work if you mix Receiver and Transmitter components from different generations. Consequences: Missing a severe low (hypoglycemia) or high (hyperglycemia) event.4.3 The Dexcom G5 Mobile CGM SystemCGMThe Dexcom G5 Mobile Continuous Glucose Monitoring (CGM) System is a medical device you use on yourself. It allows you to continually see your sensor glucose readings, updated every five minutes for up to 7 days, without the bother of taking constant fingerstick measurement. Your sensor glucose readings are measured by a single use sensor inserted under your skin. A reusable transmitter sends your data to your display device. The Dexcom G5 Mobile CGM System provides personalized trend alerts, prompting you to proactively react when your glucose levels are getting too low, or too high. Dexcom provides web-based reports reflecting your glucose trends and patterns. Share the reports with your healthcare professional when developing your diabetes management treatment plans.Options to View Your TrendsThe Dexcom G5 Mobile CGM System transmitter works with a number of display devices giving you flexibility to use what’s best for you, your situation, or your lifestyle.1. Dexcom G5 Mobile Receiver2. Dexcom G5 Mobile App on your smart deviceWhile the system works with different smart devices, they’re not interchangeable during a sensor session. Before starting one, select which smart device you want to use and stick with it throughout your session. You can’t use multiple smart devices at the same time, but you can combine the receiver with a smart device during a session. The Dexcom G5 Mobile CGM System is the first CGM system where a smart device acts as a receiver. For a list of current devices and operating systems go to: dexcom.com/compatibility
37Dexcom G5 Mobile System User GuideWhat Is the Dexcom G5 Mobile CGM System?Chapter 5 covers how to set up your smart device with the Dexcom G5 Mobile App.The primary difference between the receiver and app is not the information they give you, but how that information is presented. The following are some of the shared CGM data and system information features.Tracking Real Time CGM DataThe receiver and app give you the ability to track your glucose trends in a number of different ways. Each device’s home screen opens to your glucose trend screen.View Glucose LevelsThe receiver and app share many of the same glucose monitoring features. Your glucose values are color coded to highlight what zone you are in, allowing you, at a glance, to see what your levels are.Color coded glucose levels: • Red - Low• Grey - Within your normal range• Yellow - HighTrend ArrowsGlucose levels are not just about the numbers. The Dexcom G5 Mobile CGM System includes trend arrows so you know the speed and direction of your glucose, allowing you to proactively react before your glucose gets too high or too low.Alarm/AlertsBeing warned when your glucose value is too high or too low, falling or rising too quickly, or if it’s trending towards a severe low or high is very important. Warnings in the form of Alerts or an Alarm help you avoid getting too low or high. Alarm and Alert notifications help keep you aware of your glucose trends and are made up of a combination of sounds, vibrations, and screens.There are a number of Alerts, but only one Alarm: when your glucose level dips below 55 mg/dL. Some customization options are available and are part of the set up process for the receiver and smart device.In Chapter 11, you can learn more about the Alarm and Alerts feature.Viewing Your Glucose Values
Dexcom G5 Mobile System User Guide38What Is the Dexcom G5 Mobile CGM System?The Dexcom G5 Mobile CGM System allows you to see your last 1-3-6-12-24 hours of your sensor glucose readings. On the receiver, from the home screen, press Up/Down Arrows to view. On a smart device, hold upright in portrait mode, and see the most recent three hours, turn sideways to landscape to view your glucose levels over the last 1-3-6-12-24 hours. Go to Chapter 9 to learn more about viewing your glucose trends.4.4 What’s New to the Dexcom G5 Mobile CGM System?Dexcom’s G5 Mobile CGM System has features not found in our previous generations. These items are new to the Dexcom G5 Mobile App:• The Dexcom G5 Mobile widget in the Apple Today view• Dexcom G5 Mobile on Apple Watch• Share as a feature of the appThe Dexcom G5 Mobile Widget in the Apple Today ViewCheck your CGM information on your smart device without needing to open the app, even when the device is locked. Swipe down from the top of your screen to access the Dexcom G5 Mobile widget in the Apple Today view. This is where you might check the weather or stocks if using the default settings.For more information about the Dexcom G5 Mobile for Apple Watch, go to Chapter 9.3 under Additional Ways to View Your App’s CGM Information.Dexcom G5 Mobile for Apple WatchCheck your CGM information on your wrist! The Dexcom G5 Mobile App supports Apple Watch* and can be used to discreetly view your glucose reading, trend arrow, and trend graph. For more information about Dexcom G5 Mobile for Apple Watch or the Dexcom G5 Mobile widget in the Apple Today View, go to Chapter 9.3 under Additional Ways to View Your App’s CGM Information.*For compatibility information see dexcom.com/compatibility.Share Your DataThrough secure wireless connections, Dexcom Share allows remote viewing of your sensor glucose readings, trends, and data by your loved ones from a smart device. Activate Dexcom
39Dexcom G5 Mobile System User GuideWhat Is the Dexcom G5 Mobile CGM System?Share by tapping on the app’s Share icon, follow a few simple steps, then invite up to five people to connect with you. After downloading the Dexcom Follow™ App, they become your Follower. As a Follower, they can watch your sensor glucose readings, trends, and receive Alarm/Alerts when your glucose is low or high.You determine what your Follower can see. Based on what you allow, your Followers can receive your Alarm or Alerts, and view your trends. Followers can pick and choose, or turn off, the data they receive, including the Alarm/Alerts, trends, and messages. The Share feature in the Dexcom G5 Mobile App is different than the Dexcom Share App used with other systems.More information about Dexcom Share and instructions for use, go to Part 5.NOTE: Review all Dexcom Share System indications, contraindications, warnings, precautions and detailed procedures in Part 5.4.5 System InformationThe receiver and app also keep you informed on the system’s status. Technical notifications provide information about your sensor session and about the system’s hardware. Each chapter provides a table of the prompts, system, and error messages applicable to its subject. As an example, the calibration chapter will review all calibration messages you may see.Now you know what the Dexcom G5 Mobile CGM System does and what’s new, let’s open your Dexcom G5 Mobile packages, see what’s inside, and review each item.4.6 System ComponentsPackageThe Dexcom G5 Mobile CGM System comes to you in a number of boxes; after opening keep the packaging until you are no longer using its contents.
Dexcom G5 Mobile System User Guide40What Is the Dexcom G5 Mobile CGM System?SensorSensor packageSingle use sensor(s)InsertTransmitterTransmitter packageReusable transmitter(Continued on next page)
41Dexcom G5 Mobile System User GuideWhat Is the Dexcom G5 Mobile CGM System?ReceiverReceiver packageReceiverReceiver’s USB charging and download cableAC power adapter(Continued from previous page)(Continued on next page)
Dexcom G5 Mobile System User Guide42What Is the Dexcom G5 Mobile CGM System?ReceiverGetting Started withYour Dexcom CGMDexcom CARE is committed to making your CGM experience a positive one. We are here to ensure that you experience CGM the way it was designed to help you manage your diabetes.LBL013034 Rev 002 MT23142 *Learn at your own pace with our Self-Guided Training Tutorial at www.dexcom.com/tutorial or review the disc and Quick Start materials inside your Dexcom G5 Mobile Receiver box; or receive remote training with Dexcom’s Patient Care Specialist; or schedule an appointment for the Dexcom G5 Mobile device training in your physician’s office or diabetes center.Call us at 877-339-2664 Ext. 4900 and speak with a Certified Diabetes Educator.Register for a live, no-charge training webinar at www.dexcom.com or open an online account to begin “sharing” at www.dexcom.com/register.Get Started*Refer to your enclosed Quick Start Guide or Tutorial. Expert Advice | Personalized Training | Customized Support | Guidance | EncouragementWelcome CardQuick Start GuideTraining Checklist attached to Quick Start GuideTraining Tutorial USB CardOverview of System ComponentsThis section is meant as a quick overview of each part, specifics for each are found in following chapters. For detailed product specifications and technical information, please go to Chapter 17.(Continued from previous page)
43Dexcom G5 Mobile System User GuideWhat Is the Dexcom G5 Mobile CGM System?The Dexcom G5 Mobile CGM System is comprised of four key parts:1. Single use sensor2. Reusable transmitter3. Rechargeable receiver4. Dexcom G5 Mobile Appa. Downloaded to your smart deviceDexcom G5 Mobile CGM System optional:Dexcom ShareSensor OverviewFor your safety, the sensor is packaged in a sterile sealed pouch, containing an applicator, sensor pod, and sensor wire. When you first open the package, your sensor looks like one item, however it’s actually three: sensor applicator barrel, sensor pod, and sensor wire.The applicator barrel helps you insert the sensor wire inside the sensor pod under your skin. After inserting the sensor wire, remove the applicator barrel. The sensor wire stays in the sensor pod with the pod attached to your skin by adhesive.The sensor wire is made of silver and platinum with polymer membranes. Once inserted, the thin and flexible wire measures your glucose levels in the fluid between your cells (interstitial fluid) for up to seven days.This section is meant as a quick overview. More information on using and inserting the applicator, sensor, and sensor wire can be found in Chapter 6.Safety LockCollarSensor PodAdhesive PatchRelease TabTransmitter LatchApplicator Barrel (contains small introducer needle and sensor)PlungerFigure 1. Dexcom G5 Mobile Sensor Applicator and Pod
Dexcom G5 Mobile System User Guide44What Is the Dexcom G5 Mobile CGM System?Applicator and Sensor PodWhat it’s called What it doesApplicatorApplicator BarrelContains small insertion needle and sensor wire.Inserts sensor wire under the skin.Disposable, for single use only.Removed after insertion.Safety LockKeeps all moving parts in place before insertion.Prevents accidental sensor insertion.Tool to remove transmitter after sensor session.Put in transmitter box after removal to use later.Collar Collar removes insertion needle.Plunger Inserts sensor wire into your body.Transmitter Latch Securely snaps transmitter into sensor pod.Sensor PodSensor PodHolds transmitter and sensor wire.Water resistant when transmitter is properly installed.Discarded after sensor session.Adhesive Patch Keeps sensor pod attached to your skin.Transmitter Cradle Holds transmitter in place during sensor session.Sensor WireWire measures glucose levels in fluid in between your cells.Attached to sensor pod.Discarded with pod after session.
45Dexcom G5 Mobile System User GuideWhat Is the Dexcom G5 Mobile CGM System?Transmitter OverviewSnapping into the sensor pod, the gray plastic transmitter wirelessly sends your glucose Snapping into the sensor pod, the gray plastic transmitter wirelessly sends your glucose information to your display devices—receiver and/or smart device. If you have a new transmitter, open the package when you are ready to use it. The transmitter is:1. Reusablea. Do not discard after sensor session.b. Only for you, don’t share transmitter.2. Water resistant 3. Can transmit data to your display devices for up to 20 feeta. Range is less if you are in or under water.4. Battery lasts approximately three monthsa. Receiver or smart devices prompts you when battery is running low.5. Transmitter’s serial number is on the backMore transmitter features and insertion information is in Chapter 6. Now you are familiar with sensor and transmitter, let’s review the Dexcom G5 Mobile Receiver.Dexcom G5 Mobile ReceiverThe receiver is a small hand-held device. Your receiver, along with your smart device, shows your sensor glucose readings, trend graphs, trend arrows and alerts you when your glucose is too high or too low or if there is something you should be aware of or need to do.The receiver is neither water resistant nor waterproof and can get damaged if moisture gets inside, so keep it away from any liquids and very high humidity. Keeping the micro USB port closed helps prevent damaging fluids and dust from getting inside the receiver. If your receiver does get wet, test it to make sure the speaker and vibrations still work (see Chapter 12).If your receiver isn’t charged, see Chapter 14 for charging your receiver’s battery.Figure 2. Dexcom G5 Mobile Transmitter Front and Back
Dexcom G5 Mobile System User Guide46What Is the Dexcom G5 Mobile CGM System?If you want to use the receiver along with a smart device, you need to set them up separately.Remember, you can’t use a combination of smart devices during a sensor session; select just one.Receiver OverviewWhat you see What it’s called What it doesReceiverProvides data about your glucose trends via screen display, sounds and vibration.Micro USB Port Plug USB cable into port for recharging.USB Port DoorClose USB port door after removing USB cable to keep receiver clean and dry.Micro USB CablePlug into receiver to charge battery.Don’t plug into a computer port to charge.Battery can only be charged using the adapter/wall charger.(Continued on next page)
47Dexcom G5 Mobile System User GuideWhat Is the Dexcom G5 Mobile CGM System?(Continued from previous page)What you see What it’s called What it doesWall ChargerPlug USB cable into adapter/wall charger.Plug wall charger into an electrical outlet to charge receiver’s battery.Don’t block access to the charger.Display ScreenShows sensor glucose readings, trend graphs and arrows, Alarm/Alerts, sensor session status.Change settings on Menu screen.Speaker Allows you to hear your Alarm/Alerts sounds.Navigation WheelArrows and button to help you navigate through the receiver’s menu options and choose features.Select Button Press to select menu option.Left Arrow Press to go back to last item/screen or home screen.Right Arrow Press to highlight next item.(Continued on next page)
Dexcom G5 Mobile System User Guide48What Is the Dexcom G5 Mobile CGM System?What you see What it’s called What it doesUp/Down ArrowsPress to scroll up or down to select menu items or set values.Press to scroll back and forth beyond from the 3 hour trend graph to the 1-6-12-24 views.4.7 Smart Device OverviewThe Dexcom G5 Mobile App was created to work with your smart device, giving you even more options in monitoring your glucose trends and patterns. The app is similar to all other apps.This User Guide is not meant to show you how to use your smart device. Please contact your smart device support or read your smart device’s user guide for assistance. SummaryNow You Can:• Explain the Dexcom G5 Mobile CGM System • Describe options to view trends• Locate your historical readings• Recognize system components• Explain each part’s functionNext StepsYour next step in getting started with the Dexcom G5 Mobile CGM System is selecting how to continuously receive your sensor glucose readings: Dexcom G5 Mobile App, the Dexcom G5 Mobile Receiver or a combination. Our next chapter helps you set up both!(Continued from previous page
49Dexcom G5 Mobile System User GuideSet up Your Display Devices5.1 IntroductionIn the previous chapter, you received a high level overview of the Dexcom G5 Mobile CGM System and learned you can monitor your glucose levels with different display devices. Now it’s time to set up your Dexcom G5 Mobile App and your receiver. After this chapter, you will be able to:• Create a Dexcom username and password• Download the Dexcom G5 Mobile App• Set up the Dexcom G5 Mobile App with the recommended settings• Successfully set up your Dexcom G5 Mobile Receiver5.2 Safety StatementIf you’ve used the Dexcom G4 PLATINUM CGM System, you might still have its transmitter or receiver. While you can use the sensors across the different generations (look for the Dexcom G5 Mobile/G4 PLATINUM Sensor package), you can’t mix the transmitter or receiver between the two systems.PRECAUTIONDon’t: Never mix Dexcom G5 Mobile’s Transmitter or Receiver with Dexcom G4 PLATINUM’s Transmitter or Receiver.Why: The Dexcom G5 Mobile CGM System’s Transmitter and Receiver are not compatible with the Dexcom G4 PLATINUM CGM System’s Transmitter and Receiver. The Dexcom G5 Mobile CGM System won’t work if you mix Receiver and Transmitter components from different generations. Consequences: Missing a severe low (hypoglycemia) or high (hyperglycemia) event.Chapter 5Let’s G5! The Basics:Set up Your Display Devices
Dexcom G5 Mobile System User Guide50Set up Your Display Devices5.3 Why Different Monitoring Methods?Your convenience! By offering two separate monitoring systems, the app or receiver, you can choose to monitor your glucose levels in the handiest method at that moment. Smart device ran out of memory. If you forgot your receiver at home, use your smart device! Battery died on your smart device? Smart device memory full? Your receiver has you covered!With the exception of Dexcom Share, the primary difference between the two monitoring systems is not the data itself, but how it’s presented.The next section walks you through the initial set up for the app. To set up the receiver, go to Section 5.5. If you want to use both the mobile app and the receiver, you need to set each up individually.Once you have completed the initial set up, you’re one step closer to beginning your sensor session!5.4 Dexcom G5 Mobile AppBefore starting your first sensor session, pick the smart device you want to use. As mentioned in the previous chapter, you can use the receiver with one smart device during a session; however, you can’t use multiple smart devices during the same session. While your smart device can have the app installed, part of your initial set up is entering the transmitter’s serial number (SN). If by accident you enter the SN into more than one smart device, the system warns you and you won’t be able to complete the set up process.Suggested Smart Device SettingsBluetooth is designed wireless communication between devices (unlike Wi-Fi®, which wirelessly connects devices to the Internet). Your transmitter communicates to your app via Bluetooth® Smart! Before beginning, make sure your smart device’s Bluetooth is available and turned on.Refer to your smart device’s user guide if you have questions on how to change your smart device settings.• While checking your Bluetooth settings, check to see Silent and Do Not Disturb are off. Your app does not override these settings; if you have them on, you will miss Alarm/Alerts• After verifying all your settings are correct, there is one more thing to check. Make sure your smart device’s Volume is loud enough for you to hear any Alarm/Alerts
51Dexcom G5 Mobile System User GuideSet up Your Display Devices• Make sure your smart device settings allow your Dexcom Alarm/Alerts to always show on your lock screen• For information on how to set the above settings, see your smart device’s user guide. Once you have verified your smart device’s settings are right, the next step is installing the Dexcom G5 Mobile App• The app needs to be open and running in the background. This may drain your smart device’s battery; make sure you check its battery is charged• Don’t change your smart device’s time because it can make the time on the trend screen wrong and the app may stop displaying dataIf your smart device is broken or lost, use receiver until it’s fixed or replaced.Dexcom G5 Mobile App InstallationInstalling the app is easy! Simply download the Dexcom G5 Mobile App from your smart device’s store. However, if your smart device has been jailbroken, do not install the app.For information on how to install an app, see your smart device’s user guide. Initial Dexcom G5 Mobile App SetupSetting up your app is easy! You’ll need your Dexcom account username and password, along with your transmitter box. Once inside, simply follow the set up wizard instructions. The set up wizard walks you through safety information, recommended settings, entering transmitter SN, setting your high/low glucose levels, and receiving CGM notifications.Your initial set up will require a Dexcom username and password. You can create them by tapping Sign Up within the app, or by going to dexcom.com.From Your Web Browser:1. Go to dexcom.com.2. Click green Get Started tab or the three green bars, then “Get Started.”3. Click green Get Started button on the page.4. Fill out User account screen.5. Click the green Create New Account button towards the bottom of the screen.But what if you are unclear about a step?The Dexcom App has prompts allowing you to get more information. If you are unsure of something during your initial set up process, look at the screen for additional information prompt. Informational prompts include, but aren’t limited to: I don’t understand, Learn More, or Question Mark. Tap your informational prompt to get more information.To close out of the information prompt, tap the X in the upper right hand corner.
Dexcom G5 Mobile System User Guide52Set up Your Display DevicesInitial App SetupStep What you see What you doIntroductory Screens1Tap Dexcom G5 Mobile App icon to open app.2Swipe through introductory screens or tap Log In.(Continued on next page)
53Dexcom G5 Mobile System User GuideSet up Your Display Devices(Continued from previous page)Introductory Screens3Enter existing username and passwordORNeed a Dexcom username and password?Tap Sign Up.Complete Username/Password fields.Tap Login once.4Tap Let’s Get Started.(Continued on next page)
Dexcom G5 Mobile System User Guide54Set up Your Display Devices(Continued from previous page)Introductory Screens5The next screens are the Terms of Use, safety warnings, contraindications, and the recommended settings.Once each screen is read, tap the appropriate answer to move forward.Tap Full Safety Statement or, when applicable, I don’t understand to get more information.(Continued on next page)
55Dexcom G5 Mobile System User GuideSet up Your Display Devices(Continued from previous page)Setting up Your App Alarm/Alerts and Basic Settings6Set your Low Glucose Alert.Default is 80 mg/dL.Scroll to select another amount.Tap Save to move forward.Once set, you’ll receive an Alert notification if your glucose dips below your set amount.7Set your High Glucose Alert.Default is 200 mg/dL.Scroll to select another amount.Tap Save to move forward.Once set, you’ll receive an Alert notification if your glucose rises above your set amount.(Continued on next page)
Dexcom G5 Mobile System User Guide56Set up Your Display Devices(Continued from previous page)Setting up Your App Alarm/Alerts and Basic Settings8aMake sure you get your Alarm/Alerts notifications. Tap the appropriate response to move forward and set your notifications.8b Tap OK to receive Alarm/Alerts notifications.(Continued on next page)
57Dexcom G5 Mobile System User GuideSet up Your Display Devices(Continued from previous page)Setting up Your App Alarm/Alerts and Basic Settings9The next screens provide suggestions for device volume, Do Not Disturb, and other basic settings.Tap appropriate answer to move forward.(Continued on next page)
Dexcom G5 Mobile System User Guide58Set up Your Display Devices(Continued from previous page)Connecting/Pairing Transmitter With App10 Tap Next.11Verify Bluetooth is on.The app will check to see if Bluetooth is turned “on.”(Continued on next page)
59Dexcom G5 Mobile System User GuideSet up Your Display Devices(Continued from previous page)Connecting/Pairing Transmitter With App12a Get your Transmitter box.Tap Take Photo.12bTurn transmitter box upside down on a flat surface with barcodes facing up.Center longest barcode within green brackets.(Continued on next page)
Dexcom G5 Mobile System User Guide60Set up Your Display Devices(Continued from previous page)Connecting/Pairing Transmitter With App12c Check mark confirms successful transmitter SN scan.13a If unable to use app’s scanning device:Tap Enter transmitter SN by hand.(Continued on next page)
61Dexcom G5 Mobile System User GuideSet up Your Display Devices(Continued from previous page)Connecting/Pairing Transmitter With App13bUse keyboard to enter transmitter SN.Confirm correct SN .Tap Save.14Insert sensor and attach transmitter following video’s instructions.See Chapter 6 for more information.(Continued on next page)
Dexcom G5 Mobile System User Guide62Set up Your Display Devices(Continued from previous page)Connecting/Pairing Transmitter with App15 Wait up to 30 minutes for smart device and transmitter to connect.16 At prompt, Tap Pair to pair app with smart device.(Continued on next page)
63Dexcom G5 Mobile System User GuideSet up Your Display Devices(Continued from previous page)Connecting/Pairing Transmitter with App17Tap the Sensor warmup circle to start your two hour sensor warmup. When you see the sensor warmup timer, your initial set up is complete.Congratulations!If you have any issues setting up the Dexcom G5 Mobile App, call Technical Support toll free at 1.877.339.2664 or toll at 1.858.200.0200. We are here 24/7 to assist you.If you are having problems with your smart device, contact your smart device’s support line. After completing your initial app setup, set up the receiver or go to Chapter 6 to start your initial sensor session.5.5 Dexcom G5 Mobile ReceiverIn the previous chapter, you learned about the receiver’s components. The following is a refresher to help in your initial set up. Display Screen:• Trend screen• Menu selection screenNavigation Wheel:• Select ○Button in the middle of the navigation wheel
Dexcom G5 Mobile System User Guide64Set up Your Display Devices ▪Center button does not say “Select” ○Press to ▪Turn on receiver ▪Select options/features ▪Accept changes ▪Move forward through menus/features• Up/Down ○Scroll through trend screens ○Highlight menu items ○Change values• Left ○Go back to last item or screen• Right ○Go to next item or screenInitial Setup of the Dexcom G5 Mobile ReceiverPress Select to turn receiver on.The first screen you see is the startup screen with ascending green bars. Once complete, a set up wizard guides you through the initial set ups steps. Don’t be alarmed if your receiver buzzes or makes other sounds during this process.After your initial setup is complete, you won’t see the setup wizard again. Your settings can always be adjusted using menu options.How you complete your initial set up differs between the receiver and your smart device; however, the data is the same.Setup Wizard Prompts:• Time/Date• Transmitter Serial Number ○Back of transmitter ○Back of transmitter’s box• Setting Low Alert• Setting High AlertBefore starting a session, you may want to check the receiver’s battery level. If it is less than half, go to Chapter 4, for charging instructions.
65Dexcom G5 Mobile System User GuideSet up Your Display DevicesInitial Receiver Set upStep What you see What you doInitial Screens1Press Select to turn receiver on.2Wait.Time/Date3aPress Up/Down Arrow to change year.Press Right Arrow to move forward.Press Up/Down Arrow to change month.Press Right Arrow.Press Up/Down Arrow to change day.Press Right Arrow to move to time.(Continued on next page)
Dexcom G5 Mobile System User Guide66Set up Your Display Devices(Continued from previous page)Time/Date3bPress Up/Down Arrow to change hour.Press Right Arrow.Press Up/Down Arrow to change minutes.Press Right Arrow.Press Up/Down Arrow to select AM/PM.Press Select to save and close.NOTE: After initial set up, if battery is drained, receiver will vibrate once and you will need to reset date and time.Transmitter4a Turn transmitter box upside down to locate SN number.4b If transmitter package isn’t available:• SN is on transmitter’s back4cPress Up/Down Arrows to select and enter transmitter SN.Press Right Arrow to move to next digit.Press Select to save and close.(Continued on next page)
67Dexcom G5 Mobile System User GuideSet up Your Display Devices(Continued from previous page)Setting Low Alert5a System default is at 80 mg/dL.Press Select to save at present levels and close.5bTo change value:Press Up/Down Arrows to change value at 5 mg/dL increments.Press Select to save and close.Setting High Alert6a System default is at 200 mg/dL.Press Select to save at present levels and close.6bTo change value:Press Up/Down Arrows to change value at 10 mg/dL increments.Press Select to save and close.These steps are enough to get you going; now you can start your sensor session! SummaryNow You Can:• Create a Dexcom username and password• Download the Dexcom G5 Mobile App
Dexcom G5 Mobile System User Guide68Set up Your Display Devices• Set app up with the recommended settings• Successfully set up your Dexcom G5 Mobile ReceiverWhat’s Next?Now you have completed setting up your app and/or the receiver, your next step is starting a sensor session. No matter what monitoring method you choose, starting a sensor session is the same:1. Inserting the sensor.2. Inserting the transmitter.3. Pairing the transmitter to your device.4. Two hour sensor warmup.5. Initial calibrations.
69Dexcom G5 Mobile System User GuideStarting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session6.1 OverviewNow that your display devices are set up, you’re ready to begin a sensor session. If this is your first time inserting a sensor, you may want to watch the Dexcom G5 Mobile sensor insertion video to get a better understanding of the process. The Dexcom G5 Mobile sensor insertion video is available by three ways:1. Through the App2. USB card in your Dexcom G5 Mobile Receiver package3. Online at dexcom.com:a. Top of page, click Support Tab.b. Click Education.After inserting the sensor, start the sensor warmup on your smart device and receiver. The sensor warmup takes approximately two hours; during this time your body is getting used to the new sensor, allowing for more accurate sensor glucose readings. Once the two hour sensor warmup has passed, you enter two back-to-back fingerstick measurements to calibrate the sensor’s glucose readings with your fingerstick measurements (Calibration is covered in the next chapter). Make sure you give yourself enough time to finish the startup session. Remember your smart device’s Bluetooth needs to pair with the transmitter, adding up to 30 minutes to your wait time. Good news is you don’t need to sit around waiting: as long as you have your display device near, you can go about your day running errands, gardening, personalizing the Dexcom G5 Mobile settings, whatever you choose during that time frame. Keep your display device(s) handy during the warmup period—it shows how much time has passed, notifying you with beeps and an icon when your sensor session is ready for its initial calibrations.After this chapter you will be able to:Chapter 6Let’s G5! The Basics:Starting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session
Dexcom G5 Mobile System User Guide70Starting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session• Identify sensor applicator features• Properly prepare for sensor insertion • Choose the best location to insert your sensor• Correctly insert your sensor• Prepare transmitter for placement • Correctly attach transmitter to sensor• Outline what happens during the sensor warmup• Identify countdown icon6.2 Safety StatementsFollowing are some important Precautions and Warnings to review; we want to make sure you and the system are safe before starting a sensor session.WARNINGDon’t: If a sensor breaks under the skin with no portion visible above the skin, don’t remove it.Do: Seek professional medical help if you have symptoms of infection or inflammation (e.g., redness, swelling or pain) at the insertion site.Always report a broken sensor to our Technical Support, 24/7, team at as soon as possible:Toll free: 1.877.339.2664Toll call: 1.858.200.0200Why: Sensors may fracture on rare occasions.Testing done in a controlled environment (in-vitro) didn’t find any safety hazards during an MRI with a broken off sensor under the skin. The wire didn’t heat up nor have any significant movement during the MRI, images were affected only in the area around the sensor’s wire.MRI with broken wireIf you have experienced a broken sensor and are planning to take an MRI, please discuss the following with your doctor or technician.Laboratory (in vitro) MRI tests did not detect any safety hazards for a broken sensor that remains in the body.There was no significant movement or heating of the wire. Imaging artifacts were limited to the area around the wire.
71Dexcom G5 Mobile System User GuideStarting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your SessionWARNINGDo: Store sensor between 36° F-77° F during its shelf life.Why: Storing the sensor incorrectly might cause the sensor glucose readings to be inaccurate.Never store sensors in the freezer.Consequences: If stored outside of 36° F-77° F, your sensor glucose readings may not be accurate, resulting in you missing a severe low or high glucose event.WARNINGDon’t: Never use the Dexcom G5 Mobile CGM System sensor glucose readings for treatment decisions.Do: Only use BG values from your BG meter for treatment decisions (e.g., how much insulin to take).Why: Since they measure your glucose from different body fluids, sensor glucose readings can be different from your meter’s blood glucose values.Consequences: Using sensor glucose readings for treatment decisions could result in you missing a severe low or high event.PRECAUTIONDo: Select sensor insertion site with care.Avoid:• Areas likely to be bumped, pushed or squeezed• Areas of skin with scarring, tattoos, or irritation • Injecting insulin within 3 inches of sensor• Placing an insulin pump infusion set within 3 inches of sensorWhy: Inserting sensor in these areas may affect sensor glucose readings. Consequences: Inaccurate sensor glucose readings may result in you missing a severe low or high event.
Dexcom G5 Mobile System User Guide72Starting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your SessionPRECAUTIONDo: Check sensor package before opening.Why: Make sure the sterilized package has not been damaged or previously opened. If opened or damaged, sensor may be unsterile. Consequences: Using an unsterile sensor may cause an infection.6.3 Prepping for Sensor InsertionBefore inserting a sensor, make sure you have everything you need. Some items are included in the Dexcom G5 Mobile CGM System’s packages, others are not. Items Included in Your Dexcom G5 Mobile PackagesFor sensor insertion, you need the sensor and transmitter.Sensor ApplicatorInside Sensor BoxWhat you see What it isSterilized sensor pouch with important label information.Check expiration date.Single use sensor applicator.Knowing what each applicator piece does helps you successfully insert your sensor. Chapter 4, Section 4.6 gave you overview of the sensor applicator.
73Dexcom G5 Mobile System User GuideStarting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your SessionThe following table reviews the sensor applicator components in order of use.Order of Use Name What it does1 Sensor Pouch Sterilized for your protection.Open to remove applicator and sensor.2Adhesive Patch Holds the sensor/transmitter in place on your skin.3Safety Lock Prevents plunger from inserting sensor until you are ready.4Plunger Inserts sensor wire into your body.5Applicator BarrelContains small insertion needle and sensor wire.Disposable, for single use only.6CollarCollar removes insertion needle.Helps remove applicator barrel once sensor wire is inserted.(Continued on next page)Figure 3. Dexcom G5 Mobile Sensor Applicator and Pod3. Safety Lock6. Collar7. Sensor Pod2. Adhesive Patch9. Release Tab8. Transmitter Latch5. Applicator Barrel (contains small introducer needle and sensor)4. Plunger
Dexcom G5 Mobile System User Guide74Starting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session(Continued from previous page)Order of Use Name What it does7 Sensor Pod Holds sensor wire in place under skin.Holds transmitter.8Transmitter Latch Locks transmitter into sensor pod.9Release Tab Allows you to remove applicator barrel from sensor pod.TransmitterTransmitter BoxWhat you see What it isBottom of box with important label information.Keep box until transmitter battery dies.Reusable transmitter.In the previous chapter, you entered your transmitter SN into your display devices and made sure your smart device and/or receiver connected with the transmitter. You won’t be able to start a sensor session if your transmitter isn’t paired with your receiver and/or smart device. Not included in packages:1. Alcohol wipes2. Your blood glucose meter3. Your test stripsBefore starting, check your blood glucose meter; make sure it’s in good working order following manufacturer’s directions and the meter’s date and time match your display device’s date and time.Make sure test strips haven’t expired and work with your meter.
75Dexcom G5 Mobile System User GuideStarting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your SessionBefore removing the sensor applicator out of its sterile pouch, determine the best place to insert your sensor.6.4 Choosing Your Insertion SiteChoose a place on your belly (or if user is between the ages of 2 and 17, upper buttocks) to insert the sensor; the site should be either above or below your belt line. The best areas are usually flat, “pinchable,” and free from where rubbing can occur (along the waist band, seat belt strap or where you lay when sleeping).For more help on ideal sensor insertion sites, contact your healthcare professional.Insertion SitesLocation Where it isFront of body (belly area) for ages 2 years and above.If user is between the ages of 2 years and 17:Back of body (Upper buttocks)Do:• Remove the sensor and applicator from its sterile package only at time of use• Place at least 3 inches from your insulin pump infusion set or injection site
Dexcom G5 Mobile System User Guide76Starting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session• If needed, shave the area so adhesive patch sticks securely • Make sure area is clean and free of lotions, perfumes, medicationsDon’t:• Never use same site repeatedly for sensor insertion • Never use same site for 2 sensor sessions in a rowIf you have concerns about the sensor pod not sticking, before inserting your sensor, you can make the sensor site stickier to help ensure the sensor pod does not peel.Optional Site PreparationUse optional skin adhesives (Mastisol™, SkinTac™) as part of your insertion site preparation to help keep your sensor pod attached. Apply the skin adhesive after you selected and cleaned your insertion site. Use circular motions and create an “O” outline, making sure you don’t get any skin adhesive inside the outline. Let the “O” dry based on skin adhesive manufacturer’s instructions. Once dry, your skin may feel slightly sticky.See Step 3 in the next table for directions.NOTE: Contact your healthcare professional for specific questions regarding the use of medical tape, barrier wipes and/or other adhesives as it relates to your use of Dexcom CGM.6.5 Inserting Your SensorYou’ve collected all of the needed items to begin a sensor session, viewed the tutorials, reviewed the sensor applicator and prepped the sensor pod site. You’re now ready to insert your sensor!Step Picture What you doPreparation1Wash and dry your hands.(Continued on next page)
77Dexcom G5 Mobile System User GuideStarting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session(Continued from previous page)Preparation2Clean insertion site with alcohol wipe.Let dry.3Optional Step: Skin AdhesiveCreate an oval on the skin• Do not get any skin adhesive inside the circle• Let skin adhesive dry• Insert sensor on clean skin at the center of the circle4Check pouch: Is it damaged or already opened?Remove sensor applicator from sterile pouch.Closely inspect sensor, check it hasn’t been damaged.Keep sensor packaging until sensor session is complete.Attaching Sensor Pod5Pull adhesive backing tabs.Don’t touch sticky adhesive patch.(Continued on next page)
Dexcom G5 Mobile System User Guide78Starting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session(Continued from previous page)Inserting Sensor Wire6Place sensor horizontally, not vertically, on skin.Move fingers around adhesive patch’s top several times to secure tape.7Hold applicator barrel.Pull safety lock out.8Place fingers of one hand on edges of adhesive patch.Pinch up your skin at the tips of the white adhesive.9Place two fingers directly above collar to steady applicator barrel.Place thumb on the white plunger.Push plunger completely down the applicator barrel.You should hear 2 clicks.NOTE: Finger placement is important for correct insertion.(Continued on next page)
79Dexcom G5 Mobile System User GuideStarting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session(Continued from previous page)Removing Applicator Barrel and Collar10Move two fingers from above collar to below collar.Keeping your thumb as a base on the white plunger.Pull collar all the way back towards your thumb.You should hear 2 clicks. NOTE: Finger placement is important for correct needle removal.11Hold transmitter latch down against your body.Squeeze ribbed release tabs on the sides of sensor pod.12aMove applicator barrel forward and out, away from your body.Follow local ordinances when disposing the applicator.12bWhat’s left?1. Sensor pod 2. Transmitter latchYou have successfully inserted the sensor!At this point, you should have two items attached:1. The sensor pod2. The transmitter latchHaving problems?If it’s the first time inserting a sensor, you may have questions or need help. If you do, please contact your Dexcom G5 Mobile CGM System Technical Support team, 24/7, at:
Dexcom G5 Mobile System User Guide80Starting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session• Toll free: 1.877.339.2664• Toll call: 1.858.200.0200The next step is attaching your transmitter to the sensor pod. 6.6 Attaching Your TransmitterNow that you have inserted your sensor, you need to attach your transmitter.Since the transmitter is reusable, you don’t need a new one every time you start a sensor session. Keep your current session’s transmitter box. The bottom label has important information you may need after you’ve inserted the transmitter. Once the transmitter has been attached, you can’t remove it until your session is over. Chapter 8 reviews when and how to remove your transmitter. Before inserting your transmitter, check you entered the correct transmitter SN into your display device. Chapter 5 covers entering transmitter’s SN number.Step Picture What you do1Remove transmitter from box.Keep box.Save safety latch from sensor applicator (helps remove transmitter once sensor session is over).Get alcohol wipe.2Wipe back of transmitter with alcohol wipe.Let dry for 2-3 minutes.Don’t let the back of transmitter touch your skin.Don’t scratch transmitter’s back, this can harm the waterproof seal.3Flat side down.Slide transmitter’s small end under the sensor pod lip located in front of pod’s ribbed tabs, away from transmitter latch.(Continued on next page)
81Dexcom G5 Mobile System User GuideStarting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session(Continued from previous page)Step Picture What you do4Keep finger on transmitter holding it in place.Push transmitter latch up and forward over the transmitter’s wide end with your other hand.You should hear 2 clicks.5Is transmitter secure?Before removing transmitter latch, verify transmitter is securely in place.Make sure none of the transmitters sides popped out of the sensor pod. If not completely snapped in, you may have a bad connection and it won’t be water tight.6Hold sensor pod sides with one hand.Twist latch away from your body with other hand.Remove latch.Don’t remove transmitter while sensor pod is attached to skin.You’re almost done starting your sensor session!Inserting the sensor, attaching the transmitter, and the two hour sensor warmup are the same regardless whether you use the receiver or app.The remaining steps vary from app to receiver:1. Letting your device know you need to start the sensor warmup.2. Following your warmup countdown.6.7 Loose Sensor PodThe sensor pod should stay on your skin using its own adhesive.
Dexcom G5 Mobile System User Guide82Starting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your SessionIf the patch peels up, use medical tape (such as Blenderm™, Tegaderm™, Smith & Nephew IV3000®, 3M™ tape) for extra support. • Tape over white adhesive patch on all sides for even support• Don’t tape over the transmitter or any plastic parts of the sensor pod• Don’t tape under sensor pod • Don’t leave any substance on the skin where you insert the sensorFigure 4. The Right Way to Use Tape for Extra Support6.8 Starting Your Sensor SessionIf you choose to use both the receiver and the app, each system requires individual setups (see Chapter 5). After pairing the transmitter to your device(s), inserting your sensor, and attaching the transmitter to the sensor pod, your next step is telling your device(s) you want to start a sensor session. Transmitters are reusable; pairing is required only when using a new transmitter.During the warmup period, neither device will provide any sensor glucose readings. Your sensor glucose readings begin after the two hour sensor warmup has passed and you entered the initial two calibration BG values into either the smart device or the receiver. We’ll first review starting the sensor session for the app.
83Dexcom G5 Mobile System User GuideStarting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your SessionDexcom App: Starting a SessionStep What you see What you do1Wait for Successful Pairing notification.Tap green checkmark in black square.2Tap Sensor Warmup circle to start your two hour sensor warmup.NOTE: You will NOT get any sensor glucose readings, Alarm/Alerts during your two hour sensor warmup period.3Wait.Screen provides countdown to sensor warmup. The orange dashes darken as the countdown moves forward. Keep smart device within 20 feet of transmitter during the sensor warmup period.(Continued on next page)
Dexcom G5 Mobile System User Guide84Starting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session(Continued from previous page)Step What you see What you do4Locked screen.Initial calibration prompt tells you when warmup is complete.Chapter 7 covers calibrating.5Initial calibration prompt tells you when warmup is complete.Sensor warmup is complete.You’re ready to calibrate!Receiver: Starting a SessionStep What you see What you do1Press Select to turn on receiver.(Continued on next page)
85Dexcom G5 Mobile System User GuideStarting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session(Continued from previous page)Step What you see What you do2From Trend Graph.Press Select to go to Main Menu.3Press Down Arrow to highlight Start Sensor.Press Select to start new sensor session.NOTE: After sensor starts, Start Sensor option disappears.4“Start Sensor” progress bar confirms two hour sensor warmup.Keep your receiver within 20 feet during the warmup period.5Receiver returns to the trend graph screen.6Make sure receiver and transmitter are communicating.Check receiver 10 minutes after starting for Bluetooth icon.• Solid: Connected• Blinking: Searching for connection• No Bluetooth Icon: No connection(Continued on next page)
Dexcom G5 Mobile System User Guide86Starting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session(Continued from previous page)Step What you see What you do7Wait.Screen provides countdown of the two hour sensor warmup.8Sensor warmup is complete.You’re ready to calibrate!6.9 Receiver Bluetooth TipsYour transmitter and receiver begin communicating once you start a sensor session. After approximately 30 minutes, if the Bluetooth symbol is solid, and not blinking, your transmitter and receiver are talking to each other.• If blinking, Bluetooth is looking for your transmitter ○Make sure your transmitter and receiver are within 20 feet of each otherIf the Bluetooth icon isn’t on the receiver and the Signal Loss icon appears in the receiver’s upper right corner of the status bar, they’re not communicating.
87Dexcom G5 Mobile System User GuideStarting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your SessionNo Communication Between Transmitter and ReceiverStep What you see What you do1Check correct transmitter SN is in receiver.• SN is on the label on bottom of transmitter boxPress Select to go to Main Menu.2Press Down Arrow to Settings.Press Select.3Press Down Arrow to Transmitter.Press Select.4Press Select.(Continued on next page)
Dexcom G5 Mobile System User Guide88Starting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session(Continued from previous page)Step What you see What you do5Check correct transmitter SN is in receiver.• SN is on the label on bottom of transmitter boxCompare SN in receiver to SN on transmitter box.If correct, call our 24/7 Technical Support department, toll free at 1.877.339.2664 or toll at 1.858.200.0200 for help.Press Select to exit screen.Press Left Arrow twice to go to Main Menu.If Wrong SN Entered6Press Left Arrow twice to go to Main Menu.7If sensor session has started, to correct transmitter SN, you must stop the sensor session.Press Down Arrow to Stop Sensor.Press Select.8Press Select to stop session.(Continued on next page)
89Dexcom G5 Mobile System User GuideStarting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session(Continued from previous page)If Wrong SN Entered9Wait for sensor session to end.10From Main Menu:Press Down Arrow to Settings.Press Select.11 Press Down Arrow to Transmitter.Press Select.12 Highlight Transmitter SN.Press Select.13Enter correct SN using Up/Down Arrow.Press Up/Down Arrow to select and enter transmitter SN.Press Right Arrow to move to next digit.Press Select to save and close.Press Left Arrow twice to return to Main Menu.(Continued on next page)
Dexcom G5 Mobile System User Guide90Starting a Sensor Session: Inserting Sensor, Transmitter, and Starting Your Session(Continued from previous page)If Wrong SN Entered14Start Sensor Session.Press Up/Down Arrow to highlight Start Sensor.Press Select on Start Sensor.6.10 Sensor Session WarmupThe sensor takes about two hours to adjust to your body. While you are in the sensor warmup period, you can customize your settings. Chapter 12, steps you through how to personalize your Dexcom G5 Mobile CGM System’s display devices. Once the sensor warmup is complete, you’re ready to enter your initial calibrations! The next chapter shows you how.SummaryNow You Can:• Identify sensor applicator features• Properly prepare for sensor insertion • Choose the best location to insert your sensor• Correctly insert your sensor• Prepare transmitter for placement • Properly attach transmitter to sensor• Outline sensor warmup • Identify countdown iconWhat’s Next?The next chapter guides you through the calibration steps.
91Dexcom G5 Mobile System User GuideCalibration7.1 Introduction In the previous chapter, you learned how to insert your sensor, transmitter, and start a new sensor session. You’re now ready to begin your last step before getting your sensor glucose readings: Calibration.This chapter reviews not just your initial calibration, but also update calibrations required throughout your sensor session. After this chapter, you will be able to:• Calibration Overview ○Define calibration ○Explain the importance of calibration ○Identify steps to ensure a successful calibration • Recognize steps in taking accurate blood glucose measurement ○Identify the correct blood glucose site for calibrations ○Prepare finger for fingerstick measurement• Determine if you should/should not calibrate ○Recognize when you can enter fingerstick measurement for calibration ○Recognize when you shouldn’t enter the fingerstick measurement for calibration ○Determine if you need to calibrate outside of the normal calibration requirements• Initiate startup calibration• Perform update calibrations• Correctly enter your fingerstick measurement ○Dexcom G5 Mobile App ○Dexcom G5 Mobile Receiver• Identify calibration errorsChapter 7Let’s G5! The Basics:Calibration
Dexcom G5 Mobile System User Guide92Calibration7.2 Calibration OverviewWhat Is a Calibration?As you learned earlier, the sensor glucose readings come from measuring the glucose fluids found between your cells (interstitial fluids). Although blood and interstitial fluids are similar, sensor glucose readings can be different between your fingerstick and your CGM. Calibration provides a comparison, or measurement, between your meter’s fingerstick measurement and the sensor’s glucose readings, allowing alignment between the sensor and meter. Your BG meter ‘teaches’ the sensor your glucose values through calibration. Just like a clock can need adjusting – calibrations allow your CGM to adjust to your body.Why Is Calibrating Important?Calibrations are a must to make sure the CGM system is performing at its best.By calibrating when the system notifies you that a calibration is due, the Dexcom G5 Mobile CGM System uses your meter’s BG value to make sure the sensor glucose readings remain accurate throughout your session.How Do I Calibrate?Take a fingerstick measurement from your meter, and simply enter the meter’s BG value into your display device. This chapter lets you know what precautions you need to take before taking your BG meter value, then entering your data. Up to now, you needed to enter information such as Alerts, transmitter SN, etc., separately for the receiver and smart device. Calibration is different.Don’t enter your BG values in both devices, enter into either your app or the receiver. If you enter your meter’s BG value into your receiver, it takes about five minutes for your sensor glucose readings to begin. In approximately ten minutes, you can view the readings in the other display device.How Often Do I Calibrate?There are three primary “must do” calibration events, each with its own prompts:1. Two initial calibrations once your warmup session is complete.2. Update calibrations done twice daily, once every 12 hours.3. When you’re prompted.
93Dexcom G5 Mobile System User GuideCalibrationIf you receive a calibration prompt outside of your scheduled calibration schedule, the system doesn’t accept your most recent calibration or your meter’s BG value is very different from the sensor’s glucose reading.Don’t worry about keeping track of the time between calibrations, the system will prompt you when you are ready for another. Now you have an overview of calibration, let’s review some contraindications, warnings, and precautions you need to know and follow before you calibrate.7.3 Safety StatementsCONTRAINDICATIONDon’t: Never take any medications containing acetaminophen during your sensor session.Why: Taking medications with acetaminophen (such as Tylenol or Excedrin Extra Strength) while wearing sensor may falsely raise sensor glucose readings. Level of inaccuracy depends on:1. Amount of acetaminophen active in your body.2. May be different for each person. Consequences: Without correct readings you might miss a severe low event.WARNINGDon’t: Never use the Dexcom G5 Mobile CGM System sensor glucose readings for treatment decisions.Do: Only use BG values from your BG meter for treatment decisions (e.g., how much insulin to take).Why: Since they measure your glucose from different body fluids, sensor glucose readings can be different from your meter’s blood glucose values.Consequences: Using sensor glucose readings for treatment decisions could result in you missing a severe low or high event.
Dexcom G5 Mobile System User Guide94CalibrationWARNINGDo: Calibrate at least once every 12 hours.Why: Calibrating less often than every 12 hours might cause inaccurate sensor glucose readings.Consequences: Missing severe low (hypoglycemia ) or high (hyperglycemia) Alarm or Alerts.PRECAUTIONDo: Look at trend arrows before calibrating. Trend arrows help you determine if you can calibrate now or should wait.Don’t: Never calibrate if your blood glucose is changing at a significant rate, typically more than 2 mg/dL per minute.Never calibrate when you see: • A single arrow, pointing up ○Rising 2-3 mg/dL each minute• Two Arrows pointing up ○Rising more than 3 mg/dL each minute • Single arrow pointing down ○Falling 2-3 mg/dL each minute • Two arrows pointing down ○Falling more than 3 mg/dL each minuteWhy: Calibrating during significant rise/fall of blood glucose may affect accuracy of sensor glucose readings. Consequences: You may miss a severe low or high glucose event.PRECAUTIONDo: Enter the exact BG value displayed on your BG meter within five minutes of a carefully performed fingerstick measurement.Why: Entering the wrong blood glucose values, or waiting more than five minutes before entry, might affect sensor accuracy. Consequences: You may miss a severe low or high glucose events.
95Dexcom G5 Mobile System User GuideCalibrationPRECAUTIONDo: Only use fingerstick measurements from your BG meter for calibration.Don’t: Never use alternative site blood glucose values such as blood from palms, forearms, etc.Why: Alternative site BG values are different from a fingerstick blood glucose value and may not reflect most recent blood glucose value. Consequences: You may miss a severe low or high glucose event.7.4 When to CalibrateCalibrating on a regular schedule aligns your sensor glucose readings with your meter’s BG values. Without calibrations, your sensor may be inaccurate, and as a result, so will your display device’s sensor glucose readings, Alerts, and prompts, etc.There are important times when you must calibrate:1. Initial or Start-Up Calibration: two hours after you insert your sensor.2. 12 Hour Update: every 12 hours after two hour startup calibration.3. When system prompts you.With calibration prompts, your sensor and display device helps you keep your calibration schedule on track. If your BG values are not between 40-400 mg/dL, the system won’t accept your calibration. Wait until you are within the 40-400 mg/dL range before entering your BG values.Initial Calibration: Sensor Start-Up Completed1. At prompts (see next table) enter two back-to-back fingerstick measurements into just one device.2. No need to do initial calibrations twice.a. Calibration data flows between the receiver and your app.b. Five minute reporting delay between devices.3. First update calibration is 12 hours after your initial calibration.Update CalibrationUpdate calibrations are typically 12 hours since your last calibration, however it can be sooner. As an example, if you know your next calibration is due at 4 AM, you can do the calibration before bedtime, resetting the 12hour count down.
Dexcom G5 Mobile System User Guide96Calibration1. Enter one fingerstick measurement at least every 12 hours.2. Display devices provides calibration prompts.3. You may be prompted to enter additional fingerstick measurements as needed.Figure 5. Example Minimum Calibration Schedule During Seven-Day Sensor Session7.5 Calibration PromptsSensor Session Start-Up Calibration PromptsOnce your two hour sensor start-up is complete, your display device tells you it’s time to enter the first of your two back-to-back start-up calibrations. Once the system has accepted your BG values, your glucose readings begin. If you don’t enter your BG values right away, the system reminds you every 15 minutes. Remember, only use your BG meter for calibrations, and never enter values from your CGM.
97Dexcom G5 Mobile System User GuideCalibrationStart-Up Calibration PromptsDevice What you see What it means What you doFirst CalibrationSmart Device: Lock ScreenSensor warmup is complete.Ready for first of two initial calibrations.Follow steps in Section 7.6 and 7.7.Immediately prepare for next calibration.Smart Device: In AppReceiver(Continued on next page)
Dexcom G5 Mobile System User Guide98Calibration(Continued from previous page)Device What you see What it means What you doSecond CalibrationSmart Device: Lock ScreenSensor accepted first calibration.Ready for second BG meter value.Follow steps in Section 7.6 and 7.7.Next calibration in 12 hours.Smart Device: In AppReceiverYour sensor glucose readings begin in approximately five minutes once the device(s) accepts your calibrations. Update Calibration PromptsOnce your start-up calibration is done, your update calibration schedule begins.
99Dexcom G5 Mobile System User GuideCalibrationThe steps to enter your update calibrations are the same as your initial calibration, including only entering values in one display device. The only difference is, with update calibrations, enter your BG meter value just once. Like the reminders you received with your initial calibration, if you don’t enter your BG meter values right away, the system prompts you every 15 minutes.Update Calibration PromptsDevice What you see What it means What you doSmart Device: Lock ScreenEnter update calibration.If prompt doesn’t go away:• System didn’t accept calibration• BG values are very different from sensor glucose readingsFollow steps in Section 7.6 and 7.7.Immediately prepare for next calibration.Smart Device: In AppReceiverTap message to clear prompt on your smart device and to clear a prompt on your receiver, press Select. Sound/Vibration PromptsIn case you can’t look at your screen, both the smart device and receiver provide, with the exception of your regular 12 hour update calibration, beep/vibration prompts to let you know it’s time to calibrate or if there was a system calibration error.For more information on setting your sound/vibration prompts and how to clear them, please see Chapter 9.Smart DeviceCalibration prompts will alert you with a triple beep if your smart device is not on Silent or Do Not Disturb.
Dexcom G5 Mobile System User Guide100CalibrationReceiverThe receiver alerts you with an initial vibration for calibration prompts. If not cleared, you receive a vibrate/beep every five minutes until confirmed. 7.6 Preparing for CalibrationYour sensor depends on you to help make its sensor glucose readings accurate. If you don’t prepare properly for the calibration, your sensor may not provide you with the most accurate sensor glucose readings. Eight Steps to Successful Calibration:Do:1. Wash and dry your hands before staking a fingerstick measurement.2. Always use the same meter you routinely use to measure your blood glucose. a. Blood glucose meter and strip accuracy vary between meter brands.b. Switching within a session might cause sensor glucose readings to be less accurate.3. Follow meter’s instructions exactly when taking your fingerstick measurement.4. Verify test strips are current and, if required, coded correctly with meter.5. Check: Is Bluetooth is active?6. Use fingerstick BG values only.a. Other sites are not as accurate.b. Must enter within five minutes of taking BG meter value.c. Enter exact BG value from your meter for each calibration.Don’t:7. Don’t take acetaminophen containing medication during your session (e.g., Tylenol).a. See your healthcare professional to better understand how long acetaminophen is active in your body.8. Don’t calibrate if your BG values are under 40 mg/dL or over 400 mg/dL.a. If BG value is outside of this range, receiver doesn’t understand these values and won’t calibrate.i. You must wait until your blood glucose is in the range to calibrate.Be safe—if blood glucose is low, first treat low blood sugar, and then calibrate. 7.7 Ready? Set? Calibrate!You’ve followed the eight steps above, have a valid BG value from your meter, and your display device keeps alerting you: Calibrate! Calibrate! Calibrate!
101Dexcom G5 Mobile System User GuideCalibrationRemember:You don’t have to take a fingerstick measurement for each display device when calibrating, once you enter the reading into one, data is pushed to the other within five minutes.Next are steps to enter your calibrations using the app, followed by the steps for entering your calibrations into the receiver.Calibrate With Your Dexcom G5 Mobile AppStep What you see What you do Additional info1Tap circle.Initial calibration: Enter two back-to-back meter BG value.Update calibration: Enter one meter BG value.(Continued on next page)
Dexcom G5 Mobile System User Guide102Calibration(Continued from previous page)Step What you see What you do Additional Info2Enter meter’s BG value using number pad. Tap Save.Double check your numbers.Entering wrong values can affect the sensor’s accuracy.3Verify value is correct.Tap Save.If not correct:Tap Cancel.Reenter correct value.(Continued on next page)
103Dexcom G5 Mobile System User GuideCalibration(Continued from previous page)Step What you see What you do Additional Info4Tap circle to enter your second BG value.Follow steps 2-3 and enter second reading.5Meter icon has no calibration prompt.Calibration accepted.Your calibration was successful.(Continued on next page)
Dexcom G5 Mobile System User Guide104Calibration(Continued from previous page)Step What you see What you do Additional Info6Wait for next calibration prompt in 12 hours.Default Home Trend screen.Calibration accepted.Calibrate With Your Dexcom G5 Mobile ReceiverStep What you see What you do Additional Info1Press Select to turn on receiver.Press Select again for Main Menu.You won’t see calibration prompts when receiver screen is black.(Continued on next page)
105Dexcom G5 Mobile System User GuideCalibration(Continued from previous page)Step What you see What you do Additional Info2Press Up/Down Arrow.Highlight Enter BG.Press Select.3Press Up/Down Arrow to change numbers.Stop at meter’s BG value.Press Select.Sensor default reading is 120 mg/dL.If sensor glucose reading is within the last 15 minutes, screen will show sensor’s actual reading.4aVerify BG value is correct.If correct:Press Select.If Select is not pressed:• Receiver times out• BG level isn’t recorded4bVerify BG value is correct.If incorrect:Press Right Arrow to Cancel.Press Select.Reenter BG value.Cancel and re-enter BG value.Fingerstick measurement must be within five minute window.(Continued on next page)
Dexcom G5 Mobile System User Guide106Calibration(Continued from previous page)Step What you see What you do Additional Info5Wait.“Thinking” screen.BG value is accepted.6Immediately take another meter reading.Enter meter’s BG Value.First calibration accepted.Time for second calibration.7Wait for next calibration prompt in 12 hours.Default Trend screen.Calibration(s) accepted.7.8 Calibration ErrorsBefore or during your calibration process, your display device may show error prompts. If the prompts don’t go away after 15 minutes, refer to Chapter 18, Troubleshooting.
107Dexcom G5 Mobile System User GuideCalibrationDevice What you see What it means What you doSmart Device: In AppSensor can’t calibrate now.Wait 10-15 minutes.Retake fingerstick measurement at prompt.Enter BG value.ReceiverSmart Device: In AppSystem didn’t accept recent calibration.Additional calibration needed immediately.Calibrate.No sensor glucose readings.ReceiverApproximately five minutes after entering your second BG meter value, your display device(s) will start providing sensor glucose readings and glucose level trends. While each display device may have different ways of presenting sensor glucose readings and trends, the meanings are the same. Fingerstick measurements entered into one device will be available in the other approximately ten minutes after entering data.
Dexcom G5 Mobile System User Guide108CalibrationSummaryNow You Can:• Calibration Overview ○Define calibration ○Explain the importance of calibration ○Identify steps to ensure a successful calibration • Recognize the steps required to take an accurate blood glucose levels ○Identify the best blood glucose site for calibrations ○Prepare finger for fingerstick measurement• Determine if you should/should not calibrate ○Recognize when you can enter BG meter values ○Recognize when should not enter the BG meter values ○Determine if you need to calibrate outside of the normal calibration guides• Initiate startup calibration• Perform maintenance calibrations • Correctly enter your fingerstick measurement ○Dexcom G5 Mobile App ○Dexcom G5 Mobile Receiver• Identify calibration errorsWhat’s Next?In the next chapter, you’ll learn how to end a typical seven day sensor session, what to do if you need to end your sensor session early, along with removing the transmitter and determining if you need to replace it.
109Dexcom G5 Mobile System User GuideEnding Your Sensor Session and Transmitter Session8.1 IntroductionDexcom G5 Mobile Sensor Sessions last seven days. This chapter reviews what you should expect when your session is about to expire, removing the sensor and transmitter. It also covers how to determine if you need to end your session early. After this chapter, you will be able to:• Identify replace sensor prompts at the end of a seven day sensor session• Recognize when you have to end a sensor session early• Successfully end a sensor session early ○Identify how you can prevent sensor session failures• Remove your sensor pod with transmitter attached• Separate transmitter from sensor pod• Determine if transmitter can be used for another sensor sessionTo keep up with your glucose trends, it’s important to begin a new sensor session as quickly as possible. After a sensor session ends, the sensor stops taking your sensor glucose readings. You won’t get your trends, nor will you get any Alarm or Alerts.Before stopping a session, and removing the sensor pod and transmitter, review the following safety statements to make sure you don’t harm yourself.Chapter 8Let’s G5! The Basics:Ending Your Sensor Session and Transmitter Session
Dexcom G5 Mobile System User Guide110Ending Your Sensor Session and Transmitter Session8.2 Safety StatementsWARNINGDon’t: If a sensor breaks under the skin with no portion visible above the skin, don’t remove it. Don’t ignore sensor fractures.Do: Seek professional medical help if you have symptoms of infection or inflammation (e.g., redness, swelling or pain) at the insertion site.Always report a broken sensor to our Technical Support, 24/7, team as soon as possible:Toll free: 1.877.339.2664Toll call: 1.858.200.0200Why: Sensors may fracture on rare occasions.Testing done in a controlled environment (in-vitro) didn’t find any safety hazards during an MRI with a broken off sensor under the skin. The wire didn’t heat up nor have any significant movement during the MRI, images were affected only in the area around the sensor’s wire.MRI with broken wireIf you have experienced a broken sensor and are planning to take an MRI, please discuss the following with your doctor or technician.Laboratory (in vitro) MRI tests did not detect any safety hazards for a broken sensor that remains in the body.There was no significant movement or heating of the wire. Imaging artifacts were limited to the area around the wire.PRECAUTIONDo: Keep Transmitter until it’s battery life has ended.Why: Transmitter is reusable.• Use for multiple sessions8.3 Ending Your Sensor SessionThere are different ways your session might end.The most common is your sensor’s typical seven day timeframe ended. The second is ending the sensor session early. You may end a session early based on a personal decision,
111Dexcom G5 Mobile System User GuideEnding Your Sensor Session and Transmitter Sessionor on rare occasions, the receiver or app detects sensor issues and prompts you to end the session.Let’s review ending a normal session first, later in this chapter we’ll review the prompts for ending the session early.Ending Your Seven Day Sensor SessionJust like other prompts, your sensor session ending prompts need clearing:• App ○Tap screen• Receiver ○Press Select
Dexcom G5 Mobile System User Guide112Ending Your Sensor Session and Transmitter SessionEnd of Seven Day Sensor Session PromptsEnding Sensor Session PromptsDevice What you see What it meansAt Six HoursSmart Device: Lock ScreenPrompts begin when sensor session has only six hours left.Clock will countdown until session has ended.Continue to get sensor glucose readings.Smart Device: In AppReceiver(Continued on next page)
113Dexcom G5 Mobile System User GuideEnding Your Sensor Session and Transmitter Session(Continued from previous page)Device What you see What it meansAt Two HoursSmart Device: Lock ScreenTwo hours remain on your current sensor session.Continue to get sensor glucose readings.Smart Device: In AppReceiver(Continued on next page)
Dexcom G5 Mobile System User Guide114Ending Your Sensor Session and Transmitter Session(Continued from previous page)Device What you see What it meansAt Thirty MinutesSmart Device: Lock ScreenThirty minutes remain.Continue to get sensor glucose readings.Smart Device: In AppReceiver(Continued on next page)
115Dexcom G5 Mobile System User GuideEnding Your Sensor Session and Transmitter Session(Continued from previous page)Device What you see What it meansSession EndedSmart Device: Lock ScreenSession has ended.AppTap screen’s “?” for steps to:• Remove sensor• Insert new sensorReceiverPress Select to clear.Smart Device: In AppReceiver(Continued on next page)
Dexcom G5 Mobile System User Guide116Ending Your Sensor Session and Transmitter Session(Continued from previous page)Device What you see What it meansSession StoppedSmart Device: Lock Screen N/ASensor session has stopped.App• No sensor glucose readings• Prompts for new sessionReceiver• Straight line ○No sensor glucose readingsSmart Device: In AppReceiverSound/Vibration PromptsIn case you can’t look at your screen, both the smart device and receiver provide beep/vibration prompts to remind you your sensor session will end in 30 minutes, it has just ended, or if your sensor failed and you need to start a new session. Remember, if your smart device is on Silent or Do Not Disturb, you won’t get any sound prompts.For more information on setting your sound/vibration prompts, please see Chapter 9.Smart DeviceYour smart device prompts you with a triple beep. If not cleared, you receive the triple beep twice, five minutes apart.ReceiverThe receiver alerts you with an initial vibration prompts. If not cleared, you receive a vibrate/beep twice, five minutes apart.Once a sensor session has expired, you are ready to start your new session! If you’re not sure what to do, the app will provide instructions, or you can refer to the Quick Start Guide, online tutorials, or go to Chapter 6 in the User Guide.
117Dexcom G5 Mobile System User GuideEnding Your Sensor Session and Transmitter SessionEnding Your Sensor Session EarlyFor personal reasons, you may want to force quit a sensor session early (e.g., you’re getting an MRI and need to remove sensor pod). Or, occasionally, the app or receiver may detect something is wrong with your sensor and let you know it’s stopping the current session.This may be caused by a number of reasons:1. Unresolved calibration issues.2. Error symbol does not go away.3. Wait symbol does not go away.4. Sensor is coming out of the body (for example, the adhesive is peeling off).You’ll receive error prompts leading to a new sensor session. If you see error prompts, always contact Technical Support before stopping a sensor session early. Technical Support, 24/7, at:Toll free: 1.877.339.2664Toll call: 1.858.200.0200When your display device has system errors, you may not receive any sensor glucose readings and you should not calibrate.
Dexcom G5 Mobile System User Guide118Ending Your Sensor Session and Transmitter SessionPrompts to End Sensor Session EarlySystem PromptsDevice What you see What it meansSmart Device: Lock ScreenSensor issues detected.Session ends automatically.No: • Sensor Glucose Readings• Alarm/AlertsReplace sensor.Smart Device: In AppReceiver(Continued on next page)
119Dexcom G5 Mobile System User GuideEnding Your Sensor Session and Transmitter Session(Continued from previous page)Device What you see What it meansSmart Device: Lock ScreenWait up to three hours while the system autocorrects.Check transmitter—is it properly inserted into sensor pod?Make sure you haven’t taken acetaminophen.If not corrected after 3 hours:• Contact Dexcom Technical SupportSmart Device: In AppReceiverSmart Device: Lock ScreenWait up to three hours while the system autocorrects.Check transmitter—is it properly inserted into sensor pod?Make sure you haven’t taken acetaminophen.If not corrected after 3 hours:• Contact Dexcom Technical SupportSmart Device: In AppReceiver
Dexcom G5 Mobile System User Guide120Ending Your Sensor Session and Transmitter SessionThe Dexcom G5 Mobile CGM System knows when a typical seven day sensor session is over, automatically ending the session in each display device. However, if you need to end the session early, you need to let the system know by manually stopping the sensor session.While the end result is the same (ending a sensor session), the steps differ between the app and receiver. If you’re using both, no need to stop the sensor session in each: the other display will see the session has stopped.Let’s first look at how to end a sensor session in the app, then the receiver.App: Ending a Sensor Session EarlyStep What you see What it means What you do1 Access Main Menu. Tap Main Menu icon.1Ends sensor session.During session:• Stop Sensor option appearsNot in active session: • Start Sensor option appearsTap Stop Sensor.(Continued on next page)
121Dexcom G5 Mobile System User GuideEnding Your Sensor Session and Transmitter Session(Continued from previous page)Step What you see What it means What you do3Blue “?” icons provide additional information. Tap Stop Sensor.4Confirms sensor session has ended.Ready for new session.Remove sensor.Insert new sensor.Tap green circle when ready for new session.Receiver: Ending a Sensor Session EarlyStep What you see What it means What you do1 Go to Main Menu. Press Select.(Continued on next page)
Dexcom G5 Mobile System User Guide122Ending Your Sensor Session and Transmitter Session(Continued from previous page)Step What you see What it means What you do2Ends sensor session.During session, Stop Sensor option appears.Press Down Arrow to Stop Sensor.Press Select.3Thinking screen. Wait.4Confirms you want to stop sensor.Return to Main Menu.Press Select.5Ready to start a new session.Not in active session, Start Sensor option appears.Remove sensor.Insert new sensor.Press Start Sensor when ready for new session.Temporary Shutdown Receiver To save on its battery, you can temporarily shut down the receiver. When shut down, your receiver and transmitter no longer communicate and you will not get any Alarm or Alerts although your sensor session remains active.Shutting down the receiver does not extend your sensor session past the seven days; it only stops the receiver from communicating with the transmitter. Your sensor session will stop seven days after you started the session.
123Dexcom G5 Mobile System User GuideEnding Your Sensor Session and Transmitter SessionStep What you see What it means What you do1 Go to Main Menu. Press Select.2Shutdown confirmation screen appears.Press Down Arrow to Shutdown.Press Select.3Confirms you want to shut down.Shuts down receiver.Press Select.Press Select to turn the receiver back on. It may take up to 20 seconds for the receiver to turn on.Preventing Sensor FailuresSensor failures can happen when your display device doesn’t receive your sensor’s glucose readings. While it is rare to have a sensor failure, there are preventative steps you can take. Help prevent sensor failures by checking:1. Sensor hasn’t expired.2. Transmitter is snapped securely in sensor pod.3. Sensor pod isn’t dislodged or adhesive isn’t peeling.4. Nothing is rubbing against sensor pod (e.g., seat belts, etc.).5. You selected a good insertion site (see Chapter 6).6. Insertion site is clean and dry before sensor insertion.
Dexcom G5 Mobile System User Guide124Ending Your Sensor Session and Transmitter SessionThe app and receiver are ready for a new session! However before you can start a new sensor session, you need to end the current sensor session, and remove the old sensor and transmitter.8.4 Remove Sensor Pod and TransmitterRemove Sensor PodThink of the transmitter as being part of the sensor pod. Do not remove the transmitter before removing the sensor pod from your body.To remove the sensor pod:1. Gently peel sensor pod adhesive patch from skin.a. Sensor wire comes out with sensor pod.2. Separate the transmitter from the sensor pod.3. Discard the sensor pod following your local waste management regulations for disposing blood contacting parts (sensor and applicator).Remove Transmitter from Sensor PodRemember your transmitter is reusable. With a battery life of 90 days, use the same transmitter over a number of sensor sessions. You’ll receive prompts as you near the end of its battery life.Before reusing the transmitter in your new sensor session, separate it from the old sensor pod.You can detach transmitter two ways:1. Use safety lock (see With Safety Lock table). You removed this from the applicator barrel at the beginning of the session.2. Manually spread out tabs holding transmitter in sensor pod (see Without Safety Lock table).
125Dexcom G5 Mobile System User GuideEnding Your Sensor Session and Transmitter SessionWith Safety LockStep Picture What you do1Grasp end of adhesive patch.Peel adhesive patch up and away from your body to remove sensor pod and transmitter.2Put sensor pod on flat surface.3Place safety latch’s jagged edge:• Over transmitters wide edge • In between open slots on sensor pods sides 4Lift up safety latch.If you no longer have the safety lock, don’t worry! You can use your fingers to remove the transmitter from the old sensor pod. After removing your sensor, and taking the transmitter out of the sensor pod, you’re ready to begin a new sensor session. The transmitter’s battery is good up to three months. If you haven’t received your final seven day transmitter battery life warning, you can reuse the transmitter for your next session. Remember:1. Never use same spot repeatedly for sensor insertion.2. Never use same site for 2 sensor sessions in a row.
Dexcom G5 Mobile System User Guide126Ending Your Sensor Session and Transmitter SessionWithout Safety LockStep Picture What you do1Grasp end of adhesive patch.Peel adhesive patch up and away from your body to remove sensor pod and transmitter.2Put sensor pod on flat surface.3Grasp sensor pod’s wide end with two hands and place fingers in side’s open slots.4Pull tabs away from transmitter.8.5 End of Transmitter BatteryHow do you know if your transmitter’s battery will last through your next session?System messages help you determine if your transmitter’s battery will last through your next seven day session. Starting at three weeks to the end of its battery life, the messages countdown the transmitter’s battery until it has only seven days. If the transmitter battery has seven days or less remaining, you won’t be able to start a new session.
127Dexcom G5 Mobile System User GuideEnding Your Sensor Session and Transmitter SessionTransmitter Battery MessagesDevice What you see What it meansSmart Device: Lock ScreenBattery will expire in three weeks.Order a new transmitter.Smart Device: In AppReceiver(Continued on next page)
Dexcom G5 Mobile System User Guide128Ending Your Sensor Session and Transmitter Session(Continued from previous page)Device What you see What it meansSmart Device: Lock ScreenBattery will expire in two weeks.Order a new transmitter.Smart Device: In AppReceiver(Continued on next page)
129Dexcom G5 Mobile System User GuideEnding Your Sensor Session and Transmitter Session(Continued from previous page)Device What you see What it meansSmart Device: Lock ScreenBattery will expire in one week.Order a new transmitter.Smart Device: In AppReceiverTo make sure you have a transmitter that’s ready for a new sensor session, you may want to reorder a new one at store.dexcom.com, by calling Customer Service (see Section 16.1), or through the channels you used before, at your first low battery prompt.Sound/Vibration PromptsIn case you can’t look at your screen, both the smart device and receiver provide beep/vibration prompts to tell you your transmitters battery is low or the transmitter failed. Remember, if your smart device is turned on to Silent or Do Not Disturb, you won’t get any sound prompts. For more information on setting your sound/vibration prompts and how to clear them, please see Chapter 9.
Dexcom G5 Mobile System User Guide130Ending Your Sensor Session and Transmitter SessionSmart DeviceYour smart device prompts you with a triple beep. If not cleared, you receive the triple beep twice, five minutes apart. ReceiverThe receiver alerts you with an initial vibration prompts. If not cleared, you receive a vibrate/beep twice, five minutes apart. SummaryNow You Can!• Identify replace sensor prompts at the end of a seven day sensor session• Recognize when you have to end a sensor session early• Successfully end a sensor session early ○Identify how you can prevent sensor session failures• Remove your sensor pod with transmitter attached• Separate transmitter from sensor pod• Determine if transmitter can be used for another sensor session What’s Next?Congratulations, you have the basics down!You can set up your app and receiver, start a sensor session, calibrate, along with ending your sensor session and when to replace your transmitter. But the Dexcom G5 Mobile CGM System can do much more.In the next part, Part 3: Next Steps, you will learn how to get the most out of your Dexcom G5 Mobile CGM System.
• Reading Trend Graph Screens and Recognizing Trends• Events • Alarm and Alerts• Sounds for Alarm, Alerts and System Messages NEXT STEPS - GETTING THE MOST OUT OF YOUR DEXCOM CGM
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133Dexcom G5 Mobile System User GuideHome Screen, Rate of Change Arrows, and Errors9.1 Introduction to Home ScreensIn the previous chapter, you learned about calibrations: why they are important and how to do complete them. Within five minutes of your final calibration your sensor glucose readings begin!In this chapter, you’ll learn three things. First, reading the home screen, second, identifying your sensor glucose readings and trends: What do they mean? What’s the best way to use trend information? And third, what you do if you aren’t getting your sensor glucose readings.The purpose of this chapter isn’t to tell you how to react to your trends, but to help you recognize where your glucose was and where it’s going. Your healthcare professional can help you with your questions on what actions to take based on your glucose trends. After this chapter, you’ll be able to:• Recognize home screen icons• Locate sensor glucose reading• Explain sensor glucose target range• Recognize the importance of gray, yellow, and red colors• Identify low/high glucose alert levels on your trend graph• Describe when you receive a High or Low sensor glucose reading• Change trend graph views • Cite differences between rate of change arrows• Recognize error messages9.2 Safety StatementsTake a moment and read the safety statements. If not followed, your sensor glucose readings and trends may be less accurate, plus and you may miss important high or low glucose alerts.Chapter 9Next Steps:Home Screen, Rate of Change Arrows, and Errors
Dexcom G5 Mobile System User Guide134Home Screen, Rate of Change Arrows, and ErrorsCONTRAINDICATIONDon’t: Never take any medications containing acetaminophen during your sensor session.Why: Taking medications with acetaminophen (such as Tylenol or Excedrin Extra Strength) while wearing sensor may falsely raise sensor glucose readings. Level of inaccuracy depends on:1. Amount of acetaminophen active in your body.2. May be different for each person.Consequences: Without correct readings you might miss a severe low event.WARNINGDon’t: Never use the Dexcom G5 Mobile CGM System sensor glucose readings for treatment decisions.Do: Only use BG values from your BG meter for treatment decisions (e.g., how much insulin to take).Why: Since they measure your glucose from different body fluids, sensor glucose readings can be different from your meter’s blood glucose values.Consequences: Using sensor glucose readings for treatment decisions could result in you missing a severe low or high event.WARNINGDon’t: Never ignore symptoms of high and low glucose.Do: Measure your blood glucose with fingerstick measurement if sensor glucose readings don’t match your symptoms.Why: Your sensor glucose readings may not be accurately reading your glucose.Consequences: Using sensor glucose readings for treatment decisions could result having severe low (hypoglycemia) or high (hyperglycemia) events.9.3 Overview of Home ScreenRegardless of your display device, the home screen shows your current sensor glucose value, glucose trend, rate of change arrow and CGM system status. While the screen does look different between the receiver and smart devices, their information and color coding are the same.
135Dexcom G5 Mobile System User GuideHome Screen, Rate of Change Arrows, and ErrorsNo matter how you hold it the receiver’s view does not change; the Dexcom G5 Mobile App has two ways to view data based on how you hold your smart device:1. Vertically in portrait: 3-hour trend information with task bar.2. Horizontally in landscape: 1, 3, 6, 12 or 24 hour trend information without task bar.This section first familiarizes you with the app’s home screen, then with the receiver’s home screen. The app also supports two additional, and optional, ways that you can see your app’s CGM information: the Today view widget and the Apple Watch. See Additional Ways to View Your App’s CGM Information in this chapter for more detail. In other chapters, you’ll see how to use the icons or use the navigation wheel to enter data or make system changes. App Home ScreenThe app’s home screen has two main sections:1. The Task Bar. This is where you go to do tasks such as changing settings and entering data.2. The Glucose Information area. This area displays your sensor glucose readings and trends.Figure 6. App Home Screen on Mobile DeviceTask BarGlucose Information
Dexcom G5 Mobile System User Guide136Home Screen, Rate of Change Arrows, and ErrorsTask BarApp Name What it means What you doTask Bar: Complete TasksMain Menu Goes to other options.Tap Main Menu icon to access:• Alerts• Settings• Help• Start/Stop SensorBG Meter with red circle and numberCalibration Prompt.Tap icon and enter fingerstick BG value (see Chapter 7).BG Meter without red circleNo need to calibrate. Do nothing.EventEnter different events capturing activities affecting your glucose.Tap icon to enter data for:• Carbs• Insulin• Exercise• Health(See Chapter 10).Dexcom ShareDexcom Share is only available on the app.Gray icon means Share is not active.Tap icon to activate (see Part 5).Dexcom ShareOnce activated, Dexcom Share icon is colored.Do nothing.Tap icon to access Dexcom Share.
137Dexcom G5 Mobile System User GuideHome Screen, Rate of Change Arrows, and ErrorsGlucose InformationApp: Portrait App: Landscape What it meansHome ScreenIn Landscape mode, tap on the trend view you want to see at the top of the screen: 1, 3, 6, 12, or 24 historical trend views.Number: Most recent sensor glucose reading.Shown in milligrams per deciliter(mg/dL).1. Yellow: At or above target2. Gray: Within range3. Red: At or below target(Continued on next page)
Dexcom G5 Mobile System User Guide138Home Screen, Rate of Change Arrows, and ErrorsApp: Portrait App: Landscape What it meansN/AHistorical ReadingsTurn smart device to Landscape mode.Tap time, shows timeframe’s sensor glucose reading.Slide finger across screen to view rest of day’s sensor glucose readings.N/ARate of Change Arrow Direction and number of arrows show sensor glucose change rate.(Continued on next page)(Continued from previous page)
139Dexcom G5 Mobile System User GuideHome Screen, Rate of Change Arrows, and Errors(Continued from previous page)App: Portrait App: Landscape What it meansSensor Glucose Reading RangeShows between 40-400 mg/dL.Within Glucose Range and Alert Levels 1. Yellow Bar: High Alert level2. Gray Background: Within range 3. Red Bar: Low Alert level(Continued on next page)
Dexcom G5 Mobile System User Guide140Home Screen, Rate of Change Arrows, and Errors(Continued from previous page)App: Portrait App: Landscape What it meansTrend Graph TimeframeDefault is most recent 3 hours.Turn smart device to Landscape mode for most recent 1, 3, 6, 12, and 24 hour readings.Additional Ways to View Your App’s CGM InformationThe Dexcom G5 Mobile App offers more ways to check on your CGM information apart from opening the app. If you choose, you can expand the flexibility of your app by using either of the following features:• Dexcom G5 Mobile widget in the Apple Today view• Dexcom G5 Mobile for Apple WatchSafety StatementsPRECAUTIONUsing an accessory device (like a smart watch) might override your smart device sounds. Alarms or Alerts might vibrate or be heard on the accessory instead of your smart device.After connecting any accessories, make sure that the smart device settings allow you to continue receiving Alarms or Alerts on the smart device.
141Dexcom G5 Mobile System User GuideHome Screen, Rate of Change Arrows, and ErrorsThe Dexcom G5 Mobile Widget in the Apple Today ViewCheck your CGM information on your smart device without needing to open the app, even when the device is locked. Your Dexcom G5 Mobile App provides a widget for your Today view that’s accessed by swiping down from the top edge of the screen.Figure 7. The Dexcom G5 Mobile App widget in the Today view.You can edit your widgets by clicking on the Edit button at the bottom of the Today view. See your smart device instructions for the latest information on customizing your Today view.The Dexcom G5 Mobile for Apple WatchCheck your CGM information on your wrist! The Dexcom G5 Mobile App supports Apple Watch* and can be used to view your glucose reading, trend arrow, and trend graph. Figure 8. The Dexcom G5 Mobile for Apple WatchTrend ArrowSensor Glucose ReadingTrend GraphTrend GraphSensor Glucose ReadingTrend Arrow
Dexcom G5 Mobile System User Guide142Home Screen, Rate of Change Arrows, and ErrorsTo set up Dexcom G5 Mobile on your Apple Watch you’ll need to use the Watch app located on your smart device. See your Apple Watch instructions for more detail on setting up an app on the watch.Your Apple Watch will only communicate with your smart device, not the Dexcom G5 Transmitter. You will not receive alerts, alarms, and other notifications on the watch unless it is connected with your smart device. For example, if you have your watch on and you go out, but leave your smart device at home, you will not receive any CGM updates.When you wake your Apple Watch, it gets your current CGM data from your smart device. There may be a brief delay before your watch app shows current information.*For compatibility information see dexcom.com/compatibility.Now that you’ve learned about the app’s home screen, let’s move our focus to the Dexcom G5 Receiver.Receiver Home ScreenUnlike your smart device screens, the receiver’s screen is not interactive; all prompts are for information only. To make changes or enter data in the receiver, press Select and go to the Main Menu.The receiver’s home screen has two main sections:1. Status Bara. Status Bar reflects glucose trends, readings, status of receiver’s system (e.g., battery level). 2. Glucose Information Trend Grapha. Reflects sensor glucose readings and trends.This section will get you familiar with the receiver’s home screen. In other chapters, you’ll see how to use the navigation wheel to enter data or make system changes.
143Dexcom G5 Mobile System User GuideHome Screen, Rate of Change Arrows, and ErrorsFigure 9. Home Screen on ReceiverStatus BarGlucose InformationStatus BarReceiver Name What it does What you doStatus BarProvides at a glance information about the receiver, system, or you.Icons will change based on current data.Review and take appropriate action.Battery Shows battery level.When low, plug micro USB cable into receiver.Plug USB into the adapter and then into electrical outlet.BluetoothShows Bluetooth connection is working.Do nothing.Receiver’s Bluetooth is always on.(Continued on next page)
Dexcom G5 Mobile System User Guide144Home Screen, Rate of Change Arrows, and Errors(Continued from previous page)Receiver Name What it does What you doSensor Glucose ReadingShows most recent sensor glucose reading. Color of status bar changes:• Yellow: At or above target• Gray: Normal range• Red: At or below targetTake appropriate action.Trend Arrow Shows direction and speed your glucose is changing.Review and take appropriate action based on fingerstick BG value.Status AreaFar right.Error icons and calibration prompts.Take appropriate action.
145Dexcom G5 Mobile System User GuideHome Screen, Rate of Change Arrows, and ErrorsGlucose InformationReceiver What it doesHome screen.Number: Most recent sensor glucose reading.Shown in milligrams per deciliter (mg/dL). Color of status bar changes:• Yellow: At or above target• Gray: Normal Within range• Red: At or below targetHistorical ReadingsDefault is most recent 3 hours.Press Up/Down Arrows to access 1, 3, 6, 12, or 24 hour trend views.Rate of Change ArrowDirection and speed of your glucose changes.Sensor Glucose Reading RangeShows between 40-400 mg/dL.(Continued on next page)
Dexcom G5 Mobile System User Guide146Home Screen, Rate of Change Arrows, and Errors(Continued from previous page)Receiver What it doesGlucose target range Alert settings.• Yellow Bar: High Alert setting • Gray Fill: Normal range • Red Bar: Low Alert settingNow you’re familiar with the basic layout of the trend graph screen, can locate readings, identify color coding, and view time frames. Let’s take a closer look at the rate of change arrows.9.4 Rate of Change ArrowsNot sure of how your sensor glucose readings are trending? Rate of Change Arrows show the speed and direction of your glucose trends based on the last several sensor glucose readings. Arrows and the trend graph help you know when to take action before you are too high or too low. However, before doing anything, think about your most recent insulin dosing, food intake, overall trend graph, and your current BG value. Don’t overreact to the arrows. Remember the arrows don’t reflect your latest reading: they reflect a combination of recent readings. Rate of Change ArrowsApp Receiver What your glucose is doingGlucose is steady.Not increasing/decreasing more than 1 mg/dL per minute or up to 15 mg/dL in 15 minutes.Glucose slowly rising 1-2 mg/dL each minute or up to 30 mg/dL in 15 minutes.(Continued on next page)
147Dexcom G5 Mobile System User GuideHome Screen, Rate of Change Arrows, and Errors(Continued from previous page)App Receiver What your glucose is doingGlucose rising 2-3 mg/dL each minute or up to 45 mg/dL in 15 minutes.Glucose rapidly rising more than 3 mg/dL each minute or more than 45 mg/dL in 15 minutes.Glucose is slowly falling 1-2 mg/dL each minute or up to 30 mg/dL in 15 minutes.Glucose is falling 2-3 mg/dL each minute or up to 45 mg/dL in 15 minutes.Glucose is rapidly falling more than 3 mg/dL each minute or more than 45 mg/dL in 15 minutes.N/A No arrow System can’t calculate the speed and direction of your glucose change.There are a number of reasons why you may not get rate of change arrows:• You just started your sensor session• No sensor glucose readings over the last few minutes9.5 Error MessagesSometimes the transmitter, or sensor, or display devices aren’t communicating, causing you not to get your sensor glucose readings or rate of change arrows. Each device notifies you when there is an issue; however, the notifications look different.Before the system can move forward, you need to address the error.
Dexcom G5 Mobile System User Guide148Home Screen, Rate of Change Arrows, and ErrorsApp1. If screen is locked:a. Swipe message to go to app.2. Within app:a. Read message.i. Tap Question Marks for more information and follow steps as appropriate.Receiver1. Press Select to clear message.You will not get any sensor glucose readings or rate of change arrows on either display device until the error is resolved. Check with your BG meter to monitor your glucose during these error periods.Error MessagesWhat you see What you doBluetooth is Out of RangeSmart Device: Lock ScreenMake sure there are no obstructions, such as a wall or water between your transmitter and your display device.Move within 20 feet of display device.Wait up to 30 minutes while transmitter restores communication.Smart Device: In AppReceiver(Continued on next page)
149Dexcom G5 Mobile System User GuideHome Screen, Rate of Change Arrows, and Errors(Continued from previous page)Bluetooth OffSmart Device: Lock ScreenSmart device:1. Exit app.2. Tap Settings.3. Tap Bluetooth.4. Turn Bluetooth on.Smart Device: In AppReceiver N/A; Bluetooth is always on.Not Getting Sensor Glucose ReadingSmart Device: Lock Screen N/ACheck—Are you:• Within 20 feet of your display device?• In your two hour warmup period?• Outside of your calibration schedule?• In a sensor session?Smart Device: In App N/AReceiver(Continued on next page)
Dexcom G5 Mobile System User Guide150Home Screen, Rate of Change Arrows, and Errors(Continued from previous page)System Found Temporary Sensor IssueSmart Device: Lock Screen N/ADon’t calibrate.System may correct problem on its own and display sensor glucose readings again.If prompt stays for three hours:Contact Technical Support (see Section 16.1).Smart Device: In AppReceiverTransmitter and Sensor not CommunicatingSmart Device: Lock Screen N/AWait three hours while the transmitter tries to fix the error. Do not enter calibrations during this time.Make sure your transmitter is properly inserted into the sensor pod.If not corrected:• Contact Technical Support (Section 16.1)• Remove sensor• Insert new sensorSmart Device: In AppReceiver(Continued on next page)
151Dexcom G5 Mobile System User GuideHome Screen, Rate of Change Arrows, and Errors(Continued from previous page)Calibration RequiredSmart Device: Lock ScreenError in calibrating.Enter another BG meter value.Smart Device: In AppReceiverCalibration ErrorSmart Device: Lock Screen N/AWait 15 minutes.Enter a BG meter value.Smart Device: In AppReceiver(Continued on next page)
Dexcom G5 Mobile System User Guide152Home Screen, Rate of Change Arrows, and Errors(Continued from previous page)Display Devices and Transmitter not CommunicatingSmart Device: Lock ScreenWait 10 minutes.Move display device and transmitter within 20 feet of each other without obstruction (walls or water).Wait up to 30 minutes.In app (if not resolved):1. Tap Settings.2. Tap Bluetooth.3. Turn Bluetooth Off and On.Smart Device: In AppReceiverIf error messages don’t go away after you followed necessary steps, and you aren’t getting sensor glucose readings, contact Technical Support (see Section 16.1).Now You Can:• Recognize home screen icons• Locate sensor glucose reading• Explain glucose target range• Recognize the importance of gray, yellow, and red colors• Identify low/high alert glucose setting lines• Describe when you receive a High or Low sensor glucose reading• Change Trend Graph Hours view • Cite differences between rate of change arrows• Recognize error messagesWhat’s Next?By now you have a pretty good understanding how your trends look on the different display devices, but did you know what you do can affect your trends and patterns? It’s important to track actions or well-being, to better understand what you do or how you feel can change your trends. In the next chapter, you will learn how to enter Events in the Dexcom G5 Mobile System.
153Dexcom G5 Mobile System User GuideDaily Events Aect Your Glucose Trends and Patterns10.1 IntroductionYour daily activities can impact your glucose trends and patterns. In the previous chapter, you learned how to read your glucose trend screens; in this chapter, you learn how to enter situations, or “Events”. By tracking Events, you can determine how certain actions or circumstances affect your glucose levels.After this chapter, you’ll be able to:• Define Event• Describe each Event• Create Events ○Dexcom G5 Mobile App ○Dexcom G5 Mobile Receiver• Recognize Event markers on the Dexcom G5 Mobile App ○Describe how Event markers are different in portrait and landscape view• Describe how to view Events entered via your receiver• View Event markers on your smart device10.2 What Is an Event?Did you take a walk after lunch today? Did you go to happy hour with your co-workers and have a beer? Are you feeling stressed? Did you catch your kid’s sniffles? How much insulin did you take for your dinner meal? These are all Events that can raise or lower your blood sugars.An Event is an action or situation affecting your glucose levels. With the Dexcom G5 Mobile CGM System, you have the ability to enter your daily Events, helping you track their effect on your glucose trends. Once entered into the smart device or receiver, Events can be viewed in Dexcom reports. The reports help you review how each Event influenced your glucose trends. Chapter 10Next Steps:Daily Events Affect Your Glucose Trends and Patterns
Dexcom G5 Mobile System User Guide154Daily Events Aect Your Glucose Trends and PatternsYou can use the reports with your healthcare professional to create a game plan in managing your diabetes.Even though they differ on how to enter an Event and time, the app and receiver have the same Event categories and subcategories. Later in this chapter, you’ll learn how to enter Events in each device. Event CategoriesThere are four main Event categories:1. Carbs2. Insulin3. Exercise4. HealthThe fourth category, Health, has more options:• Illness• Stress• Feel High• Feel Low• Cycle• AlcoholThe following table provides more detail on each type of Event.
155Dexcom G5 Mobile System User GuideDaily Events Aect Your Glucose Trends and PatternsEvents MenuDevice What you see What it means What you doCarbsSmart Device: In App How many grams did you just eat?Receiver’s screen reflects last number entered.Enter Carb grams per snack or meal, up to 250 grams.Receiver(Continued on next page)
Dexcom G5 Mobile System User Guide156Daily Events Aect Your Glucose Trends and Patterns(Continued from previous page)Device What you see What it means What you doInsulinSmart Device: In AppReceiver’s screen reflects last number entered.Enter insulin units for each dose, up to 250 units.Can’t enter type of insulin, only dosage.Receiver(Continued on next page)
157Dexcom G5 Mobile System User GuideDaily Events Aect Your Glucose Trends and Patterns(Continued from previous page)Device What you see What it means What you doExerciseSmart Device: In AppDefaulted at 30 minutes.Select each exercise’s intensity level and duration.Enter intensity and duration.Type of exercise isn’t an option.Receiver(Continued on next page)
Dexcom G5 Mobile System User Guide158Daily Events Aect Your Glucose Trends and Patterns(Continued from previous page)Device What you see What it means What you doHealthSmart Device: In AppGeneral well being.Enter different health Events (see following Health Events Menu table).Receiver(Continued on next page)
159Dexcom G5 Mobile System User GuideDaily Events Aect Your Glucose Trends and Patterns(Continued from previous page)Device What you see What it means What you doEvent TimeSmart Device: In AppEvent time.For each separate Event, enter date/time Event began.ReceiverAs mentioned in the last table, Health has a series of Events. Tell the system how you are feeling, if you had a drink, if you’re having low or high BG symptoms, etc. You select the Event: no amounts are entered, just date and time.
Dexcom G5 Mobile System User Guide160Daily Events Aect Your Glucose Trends and PatternsHealth Events MenuDevice What you see What it meansHealth Main MenuSmart Device: In AppUse Health Main Menu to access selections.Receiver(Continued on next page)
161Dexcom G5 Mobile System User GuideDaily Events Aect Your Glucose Trends and Patterns(Continued from previous page)Device What you see What it meansHealth EventsSmart Device: In AppIllnessHave a cold, flu, or any other temporary illness affecting your well-being?StressAre you under stress? Feeling anxious?High SymptomsFeel high BG symptoms?Low SymptomsFeel low BG symptoms?CycleHave you started your menstrual cycle?AlcoholHad a glass of wine, beer, or cocktail?ReceiverYou can have multiple Events in a single day, or even during the same time frame and enter them all in at the same time. As an example, you’re running late because of traffic (Stress) and quickly swing by a drive-thru to get lunch (Carbs of 85 grams).
Dexcom G5 Mobile System User Guide162Daily Events Aect Your Glucose Trends and PatternsFor your convenience (and safety!), no need to stop everything and enter your Events as they are happening. When you have a moment, you can enter your Events retroactively in your app or receiver. Events are meant to be entered as individual occurrences: don’t enter daily totals, enter each Event separately.In the next section, you will learn how to enter Events, first in your smart device, then into the receiver.10.3 Entering EventsYou probably will enter Events in your in the display device you use most often; however, you should know how to enter Events into each.First, let’s look at how to enter Events in a smart device, then in the receiver. When using Dexcom Share, you can allow your Followers see your Event entries. For more Dexcom Share information, please see Part 5.Enter Events: Smart DeviceIn the Dexcom G5 Mobile App, Events are just a tap away! The Event icon, a running man, is on the app’s home screen’s task bar in portrait mode (remember, you don’t have the task bar in landscape).Entering Events for Carbs, Insulin, Exercise, and Health’s categories follow the same steps. If you can enter a Carb Event, you can enter an Insulin Event. To enter Events, we’ll use the above scenario. The following table shows how to enter Carb (drive-thru lunch) and Stress (traffic jam) Events. Entering Events: Dexcom G5 Mobile AppStep What you see What you doEnter Carb Event1Tap Running Man.(Continued on next page)
163Dexcom G5 Mobile System User GuideDaily Events Aect Your Glucose Trends and Patterns(Continued from previous page)Enter Carb Event2Tap Carbs.3Add up all carb grams from lunch.Enter “85” using keypad.Tap Done.(Continued on next page)
Dexcom G5 Mobile System User Guide164Daily Events Aect Your Glucose Trends and Patterns(Continued from previous page)Enter Carb Event4Tap Event Time.5Scroll and select date and time.Tap Done.(Continued on next page)
165Dexcom G5 Mobile System User GuideDaily Events Aect Your Glucose Trends and Patterns(Continued from previous page)Enter Carb Event6Tap Save or Cancel.Enter Stress Event7Tap Running Man.8Tap Health.(Continued on next page)
Dexcom G5 Mobile System User Guide166Daily Events Aect Your Glucose Trends and Patterns(Continued from previous page)Enter Stress Event9Tap Stress.Tap Done.10 Tap Event Time.(Continued on next page)
167Dexcom G5 Mobile System User GuideDaily Events Aect Your Glucose Trends and Patterns(Continued from previous page)Enter Stress Event11 Scroll and select date and time.Tap Done.12 Tap Save or Cancel.(Continued on next page)

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