Can 2 G5 Mobile App Read Transmitter

By Adam Brown and Kelly Shut

Twitter summary: Dexcom G5 CGM: expands options for viewing information (app, receiver, both), customizable alarms, better information analysis, maintains leading accuracy

V years ago, the concept of Dexcom'south G5 organization seemed utterly impossible. Sending continuous glucose monitoring (CGM) data from a sensor on the trunk directly to a telephone – no receiver required? The FDA would never approve it!

Well, what seemed impossible five years ago is now available. G5 takes the aforementioned authentic G4 continuous glucose sensor, adds Bluetooth to a new on-body transmitter, and introduces a new iPhone/iPod Touch app for viewing the existent-time data and getting notifications on the phone. The data can also be viewed on a CGM receiver solitary (eastward.g., for those with an Android telephone).

Dexcom's G5 is a landmark device approval for the FDA, and a sign of how tremendously far CGM and connectivity take come up since Steve Jobs introduced the iPhone in 2007 (we were using the first-gen Dexcom STS!). Simply expectations have too risen markedly in that time. In much of the U.s.a., people now expect things to work right out of the box with a world-class user feel. Attention spans are way shorter. The bar for great devices is far higher.

The G5 has many advantages. It expands patient options for viewing real-fourth dimension CGM data (phone or receiver or both) and takes reward of the smartphone's many assets to evangelize a stronger patient experience (more customizable alarms, improve screen, cloud connection). The spider web-based Dexcom Clarity software is an first-class upgrade for those trying to digest overwhelming CGM charts and statistics. And importantly, G5 retains the G4 Platinum sensor accurateness and the widely praised receiver design.

Merely for others, G5 is a symbol of the complicated and tumultuous fourth dimension nosotros live in. As phones and gadgets become more useful and more addictive, many are pushing back – "spend less time in front of screens and more time in the earth." If my Dexcom G5 app goes off in the center of a meeting, will my co-workers think I'm rude to wait at my phone? Is it okay to take my phone in the bedroom? If I trust my phone with my life, what exercise I do when the bombardment dies in the middle of a hike?

The G5 is an ambitious and stiff foray into an incredibly challenging area: merging a high-take chances medical device with cutting-border consumer electronics. Dexcom deserves tremendous credit for getting information technology approved and launched speedily.

This is a long test drive, and then nosotros've created a Summary section below for those who want the well-nigh disquisitional takeaways: major highlights; areas for improvement; who might love G5; and who might be less impressed. Those interested in a very detailed review should read on to the Deep Dive section.

Summary

G5 Highlights

• Expanded options for viewing existent-time CGM data – telephone, receiver, or both. Switching between devices is effortless, and you can calibrate on either device and the other will update.

• More than customizable alarms on the G5 app – 22 different sounds, more than book options than the receiver.

• Improved visual pattern – a more prominent CGM value in the app, bold colors, the font is easier to read.

• Strong spider web-based Clarity assay software with like shooting fish in a barrel upload, improve pattern recognition, and more digestible charts and statistics.

• G5 posts glucose information to Apple Health, allowing other apps like Glooko, Meal Memory, and 1 Drop to employ it (very few diabetes devices exercise this).

• It retains the excellent accuracy and reliability of the G4 Platinum with Software 505 (9% error vs. laboratory claret glucose values).

• Keeps the widely praised G4 receiver design, updated with a brighter screen and more specific depression and high alert notifications.

• Retains the Dexcom Share feature for remote monitoring.

• Fast setup passed our no-didactics-manual test.

G5 - Areas for Improvement

• Low glanceability when using G5 app alone – seeing the current CGM value requires unlocking the phone and pulling the app upwards. Could do good from a "Today" widget (like seeing the weather with just i swipe on the lock screen) or smart spotter compatibility (presumably coming soon).

• Not Android compatible, but this is coming in 2016 (and a receiver option is withal available for now).

• The G5 app depletes phone bombardment slightly faster than if yous were not using information technology. Information technology does work in Aeroplane and Depression Ability Mode.

• The G5 transmitter range seems shorter than the G4, and the phone app loses betoken a bit more often than the receiver.

• There are no statistics or design recognition within the G5 app, and the split Clarity iPhone app but allows viewing a static PDF (total functionality on the web).

• The transmitter is slightly larger than the most recent G4 transmitter, and has a labeled battery life of three months (down from six months with the G4).

• The three-60 minutes delay to mail information to Apple Wellness could be reduced (this is an FDA consequence).

• Cost, especially for those without insurance or high deductibles.

Dexcom told us it is actively working on these improvements, or is because them for future products – most are not unproblematic or they would take been washed already!

Who might dear G5?

• Dexcom users who prefer not to carry the receiver, or those resisting CGM because they don't want to comport another device.

• Heavy sleepers that don't wake up to CGM alarms.

• Very active users who don't like carrying the receiver during exercise.

• CGM users desiring more than alarm customizability.

• Those who want more discretion (eastward.yard., bellyaching by questions nigh the receiver like, "Is that a pager?")

• Parents, caregivers, and loved ones that want to remotely monitor CGM data.

• Those who take trouble reading the small-scale font on the receiver.

• Those who want automated data upload for analysis and pattern recognition.

• Anyone that loves apps and nerds out on data!

Who might be unimpressed with the additional benefits of G5 vs. G4?

• Those trying to spend less time on their phone or who find smartphones stressful.

• Those who struggle to keep their telephone charged.

• Android users (until 2016).

• Current Dexcom users who don't intendance about getting CGM data on their phone.

• Current Animas Vibe and t:slim G4 users that are happy with the G4-integrated pumps.

• Not-CGM users that: want something smaller on the body than the G4/G5 transmitter; detect CGM too expensive; or want a device that requires no fingerstick calibrations.

Deep Swoop

Tabular array of Contents:

• What is G5 and How Does it Work?

• The G5 iPhone App

• G5 Daily App Interaction, Alarms, and Customization

• G5 Transmitter

• G5 Receiver

• Sensor Accurateness and Calibration

• Dexcom Clarity (web-based assay software)

• Apple Health

• What Does information technology Toll?

• Our G5 Wishlist

• What is Side by side for Dexcom?

• Terminal Thoughts

What is G5 and How Does it Work?

Dexcom's G5 CGM system has iv primary components:

1. The same G4 Platinum CGM sensor inserted under the skin for seven days. Information technology requires ii fingerstick meter calibrations per day and has an industry-leading 9% error vs. lab-measured glucose values.

2. A new transmitter equipped with Bluetooth that sends a glucose value every five minutes. The transmitter pairs with ii devices, allowing you to choose how you want to see your CGM data: receiver lone, G5 phone app alone, or both.

3. A new G5 iPhone/iPod Bear on app that (i) displays the real-time CGM information and trend; (ii) alarms the user with sounds and notifications; and (iii) sends the information to caregivers (Share), the new web-based Dexcom Clarity analysis software, and Apple Health. The app functions on the telephone as a fully standalone receiver. Information technology is a free download on the App Store.

4. A slightly updated G4 receiver that can display the CGM data alongside or contained of the G5 app (e.g., if you don't have your phone with you, for Android users). You must purchase the receiver when you get G5, but you don't take to use it. Those who own the G4 Share receiver can update the software to work with G5.

Setting upwards G5 took less than 10 minutes, and we did not demand to open the paper instruction manual once. After downloading the G5 app from the iTunes app store, nosotros fabricated a Dexcom business relationship and ran through the easy guided setup screens. Instead of having to enter a clunky transmitter serial number, the app simply asks yous to take a picture of the box – very cool. From there, the G5 app Bluetooth paired with the G5 transmitter inside five minutes.

Current Dexcom users will be familiar with the rest. Later on inserting a sensor and snapping the G5 transmitter in, yous but press "Start Sensor" on the app. G5 nevertheless needs a 2-hour warm-up, and then information technology asks for two start-upward fingerstick calibrations. Yous can get-go a sensor session on either the app or the receiver; the other brandish will update within a few minutes.

The G5 iPhone App

Highlights

• Current CGM value shown front-and-middle in larger font.

• Excellent use of color.

• The clean menu layout includes the essentials and doesn't bog users downwards with likewise many options.

The G5 app communicates via Bluetooth with the transmitter every five minutes, at which point it updates the CGM value, graph, trend arrow, and sends a notification (if applicative; more on that below).

The benefit of the telephone over the receiver is immediately credible afterwards opening the G5 app. A larger screen area shows the CGM value more than prominently – if the G4 receiver showed the CGM value in size ~12 font, this is size ~36 font on an iPhone 5. It's a big improvement, since real-fourth dimension CGM should prioritize "What's my electric current number and tendency" above all else.

Colour is much amend used in the G5 app, and Dexcom has redesigned the way the CGM value and trend arrows appear – a crimson balloon denotes a low, a yellow balloon denotes a loftier, and a muted gray means in-range. The arrows wrap around the balloons, a pattern choice that makes the trend less apparent than with G4 (where the arrow appeared separately to the right of the CGM value; see picture). Nosotros like that G5 changes the graph background colour dynamically, providing a bolder visual reminder that blood glucose is low or high.

The telephone app was a scrap less reliable than the receiver connectivity-wise. In our tests, the G5 app had more than "signal lost" alerts and isolated dropped information points throughout the twenty-four hour period. That said, the G5 app connectivity is definitely reliable enough to use as the sole receiver. And perhaps our feel stemmed from lots of Bluetooth interference here in San Francisco.

G5 can deplete your phone bombardment slightly more quickly than if you were non using it at all, so beware if your telephone tends to dice in the middle of the twenty-four hour period. Fortunately, the G5 app will continue giving y'all real-fourth dimension data in Aeroplane Mode and Low Power Manner, both first-class options for extending the iPhone's bombardment life.

The G5 app menu structure is uncomplicated and there is null unnecessary or overwhelming. Besides the master home screen (described above), in that location are iii other main screens: enter a meter calibration, enter "Events," and Dexcom Share. A few highlights:

• Fingerstick calibrations can now be entered using a keypad, saving time over the previous curl interface on the receiver.

• The events screen – allowing manual entry of carb grams, do, insulin, and health – demands enough extra steps that it's difficult to utilise routinely. This could exist automated if Dexcom eventually integrates with other apps and devices.

• G5 preserves remote monitoring with Dexcom Share, allowing parents and caregivers to receive notifications on Apple or Android devices (via Dexcom Follow). G5 users at present won't need to run the Share app.

Interface wise, there is notwithstanding some wasted white space on the main trend graph screen in the G5 app, though at least you tin can reduce the top-end to 300 mg/dl. It would be dainty if this graph was fully customizable (eastward.thou., you could elevate the alert bars to betoken how much space you want the hypoglycemia and hyperglycemia ranges to take up).

There is also no way to view statistics or trends within the G5 app (unlike the FreeStyle Libre reader). You lot must either open the carve up Clarity iPhone app to view a static PDF, or log onto the spider web-based Clarity software (see below) for full functionality. Both are easy but information technology is an actress stride. According to Dexcom, making the analysis software divide from the G5 app actually fabricated the regulatory process easier (i.e., Clarity is lower risk). That should hopefully result in faster improvements to the software.

G5 Daily App Interaction, Alarms, and Customization

Highlights

• Alarms are much more customizable and can be louder than receiver.

• Notifications appear on the lock screen, one swipe and phone unlock to become directly to the G5 app.

The G5 app runs in the background, meaning you can use other apps at the same time or take the phone locked. If the app is fully exited you will not receive CGM data or alerts, though you volition get an immediate notification ("App is airtight. You volition not receive glucose information.")

Unlike the receiver - which requires pushing i button to meet the current CGM value – the G5 app requires you to unlock your phone then bring the G5 app on screen. The glanceability could improve with a "Today" widget that enables a single down swipe on the lock screen to see the CGM value and trend graph (e.1000., like weather or calendar). We presume Dexcom will eventually release an Apple Watch version of G5 also. Unlocking the phone and pulling up the app just takes a couple seconds, just information technology does add upwardly, and it is more inconvenient than the receiver.

• A workaround is to disable your phone's passcode, but that has its own drawbacks.

• Y'all tin can also use Siri and say, "Open G5 app," though you lot'll however take to enter your passcode if yous have one. (Hint: Siri hears "Dexcom" as "Decks COM," so stick with "G5 app").

When glucose goes to a higher place or below range, a notification conveniently appears on the iPhone lock screen – for example, "Low glucose alert." The notification does not show the actual CGM value or trend arrow, though a right swipe and phone unlock volition immediately pull up the Dexcom G5 app with the popular-upwardly alert.

Notifications can be accompanied with a sound like on the receiver, assuming:

• The phone ringer is on and loud enough to hear.

• The telephone is not on vibrate (silent) or "do not disturb."

Of form, you tin can too opt for vibration alerts alone.

Similar any other iPhone app, the notification settings and sounds are customizable, which has pros and cons. On the plus side, the iPhone tin can be louder than the receiver alarms, and upward to 22 different sounds can exist selected for the high and low alerts (including the original G4 receiver sounds). Adam initially selected "Sonar Horn" for his low alert, but when his colleagues jumped out of their chairs and thought it was a fire drill, he opted for the same low alert equally on the receiver. Choose your sounds carefully!

Customizing sound preferences does take some little on the iPhone. Adam usually keeps his telephone on silent or "do not disturb," so turning the ringer on was not something he was excited to exercise. Simply he nonetheless wanted the Dexcom audio alerts, then here was his workaround:

• Plough ringer on.

• Go into "Notifications" settings and turn off audio alerts for every app except Dexcom.

• Get into "Sounds" settings and turn off audio alerts for text letters, calendar, postal service, social media, etc. Adam set these to vibrate or off completely.

This is a good fashion to duplicate the receiver's sound functions, just to minimize the cacophony from other random telephone notifications. Obviously, G5 app notifications can exist turned off or set to vibrate at any time.

Information technology can be easier to wake upward to alarms at night with G5, since the iPhone sounds are much louder and more than varied than on the receiver. G5 volition work on airplane mode (though Share won't work), offer a skillful nighttime option to minimize notifications and proceed the phone in the same room.

G5 Transmitter

Highlights

• The transmitter pairs with two devices (telephone and receiver), which can be used independently, together, and seamlessly swapped.

The transmitter is really the hub of G5: information technology broadcasts the sensor signal via Bluetooth and allows both the phone and receiver to independently pick it up. Yous can enter a fingerstick calibration on the phone or app, and the other device volition update automatically within a few minutes.

Fortunately, yous don't have to tell the telephone or receiver which one you are going to employ at any given time. The transmitter sends out a new betoken every five minutes, pregnant each device will independently choice the point up if it is in range. This allows switching between displays effortlessly.

On the downside, the G5 transmitter range seems shorter than on the G4. While G4 had a 20+ foot range in our feel, we got more of a 5-10 human foot range with G5. G5 cannot transmit through multiple floors of a house, while G4 generally could. The G5 telephone app drops the indicate more than ofttimes than the receiver, but it doesn't happen overwhelmingly often. And ordinarily it is only one or ii data points.

The G5 transmitter is the same size as the original G4 Platinum transmitter. That is smaller than we would have guessed, given the add-on of Bluetooth and the ability to pair with two devices. A downside to the new transmitter is a battery life of three months, down from 6 months for the G4 Platinum. The G4 transmitter generally lasted longer than half-dozen months, so perchance G5 will too.

We'd annotation that the transmitter sends data in real-time and does not save any glucose history. In other words, information technology cannot backfill missing data when both displays are out of range. For example, if y'all leave both the receiver and phone at home and become for a run, the information is completely lost. This is an issue for those limited cases when you don't have either the phone or receiver in-range, but really want to assemble the glucose data during that time (exercise is the obvious one)

G5 Receiver

Highlights

• White background screen is easier to read.

• Better utilize of color and notifications actually show the current glucose value and tendency arrow instead of a generic low or high alert.

For those familiar with the G4 receiver, the new G5 receiver won't feel much different. Dexcom has primarily made some user interface tweaks: (i) the groundwork screen is now white, making it much easier to read (ii) the receiver shows colored banners across the top to betoken a depression or high (instead of a colored number on a black background); (iii) high or depression pop-upward notifications actually show the current glucose value and trend (Low – 77 mg/dl > ) instead of just a generic message (Depression).

The receiver still has outstanding battery life (lasting at least a few days on a single charge), and the size is still MP3-like (great for a pocket or purse). The warning settings, profiles, and volume are identical to the G4 receiver.

Similar the G5 app, there is nevertheless a lot of wasted white space on the chief trend graph screen, and y'all cannot get statistics or pattern recognition on the receiver itself. On a positive note, Dexcom Clarity automatically detects a plugged in receiver (via a Mac or PC software tool), and so uploading data and viewing stats takes less than one minute on a estimator.

Those using the G4 Receiver with Share can update the software to brand their current receiver talk to the G5 transmitter.

Sensor Accuracy and Calibration

Highlights

• Retains the splendid G4 Platinum accurateness and reliability – an average 9% error versus laboratory blood glucose values.

G5 uses the aforementioned G4 Platinum sensor and includes the updated Software 505 algorithm. This gives G5 an average ix% error vs. laboratory blood glucose values – for context, if your blood sugar is 100 mg/dl on average, that ways G5 volition be off from your real blood glucose value by ~9 mg/dl on average. This is the all-time accuracy of whatsoever CGM bachelor (on boilerplate), though anybody experiences different results. Dexcom believes this accuracy approaches glucose meters; we would agree in our experience.

Like G4, G5 asks for two calibrations per day. The most important calibrations are the first few. It'southward crucial to wash easily and actually take two individual fingersticks at starting time-upward – meters are less accurate than we all believe!

G5 is still not approved for dosing insulin in the The states (it is in Europe), only many patients do this in the real world as they gain trust. Adam has congenital enough confidence in G4 and G5 that he often but tests two times per twenty-four hours (in one case in the morning and once at night). He tests more often on day one of a sensor (when accurateness is the worst), if he doesn't believe the CGM value, or if he is about to accept a large correction dose of insulin.

Dexcom Clarity (web-based assay software)

Highlights

• Outstanding blueprint recognition, critical statistics, and colorful graphs to identify problem times.

• Makes CGM data more than approachable, only allows for customization in the right places.

• Data running through G5 app posts automatically to Clarity; the uploader is PC and Mac uniform and automatically detects receiver.

• "Best Glucose Day" report.

Adam is addicted to Dexcom Clarity, the new spider web-based analysis software (free) that launched with G5 and also works with the G4 receiver. If you're running the G5 app, CGM automatically posts to Clarity with a four-hour filibuster. Otherwise, you tin can download the PC and Mac uniform uploader, which sits in the background on your reckoner, auto-detects the receiver within seconds, and uploads the data in ~20 seconds.

The web version of Clarity revolves around just four screens and is focused on identifying trouble areas (When am I going low or high?) and keeping things approachable. Every screen allows for customizing the date range, though it defaults to ii weeks and can't display more than 30 days of information at a time.

The "Overview" screen is a terrific one-folio snapshot of key information – within threescore seconds you tin respond, "Where am I having trouble?" This page shows an estimated A1c, average blood glucose, hypoglycemia risk (depression, medium, loftier), time-in-range, calibrations per day, and any identified patterns.

"Patterns" gives a deeper dive on the times of twenty-four hour period when glucose was consistently above or below target, and Clarity shows the days of CGM traces that brand upwardly a particular pattern. The software also identifies your "best glucose day," a dainty focus on the underappreciated positive side of diabetes. This screen also gives "possible considerations" based on the pattern, but they are too generic to exist actionable.

The "Information" folio shows a single CGM graph with error bars to indicate times of day with lots of variability. The use of color and the error bars makes it articulate what times of twenty-four hour period are a trouble. You tin can besides thumb through daily CGM traces, and Clarity will add together "event" markers entered into G5, such equally logged grams of carbs, exercise, and insulin doses. It's currently not piece of cake plenty for Adam to regularly add events, but maybe hereafter app integrations will ameliorate this feel.

"Compare" shows 2 periods of fourth dimension side-by-side each other. This is useful to see the impact a particular alter has had on your diabetes – e.thousand., eating lower carb for a week, exercising more than oftentimes over two weeks.

Dexcom does have a Clarity iPhone app, though it only allows viewing a PDF of the past two weeks of data, which will be absent unless you've uploaded the receiver or are using the G5 app. It would exist nice if more than Clarity functionality was available in the iPhone app, though information technology is not a tremendous hassle to open up the website. The Clarity app seems ideal every bit an on-the-go pick for appointments with a provider.

Apple Health

The G5 app automatically posts information to Apple Health, allowing other diabetes apps like Glooko, Meal Memory, and 1 Drop to admission it (probably mySugr too in the future). This is the idea of a diabetes "ecosystem of apps" targeted to specific needs and patient preferences. Imagine apps for meals, for practise, for deeper CGM analysis, for social networking, or anything else. That is the promise of Apple tree Health.

The one downside is G5 posts data to Apple Health with a three-60 minutes delay, meaning other apps cannot offer real-time benefits. This delay stems from how the FDA defines historical ("retrospective") information; perhaps information technology will decrease in the time to come.

What Does it Cost?

The best answer is to talk to Dexcom, since insurance varies by company and plan. Almost United states of america private insurance companies (e.g., United, Aetna, Humana, Anthem, Cigna) embrace CGM, though requirements, co-insurance, and deductibles vary widely. Medicare does non embrace personal CGM, but this will hopefully change. Many European countries are now paying for CGM, but once again, it varies across the board.

If y'all don't accept insurance, CGM is expensive, probably running a few chiliad dollars per year.

The G5 pricing model is similar to G4: an upfront price to get the starter kit, which includes the receiver, a transmitter, and four sensors. The G5 app is complimentary. Ongoing costs include transmitters (up to iv per yr, though might be less in practice) and seven-twenty-four hours sensors. Dexcom has non disclosed what each component costs.

We hope CGM gets less expensive over time, peculiarly if more patients can pay a pharmacy co-pay for sensors (similar to picking up a drug).

Our G5 Wishlist

App

• Make information technology easier and faster to meet real-time CGM values and trends on the phone: (i) add a Today widget; (two) add smart watch compatibility; (3) evidence bodily CGM values and trends on the lock screen notifications.

• Android compatibility (reportedly coming in 2016).

• Add together statistics inside the G5 app, or build out the Clarity iPhone app with more functionality.

• Enable users to take a picture of a meal instead of just manually logging the carbs in Events.

• Better Events logging by integrating with other apps and devices (Fitbit, Strava, LoseIt!, myfitnesspal).

• Let customization of the trend graph to prevent wasted white space. Tin the scale be modified to devote larger areas of the screen to hypoglycemia and in-range?

• Reduce the three-hour time-delay to mail service data to Apple Health (this is an FDA issue).

• Add an insulin-dosing figurer that uses the CGM value, trend arrow, and planned carb intake.

Transmitter

• Improve the bespeak reliability between the transmitter and the G5 phone app.

• Increase signal range.

• Reduce transmitter size and extend the battery life beyond three months.

• Enable some data back-filling – could the transmitter store the last 30 minutes of data?

System

• Make it less expensive.

• Obtain FDA approval to dose insulin without a confirmatory fingerstick (the G5 already has this blessing in Europe).

• Factory calibration (no fingersticks).

Dexcom told us it is actively working on these improvements, or is considering them for future products – most are not uncomplicated or they would take been washed already!

What Is Side by side for Dexcom?

• Android G5 – 2016

• FDA approval for insulin dosing off CGM – 2016

• G5 pump integrations (Tandem, Insulet, Animas, and Bigfoot Biomedical) – belatedly 2016 at the very earliest

• G6 – 2017 (one calibration per twenty-four hours, with fewer expected over time)

• Smaller transmitters and a new receiver – In evolution

• Google/Dexcom disposable sensor – 2017-2018+

Last Thoughts

We're excited that the G5 has arrived – earlier than expected – and we're obvious fans, unsurprising since we both started wearing CGM many years ago. Information technology's bully to see how fast Dexcom is moving, a company with aggressive goals and stiff leadership. We can't expect to see what'south next!

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Source: https://diatribe.org/dexcom-g5-mobile-cgm-your-phone-receiver-optional