Dexcom MCT2D Continuous Glucose Monitor User Guide

: September 3, 2024
: Dexcom

Table of Contents

MCT2D Continuous Glucose Monitor
Specifications:
Product Information:
Product Usage Instructions:
1. Getting Started
2. Monitoring Glucose Levels
3. Analyzing Data
4. Setting Goals
- FAQ:
Q: How often should I calibrate the Dexcom CGM?
Q: Can I swim or shower with the Dexcom CGM sensor?

MCT2D Continuous Glucose Monitor

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Specifications:

Product Name: Dexcom Continuous Glucose Monitor (CGM)
Developed in collaboration with Gary Scheiner, MS, CDCES
Units for all glucose values are shown in mg/dL

Product Information:

The Dexcom Continuous Glucose Monitor (CGM) is designed to help
users monitor their unique glucose patterns, understand how factors
like physical activity and food affect glucose levels, and
determine effective strategies for managing diabetes. It provides
real-time data on glucose levels to assist users in making informed
decisions about their health.

Product Usage Instructions:

1. Getting Started

To begin using the Dexcom CGM:

Insert the sensor according to the instructions provided.
Pair the device with the receiver or compatible smartphone
app.
Calibrate the system as recommended by your healthcare
provider.

2. Monitoring Glucose Levels

The Dexcom CGM continuously tracks glucose levels and displays
real-time data on the receiver or smartphone app. Users can set
target ranges and receive alerts for high or low glucose
levels.

3. Analyzing Data

Review the data collected by the Dexcom CGM to identify trends,
understand time spent in target range, and make adjustments to
diet, exercise, or medication based on the insights gained.

4. Setting Goals

Aim to increase time spent in the target glucose range (70-180
mg/dL) as recommended by healthcare professionals. Track progress
over time and adjust lifestyle habits accordingly.

FAQ:

Q: How often should I calibrate the Dexcom CGM?

A: Calibration frequency may vary for each user. Follow the
recommendations provided by your healthcare provider for accurate
calibration.

Q: Can I swim or shower with the Dexcom CGM sensor?

A: The Dexcom CGM sensor is water-resistant, allowing users to
swim or shower with it. However, prolonged exposure to water may
affect sensor accuracy.

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Understanding Your Glucose Using Dexcom Real-Time CGM: A Playbook for Your Health
This playbook was developed in collaboration with Gary Scheiner, MS, CDCES

2

YOUR DEXCOM GUIDES
This playbook is designed to help you learn about your unique glucose patterns, how different factors like physical activity and food affect your glucose, and ways you can use your Dexcom Continuous Glucose Monitor (CGM) to discover what strategies work best for you.
To guide you through this playbook, Joe and Joanne* share their stories about how they use Dexcom CGM to help them navigate their diabetes journeys.
Joanne and Joe are cousins who live on opposite sides of the country. Joanne is married with two teenage daughters and works full-time managing a busy office.
Joe is a retired electrician with six grandkids and loves his local sports teams.
Joanne and Joe both have type 2 diabetes (T2D). Joe takes one injection daily of long-acting insulin along with a couple of oral medications. He tries to stay away from high-carb and fried foods, but like many people, he finds this hard to do. To stay active, he takes his grandkids to the park and pedals a stationary bike while watching his home sports teams on TV. Joanne manages her diabetes with an injected medication (not insulin) that helps with her appetite and an oral medication that can sometimes cause her glucose to go too low. She sticks with mostly low-carb foods and walks with a co-worker during their lunch breaks.

*All characters in this book are fictional. Any similarity with actual people is completely coincedental. This book is not intended as a medical advice, always consult

your healthcare provider before making changes to your diabetes treatment plan. Units for all glucose values are shown in mg/dL.

3

WHAT’S IN IT FOR ME?
Joe, most people know that the A1C is a blood test that estimates the average glucose level for the past two to three months. But there are many things that can cause the A1C to be higher or lower than what you would expect including race/ethnicity, anemia, pregnancy, blood transfusions & donations, and certain medications.1 Plus, the A1C is just an average it does not tell us how stable the glucose levels have been.2
That’s for sure, Joanne. Since I’ve been using my Dexcom CGM, not only has my A1C gone down, but I’ve also had fewer highs and lows.3 Instead of waiting months to recheck my A1C, I can see the changes immediately on my Dexcom CGM to know what’s working and what’s not working so well. And one of the best parts, I feel much better!
Take a look at the graph below. That time in the gray, between 70 and 180 mg/dL, that’s my target glucose range called Time in Range (TIR). When I’m in that range, I feel better. My energy is up, I can focus, I run to the bathroom less, and I wake up feeling more rested.
So now I’m looking at more than just my A1C. Dexcom CGM shows me how much time I spend in my target glucose range.

180 70

Before CGM

After CGM

Joe’s typical daily glucose levels when he started using Dexcom CGM (dashed line) compared to his current glucose levels after using Dexcom CGM for a few weeks (dotted line). His glucose is more stable, and he is within his target range (shaded area) more of the time. Note: for illustrative purposes only.

When I first started using Dexcom CGM, my TIR was less than 50%. I was spending almost 12 hours a day above 180! That’s when I started paying more attention to my food and activity and learning about my diabetes.
Now I’m in range more than 80% of the time.4 That’s about 8 more hours a day feeling better than I did before! Because of this, I’ve been able to stop taking one of my diabetes medications. My doctor told me if I can continue this progress, she sees no reason why I would have to add it back.
GOALS FOR TIME IN RANGE
The International Consensus on Time in Range2 recommendations for most people with type 1 and type 2 diabetes:*2

250 mg/dL >180 mg/dL
Target Range: 70-180 mg/dL

Target Time <5% Very High <25% High**

70%

<25% above 180 mg/dL >70% between 70-180 mg/dL

<70 mg/dL <54 mg/dL

<4% Low*** <1% Very Low

<4% below 70 mg/dL

DID YOU KNOW?
A TIR of 70% is equal to an A1C of about 7%.2 Fast Fact: 1% of the day equals about 15 minutes. So, 4% of the day represents about an hour.2

*Recommendations from the International Consensus on Time in Range, 2019 recommend individualized glycemic targets for high risk and/or older adults with

a focus on reducing the percentage of time spent less than 70 md/dL and preventing excessive hyperglycemia. **Includes percentage of values >250 mg/dL

***Includes percentage of values <54 mg/dL

7

Good question, Joe! Glucose levels are constantly changing. Dexcom CGM lets us know where our glucose is headed, not just where it is at the time. That helps us to make smarter decisions about things like:
When and what can I eat?
Is it a good time to exercise?
Is it safe to drive? When do I need to check my glucose again?
Oh, I get it. For example, if my glucose looks like this a few hours after lunch, I don’t need to worry because it’s trending back into my target range.
But if it looks like this, I could go for a quick walk to help lower my glucose. Or maybe I need to cut down on the carbs in my lunch next time.
Trend arrows help us predict where our glucose will be soon and let us be proactive with how we manage it. We may want to ask ourselves questions about when and what our last meal was, if we’ve recently done physical activity, been under stress, or if we took our medication as prescribed. Again, I don’t know how I ever managed without them.
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Great point, Joe! I’ve also learned that my glucose comes into target range faster if I go for a walk after a meal. We sometimes take the kids out for pasta. Here’s what happens to my glucose if I walk compared to sitting in front of the TV afterwards.
Yea, Joanne, exercise can be pretty powerful. I’ve seen that. Sometimes I lift weights and sometimes I use an exercise bike, and each one affects my glucose differently. My Dexcom CGM shows a pretty quick drop when I’m on the bike, so I know I have to snack before. But my glucose holds pretty steady when I lift weights, so I don’t usually need a snack. I never expected that! Glad I’m looking at my Dexcom CGM.

Joanne’s dinner without a walk

Joanne’s dinner after a walk

CONSIDER THIS
What you learn can help you spend more time in the grey zone (70-180 mg/dL) on the trend graph. O See how different food types (carbs, proteins, fats) and portion sizes
impact your glucose level O Find out which of your favorite foods causes less of a glucose rise
after you eat them O Learn how different forms of physical activity affect your glucose O See how exercising at different times of day affect your glucose O Discover the impact of relaxation and stress-reduction O Check to see how different sleep patterns affect your glucose levels
13

When I add notes into my Dexcom app I can look back and see what I did that day and try to do more of what’s working well for me. A report that my doctor asked me to look at is called the AGP report. AGP stands for “Ambulatory Glucose Profile.” It’s like a summary of a person’s glucose levels for a two- week period in the form of a picture. There are two solid lines going across the graph that represent the target glucose range, 70 mg/ dL to 180 mg/dL.
Feature not available on Dexcom receiver.

TECH TIP
Clarity can produce weekly notifications sent to your email or smart phone. These notifications show things like how much time you are spending in range, how much it’s changed from the previous week, and patterns that may be developing.
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Here is what my AGP graph looked like soon after I started using the Dexcom CGM. The time of day runs from left to right: the far-left side shows my average glucose levels at midnight. The middle shows noontime, and the far right is midnight again. The solid squiggly line running through the middle of the graph shows my average glucose level at each phase of the day.
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Here is my recent AGP graph. It wasn’t perfect, but I’m in range (in the green) a LOT more than I used to be. I also don’t have as many extreme highs in the afternoon/evening as I used to. I think that has a lot to do with my after-lunch walks and cutting down on all the afternoon snacks.
What do the shaded areas mean, Joanne? The green shaded area shows when you are in your target range. Yellow is above your target range and red is below. The goal is to see lots of green and as little yellow and red as possible. It is also nice to see a fairly flat and narrow band going across the day this means that the glucose levels are fairly consistent, without a lot of high highs and low lows.
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5 JOE & JOANNE’S DEXCOM GRAB BAG: A FEW OF OUR FAVORITE THINGS
In this section, we’ll highlight some of our personal favorite features and additional strategies for getting the most out of Dexcom CGM.
URGENT LOW SOON ALERT
Urgent Low Soon is an alert feature that is automatically turned on in your Dexcom CGM. This alert “predicts” when your glucose is expected to reach 55 mg/dL within the next 20 minutes and provides an alert for you to take action ahead of time. Utilizing the Urgent Low Soon Alert is proven to help Dexcom users spend less time in hypoglycemia.7 I know it has helped me avoid a number of potential lows!
LOGGING EVENTS
Logging events can help you understand what caused your glucose to change. Log events regularly or when you want to learn about new foods, physical activity or when you experience something out of your normal routine.
You can add events for insulin doses, meals (number of carbs consumed), activity, and blood glucose meter values into your G7 app. You can also take notes where you type something specific about an event (e.g., “ate half of my sandwich with chips and an apple” or “stressful drive into work”).
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WRAPPING THINGS UP
There you have it! Joe and Joanne shared the top strategies they found helpful throughout their diabetes journeys. Now it’s your turn to explore with your Dexcom CGM and learn what works best for you!
· Go on a journey of personal discovery! Be curious, try different things and learn how your body responds in real-time.
· Review your glucose history and learn from the patterns you find. Glucose values are not good or bad. They all provide helpful information for making smart choices and behavior changes.
· Use the features of your Dexcom CGM to see more green on the TIR bar and AGP reports.
· Acknowledge the hard work required to manage diabetes and celebrate your success!

HELPFUL PHONE NUMBERS:
· Dexcom CGM training and education support: 888-738-3646 · 24/7 Product Support: 844-607-8398 · Or use your Dexcom G7 app to complete a Product Support Request (in the
Profile tab, scroll down to Support section and select Contact)
HELPFUL WEBSITES:
· Online Dexcom Support and Education resources · Learn tab of the Dexcom homepage for information about CGM, Dexcom G7
training, and Dexcom G6 training · Brief Training videos for Dexcom G6 and G7 apps and receivers · Dexcom Frequently Asked Questions · Submit Product Support Request
Work with your healthcare team to figure out what’s best for you when making treatment decisions. Always use their instructions to manage your diabetes.

REFERENCES
1. Radin MS. Pitfalls in hemoglobin A1c measurement: when results may be misleading. J Gen Intern Med. 2014;29(2):388-394. doi:10.1007/s11606-013-2595-x
2. Battelino T, Danne T, Bergenstal RM, et al. Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range. Diabetes Care. 2019;42(8):1593-1603. doi:10.2337/dci19-0028
3. Acciaroli G, Welsh JB, Akturk HK. Mitigation of Rebound Hyperglycemia With Real-Time Continuous Glucose Monitoring Data and Predictive Alerts. J Diabetes Sci Technol. 2022;16(3):677-682. doi:10.1177/1932296820982584
4.Martens T, Beck RW, Bailey R, et al. Effect of Continuous Glucose Monitoring on Glycemic Control in Patients With Type 2 Diabetes Treated With Basal Insulin: A Randomized Clinical Trial. JAMA. 2021;325(22):2262-2272. doi:10.1001/jama.2021.7444
5. Pettus J, Price DA, Edelman SV. HOW PATIENTS WITH TYPE 1 DIABETES TRANSLATE CONTINUOUS GLUCOSE MONITORING DATA INTO DIABETES MANAGEMENT DECISIONS. Endocr Pract. 2015;21(6):613620. doi:10.4158/EP14520.OR
6. Akturk HK, Dowd R, Shankar K, Derdzinski M. Real-World Evidence and Glycemic Improvement Using Dexcom G6 Features. Diabetes Technol Ther. 2021;23(S1):S21-S26. doi:10.1089/dia.2020.0654
7. Puhr S, Derdzinski M, Welsh JB, Parker AS, Walker T, Price DA. Real-World Hypoglycemia Avoidance with a Continuous Glucose Monitoring System’s Predictive Low Glucose Alert. Diabetes Technol Ther. 2019;21(4):155-158. doi:10.1089/dia.2018.0359
8. Welsh JB, Derdzinski M, Parker AS, Puhr S, Jimenez A, Walker T. Real-Time Sharing and Following of Continuous Glucose Monitoring Data in Youth. Diabetes Ther. 2019;10(2):751-755. doi:10.1007/s13300-0190571-0
9. Polonsky WH, Fortmann AL. Impact of Real-Time Continuous Glucose Monitoring Data Sharing on Quality of Life and Health Outcomes in Adults with Type 1 Diabetes. Diabetes Technol Ther. 2021;23(3):195-202. doi:10.1089/dia.2020.0466
Brief Safety Statement: Failure to use the Dexcom G7 Continuous Glucose Monitoring System (G7) and its components according to the instructions for use provided with your device and available at https://www.dexcom. com/safety- information and to properly consider all indications, contraindications, warnings, precautions, and cautions in those instructions for use may result in you missing a severe hypoglycemia (low blood glucose) or hyperglycemia (high blood glucose) occurrence and/or making a treatment decision that may result in injury. If your glucose alerts and readings from the G7 do not match symptoms, use a blood glucose meter to make diabetes treatment decisions. Seek medical advice and attention when appropriate, including for any medical emergency.

ABOUT THE AUTHOR
This playbook was developed in collaboration with Gary Scheiner, MS, CDCES, Owner and Clinical Director, Integrated Diabetes Services. Gary is a Certified Diabetes Care and Education Specialist in private practice and author of “Think Like a Pancreas” and “Practical CGM.” He was named Diabetes Educator of the Year in 2014 and has lived a positive life with diabetes since 1985.
Dexcom, Dexcom Clarity, Dexcom Follow, Dexcom One, Dexcom Share, Share are trademarks or registered trademarks in the U.S. and may be in other countries. LBL-1003949 Rev001