Insert your sensor and attach the Transmitter (see pg5-6. Enter 2 calibrations after 2 hour start up period (5 min apart with BG meter)

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2 Dexcom Start Date: Receiver out of Warranty (12months): Transmitter out of Warranty (6months): Your high alert is set at: Your low alert is set at: Date of return to clinic: CGM is a tool that tracks and trends your diabetes patterns. With the Dexcom G4 PLATINUM CGM System you will see sensor readings every ~5 minutes for up to 7 days. These readings allow you to see where your glucose levels have been, which direction they are heading, and how fast they are rising or falling. This information will help you understand how your body responds to activities and food in your daily life. Enter your Transmitter ID into the insulin pump/ Receiver Insert your sensor and attach the Transmitter (see pg5-6 Check all your settings in the menu of the insulin pump or Receiver Start your session and await the 2 hour warm up period Enter 2 calibrations after 2 hour start up period (5 min apart with BG meter) Enter 1 calibration every 12 hours for 7 days Towards end of 7 day sensor session, sensor expiration notifications will appear After your session has ended, remove the Sensor Insert a new sensor (see pg5-6) NOTE: Each Sensor is approved for up to 7 days use only 2

3 Enter two blood glucose finger stick tests for calibration in the first 5 minutes these are the most important calibrations After the initial two calibrations, you must calibrate once every 12 hours Only calibrate when glucose values are between mmol/L Always calibrate within 5 minutes of taking finger stick reading Always use the same BG meter for all calibrations Don t calibrate when you see??? or ANT/Antenna Symbol That is OK. Readings can be different and still be considered accurate. If you have a Receiver, you are able to enter your events (Carbs/Food, Insulin, Exercise and Health) and upload this data to view on your computer Taking acetaminophen (paracetamol) containing products while wearing the sensor may falsely raise your sensor glucose readings Only use approved sites 3

4 Plunger Safety Lock/Key Collar Application Barrel (contains small introducer needle and sensor) Release Tab Transmitter Latch Sensor Pod 4

5 Remove the Adhesive Backing (two pieces) Place the sensor horizontally on your abdomen and secure it by firmly going around the Adhesive Backing with your finger Remove the Safety Lock/Key by pulling it straight out. Keep the Safety Lock for reuse Whilst pinching up on your skin (with non-dominant hand) at the base of Sensor Pod put your thumb on Plunger (with dominant hand). Also, with your dominant hand, place two fingers above the Collar Push down on the Plunger completely and you should hear two clicks Using your thumb as a base place your two fingers below the Collar and pull back towards your thumb. You should now hear another two clicks. Hold the Sensor Applicator with one hand and use your other hand to squeeze the ribbed tabs 5

6 Rock the Sensor Applicator forward and lift it up and away from your body Clean the bottom of the Transmitter with an alcohol wipe and let it dry Place your thumb and finger on your skin either side of the Sensor Pod. Pinch up skin on base of Sensor Pod (the side away from the Transmitter Latch) Hold the Transmitter in place with the 4 of DexcomG4 of the Transmitter sliding into the side away from the Transmitter Latch With your other hand move the Transmitter Latch forward until you hear two clicks and the Transmitter is secured onto the Sensor Pod Once the Transmitter is secured onto the Sensor remove the Transmitter Latch To remove the Transmitter Latch hold sides of Sensor Pod with one hand and twist the latch off 6

7 Glucose steady. Could increase by 0.8mmol/L in 15 minutes Glucose rising mmol/L glucose could increase up to 1.7mmol/l in 15 minutes Glucose rising mmol/L glucose could increase up to 2.5mmol/L in 15 minutes Glucose rising > 0.17mmol/L glucose could increase >2.5mmol/L in 15 minutes Glucose falling mmol/L glucose could decrease up to 1.7mmol/L in 15 minutes Glucose falling mmol/L glucose could decrease up to 2.5mmol/L in 15 minutes Glucose falling > 0.17mmol/L glucose could decrease > 2.5mmol/L in 15 minutes No Arrow (No information) = Receiver cannot calculate how fast glucose changing 7

8 There is no active CGM session A CGM Sensor was inserted within the last 30min. No CGM readings are available A CGM Sensor was inserted 30-60min ago. No CGM readings are available A CGM Sensor was inserted 60-90min ago. No CGM readings are available A CGM Sensor was inserted min ago. No CGM readings are available ERR 0 ERR 1 BG CGM Sensor Error 0. Wait 15min and then enter at least one BG value into pump to recalibrate CGM Sensor Error 1. Wait 1 hour and then enter at least one BG value into pump to recalibrate Finger stick BG values needed for calibration??? The CGM reading cannot be displayed at this time ANT HIGH LOW There was no communication between the pump and CGM Transmitter within the last 5min Most recent CGM reading was higher than 22.2mmol/L Most recent CGM reading was lower than 2.2mmol/L 8

9 This icon means you need to enter a calibration. This may occur when it is time for your 12 hour calibration update or any other time an additional calibration is needed This icon means you need to enter one more blood glucose value in order to calibrate the system and start receiving sensor glucose readings This icon means the receiver does not understand the sensor signal temporarily. Wait for more prompts and do not enter any blood glucose values This icon means the receiver and sensor/transmitter are not communicating. Make sure the receiver and sensor/transmitter are within 6m of each other This icon means the sensor is not calibrating correctly. Enter at least one more calibration blood glucose value after about minutes This icon means the sensor is not calibrating correctly. Wait a minimum of one hour and then enter one more blood glucose value This icon means the receiver has detected a potential problem with the sensor signal. Do not enter any blood glucose values when you see this. Wait 30 minutes for more prompts 9

10 Dexcom Contraindications etc. Indications for use The Dexcom G4 PLATINUM Continuous Glucose Monitoring System is a glucosemonitoring device indicated for detecting trends and tracking patterns in persons (age 2 and older) with diabetes. The system is intended for use by patients at home and in healthcare facilities The Dexcom G4 PLATINUM 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 System aids in the detection of episodes of hyperglycaemia and hypoglycaemia, facilitating both acute and long-term therapy adjustments, which may minimize these excursions. Interpretation of the Dexcom G4 PLATINUM System results should be based on the trends and patterns seen with several sequential readings over time Contraindications The blood glucose value from your blood glucose meter should be used for treatment decisions, such as how much insulin you should take. The Dexcom G4 System does not replace a blood glucose meter The Dexcom G4 PLATINUM Sensor, Transmitter, and Receiver must be removed prior to Magnetic Resonance Imaging (MRI), CT scan, or diathermy treatment. The Dexcom G4 PLATINUM System has not been tested during MRI or CT scans or with diathermy treatment, and it is unknown if there are safety or performance issues Taking acetaminophen (paracetamol) containing products while wearing the sensor may falsely raise your sensor glucose readings. The level of inaccuracy depends on the amount of acetaminophen (paracetamol) active in your body Warnings Do not use the Dexcom G4 PLATINUM CGM System until after you have been trained or viewed the training materials included with your CGM system The blood glucose value from your blood glucose meter should be used for treatment decisions, such as how much insulin you should take. The Dexcom G4 System does not replace a blood glucose meter. Blood glucose values may differ from sensor glucose readings. The direction, rate of glucose change, and trend graph on your Dexcom G4 PLATINUM System provide additional information to help with your diabetes management decisions Symptoms of high and low glucose should not be ignored. If your sensor glucose readings do not fit with your symptoms, you should measure your blood glucose with a blood glucose meter Your sensor glucose readings may be inaccurate if you calibrate less than every 12 hours The Dexcom G4 PLATINUM System is not approved for use in pregnant women or persons on dialysis Sensor placement is approved for placement in abdomen or, in the case of patients between the ages of 2 and 17, the abdomen or upper buttocks 10

11 For the Dexcom G4 PLATINUM Receiver: You may download your CGM information using the Dexcom Studio software or Diasend web based software. For the Animas Vibe Insulin pump: You may download your CGM information using Diasend web based software. For Dexcom Studio go to: For Diasend go to: