Dexcom G4 Platinum User manual

Dexcom G4 PLATINUM User’s Guide |1
USER’S GUIDE
DEXCOM G4®PLATINUM
(PEDIATRIC) CONTINUOUS
GLUCOSE MONITORING SYSTEM
IMPORTANT CONTACTS AND NUMBERS
Dexcom®Website: www.dexcom.com
Your Transmitter ID:
Your Receiver ID:
Your Healthcare Professional:
Nearest Hospital:
© 2013 Dexcom, Inc. All rights reserved.
Dexcom, Dexcom G4, Dexcom G4 PLATINUM, Dexcom STUDIO, and
SEVEN are either registered trademarks or trademarks of Dexcom, Inc.
in the United States and/or other countries. All other product or company
names that may be mentioned in this publication are tradenames,
trademarks or registered trademarks of their respective owners.
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2 |Dexcom G4 PLATINUM Continuous Glucose Monitoring System
DEXCOM G4 PLATINUM (PEDIATRIC) CONTINUOUS
GLUCOSE MONITORING SYSTEM
table of contents
GLOSSARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
CHAPTER 1: DEXCOM G4 PLATINUM (PEDIATRIC)
CONTINUOUS GLUCOSE MONITORING (CGM)
SYSTEM DESCRIPTION 9
1.1 System Contents ..................................... 11
1.2 Introduction .........................................12
1.3 Sensor Overview .....................................13
1.4 Transmitter Overview ..................................14
1.5 Receiver Overview....................................15
CHAPTER 2: INDICATIONS FOR USE AND SAFETY
STATEMENT ................................17
2.1 INDICATIONS FOR USE ...............................19
2.2 IMPORTANT USER INFORMATION ......................19
2.3 CONTRAINDICATIONS................................20
2.4 WARNINGS .........................................20
2.5 PRECAUTIONS ......................................23
2.6 CAUTION...........................................26
CHAPTER 3: RISKS AND BENEFITS 27
3.1 Risks ..............................................29
  ............................................30
CHAPTER 4: CHARGING YOUR RECEIVER AND THE
RECEIVER MAIN MENU 33
4.1 Charging Your Receiver Battery..........................35
4.1.1 Charging Your Receiver Battery from an AC Power Outlet 36
4.1.2 Charging Your Receiver Battery from a Windows Compatible
Computer ......................................37
4.1.3 Knowing Your Receiver is Charged ..................38
4.2 Receiver Menu Options ................................38
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Dexcom G4 PLATINUM User’s Guide |3
CHAPTER 5: DEXCOM G4 PLATINUM (PEDIATRIC)
SYSTEM SETUP 41
5.1 Setting Up the Receiver and Pairing with Your Transmitter .....43
5.2 The Settings Menu....................................45
5.2.1 Getting to the Settings Menu .......................45
5.2.2 Setting Your Receiver Time and Date . . . . . . . . . . . . . . . . 45
5.2.3 Entering Your Transmitter ID . . . . . . . . . . . . . . . . . . . . . . . 46
5.3 Checking Information About Your Dexcom G4 PLATINUM
(Pediatric) System ....................................47
5.4 Transmitter and Receiver Communication..................48
CHAPTER 6: INSERTING A SENSOR AND STARTING A
SENSOR SESSION 51
6.1 Before You Start......................................54
6.2 Removing the Sensor from its Packaging ..................55
6.3 Choosing an Insertion Site..............................56
6.4 Placing the Sensor....................................58
6.5 Sensor Insertion......................................60
6.6 Transmitter Attachment ................................61
6.7 Starting a Sensor Session ..............................63
6.8 Sensor Startup Period .................................65
6.9 Taping the Sensor Pod.................................66
6.10 Temporary Receiver Shutdown .........................66
6.11 The Dexcom G4 PLATINUM (Pediatric) System and Water....67
CHAPTER 7: CALIBRATING YOUR DEXCOM G4
PLATINUM (PEDIATRIC) SYSTEM 69
7.1 Calibration Overview ..................................71
7.2 How to Calibrate .....................................73
7.3 Startup Calibration ....................................77
7.4 12-Hour Calibration Update .............................77
7.5 Other Reasons You May Need to Calibrate .................78
CHAPTER 8: SENSOR GLUCOSE READINGS AND
TRENDS 81
8.1 Sensor Glucose Readings ..............................84
8.2 Rate of Change Arrows ................................87
8.3 Glucose Status Area Symbols ...........................89
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4 |Dexcom G4 PLATINUM Continuous Glucose Monitoring System
CHAPTER 9: ALERTS, ALARM & PROFILES 93
9.1 Setting Your Alerts .................................... 95
9.1.1 Default Alert/Alarm Settings ........................ 95
9.1.2 Glucose Alerts and Alarm .......................... 98
9.1.2.1 High Glucose Alert......................... 99
9.1.2.2 Low Glucose Alert ......................... 99
9.1.2.3 Low Glucose Alarm ....................... 100
9.1.3 Getting to the Alerts Menu ........................ 101
9.1.4 High and Low Glucose Alerts ...................... 101
9.2 Advanced Alerts ..................................... 103
9.2.1 Setting a Snooze Time for Your High and Low Glucose
Alerts ........................................ 103
9.2.2 Rise and Fall Glucose Rate Alerts . . . . . . . . . . . . . . . . . . 104
9.2.3 Setting the Out of Range Alert . . . . . . . . . . . . . . . . . . . . . 106
 ........................................ 108
   ............................. 109
  .............................. 110
CHAPTER 10: EVENTS AND DEXCOM STUDIO™
SOFTWARE 113
10.1 Events .......................................... 115
10.1.1 Selecting an Event ............................. 115
10.1.2 Setting the Date and Time for an Event ............. 116
10.1.3 Carbohydrates ................................. 117
10.1.4 Insulin . ...................................... 118
10.1.5 Exercise . .................................... 119
10.1.6 Health . ...................................... 120
10.2 Dexcom STUDIO Software . .......................... 121
CHAPTER 11: ENDING A SENSOR SESSION 123
11.1 Automatic Sensor Shut-Off . .......................... 125
11.2 Removing a Sensor . ................................ 127
11.3 Transmitter Removal . ............................... 128
CHAPTER 12: TAKING CARE OF YOUR DEXCOM G4
PLATINUM (PEDIATRIC) SYSTEM 129
12.1 Maintenance . ..................................... 131
12.2 Storage . ......................................... 131
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Dexcom G4 PLATINUM User’s Guide |5
1
12.3 Product Disposal . ..................................132
CHAPTER 13: TROUBLESHOOTING 133
13.1 Sensor Insertion Troubleshooting ......................135
13.2 Calibration Troubleshooting...........................136
13.2.1 Types Of Calibration Prompts ...................137
13.2.2 What To Do For Calibration Prompts..............138
13.3 Calibration Error Troubleshooting ......................138
13.4 System Glucose Error ...............................139
13.5 Sensor Inaccuracies ................................140
13.6 Sensor Shut-Off Troubleshooting ......................142
13.6.1 Early Sensor Shut-Off - Sensor Failure ............142
13.6.2 Manual Sensor Shut-Off - “Stop Sensor”...........143
13.7 Battery and Charger Troubleshooting . . . . . . . . . . . . . . . . . . . 144
13.8 Receiver and Transmitter Communication Troubleshooting . . 145
13.8.1 System Recovery Check .......................145
13.8.2 Receiver Error Code ..........................146
13.8.3 Low Transmitter Battery........................146
13.8.4 Transmitter Failed Error Code ...................146
13.9 Out of Range/No Antenna ............................147
13.10 Alerts Are Not Working ..............................148
CHAPTER 14: TECHNICAL INFORMATION 149
14.1 Device Performance Characteristics ....................151
 ...............................172
14.3 FCC Requirements .................................183
CHAPTER 15: USER ASSISTANCE 185
CHAPTER 16: WARRANTY 189
CHAPTER 17: TRAVEL INFORMATION 197
CHAPTER 18: APPENDIX 201
Appendix I: Receiver Alerts, Alarm and Prompt . . . . . . . . . . . . . . . . 203
Appendix II: Index.......................................212
Appendix III: Symbols Used in Labeling......................217
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6 |Dexcom G4 PLATINUM Continuous Glucose Monitoring System
GLOSSARY
Alternative Site
BG Testing
This is when you take a blood glucose value on your meter
using a blood sample from an area on your body other than


Applicator A disposable piece that comes attached to the sensor pod and


BG Meter 

BG Value 

Calibration When you enter blood glucose values from a blood glucose

receiver to show continuous sensor glucose readings and trend

CGM 
Commercially
Available

Default A setting that is selected automatically, unless you choose

Dexcom G4
PLATINUM
(Pediatric)
System

Glucose Data
Gaps

glucose reading to let you know that the receiver cannot

Glucose
Trends

graph shows where your glucose levels have been during the
time shown on the screen and where your glucose levels are

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Dexcom G4 PLATINUM User’s Guide |7
GLOSSARY (continued from page before)
Hypoglycemia 

professional to determine the appropriate hypoglycemic setting

Hyperglycemia 

professional to determine the appropriate hyperglycemic setting

HypoRepeat 
alarm every 5 seconds until your sensor glucose value rises


Mg/dL 

Obstruction Something that blocks the path between the transmitter and



tested whether items blocking the transmitter or receiver could

 
Range 
two devices within 20 feet of each other without obstruction to

Re-alert 
Receiver The small device that collects your glucose information from the


Rise and Fall
(Rate of
Change) Alerts
Alerts based on how fast and how much your glucose levels

(continued on next page)
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8 |Dexcom G4 PLATINUM Continuous Glucose Monitoring System
RF Radio-frequency transmission used to send glucose information

Safety Lock The safety lock keeps the needle inside the applicator before

transmitter out of the sensor pod after your sensor session

Sensor 

under your skin, and the wire measures glucose levels in your

Sensor Pod The small plastic base of the sensor attached to your skin that

Snoozing 

Startup Period The 2-hour period after you tell the receiver you inserted a new


System
Reading


Transmitter 
into the sensor pod and wirelessly sends glucose information to

Transmitter ID A series of numbers and/or letters that you enter into your

Transmitter
Latch
The small, disposable piece that snaps the transmitter into the

Trend (Rate
of Change)
Arrows
Arrows on trend graphs that show how fast your glucose levels


GLOSSARY (continued from page before)
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Dexcom G4 PLATINUM User’s Guide |9
1
o
n
e
1
1
DEXCOM G4 PLATINUM (PEDIATRIC)
CONTINUOUS GLUCOSE MONITORING (CGM)
SYSTEM DESCRIPTION
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10 |Dexcom G4 PLATINUM Continuous Glucose Monitoring System
1
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Dexcom G4 PLATINUM User’s Guide |11
CHAPTER 1: DEXCOM G4®PLATINUM
(PEDIATRIC) CONTINUOUS GLUCOSE
MONITORING (CGM) SYSTEM DESCRIPTION
1.1 SYSTEM CONTENTS:










™software (available for download online at
www.dexcom.com)
Sensors are sold separately. Commercially distributed blood
glucose (BG) meter required for use.
Dexcom G4 PLATINUM
Sensor
Dexcom G4 PLATINUM
(Pediatric) Receiver
Dexcom G4 PLATINUM
Transmitter
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12 |Dexcom G4 PLATINUM Continuous Glucose Monitoring System
1.2 INTRODUCTION
When you use the system, you will see continuous sensor glucose
readings updated every 5 minutes for up to 7 days. These readings will
help you notice trends and patterns in your glucose levels.
The system includes the Dexcom G4 PLATINUM Sensor, the Dexcom
G4 PLATINUM Transmitter, and the Dexcom G4 PLATINUM (Pediatric)
Receiver. The sensor is a disposable unit that you insert under your
skin to continuously monitor your glucose levels for up to 7 days. The
transmitter is a reusable device that wirelessly sends your sensor’s
glucose information to your receiver. The receiver is a hand-held device
that receives and displays your glucose information.
Please read this user’s guide closely. It describes how to use your
system.
In addition, Dexcom®has a self-guided training tutorial for the Dexcom
G4 PLATINUM (Pediatric) CGM System. Some people have found
this to be an effective method of product training. Please review the
tutorial on the disc and discuss with your healthcare professional to
decide if the Dexcom G4 PLATINUM (Pediatric) System Tutorial is a
good training option for you. The tutorial disc can only be used with
your computer and cannot be used in DVD players. The tutorial is also
found on the Dexcom website – www.dexcom.com.
1
PRECAUTION
The Dexcom G4 PLATINUM Sensor, Transmitter, and
Receiver are not compatible with the SEVEN®/SEVEN®
PLUS Transmitter and Receiver. Different generations
will not connect with each other and will not work. Also,
make sure to use the correct version of Dexcom STUDIO
with your system.
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1.3 SENSOR OVERVIEW
The sensor is the piece that comes in a sterile, sealed sensor pouch.
The sensor is made up of an applicator, a sensor pod, and a sensor
wire. You remove the applicator after insertion. The sensor pod stays on
your skin for the entire sensor session, up to 7 days. The pod is made of

inserts just under your skin. It is attached to the sensor pod, and is made
of silver and platinum metal with polymer membranes. You discard the
sensor at the end of the session.

Plunger
Applicator barrel
(contains small introducer
needle and sensor)
Transmitter latch
Safety lock
Collar
Sensor pod
Release tab Adhesive patch
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14 |Dexcom G4 PLATINUM Continuous Glucose Monitoring System
1.4 TRANSMITTER OVERVIEW
The transmitter is the gray, plastic “chip” that snaps into your sensor
pod. The transmitter (including sensor pod) is about 1.5 inches long, 0.9
inches wide and 0.5 inches thick. Once snapped into the sensor pod,
the transmitter wirelessly sends your glucose information to the receiver.
The transmitter and sensor are water resistant when properly connected.
Do not throw away your transmitter. It is reusable.
The transmission range from the transmitter to the receiver is up to 20
feet without obstruction. Wireless communication does not work well
through water, so the range is much less if you are in a pool, bathtub or
water bed.
The transmitter battery will last at least 6 months. Once you see the
transmitter low battery screen, replace the transmitter as soon as
possible. Your transmitter battery may drain as quickly as one week after
this alert appears.

Transmitter
Transmitter Low Battery screen
1
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1.5 RECEIVER OVERVIEW
The receiver is the small hand-held device that looks like a cell phone.
It is about 4 inches long, 1.8 inches wide and 0.5 inches thick. It shows
your sensor glucose readings, trend graph, direction and rate of change
arrow.


getting inside the receiver.
The trend graph screen on your receiver shows your sensor glucose
readings, trend graph, direction and rate of change arrow

trend graph screens show sensor glucose readings, trend graphs and
trend arrows. The receiver menu screens let you change your receiver
settings.
EXAMPLE: 3-Hour Trend Graph Screen
Status area
High glucose
alert setting
Low glucose
alert setting
Antenna
Battery
Most recent 5-minute
sensor glucose reading
Glucose
target
range
Plot of most
recent sensor
glucose
readings
Current time
Trend arrow
Trend graph hours
Glucose
values
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16 |Dexcom G4 PLATINUM Continuous Glucose Monitoring System
Your receiver and transmitter wirelessly pair together to communicate
securely and only with each other.
You will need a commercially available blood glucose meter to use with
your system.

Receiver buttons:
UP and DOWN buttons to scroll through trend screens,
highlight menu items, or set values.
SELECT button to turn the receiver on or select the
highlighted option.
LEFT button to go back to the last item or screen.
RIGHT button to highlight the next item.
UP button
DOWN
button
SELECT
button
RIGHT
button
LEFT
button
1
SpeakerDisplay screen USB port cover
USB port
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Dexcom G4 PLATINUM User’s Guide |17
2
2
2
INDICATIONS FOR USE AND
SAFETY STATEMENT
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18 |Dexcom G4 PLATINUM Continuous Glucose Monitoring System
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Dexcom G4 PLATINUM User’s Guide |19
CHAPTER 2: INDICATIONS FOR USE AND
SAFETY STATEMENT
2.1 INDICATIONS FOR USE
The Dexcom G4 PLATINUM (Pediatric) Continuous Glucose
Monitoring System is a glucose monitoring device indicated
for detecting trends and tracking patterns in persons ages 2
to 17 years with diabetes. The system is intended for single
patient use and requires a prescription.
The Dexcom G4 PLATINUM (Pediatric) System is indicated
for use as an adjunctive device to complement, not
replace, information obtained from standard home glucose
monitoring devices.
The Dexcom G4 PLATINUM (Pediatric) 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 G4 PLATINUM (Pediatric) System results should
be based on the trends and patterns seen with several
sequential readings over time.
2.2 IMPORTANT USER INFORMATION
Please review your product instructions before using
your continuous glucose monitoring system. Indications,
contraindications, warnings, precautions, cautions, and other
important user information can be found in your product
instructions. Discuss with your healthcare professional
how you should use your sensor trend information to help
manage your diabetes. Your product instructions contain
important information on troubleshooting your system and on
the performance characteristics of the device.
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20 |Dexcom G4 PLATINUM Continuous Glucose Monitoring System
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2.3 CONTRAINDICATIONS

and receiver before Magnetic Resonance Imaging (MRI),
Computed Tomography (CT) scan, or diathermy treatment.
The Dexcom G4 PLATINUM (Pediatric) System has not
been tested during MRI or CT scans or with diathermy

device so that it might not display sensor glucose readings
or provide alerts, and you might miss a low or high blood
glucose value.
®)
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 may be
different for each person.
2.4 WARNINGS

System until you have thoroughly reviewed the training
materials. Incorrect use might lead you to misunderstand
the CGM information or affect system accuracy. This could
result in you missing severe hypoglycemia (low blood
glucose) or hyperglycemia (high blood glucose) events.

for treatment decisions, such as how much insulin you
should take. The Dexcom G4 PLATINUM (Pediatric)
System does not replace a blood glucose meter. Always
use the values from your blood glucose meter for treatment
decisions. Blood glucose values may differ from sensor
glucose readings. Solely relying on the sensor glucose
alerts and readings for treatment decisions could result in
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