FCC ID: PH29688 G6 Firefly Transmitter

Continuous Glucose Monitoring System User Guide LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 1 2/5/19 9:26 AM LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 2 2/5/19 9:26 AM WARNING:

Failure to use the Dexcom G6 Continuous Glucose Monitoring System (G6) and its components according to the instructions for use and all indications, contraindications, warnings, precautions, and cautions 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 G6 do not match your symptoms or expectations, use a fingerstick blood glucose value from your blood glucose meter to make diabetes treatment decisions. Seek medical attention when appropriate. Please review the product instructions before using the G6. Indications, contraindications, warnings, precautions, cautions, and other important user information can be found in the product instructions that are included with, or accompany, the G6. Discuss with your healthcare professional how you should use the information displayed on the G6 to help manage your diabetes. The product instructions contain important information on troubleshooting the G6 and on the performance characteristics of the system. LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 1 2/5/19 9:26 AM Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 2 2/5/19 9:26 AM Table of Contents Part 1: Get Started Chapter 1 | Begin Your Dexcom G6 Continuous Glucose Monitoring System (G6) Journey 1.1 Introduction . 9 1.2 Resources . 9 1.3 Your Dexcom Account . 12 1.4 Glossary . 13 1.5 What Was Covered and Whats Coming . 17 Chapter 2 | Indications for Use and Safety Statements 2.1 Introduction . 19 2.2 Important User Information . 19 2.3 Dexcom G6 Safety Statements . 20 2.4 What Was Covered and Whats Coming . 34 Chapter 3 | Risks and Benefits 3.1 Risks . 35 3.2 Benefits. 37 3.3 What Was Covered and Whats Coming . 40 Part 2: Let's G6 Chapter 4 | What is the Dexcom G6 Continuous Glucose Monitoring System (G6)?

4.1 Introduction . 43 4.2 G6 CGM System . 43 4.3 Whats New for G6? . 44 4.4 G6 Components . 47 4.5 What Was Covered and Whats Coming . 49 Dexcom G6 System User Guide Chapter 5 | Set Up Your Display Devices 5.1 Introduction . 51 5.2 Choose the App, the Receiver, or Both . 51 5.3 App . 52 5.4 Receiver . 63 5.5 What Was Covered and Whats Coming . 69 Chapter 6 | Start Your Sensor 6.1 Introduction . 71 6.2 Prepare to Insert Sensor . 71 6.3 Choose Sensor Site . 73 6.4 Insert Sensor . 75 6.5 Attach Transmitter . 81 6.6 Pair and Start Your Sensor. 85 6.7 Pairing Tips. 91 6.8 What Was Covered and Whats Coming . 92 Chapter 7 | Calibrate 7.1 Introduction . 93 7.2 Calibration Overview . 93 7.3 Prepare to Calibrate . 95 7.4 Calibrating . 96 7.5 Calibrate Without Prompts . 106 7.6 Check In With Jake and Kelly . 106 7.7 What Was Covered and Whats Coming . 108 Part 3: Next Steps Chapter 8 | Home Screen 8.1 Introduction . 111 8.2 Home Screen Overview . 111 8.3 Glucose Information . 113 8.4 Navigation and Status Bar . 116 8.5 What Was Covered and Whats Coming . 121 3 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 3 2/5/19 9:26 AM Chapter 9 | Events 9.1 Introduction . 123 9.2 Events Overview . 123 9.3 Enter Insulin Event . 124 9.4 Other Events . 128 9.5 App: Edit or Delete an Event . 129 9.6 App: View Events. 131 9.7 What Was Covered and Whats Coming . 132 Chapter 10 | Alarm and Alerts 10.1 Introduction . 133 10.2 Alarm and Alerts Overview . 133 10.3 Check In With Kelly . 147 10.4 Confirming Alarm/Alerts . 148 10.5 Customizing Your Alerts . 150 10.6 Why Customize Alerts? . 162 10.7 Check In With Jake and Kelly . 163 10.8 App: Control When Alarm/Alerts Sound . 165 10.9 App: Alert Schedule . 166 10.10 What Was Covered and Whats Coming . 171 Chapter 11 | Treatment Decisions 11.1 Introduction . 173 11.2 How Do You Know Youre Ready? . 173 11.3 Your HCP Is Your Partner . 174 11.4 When to Use Your Meter . 175 11.5 Watch and Wait . 177 11.6 Using Your G6 for Treatment Decisions . 177 11.7 Check In With Jake and Kelly . 179 11.8 You Decide! . 181 11.9 What Was Covered and Whats Coming . 183 Chapter 12 | App: Sharing Information With Your Support Team 12.1 Introduction . 185 12.2 Share and Follow . 185 12.3 Check In With Jake and Kelly . 203 12.4 What Was Covered and Whats Coming . 205 Chapter 13 | End Sensor and Transmitter Sessions 13.1 Introduction . 207 13.2 End Your Sensor Session . 207 13.3 Remove Sensor and Transmitter 210 13.4 End of Transmitter Battery . 214 13.5 Pair New Transmitter . 214 13.6 What Was Covered and Whats Coming . 224 Chapter 14 | Troubleshooting 14.1 Introduction . 225 14.2 Alarm/Alerts and G6 Readings . 225 14.3 Applicator . 235 14.4 App . 240 14.5 Receiver . 240 14.6 Recalibration Alert . 250 14.7 Transmitter . 252 14.8 Sensor . 254 14.9 Share . 255 14.10 Accuracy . 257 14.11 Calibration Prompts . 258 14.12 What Was Covered and Whats Coming . 259 Part 4: Everything Else G6 Appendix A | Need Help?

Youre Not Alone! . 263 Appendix B | Security and Air Travel . 267 Appendix C | Extend Your App . 269 Appendix D | Take Care of Your G6 . 275 Appendix E | Warranty . 283 Appendix F | Technical Information . 289 Dexcom G6 System User Guide 4 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 4 2/5/19 9:26 AM Appendix G | Label Symbols . 327 Appendix H | Alarm/Alerts Vibrations and Sounds . 331 Index . 347 Dexcom G6 System User Guide 5 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 5 2/5/19 9:26 AM Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 6 2/5/19 9:26 AM Get Started Risks and Benefits Indications for Use and Safety Statement 1Get Started 2/5/19 9:26 AM LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 7 Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 8 2/5/19 9:26 AM Chapter 1 | Begin Your Dexcom G6 Continuous Glucose Monitoring System (G6) Journey 1.1 Introduction Welcome to the G6 continuous glucose monitoring (CGM) family!

This User Guide supports you in getting to know your G6. We also have numerous other resources available to help you to get the most out of your G6. After this chapter, youll be able to:

Locate different training resources Explain why you need a Dexcom account Images and screens in this User Guide are representational and may differ from your G6. 1.2 Resources Tutorial Our tutorial walks you through your first sensor session, including picking a display device, inserting the sensor, and using alarm/alerts, and making treatment decisions. Your First Sensor Session tutorial is at dexcom.com/support In-App Videos Watch the videos in your app to find out more:

Overview: See how your CGM shows where your sensor glucose is now, where its going, and where its been Dexcom G6 System User Guide Chapter 1: Begin Your Dexcom G6 Continuous Glucose Monitoring System (G6) Journey 9 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 9 2/5/19 9:26 AM Sensor Insertion and Attaching Transmitter Attachment: Walks through inserting your sensor and attaching your transmitter Treatment Decisions: Learn how to use your G6 to make treatment decisions, like dosing for highs and treating for lows You can watch these videos when you set up your app or anytime at Settings > Help

> Videos. Guides Getting Started Guides Two guides are included with your boxes:

Start Here guides you through setting up your display devices, inserting your sensor, and starting your first sensor session Using Your G6 helps you during your first week (for example, how to read the home screen) and beyond User Guide This User Guide is your encyclopedia. It gives you the most extensive overview of the G6, detailing features, important safety information, and so much more. Download the User Guide or ask for a printed version:

Download a PDF at dexcom.com/guides Complete an online form at dexcom.com/guides to receive a free printed copy Ask for a free copy by mail by filling out and returning the business card found in the back of this guide Ask for a free copy by phone:

Toll free: 1.888.738.3646 Toll: 1.858.200.0200 Dexcom G6 System User Guide Chapter 1: Begin Your Dexcom G6 Continuous Glucose Monitoring System (G6) Journey 10 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 10 2/5/19 9:26 AM The G6 User Guide is grouped into four parts:

Part 1: Get Started Chapter 1: Begin Your Dexcom G6 Continuous Glucose Monitoring System (G6) Journey Chapter 2: Indications for Use and Safety Statements Chapter 3: Risks and Benefits Part 2: Lets G6! The Basics Chapter 4: What is the G6?

Chapter 5: Set Up Your Display Devices Chapter 6: Start Your Sensor Chapter 7: Calibrate Part 3: Next Steps Chapter 8: Home Screen Chapter 9: Events Chapter 10: Alarm and Alerts Chapter 11: Treatment Decisions Chapter 12: Sharing Information With Your Support Team Chapter 13: End Sensor and Transmitter Sessions Chapter 14: Troubleshooting Part 4: Appendices Appendix A: Need Help? You're Not Alone Appendix B: Security and Air Travel Appendix C: Extend Your App Appendix D: Take Care of Your G6 Dexcom G6 System User Guide Chapter 1: Begin Your Dexcom G6 Continuous Glucose Monitoring System (G6) Journey 11 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 11 2/5/19 9:26 AM Appendix E: Warranty Appendix F: Technical Information Appendix G: Label Symbols Appendix H: Alarm/Alert Vibrations and Sounds How to Use Your User Guide Start with the table of contents. Each chapter includes information to guide you through your sensor session, from setting it up, to taking it off, and everything in between. All chapters in the G6 User Guide are structured the same way: The beginning of each chapter lists what youll be able to do after youve finished, followed by the chapters content. At the end, theres a recap of what was covered and whats in the next chapter. The appendices have additional information you may want to reference. For example, about the warranty, and taking care of your device. This User Guide isnt meant to show you how to use your smart device. Contact your smart device support or read your smart devices user guide for assistance. Label Symbols Symbols may be found on the sensor, transmitter, and receiver package labels. These symbols tell you about the proper and safe use of the G6. For a listing of what they mean, see the Symbols Glossary in Appendix G and at dexcom.com/symbols. 1.3 Your Dexcom Account Youll need a Dexcom username and password to set up the Dexcom G6 App (app) and for reordering. If you don't have a Dexcom user name and password, go to dexcom. com and set up an account. Or, if you prefer, create your account in the app during setup. Dexcom G6 System User Guide Chapter 1: Begin Your Dexcom G6 Continuous Glucose Monitoring System (G6) Journey 12 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 12 2/5/19 9:26 AM 1.4 Glossary A1C Blood test used to diagnose type 1 or 2 diabetes and to gauge how well youre managing your diabetes. A1C reflects your average blood sugar level for the past 2 to 3 months. Airplane Mode A setting on a smart device where certain features are disabled to comply with airline regulations. Alternative Site Testing Using a blood sample from non-fingertip (alternate) sites such as the palm, forearm, or upper arm for meter values. Dont use alternative site testing to calibrate the G6. Only use fingerstick measurements. Android Operating system used for smart devices. Android Wear A type of smart watch. App or Application App Store or Play Store Software installed on a smart or mobile device. The G6 app is a display for continuous glucose monitoring. Internet store for downloading applications to a smart device. Apple Watch A smart watch for iPhone. Blood Glucose

(BG) Meter A medical device used to measure how much glucose is in the blood. Blood Glucose

(BG) Value Blood glucose value is the amount of glucose in the blood measured by a meter. Bluetooth A technology that allows devices to wirelessly communicate with each other. Dexcom G6 System User Guide Chapter 1: Begin Your Dexcom G6 Continuous Glucose Monitoring System (G6) Journey 13 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 13 2/5/19 9:26 AM Calibration Calibration is a comparison or measurement between your meter fingerstick BG values, and the sensor interstitial fluid glucose readings. Although blood and interstitial fluids are similar, glucose concentrations may differ. Calibration allows alignment between your G6 readings and meter values. When you calibrate, you take a fingerstick measurement from your meter then enter the value into your receiver or smart device Calibrating your G6 is optional. Continuous Glucose Monitoring Contraindication A sensor inserted under the skin checks glucose levels in interstitial fluid. A transmitter sends readings to a display device. A safety statement outlining specific situations where the G6 shouldn't be used because it may be harmful to you. The risk of use clearly outweighs any possible benefit. Default A manufacturers preset option for a device setting. Follow or Dexcom Follow App A Dexcom app used for monitoring another users glucose information and alerts. Follower A person who receives a Sharers information in Follow. High BG. Same as high or high blood sugar. Hyperglycemia is characterized by an excess of glucose in the bloodstream. Hyperglycemia Its important to treat hyperglycemia. If left untreated, hyperglycemia can lead to serious complications. The default High Alert in the G6 is set to 200 mg/dL. Consult your HCP (healthcare professional) to determine the appropriate hyperglycemia setting for you. Dexcom G6 System User Guide Chapter 1: Begin Your Dexcom G6 Continuous Glucose Monitoring System (G6) Journey 14 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 14 2/5/19 9:26 AM Low BG. Same as low or low blood sugar. Hypoglycemia is characterized by a low level of glucose in the bloodstream. Hypoglycemia Its important to treat hypoglycemia. If left untreated, hypoglycemia can lead to serious complications. The default Low Alert in the G6 is set to 80 mg/dL. Consult your HCP to determine the appropriate hypoglycemia setting for you. Indications How, for what purposes, and under what circumstances you should use the G6. iOS Operating system used for Apple smart devices. The International Electrotechnical Commission (IEC) is a nonprofit, non-governmental, international organization created to produce safety standards for electronics. One of the safety standards 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 encounters. An IP22 rating lets you know your electronic device wont allow you to stick your fingers in it and wont get damaged or be unsafe during specific testing with water dripping down. 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. Don't install the G6 app on a jailbroken or rooted smart device. It may not work correctly. IP Jailbroken or Rooted mg/dL Milligrams per deciliter. The standard unit of measure for BG readings in the United States. Dexcom G6 System User Guide Chapter 1: Begin Your Dexcom G6 Continuous Glucose Monitoring System (G6) Journey 15 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 15 2/5/19 9:26 AM Notification Peripheral Device Precaution Safety Statement An app message that appears on the screen of a smart device. Notification may also include a sound or vibration, depending on the smart device settings. Hardware connected to your smart device. For example, a Bluetooth headset, Apple watch, or other smart watch. A safety statement regarding any special care to be exercised by you or your HCP for the safe and effective use of the G6. A statement of the intended uses of G6 and relevant warnings, precautions, and contraindications. Sensor Glucose Reading A BG measurement taken by the G6. Typically referred to as G6 readings in these instructions. Sensor Session The 10-day monitoring period after inserting a new sensor. During this time frame, your glucose is being monitored and reported every 5 minutes, with data being sent to your display device(s). Share or Dexcom Share App A feature of the Dexcom G6 app that lets you securely send your G6 information to Followers. Sharer The G6 user who shares their G6 information with Followers. Simultaneous Voice and Data The ability to make a phone call and access the Internet on the same cellular connection at the same time. Smart or Mobile Device An electronic device that is cordless, mobile, and connected to the Internet, such as a smartphone or tablet. Smart Watch A watch that communicates with and extends a smart device. For example, an Apple Watch. Stacking Insulin Taking a dose of insulin soon after your most recent dose. This can result in low blood sugar. Doesnt apply to taking insulin doses to cover what you just ate. Warning Describes serious and life-threatening circumstances, the consequences, and how to avoid the hazard while using the G6. Dexcom G6 System User Guide Chapter 1: Begin Your Dexcom G6 Continuous Glucose Monitoring System (G6) Journey 16 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 16 2/5/19 9:26 AM 1.5 What Was Covered and Whats Coming Now You Can:

Locate different training resources Explain why you need a Dexcom account Whats Next?

Next youll learn when and how to use the G6 safely. Dexcom G6 System User Guide Chapter 1: Begin Your Dexcom G6 Continuous Glucose Monitoring System (G6) Journey 17 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 17 2/5/19 9:26 AM Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 18 2/5/19 9:26 AM Chapter 2 | Indications for Use and Safety Statements 2.1 Introduction We want the Dexcom G6 Continuous Glucose Monitoring System (G6) to be a valuable tool in your diabetes management. Like any system, there are steps to take to get the most out of it. In this chapter, you will learn about some key areas that might prevent you from having the best CGM experience or if you are not careful might even harm you or the G6. 2.2 Important User Information What is a Safety Statement A Safety Statement is a brief statement of the G6 indications, contraindications (when to avoid using it), relevant warnings, and precautions. The Safety Statements are meant to keep you and the G6 safe while using it:

1) Indications How, for what purposes, and under what circumstances you should use the G6. Indications let you know who should use the G6 and when. 2) Contraindications Contraindications let you know when not to use the G6. If used during these situations, you may hurt yourself or the G6 and 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 system, their consequences, and how to avoid danger. 4) Precaution Special steps you need to take while using the system preventing minor or moderate injury to either you or the system. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 19 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 19 2/5/19 9:26 AM Safety Statements in Chapters Each chapter shows applicable indications, contraindications, precautions, and warnings. Some chapters have multiple Safety Statements; others have none. The same statement may be repeated in several chapters. 2.3 Dexcom G6 Safety Statements Indications for Use The Dexcom G6 Continuous Glucose Monitoring System (Dexcom G6 System) is a real time, continuous glucose monitoring device indicated for the management of diabetes in persons age 2 years and older. The Dexcom G6 System is intended to replace fingerstick blood glucose testing for diabetes treatment decisions. Interpretation of the Dexcom G6 System results should be based on the glucose trends and several sequential readings over time. The Dexcom G6 System also aids in the detection of episodes of hyperglycemia and hypoglycemia, facilitating both acute and long-term therapy adjustments. The Dexcom G6 System is also intended to autonomously communicate with digitally connected devices, including automated insulin dosing (AID) systems. The Dexcom G6 System can be used alone or in conjunction with these digitally connected medical devices for the purpose of managing diabetes. Contraindication No MRI/CT/Diathermy MR Unsafe MR Dont wear your CGM (sensor, transmitter, receiver, or smart device) for magnetic resonance imaging (MRI), computed tomography (CT) scan, or high-frequency electrical heat (diathermy) treatment. The G6 hasnt been tested in those situations. The magnetic fields and heat could damage the components of the G6, which may cause it to display inaccurate G6 sensor glucose readings (G6 readings) or may prevent alerts. Without G6 readings or alarm/alert notifications, you might miss a severe low or high glucose event. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 20 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 20 2/5/19 9:26 AM Warnings Read User Materials Before you use your G6, carefully read the materials included with it. If you dont, you might:

Not use the G6 correctly Not understand G6 information Affect how well it works Dont Ignore Low/High Symptoms Dont ignore how you feel. If your glucose alerts and G6 readings dont match what youre feeling, use your blood glucose meter (meter) to make diabetes treatment decisions or, if needed, seek immediate medical attention. When in doubt, get your meter out. No Number, No Arrow, No CGM Treatment Decision If your G6 doesnt show a number or arrow, or your readings dont match your symptoms, use your meter to make diabetes treatment decisions. No number, no arrow, no treatment decision. When in doubt, get your meter out. Dont Use If Do not use the G6 if you are pregnant, on dialysis, or critically ill. It is not known how different conditions or medications common to theses populations may affect performance of the system. G6 readings may be inaccurate in these populations. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Precaution Avoid Sunscreen and Insect Repellent Some skin care products, such as sunscreens and insect repellents, can make the plastic used in your G6 crack. Before using your G6, make sure there are no cracks in your receiver, transmitter, and transmitter holder. If you find a crack, please contact Technical Support. Do not allow these skin care products to contact your G6. After using skin care products, wash your hands before touching your G6. If any skin care products get on your G6, immediately wipe with a clean cloth. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 21 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 21 2/5/19 9:26 AM Start Up Safety Statements Warnings Use Meter During Startup When you start a new sensor, you wont get any G6 readings or alarm/alerts until you enter your sensor code or two calibrations. Use your meter to make treatment decisions during the 2-hour sensor warmup period. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Precautions Use Correct Sensor Code When you start a new sensor, you must enter a code into your display device to use the G6 without fingerstick calibrations. Each sensor has its own code printed on the back of the adhesive patch. Do not use a code from a different sensor or make up a code. If you do not enter the correct code, your sensor will not work as well and could be inaccurate. If you lost the sensor code, you may calibrate the G6 using fingersticks. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Calibration Safety Statements Calibration is not required if users enter a sensor code. If users do not enter a sensor code, the following warnings and precautions apply. Warnings Dont Wait Calibrate!

If you have not used the calibration code, you must manually calibrate your G6 using values obtained from a blood glucose meter and fingersticks daily. You must calibrate immediately when the G6 notifies you. If you havent calibrated when notified, your G6 may not be accurate, so use your glucose meter to make treatment decisions until you calibrate your G6. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 22 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 22 2/5/19 9:26 AM Use Fingersticks Use fingertips to calibrate from your BG meter. Blood from other places may be less accurate and not as timely. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Precautions Be Accurate, Be Quick. Enter the exact BG value displayed on your meter within five minutes of using your meter. Dont enter the G6 reading as a calibration. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. System/Hardware/Software Safety Statements Warnings Wire Breaks Off Dont ignore broken or detached sensor wires. A sensor wire could remain under your skin. If this happens, please contact our 24/7 Technical Support. If a sensor wire breaks off under your skin and you cant see it, dont try to remove it. Contact your HCP. Also seek professional medical help if you have symptoms of infection or inflammation redness, swelling, or pain at the insertion site. Where to Insert: Belly or Buttocks?

All patients can use their bellies (abdomen). Patients 2 to 17 years old can also choose their upper buttocks. Look for a place on your belly or upper buttocks where you have some padding. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 23 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 23 2/5/19 9:26 AM The sensor is not tested or approved for other sites. Talk to your HCP about the best site for you. 18 years and older 2-17 years or Where to Store You can store your sensors at room temperature or in your refrigerator as long as its between 36F and 86F. Dont store sensors in the freezer. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Precautions Dont Use if Expired Dont use expired sensors, because they may give incorrect results. Check the package label for the expiration date. Its in YYYY-MM-DD (Year-Month-Day) format. Check Package Dont use sensor if its sterile package has been damaged or opened, because it might cause an infection. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 24 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 24 2/5/19 9:26 AM Clean and Dry Skin Clean and dry your hands and your insertion site before inserting your sensor. Wash your hands with soap and water, not gel cleaners, and then dry them before opening the sensor package. If your hands are dirty when you insert the sensor, you may get germs on the insertion site and get an infection. Clean your insertion site with alcohol wipes to prevent infections. Dont insert the sensor until your skin is dry. If your insertion site is not clean and completely dry, you run the risk of infection or the transmitter holder not sticking well. Make sure you dont have insect repellent, sunscreen, perfume, or lotion on your skin. Where to Insert: Things to Check Keep the safety guard on until you put the G6 applicator against your skin. If you remove the safety guard first, you may hurt yourself by accidentally pushing the button that inserts the sensor before you mean to. Change your insertion site with each sensor. Using the same site too often might not allow the skin to heal, causing scarring or skin irritation. Sensor placement is important. Choose a site:

At least 3 inches from insulin pump infusion set or injection site Away from waistband, scarring, tattoos, irritation, and bones Unlikely to be bumped, pushed, or laid on while sleeping Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Transmitter Safety Statements Warnings Inspect Dont use a damaged or cracked transmitter. A damaged transmitter could cause injuries from electrical shocks and may make the G6 not work correctly. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 25 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 25 2/5/19 9:26 AM Use as Directed The transmitter is small and may pose a choking hazard. Dont put it in your mouth or let children hold it without adult supervision. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Precautions Reuse Dont Throw Away When ending a session, dont throw away the transmitter. The transmitter is reusable until the G6 notifies you that the transmitter battery is about to expire. Dont Share Never share your transmitter. The G6 is a prescription-only medical device and is meant for your use only. The transmitter is tied to the G6 readings. If used by more than one person, the G6 readings, reports, alarm/alerts, etc., may be wrong. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. System Safety Statements Precautions Treatment Decisions Use your G6 reading and trend arrow to make treatment decisions. Use Correct Transmitter, Receiver, and Sensor G6 components are not compatible with any previous Dexcom products. Do not mix transmitters, receivers, and sensors from different generations. Going Through Security Check Point When wearing your G6, ask for hand-wanding or full-body pat-down and visual inspection instead of going through theAdvanced Imaging Technology (AIT) body scanner (also called a millimeter wave scanner) or putting any part of the G6 in the baggage x-ray machine. You can wear the G6 for the walk-through metal detector. If you do, use your meter for treatment decisions until you leave the security area. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 26 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 26 2/5/19 9:26 AM Because we havent tested every x-ray and scanner, we dont know if they damage the G6. Not sure what kind of machine it is? Be safe either ask the TSA officer, request hand-wanding, or request full-body pat-down. Interfering Substance Risks In previous generations of Dexcom CGM systems (G4/G5), acetaminophen could affect your sensor readings, making them look higher than they really were. However, with the G6, you can take a standard or maximum acetaminophen dose of 1 gram (1,000 mg) every 6 hours and still use the G6 readings to make treatment decisions. Taking higher than the maximum dose of acetaminophen (e.g. > 1 gram every 6 hours in adults) may affect the G6 readings and make them look higher than they really are. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Receiver and Smart Device Safety Statements Precautions Keep Transmitter Close to Display Device Keep your transmitter and display device within 20 feet with no obstacles (like walls or metal) between them. Otherwise, they might not be able to communicate. If water is between your transmitter and the display device for example, if youre showering or swimming keep them closer to each other. The range is reduced because Bluetooth doesnt work as well through water. Get Alarm/Alerts on Display Device You Use To get your alarm/alerts, set them on the display device you use. Your receiver wont get the alarm/alerts you set on your app. Likewise, your app wont get the alarm/alerts you set on your receiver. Is It On?

If the receiver or smart device is turned off (shut down), it will not show G6 readings or alarm/alerts. Make sure your display device is turned on. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 27 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 27 2/5/19 9:26 AM Smart Device Safety Statements Warning Check Settings Your alarm and important alerts sound and display information even when your volume is low or muted. Specifically, if your smart device is on mute and you have the Always Sound setting turned on (the default setting), only these notifications make a sound:

Glucose Alarm/Alerts:

Urgent Low Urgent Low Soon Low Glucose High Glucose Rise Rate Fall Rate No Readings Alert System Alerts:

Calibration Required (after 2-hour sensor warmup, only appears when a sensor code is not active) Calibration Error (only appears when a user enters a calibration; calibration is not required) Sensor Expired Replace Sensor Transmitter (not working) No Storage Error App Stopped Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 28 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 28 2/5/19 9:26 AM Exceptions: On Apple devices, Signal Loss does not sound when your volume is low or muted. No alarm/alerts sound on your phone when your Android phone is in the most restrictive Do Not Disturb setting. Repeating: Some notifications are silent during the first visual and vibrate notification and then make a sound on the second notification. If you do not clear the alert, it repeats at half volume after 5 minutes and at full volume after 10 minutes. Accessories: When using Bluetooth headphones, speakers, etc., your alarm/

alerts may sound on your primary smart device or on the accessory. Each accessory is different. Test yours so you know where youll hear your alarm/

alerts. Bluetooth: Your transmitter talks to your app with Bluetooth. Make sure your smart device Bluetooth is on. If not, you will not get alarm/alerts or CGM information. Notifications:

Make sure your smart device settings allow Dexcom app notifications to show on your Lock screen. This will allow you to see notifications without unlocking your phone. Apple: During G6 setup, enable Dexcom app notifications or you wont get alarm/alerts. Battery: The app must always be running in the background and may drain your smart device battery. Keep the battery charged. Compatibility: Before upgrading your smart device or its operating system, check dexcom.com/compatibility. Automatic updates of the app or your device operating system can change settings or shut down the app. Always update manually and verify correct device settings afterward. Time: Let the date and time on your smart device automatically update when you travel across time zones or switch between standard and daylight saving times. Dont manually change your smart device time, because it can make the time on the trend screen wrong and the app may stop displaying data. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 29 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 29 2/5/19 9:26 AM Precautions Test Speaker and Vibrations You have to hear or feel alarm/alerts to react to them, so test your smart device speaker and vibrations regularly (see your smart device product instructions). If they dont work, contact your smart devices product support. Check Peripheral Devices Do you use headphones with your smart device? What about Bluetooth speakers or a smart watch? When using peripherals, keep in mind you may get your alarm/

alerts on only one device or peripheral, not all. After connecting any peripheral devices, make sure that your smart device settings allow you to continue receiving alarms or alerts. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Receiver Safety Statements Warnings Dont Use if Damaged Dont use a receiver that is damaged or cracked. A damaged receiver could cause injuries from electrical shocks and may make the G6 not work correctly. Use Cable as Directed Use USB cable only as directed, and store safely. Misuse of the USB cable can be a strangulation risk. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Precautions Test Speaker and Vibrations You have to hear or feel alarm/alerts to react to them, so test your receiver speaker and vibrations regularly. To make sure the speaker and vibrations work, plug in the receiver to charge. The Speaker Test screen appears for a few seconds. Follow the directions on the screen to test the speaker and vibrations. If you hear and feel them, great! But if it doesnt beep and vibrate perhaps it got wet or was dropped contact Technical Support and use your app until the receiver is fixed. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 30 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 30 2/5/19 9:26 AM Keep Clean and Dry Dont submerge your receiver in water and dont get dirt or water in the USB port. That could damage it. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Caution Requires Prescription U.S. law restricts the sale of the G6 Mobile to sale by, or on the order of, a physician. Dexcom Share Safety Statements Important User Information Dexcom Share (Share) lets you send your sensor information from your app to your Followers smart devices! Read the indications, warnings, and precautions below to find out how you can safely use this app feature. Share and Managing Your Diabetes Safety Statements Indications Keep Followers Informed Use Share to send your sensor information from your smart device to your Followers smart devices. Use as Secondary Notice The information on your smart device is sent directly from your G6 transmitter. After it is on your device, Share sends it to your Followers. So your Followers information is always older than yours. Use your current information to manage your diabetes, not your Followers possibly outdated information. Your Followers can use the information they get to reach out to you and support you in managing your diabetes. The information they get is not meant to be used for treatment decisions, analysis, or teaching. Followers cant change your information. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 31 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 31 2/5/19 9:26 AM Warnings Use Your G6 to Make Treatment Decisions Dont use Share information for treatment decisions, like treating for a low or dosing for a high. Use the sensor information on your G6 instead. Take HCP Advice Has your HCP given you self-monitoring tasks? Keep doing them. Having Followers doesnt replace them. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Share Setup and Settings Safety Statements Warning Followers Must Follow and You Must Share You have to turn Share on to make it send your sensor information to your Followers. Followers have to download the Dexcom Follow app to see what you send. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Precautions Followers Dont Manage Your Diabetes, You Do Dont rely on your Followers to let you know you need to make a treatment decision. Stay on top of your diabetes management. Look at your G6 often. Respond to alarm/alerts. Dont wait for a Follower to reach out they may not be getting your sensor information because of a technical issue. Check Your Smart Device and Your Followers Smart Devices Internet access required: Both smart devices need to be connected to the Internet to use Share. Try sending your Follower an email from your device. If your Follower gets it on their device, both smart devices are connected. Batteries charged: Make sure the smart device batteries are charged. If either your or your Followers smart device batteries arent charged, Share wont work. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 32 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 32 2/5/19 9:26 AM Check Your Smart Device App on: Whenever you power on your smart device, tap the G6 app to open it. If the app isnt open, Share wont work. Check Followers Smart Devices Sounds on: Followers must keep their smart device volume on, or at least the keep vibration on, so they can hear and/or feel alarm/alerts. Smart device settings trump Follow app settings Sharing gaps: Followers wont get your sensor information when their smart device is off, not connected to the Internet, or in Do Not Disturb or Airplane mode. When the Followers fix those issues, theyll start getting the current information but they wont get the information they missed Cell carrier supports simultaneous voice and data: Most cell service carriers support using voice and data at the same time. Check yours and have Followers check theirs. If its not supported, Share wont work during phone calls. Share will restart when the call is over and send any waiting notifications Customize Share So Followers Can Support You Customize Share to make sure your Followers have the information they need to help you manage your diabetes Delay feature: Your Follower wont get notified until after the delay time you set Not Share feature: You can stop sharing with a Follower any time by choosing Not Share. That Follower will stop getting any of your sensor information until you choose to Share again Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 33 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 33 2/5/19 9:26 AM 2.4 What Was Covered and Whats Coming Now You:

Can explain how safety statements keep you safe Can explain how to interpret safety statements Have an overview of safety statements Whats Next?

In the next chapter, youll learn the risks and benefits of using the G6. Dexcom G6 System User Guide Chapter 2: Indications for Use and Safety Statements 34 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 34 2/5/19 9:26 AM Chapter 3 | Risks and Benefits When using any medical device, there are risks and benefits. In this chapter, youll learn what they are. 3.1 Risks The risks with using Dexcom G6 Continuous Glucose Monitoring System (G6) are:

Not getting your alarm/alerts Using G6 to make treatment decisions when you shouldnt Sensor insertion issues This section covers each of those risks in detail. Follow system instructions. If you dont, you could have a severe low or high glucose event. Not Getting Alarm/Alerts If you arent getting your alarm/alerts, you could have severe low or high glucose without knowing it. Check your display device:

Battery charged: If the display device battery is dead, you wont get G6 readings or alarm/alerts. App on: Keep the app on so you get G6 readings or alarm/alerts. Alerts on: Leave the alert function on to get alarm/alerts. Volume up: Keep the volume loud enough to hear your alarm/alerts. Speaker and vibrations work: If the speaker or vibrations arent working, you wont hear or feel your alarm/alerts. In range: Keep your display device no more than 20 feet from your transmitter, with no obstacles between them. They have to be that close to communicate. If they arent in range, you wont get G6 readings or alarm/alerts. Dexcom G6 System User Guide Chapter 3: Risks and Benefits 35 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 35 2/5/19 9:26 AM No System errors: If you get a system error such as No Readings, Sensor Error, or Signal Loss you wont get G6 readings or alarm/alerts. During warmup and after session ends: You wont get alarm/alerts or G6 readings during the 2-hour warmup or after a sensor session ends. See Troubleshooting (Chapter 14), recommended settings (Chapter 5), and notifications that sound while smart device is silenced/muted (Appendix H) for more information. Using G6 for Treatment Decisions You can use your G6 to treat for a low or dose for a high in all but these few situations . See table below for details. Situation Treatment Descision Tool How you feel is consistent with our G6 reading Use your CGM to make a treatment decision How you feel is inconsistent with your CGM G6 reading Take a fingerstick with your blood glucose meter to make a treatment decision Your CGM displays a sensor glucose number and arrow(s) Use your CGM to make a treatment decision Your CGM display is missing G6 reading

(number) or arrow(s), or both Take a fingerstick with your meter to make a treatment decision Use your G6 for treatment decisions, not your Followers: Dexcom Share allows you to share your sensor glucose information from your smart device to your Followers. The main risk with Share is misunderstanding its purpose. The information on your display device is the most current it comes straight from your transmitter so only use yours for treatment decisions. There can be technical issues and delays in sharing information. Followers can reach out and support you, but dont rely on them or their information to manage your diabetes for you. Some users found accuracy between different sensors varied significantly. When you insert each sensor, pay attention to its accuracy before deciding to use it for treatment decisions. Dexcom G6 System User Guide Chapter 3: Risks and Benefits 36 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 36 2/5/19 9:26 AM For more information on how to make treatment decisions using your G6, see Chapter 11. For more information on Share, see Chapter 12. Interfering Substance Risks In previous generations of Dexcom CGM systems (G4/G5), acetaminophen could affect your sensor readings, making them look higher than they really were. However, with the G6, you can take a standard or maximum acetaminophen dose of 1 gram (1,000 mg) every 6 hours and still use the G6 readings to make treatment decisions. Taking higher than the maximum dose of acetaminophen (e.g. > 1 gram every 6 hours in adults) may affect the G6 readings and make them look higher than they really are. Sensor Insertion Risks Its uncommon, but inserting the sensor can cause infection, bleeding, or pain, and wearing the adhesive patch can irritate your skin. Only a few patients in the G6 clinical studies got slight redness and swelling. No sensor wires broke in the clinical studies; however, there is a remote chance a sensor wire could break or detach and remain under your skin. Sterile broken sensor wires usually dont pose a significant medical risk. If a sensor wire breaks off or detaches and remains under your skin, contact your HCP and Technical Support (24/7):

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll call: 1.858.200.0200 3.2 Benefits Some benefits of using your G6 are:

Knowing your trends Making treatment decisions using your G6 Managing your diabetes Getting alerted for low and high G6 readings This section covers each of those benefits in detail. Dexcom G6 System User Guide Chapter 3: Risks and Benefits 37 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 37 2/5/19 9:26 AM Knowing Your Trends The G6 sends you a reading every 5 minutes. It also provides reports and views of your information so you can detect and reflect on trends, patterns, and how your body responds to different things, like exercise or pizza. This provides you with a more complete picture of your glucose and lets you see how your daily habits impact your glucose trends. Making Treatment Decisions Using G6 You can use your G6 reading and trend arrow to make treatment decisions like treating for a low or dosing for a high. See Chapter 11 for more information on treatment decisions. With G6, theres no need to take fingersticks to calibrate the system or for treatment decisions (as long as your symptoms match your G6 readings). This can reduce the pain and burden of excessive fingersticks (Aleppo 2017) and reduce potential errors due to inaccurate calibration. Helping Your Diabetes Management The alarm/alerts features (Chapter 10) keep you aware of your glucose levels. Alarm/

alerts notify you when your glucose goes outside your target range, goes too low, or too high, or is rapidly falling or rising. This lets you take action to prevent glucose from going too low or high (Pettus 2015). Some people perceive an increase in their quality of life and peace of mind when using real-time CGM (Polonsky 2017). Share may improve the quality of life and peace of mind for patients, their caregivers, and their support team because it sends Followers G6 readings and alarm/alerts remotely. Followers can then reach out when G6 readings go too low or high. Dexcom G6 System User Guide Chapter 3: Risks and Benefits 38 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 38 2/5/19 9:26 AM References Aleppo, Grazia,KatrinaRuedy,TonyaRiddlesworth,DavidaKruger,Anne Peters,IrlHirsch,Richard Bergenstal,ElenaToschi,AndrewAhmann,Viral Shah,MichaelRickels,BruceBode,AthenaPhilis-Tsimikas,RodicaPop-

Busui,HenryRodriguez,EmilyEyth,AnujBhargava,CraigKollman,and Roy Beck. 2017. Replace-BG: a randomized trial comparing continuous glucose monitoring with and without routine blood glucose monitoring in well-controlled adults with type 1 diabetes. DiabetesCare.40(4):538-545. doi: 10.2337/dc16-2482. Beck, Roy, Tonya Riddlesworth, Katrina Ruedy, Andrew Ahmann, Richard Bergenstal, Stacie Haller, Craig Kollman, Davida Kruger, Janet McGill, William Polonsky, Elena Roschi, Howard Wolpert, and David Price for the DIAMOND Study Group. 2017. Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: the DIAMOND randomized clinical trial. JAMA.317(4):371-

378. doi:10.1001/jama.2016.19975. The Diabetes Control and Complications Trial Research Group. September 30, 1993. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 329:977-986. Lind, Marcus, William Polonsky, Irl Hirsch, Tim Heise, Jan Bolinder, Sofia Dahlqvist, Erik Schwarz, Arndis Finna Olafsdottir, Anders Frid, Hand Wedel, Elsa Ahlen, Thomas Nystom, and Jarl Hellman. 2017. Continuous glucose monitoring vs conventional therapy for glycemic control in adults with type 1 diabetes treated with multiple daily insulin injections: the gold randomized clinical trial. JAMA. 317(4):379-387. doi:10.1001/jama.2016.19976. Pettus, Jeremy, David Price, and Steven Edelman. 2015. How patients with type 1 diabetes translate continuous glucose monitoring data into diabetes management decisions. Endocr Pract. 21(6):613-620. doi: 10.4158/EP14520.OR. Polonsky, William, Danielle Hessler, Katrina Ruedy, Roy Beck, for the DIAMOND Study Group. 2017. The impact of continuous glucose monitoring on markers of quality of life in adults with type 1 diabetes: further findings from the DIAMOND randomized clinical trial. Diabetes Care. 40(6):736-741. doi:10.2337/dc17-0133. Dexcom G6 System User Guide Chapter 3: Risks and Benefits 39 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 39 2/5/19 9:26 AM 3.3 What Was Covered and Whats Coming Now You Can:

List the risks and benefits of using the G6 Whats Next:

Now lets take a look at the G6!

Dexcom G6 System User Guide Chapter 3: Risks and Benefits 40 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 40 2/5/19 9:26 AM Calibrate What is the G6?

Start Your Sensor Set up Display Devices 2Lets G6The Basics 2/5/19 9:26 AM LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 41 Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 42 2/5/19 9:26 AM Chapter 4 | What is the Dexcom G6 Continuous Glucose Monitoring System (G6)?

4.1 Introduction This chapter is an overview of the G6. After this chapter, youll be able to:

Explain what the G6 does List whats new in the G6 Explain each components function 4.2 G6 CGM System The G6 allows you to continually see your G6 readings, updated every 5 minutes for up to 10 days, without the bother of taking constant fingerstick measurements or calibrations. Youll see:

G6 readings are updated every 5 minutes. Trend arrows show where your BG is heading. Alarm/alerts warn you when you need to take action; for example, when your BG is too high or too low. Trend graphs show the last 1, 3, 6, 12, and 24 hours of your G6 readings. Share/Follow App allows you to share your G6 readings and trends with your support team. CLARITY Reports lets you see different reports reflecting your glucose trends. With CLARITY, you and your HCP can review, analyze, and evaluate your historical G6 data. Go to clarity.dexcom.com for more information, and download the app from the app store. Dexcom G6 System User Guide Chapter 4: What is the G6?

43 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 43 2/5/19 9:26 AM 4.3 Whats New for G6?

Dexcoms G6 features include:

No fingerstick calibrations are required! You still have the option to enter calibration if you want to. Wear sensor for 10 days Sensor overpatch Urgent Low Soon Alert Acetaminophen blocking New sensor applicator Streamlined transmitter and transmitter holder No Fingerstick Calibrations With the G6, theres no need to calibrate! The G6 was designed as a no calibration system. After entering the sensor code (See Chapter 5), you wont receive any calibration prompts. One of the great things about the G6 is that, although calibrations are not required, you have the option to calibrate if you want to (See Chapter 7). Sensor Overpatch If you have problems with your sensor coming off, use the overpatch. Its designed to cover the sensors adhesive patch and help keep your sensor in place for all of your 10-day sensor session. Urgent Low Soon Alert Get an alert when your glucose is quickly heading toward 55 mg/dL. Sometimes glucose levels fall fast. The Urgent Low Soon Alert notifies you when your G6 reading is predicted to reach 55 mg/dL within 20 minutes. This helps you to determine what the appropriate treatment action will be before your glucose levels drop too low. For additional information on alerts, please see Chapter 9. Dexcom G6 System User Guide Chapter 4: What is the G6?

44 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 44 2/5/19 9:26 AM Acetaminophen Blocking In previous generations of Dexcom CGM systems (G4/G5), acetaminophen could affect your sensor readings, making them look higher than they really were. However, with the G6, you can take a standard or maximum acetaminophen dose of 1 gram (1,000 mg) every 6 hours and still use the G6 readings to make treatment decisions. Taking higher than the maximum dose of acetaminophen (e.g. > 1 gram every 6 hours in adults) may affect the G6 readings and make them look higher than they really are. Additional notes for health care professionals:

A clinical study was conducted to demonstrate that a maximum dose of acetaminophen

(1000 mg) does not interfere with the G6 readings. 65 adult subjects wore both a G6 and a G4 PLATINUM with SW505 CGM system. The G4/G5 sensor was used as a comparator for establishing the time to reach a peak acetaminophen concentration (~1 hour), in the interstitial fluid, from the time the acetaminophen was administered. The observed peak plasma acetaminophen concentration ranged from 0.2 to 2.6 mg/dL. To assess whether this peak acetaminophen concentration had an interference effect on the G6 readings, the G6 readings were compared to reference plasma glucose measurements with YSI. Venous blood was sampled every 10-15 minutes from 1 hour before and up to 6 hours after the acetaminophen was administered. The observed mean maximum bias of the G6 readings to the reference YSI measurements at the time of peak acetaminophen concentration across all subjects was +5.2 mg/dL and was statistically significantly lower than the performance goal of <10 mg/dL (one-sided upper 95% CI of 6.4 mg/dL, p < 0.001). While no interference effect was observed in the clinical study with a maximum dose, bench studies were conducted to test higher concentrations of acetaminophen. According to the bench testing, acetaminophen concentrations of > 6.5 mg/dL

(~2-3 times maximum therapeutic levels) showed significant bias. Supratherapeutic

(high levels of acetaminophen beyond the maximum dose) levels may cause an overestimation of G6 readings. Dexcom G6 System User Guide Chapter 4: What is the G6?

45 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 45 2/5/19 9:26 AM Sensor Applicator The redesigned sensor applicator allows you to insert a sensor with just one hand. Peel away the adhesives backing, place the applicator on your body, fold and break off the safety guard, and push the applicators button. For detailed steps on sensor insertion, see Chapter 6. Streamlined Transmitter Holder and Transmitter The redesigned transmitter and its holder have a lower profile. With the transmitter holders new breakaway feature, when your sensor session is done, the transmitter snaps out for easy removal. For more information on how to attach the transmitter, go to Chapter 6. After a sensor session has ended, see Chapter 13 about transmitter removal. Dexcom G6 System User Guide Chapter 4: What is the G6?

46 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 46 2/5/19 9:26 AM 4.4 G6 Components The G6 has three key parts. See the table below for details. What you see What it's called What it does Applicator Sensor

(inside) Applicator with built-in sensor Transmitter Display Device(s):

Receiver Your smart device Applicator helps you insert the sensor wire under your skin. Sensor gets your glucose information. Transmitter sends your glucose information from the sensor to the display device. Display device(s) shows your glucose information. Receiver is required for Medicare. Its not required for some plans. See dexcom.com/compatibility for a list of compatible smart devices and operating systems. Dexcom G6 System User Guide Chapter 4: What is the G6?

47 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 47 2/5/19 9:26 AM Once youve set up your G6, it sends G6 readings to your display device every five minutes for up to 10 days. G6 and Previous Dexcom System Components The G6 isn't compatible with previous generations such as the Dexcom G4 PLATINUM CGM System or the Dexcom G5 Mobile system. You cant switch the transmitter or sensor between the two systems. If you have an older receiver, it might need an upgrade to use it with the G6. PRECAUTION Use Correct Transmitter, Receiver, and Sensor G6 components are not compatible with any previous Dexcom products. Do not mix transmitters, receivers, and sensors from different generations. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Dexcom G6 System User Guide Chapter 4: What is the G6?

48 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 48 2/5/19 9:26 AM 4.5 What Was Covered and Whats Coming Now You Can:

Explain what G6 does List whats new in G6 Explain each components function What's Next Your next step is setting up your display device(s). Dexcom G6 System User Guide Chapter 4: What is the G6?

49 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 49 2/5/19 9:26 AM Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 50 2/5/19 9:26 AM Chapter 5 | Set Up Your Display Devices 5.1 Introduction This chapter helps you choose and set up your display device(s). After this chapter, youll be able to:

Determine which display device(s) youll use Create a Dexcom username and password Use the recommended smart device settings Download and set up the Dexcom G6 CGM System (G6) app Set up your receiver 5.2 Choose the App, the Receiver, or Both Use the receiver, the app, or both. You can choose to use the display device thats best for you. The receiver is required for Medicare. Its not required for some plans. Both devices give you the information you need to make treatment decisions your G6 reading and arrow(s) as well as alarm/alerts. The app has more features than the receiver. The app includes these additional features and functions:

Dexcom SHARE (Share): Lets you send your glucose information to others. Alert Schedule: You can have your alarm/alerts sound different during different times of the day. Always Sound: You can override your phone settings so your alarm/alerts will always sound, even when your phone is on mute/Do Not Disturb. Smart watch: Lets you see your G6 sensor information on your smart watch. Events: See the events you record on your app and how they impact your trend graph. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 51 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 51 2/5/19 9:26 AM The receiver is a dedicated medical device with a two-day battery life. Use the receiver or your BG meter if you are concerned about any problems with your smart device due to settings, lack of storage, low smart device battery, etc. Whether you carry the app or the receiver, remember to keep your display device on. PRECAUTION Is It On?

If the receiver or smart device is turned off (shut down), it will not show G6 readings or alarm/alerts. Make sure your display device is turned on. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. The following section walks you through setting up the app. To set up the receiver, go to the next section. If you want to use both the receiver and the app, you need to set each up separately. Make sure you have started your sensor session first before setting up the other display device. See Appendix C for setting up peripheral devices. 5.3 App Before starting your first sensor, pick the smart device. You can use the receiver with one smart device during a session; however, you cant use multiple smart devices during the same session. Part of your setup is entering the transmitter serial number

(SN). If by accident you enter the SN into more than one smart device, the system warns you and you wont be able to complete the setup process. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 52 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 52 2/5/19 9:26 AM Recommended Smart Device Settings See your smart device instructions to learn how to change its settings. Use the following with your CGM system:

Bluetooth on: Your transmitter and app communicate via Bluetooth. If it isn't on, you wont get alarm/alerts or G6 readings. Notifications on:

Enable Dexcom app notifications so you get alarm/alerts. Make sure you allow Dexcom app notifications to show on your locked screen. Battery charged: The app must always be running in the background and may drain your battery. Keep the battery charged. Device and app on: If you restart your smart device, reopen the Dexcom app. Update manually: Automatic updates of the app or your device operating system can change settings or shutdown the app. Always update manually and verify correct device settings afterward. Compatibility: For a list of smart devices and operating systems that work with the G6 app, check dexcom.com/compatibility. Before upgrading your smart device or its operating system, check the list. Time: Dont change your smart device time, because it can make the time on the home screen wrong and the app may stop displaying data. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 53 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 53 2/5/19 9:26 AM WARNING Check Settings Your alarm and important alerts sound and display information even when your volume is low or muted. Specifically, if your smart device is on mute and you have the Always Sound setting turned on (the default setting), only these notifications make a sound:

Glucose Alarm/Alerts:

Urgent Low Urgent Low Soon Low Glucose High Glucose Rise Rate Fall Rate No Readings Alert System Alerts:

Calibration Required (after 2-hour sensor warmup, only appears when a sensor code is not used) Calibration Error (only appears when a user enters a calibration; calibration is not required) Sensor Expired Replace Sensor Transmitter (not working) No Storage Error App Stopped Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 54 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 54 2/5/19 9:26 AM WARNING (CONTINUED) Exceptions: On Apple devices, Signal Loss does not sound when your volume is low or muted. No alarm/alerts sound on your phone when your Android phone is in the most restrictive Do Not Disturb setting. Repeating: Some notifications are silent during the first visual and vibrate notification and then make a sound on the second notification. If you do not clear the alert, it repeats at half volume after 5 minutes and at full volume after 10 minutes. Accessories: When using Bluetooth headphones, speakers, etc., your alarm/

alerts may sound on your primary smart device or on the accessory. Each accessory is different. Test yours so you know where youll hear your alarm/

alerts. Bluetooth: Your transmitter talks to your app with Bluetooth. Make sure your smart device Bluetooth is on. If not, you will not get alarm/alerts or CGM information. Notifications:

Make sure your smart device settings allow Dexcom app notifications to show on your Lock screen. This will allow you to see notifications without unlocking your phone. Apple: During G6 setup, enable Dexcom app notifications or you wont get alarm/alerts. Battery: The app must always be running in the background and may drain your smart device battery. Keep the battery charged. Compatibility: Before upgrading your smart device or its operating system, check dexcom.com/compatibility. Automatic updates of the app or your device operating system can change settings or shut down the app. Always update manually and verify correct device settings afterward. Time: Let the date and time on your smart device automatically update when you travel across time zones or switch between standard and daylight saving times. Dont manually change your smart device time, because it can make the time on the trend screen wrong and the app may stop displaying data. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 55 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 55 2/5/19 9:26 AM App Installation and Setup Installing the app is easy! Simply download the Dexcom G6 App from your app store. For information on how to install an app, see your smart device instructions. If your smart device has been jailbroken or rooted, do not install the app. The app may not work correctly or remain secure on a jailbroken/rooted smart device. Is this your first Dexcom CGM app? If so, the app will walk you through setting it up. If youve used the app before, for your convenience, the G6 imports your existing settings. Either way, follow the instructions in the app: it knows if youre new or an existing user based on your Dexcom login. If you want more information about a step, tap Help or Learn More. If youd like, follow along with the steps below. The following screens may look different than your app because of different operating systems or updates. App: Setup STEP 1 of 14 App: Setup Tap Dexcom G6 to open app. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 56 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 56 2/5/19 9:26 AM STEP 2 of 14 App: Setup Enter existing username and password. Or, if you need a Dexcom username and password, follow the onscreen instructions STEP 3 of 14 App: Setup Tap Lets Get Started. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 57 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 57 2/5/19 9:26 AM STEP 4 of 14 App: Setup The next screens go over legal and safety information, including videos on using your G6. To see videos later, go to Settings > Help > Videos. Tap the appropriate answer to get more information or move forward. STEP 5 of 14 App: Setup Existing users only:

If youve used the Dexcom CGM app before, the system imports your settings and shows the new G6 features, including your Urgent Low Soon Alert. After reading each screen, tap the appropriate answer to move forward. STEP 6 of 14 App: Setup New users:

If youre new to the Dexcom app, review and set your alarm/alerts. After reading each screen, tap Next to move forward. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 58 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 58 2/5/19 9:26 AM STEP 7 of 14 App: Setup New users:

Set your Low Alert. You get an alert if your glucose dips below the number you set. Default is 80 mg/dL. Scroll to select your level. Tap Save. STEP 8 of 14 App: Setup New users:

Set your High Alert. You get an alert if your glucose rises above the number you set. Default is 200 mg/dL. Scroll to select your level. Tap Save. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 59 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 59 2/5/19 9:26 AM STEP 9 of 14 App: Setup Apple:

Make sure you get your alarm/alerts. When asked, tap Allow to receive alarm/alerts. STEP 10 of 14 App: Setup Next are recommendations for making sure you hear your alarms/alerts, going over the transmitter, and making sure Bluetooth is on. Tap the appropriate answers to move forward or get more information. STEP 11 of 14 App: Setup Android: To use Bluetooth, the app may ask for access to your device location. Tap Allow. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 60 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 60 2/5/19 9:26 AM STEP 12 of 14 App: Setup Enter sensor code. If you dont enter the sensor code, the G6 requires you to calibrate on a daily basis. The sensor code is on the applicators adhesive label and is unique to that specific sensor. Enter the code from the applicator youll use to insert your sensor. If you enter the sensor code from another applicator, your G6 readings may be off. Enter the code by manually typing it into the app or take a picture of the 2D barcode. Setting up both the app and the receiver? No need to enter the sensor code again; the receiver will join your current sensor session. STEP 13 of 14 App: Setup Enter transmitter SN. To enter, either take a photo of the 2D barcode on the transmitter box or type in the SN. Photo instructions:

a. Get your transmitter box. Tap Take Photo. b. Turn transmitter box on a flat surface with 2D barcode facing up Checkmark confirms you entered the SN. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 61 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 61 2/5/19 9:26 AM Manual instructions:

a. Tap Manually Enter. b. Find your transmitter SN on the transmitter box or the back of the transmitter. Confirm correct SN. Tap Save. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 62 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 62 2/5/19 9:26 AM STEP 14 of 14 App: Setup Insert sensor Tap Start Video. Insert sensor and attach transmitter following videos instructions. If you want, after completing your app setup, set up your receiver. Before setting up your receiver, make sure you have started the sensor session (Chapter 6). Problems setting up G6 app? Contact Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 If youre having problems with your smart device, contact your smart device support line. Finished!

5.4 Receiver Receiver Setup Overview The receiver guides you through initial setup. If youre using two display devices, make sure you started the sensor session in one before setting up the other. Your receiver has a touchscreen. Be sure your fingers are dry when you touch it. Dont worry if your receiver buzzes or makes other sounds during setup. After your initial setup is complete, you wont see the setup screens again but your settings can always be adjusted using the menu. Before putting your receiver in your pocket or purse, briefly press the power button to put the screen to sleep. This way, accidental movements and bumps dont turn into screen selections. Just tap the power button again to wake the screen up. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 63 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 63 2/5/19 9:26 AM Receiver: Setup STEP 1 of 11 Receiver: Setup Press and hold power button for 2 seconds to turn receiver on. Wait for loading screen to appear. STEP 2 of 11 Receiver: Setup Wait. STEP 3 of 11 Receiver: Setup Welcome!

Tap Next. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 64 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 64 2/5/19 9:26 AM STEP 4 of 11 Receiver: Setup Enter the date and time:

The blue outlined box shows what is selected. Key for date boxes:

mm = month dd = day yyyy = year Key for time boxes:

hh = hour mm = minute AM/PM = switch between the two Tap each box. Tap up/down arrows to change value in box. Use this method throughout to enter information. When done, tap Save. If battery is ever completely drained, youll need to reset date and time. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 65 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 65 2/5/19 9:26 AM STEP 5 of 11 Receiver: Setup The next screens tell you about your alarm/alerts. After reading each screen, tap Next. STEP 6 of 11 Receiver: Setup Set your Low and High alerts using levels youve discussed with your HCP. The Low Alert default is 80 mg/dL; High is 200 mg/dL. Tap the up/down arrows to change the level. Tap Save. STEP 7 of 11 Receiver: Setup Enter your transmitter serial number. Tap Next. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 66 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 66 2/5/19 9:26 AM STEP 8 of 11 Receiver: Setup Enter sensor code. If you dont enter the sensor code, the G6 requires you to calibrate on a daily basis. The sensor code is on the applicators adhesive label and is unique to that specific sensor. Enter the code from the applicator youll use to insert your sensor. If you enter the sensor code from another applicator, your G6 readings may be off. Setting up both the receiver and app? No need to enter the sensor code again, the app will join your current sensor session. STEP 9 of 11 Receiver: Setup Your transmitter serial number is on the bottom of the transmitter and its box. Look for SN. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 67 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 67 2/5/19 9:26 AM STEP 10 of 11 Receiver: Setup Enter your transmitter SN by tapping the up/down arrows. Tap Save. STEP 11 of 11 Receiver: Setup Go to Chapter 6, for step-by-step instructions on inserting your sensor and attaching, your transmitter, pairing your transmitter to your display device, and starting your sensor. Finished!

Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 68 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 68 2/5/19 9:26 AM 5.5 What Was Covered and Whats Coming Now You Can:

Create a Dexcom username and password Download the Dexcom G6 app Set up the app with the recommended settings Set up your receiver Whats Next?

No matter which display device you use, next, youll insert your sensor. Dexcom G6 System User Guide Chapter 5: Set Up Your Display Devices 69 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 69 2/5/19 9:26 AM Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 70 2/5/19 9:26 AM Chapter 6 | Start Your Sensor 6.1 Introduction After this chapter, youll be able to:

Prepare for sensor insertion Insert your sensor Attach transmitter to sensor Identify when the transmitter and display device pair Start sensor warmup 6.2 Prepare to Insert Sensor Before inserting a sensor, make sure you have everything you need. Dexcom Items:

Sensor package Check expiration date on sensor tray. Dont use if expired. Dont open the sensor tray until youre ready to insert the sensor. Transmitter box Check use by date on box. Start using the transmitter before that date. Your Items:

Alcohol wipes Your meter Dexcom G6 System User Guide Chapter 6: Start Your Sensor 71 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 71 2/5/19 9:26 AM Optional Item:

If this is your first time inserting a sensor, watch the sensor insertion video to get a better understanding of the process. To see the sensor insertion video, go to:

The app:

In the setup screens In Settings > Help > Videos. The tutorial:

Online at dexcom.com/support PRECAUTION Check Package Dont use sensor if its sterile package has been damaged or opened, because it might cause an infection. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. PRECAUTION Dont Use if Expired Dont use expired sensors, because they may give incorrect results. Check the package label for the expiration date. Its in YYYY-MM-DD format. Follow Dexcom G6 Continuous Glucose Monitoring System (G6) instructions. If you dont, you could have a severe low or high glucose event. Dexcom G6 System User Guide Chapter 6: Start Your Sensor 72 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 72 2/5/19 9:26 AM 6.3 Choose Sensor Site 18 years and older 2-17 years or Choosing a comfortable, effective place for your sensor is important. Discuss ideal sensor insertion sites with your HCP. People from 2 to 17 years old can use either their upper buttocks or bellies (abdomens). Those 18 years and older can only use their belly. Tips Do:

Place at least 3 inches from your insulin pump infusion set or injection site If needed, shave the area so adhesive patch sticks securely Make sure area is clean and free of lotions, perfumes, and medications Contact your HCP if sensor adhesive irritates your skin Dont:

Don't use same site for 2 sensors in a row Don't use bony sites, such as over your ribs Don't use sites where sensor can be rubbed by your belt, waist band, seat belt strap or where you lay when you sleep Dexcom G6 System User Guide Chapter 6: Start Your Sensor 73 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 73 2/5/19 9:26 AM PRECAUTION Where to Insert: Things to Check Keep the safety guard on until you put the G6 applicator against your skin. If you remove the safety guard first, you may hurt yourself by accidentally pushing the button that inserts the sensor before you mean to. Change your insertion site with each sensor. Using the same site too often might not allow the skin to heal, causing scarring or skin irritation. Sensor placement is important. Choose a site:

At least 3 inches from insulin pump infusion set or injection site Away from waistband, scarring, tattoos, irritation, and bones Unlikely to be bumped, pushed, or laid on while sleeping Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Optional: Help Patch Stay On Are you concerned about the patch not sticking? There are two ways to help keep it on:

Before inserting your sensor, make the sensor site stickier After inserting your sensor, apply the overpatch or medical tape Both are described in detail below. Contact your HCP for specific questions regarding the use of medical tape, barrier wipes, or other adhesives. Dexcom G6 System User Guide Chapter 6: Start Your Sensor 74 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 74 2/5/19 9:26 AM 6.4 Insert Sensor The sensor is inside the applicator. Before inserting the sensor, get familiar with its applicator. Safety Guard Protects button Remove when ready to insert sensor Button Inserts sensor under your skin Sensor Sensor inserts through this hole Adhesive Keeps sensor and transmitter holder on skin Transmitter Holder Transmitter snaps in Dexcom G6 System User Guide Chapter 6: Start Your Sensor 75 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 75 2/5/19 9:26 AM Insert Sensor STEP 1 of 10 Insert Sensor STEP 2 of 10 Insert Sensor Thoroughly wash and dry your hands. Clean insertion site with alcohol. Let dry. Dexcom G6 System User Guide Chapter 6: Start Your Sensor 76 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 76 2/5/19 9:26 AM STEP 3 of 10 Insert Sensor STEP 4 of 10 Insert Sensor Optional Step: Skin Adhesive Create an empty oval on the skin with the skin adhesive, such as Mastisol or SkinTac. Let skin adhesive dry. Insert sensor on clean skin in center of oval. Get the applicator you used when entering the sensor code. Check its packaging. Dont use if its damaged or was already opened before you took it out of its box. Make sure you use the same applicator Peel off cover. Keep sensor packaging until sensor session is complete. Check sensor for damage. Dexcom G6 System User Guide Chapter 6: Start Your Sensor 77 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 77 2/5/19 9:26 AM STEP 5 of 10 Insert Sensor X X X X Pull off both adhesive labels. Keep the tab with the sensor code. Dont touch adhesive. STEP 6 of 10 Insert Sensor Place applicator horizontally, not vertically, on skin. Firmly press down, sticking adhesive to your skin. Dexcom G6 System User Guide Chapter 6: Start Your Sensor 78 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 78 2/5/19 9:26 AM STEP 7 of 10 Insert Sensor Fold and break safety guard and throw it away. STEP 8 of 10 Insert Sensor Push and release button to insert sensor. Dexcom G6 System User Guide Chapter 6: Start Your Sensor 79 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 79 2/5/19 9:26 AM STEP 9 of 10 Insert Sensor Remove applicator. Throw out applicator following local guidelines for disposal of blood-contacting components. STEP 10 of 10 Insert Sensor Finished!

Whats left on you?

Sensor wire Transmitter holder You've successfully inserted the sensor!

Dexcom G6 System User Guide Chapter 6: Start Your Sensor 80 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 80 2/5/19 9:26 AM Having problems?

Do you have questions or need help? Contact Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 6.5 Attach Transmitter Now that youve inserted your sensor, attach your reusable transmitter. Keep your current sessions transmitter box. It has important information you may need after youve attached the transmitter. Before attaching your transmitter, check youve entered the correct transmitter SN into your display device. Chapter 5 covers entering transmitter SN during initial setup. Once youve snapped the transmitter into the holder, you cant remove it until your session is over. WARNING Wire Breaks Off Dont ignore broken or detached sensor wires. A sensor wire could remain under your skin. If this happens, please contact our 24/7 Technical Support. If a sensor wire breaks off under your skin and you cant see it, dont try to remove it. Contact your HCP. Also seek professional medical help if you have symptoms of infection or inflammation redness, swelling, or pain at the insertion site. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Dexcom G6 System User Guide Chapter 6: Start Your Sensor 81 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 81 2/5/19 9:26 AM Attach Transmitter STEP 1 of 5 Attach Transmitter Remove transmitter from box. STEP 2 of 5 Attach Transmitter STEP 3 of 5 Attach Transmitter Wipe bottom of transmitter with alcohol wipe. Let dry. Be careful with the bottom of the transmitter. Dont:

Touch its metal dots Scratch it that may harm the waterproof seal Slide transmitter tab into the slot at the narrow end of the holder. Dexcom G6 System User Guide Chapter 6: Start Your Sensor 82 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 82 2/5/19 9:26 AM STEP 4 of 5 Attach Transmitter STEP 5 of 5 Attach Transmitter Press the wide end of the transmitter until it clicks into the holder. Secure by rubbing fingers around the patch three times. Youre almost done starting your sensor!

Finished!

Loose Transmitter Holder The transmitter holder should stay on your skin using its own adhesive, but the patch may start to peel up. If it peels up, or you want to prevent that, use either the overpatch or another adhesive, such as medical tape (brand names include Blenderm, Tegaderm, Smith & Nephew IV3000, 3M tape) for extra support. Order overpatches at dexcom.com/order. Dexcom G6 System User Guide Chapter 6: Start Your Sensor 83 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 83 2/5/19 9:26 AM

Tips for putting on the overpatch or extra adhesive tape:

Put overpatch or tape over white patch on all sides for even support Dont put overpatch or tape over or under the transmitter or its plastic holder STEP 1 of 1 Attach Transmitter: Optional Step Put overpatch or medical tape over the patch. Overpatch Medical tape Finished!

Dexcom G6 System User Guide Chapter 6: Start Your Sensor 84 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 84 2/5/19 9:26 AM 6.6 Pair and Start Your Sensor After inserting your sensor and attaching your transmitter, the transmitter will automatically pair with your display device. Youre ready to start your sensor session after getting confirmation the transmitter paired successfully. During the warmup period, neither device provides alarm/alerts or G6 readings. Your G6 readings begin after the 2-hour sensor warmup has passed. If you didnt enter the sensor code as part of your set up, youll be prompted to do initial calibrations once the 2-hour warmup is finished, then calibrate daily. If you entered a sensor code, calibrations arent required. During sensor warmup, use your meter. Using both the receiver and the app? First, start your sensor session in one, then pair and join the sensor session in the other. Keep your display device within 20 feet of your transmitter for them to pair and communicate. PRECAUTION Keep Transmitter Close to Display Device Keep your transmitter and display device within 20 feet with no obstacles (like walls or metal) between them. Otherwise, they might not be able to communicate. If water is between your transmitter and the display device for example, if youre showering or swimming keep them closer to each other. The range is reduced because Bluetooth doesnt work as well through water. Follow G6 instructions. If you dont, you could miss a severe low or high glucose event. Well go over pairing and starting a sensor for the app, then for the receiver. Dexcom G6 System User Guide Chapter 6: Start Your Sensor 85 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 85 2/5/19 9:26 AM App: Pair and Start Sensor STEP 1 of 5 App: Pair and Start Sensor Wait up to 30 minutes while app and transmitter pair. Wait for pairing confirmation. Dexcom G6 System User Guide Chapter 6: Start Your Sensor 86 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 86 2/5/19 9:26 AM STEP 2 of 5 App: Pair and Start Sensor Tap Start Sensor to start your 2-hour sensor warmup. You wont get alarm/alerts or G6 readings during sensor warmup. Use your meter when making a treatment decision during warmup. STEP 3 of 5 App: Pair and Start Sensor Wait. Screen provides countdown to sensor warmup. The ring darkens as the countdown moves forward. Keep smart device within 20 feet of transmitter. STEP 4 of 5 App: Pair and Start Sensor If you didnt enter a sensor code during setup, once your 2-hour warmup is complete, youll be prompted to calibrate twice. See Chapter 7 to learn the best way to calibrate Dexcom G6 System User Guide Chapter 6: Start Your Sensor 87 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 87 2/5/19 9:26 AM STEP 5 of 5 App: Pair and Start Sensor Sensor warmup is complete!

Finished!

Receiver: Pair and Start Sensor STEP 1 of 6 Receiver: Pair and Start Sensor If needed, press power button briefly to wake up receiver. Dexcom G6 System User Guide Chapter 6: Start Your Sensor 88 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 88 2/5/19 9:26 AM STEP 2 of 6 Receiver: Pair and Start Sensor After attaching your transmitter, pairing is automatic, just wait for confirmation. STEP 3 of 6 Receiver: Pair and Start Sensor Your transmitter and receiver can communicate now! You may need to unlock your screen. If so, tap 1, then 2. STEP 4 of 6 Receiver: Pair and Start Sensor Tap Start Sensor. This starts the 2-hour sensor warmup. Dexcom G6 System User Guide Chapter 6: Start Your Sensor 89 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 89 2/5/19 9:26 AM STEP 5 of 6 Receiver: Pair and Start Sensor Wait. Keep your receiver within 20 feet. Ring darkens to track progress. You wont get alarm/alerts or G6 readings during sensor warmup. Use your meter when making a treatment decision during warmup. After sensor starts, Start Sensor option disappears from Menu, and Stop Sensor appears. STEP 6 of 6 Receiver: Pair and Start Sensor Sensor warmup is complete. If you didnt enter a sensor code during setup, once your 2-hour warmup is complete, youll be prompted to calibrate twice. See Chapter 7 to learn the best way to calibrate. Finished!

Dexcom G6 System User Guide Chapter 6: Start Your Sensor 90 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 90 2/5/19 9:26 AM 6.7 Pairing Tips Your transmitter and display device pair after you insert your sensor and attach your transmitter. (On the receiver, the Bluetooth symbol will blink while it is trying to pair with the transmitter.) It usually takes less than 10 minutes for your transmitter and display device to pair, but it can take up to 30 minutes. During this time:

Make sure your transmitter and display device are within 20 feet of each other Remove barriers between them If these errors display, your transmitter and display device are not communicating. App Notification App Receiver Dexcom G6 System User Guide Chapter 6: Start Your Sensor 91 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 91 2/5/19 9:26 AM Verify display device and transmitter are within 20 feet of each other without obstruction. Wait up to 30 minutes. Tap Help for more information. Dont calibrate. Use meter for BG value. More than 30 minutes? Contact Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 You wont get alarm/alerts or G6 readings until error is fixed. 6.8 What Was Covered and Whats Coming Now You Can:

Prepare for sensor insertion Insert your sensor Attach transmitter to sensor Identify when transmitter and display device pair Start sensor warmup Whats Next?

The next chapter guides you through calibration. Dexcom G6 System User Guide Chapter 6: Start Your Sensor 92 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 92 2/5/19 9:26 AM Chapter 7 | Calibrate 7.1 Introduction This chapter discusses calibration. What it is, when to do it, and how. If you entered your sensor code during setup, calibrate only if you want to. The system doesnt need it. After this chapter, youll be able to:

Describe calibration Recognize how to get accurate meter values Understand precautions for when not to calibrate Enter calibrations into the Dexcom G6 Continuous Glucose Monitoring System (G6) 7.2 Calibration Overview What's Calibration?

You calibrate when you enter a meter value into your display device. It aligns your sensor to your meter. By calibrating when the system notifies you, the G6 uses your meter value to make sure the G6 readings remain accurate throughout your session. How Do I Calibrate?

Take a fingerstick with your meter, and simply enter the meter value into your display device. This chapter walks you through the entire process, from preparing to take a meter value through making sure the system saved your input. When taking a fingerstick, its important to do it correctly. Make sure you thoroughly wash and dry your hands right before. And remember: Always use your finger, never another site. Dexcom G6 System User Guide Chapter 7: Calibrate 93 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 93 2/5/19 9:26 AM For everything except calibration (such as alarm/alerts), you must enter information into both the receiver and smart device. Calibrating is different. Dont enter your BG values into both devices; only enter your meter value into either the app or the receiver. When you enter your meter value into one display device, it takes about 5 minutes to show on your other display device. How Often Do I Calibrate?

If you entered the sensor code during set-up, theres no need to calibrate. You can calibrate if you want, but the system doesnt require it. If you didnt enter a sensor code during setup, you must calibrate your G6. After sensor warmup, you're prompted to calibrate twice. Then you start getting your G6 readings. You'll be prompted to calibrate 12 hours later, and again 12 hours after that. For the rest of your 10-day sensor session, youre prompted to calibrate once every 24 hours. WARNING Don't Wait Calibrate!

If you have not used the calibration code, you must manually calibrate your G6 using values obtained from a blood glucose meter and fingersticks daily. You must calibrate immediately when the G6 notifies you. If you havent calibrated when notified, your G6 may not be accurate, so use your glucose meter to make treatment decisions until you calibrate your G6. Follow G6 instructions. If you dont, you could miss a severe low or high glucose event. If you receive a calibration notification outside of your scheduled calibrations, the system didnt accept your most recent calibration or your meter value is very different from your G6 reading. Dexcom G6 System User Guide Chapter 7: Calibrate 94 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 94 2/5/19 9:26 AM 7.3 Prepare to Calibrate When using a glucose meter to calibrate, if you dont prepare properly, your sensor may become inaccurate. Calibration Tips Hands:

Clean: Thoroughly wash and dry your hands before fingersticks. Use soap and water, not gel cleaners. Poorly washed hands are the cause of many meter errors. Finger: Use fingerstick meter values only. Other sites are less accurate. Meter:

Test strips: Verify theyre current and, if required, coded correctly with meter. Same meter: Always use the same meter during your sensor session. Meter and strip accuracy vary between meter brands. Switching within a session might cause G6 readings to be less accurate. Also make sure meter date and time match your display device date and time. Instructions: Follow meter use and maintenance instructions exactly. Use meter value: Only use your meter for calibrations; never enter values from your G6. G6:

Bluetooth: Make sure its active. Trend arrow(s) straight up or down: This means your reading is changing more than 2 mg/dL per minute. Because of this, enter your meter value immediately after taking a fingerstick. Timing: Enter your meter value within 5 minutes of taking a fingerstick. Accuracy: Enter exact meter value for each calibration. Be safe if BG is low, first treat, then if you want, align your sensor to your meter by calibrating. Dexcom G6 System User Guide Chapter 7: Calibrate 95 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 95 2/5/19 9:26 AM WARNING Dont Wait Calibrate!

If you have not used the calibration code, you must manually calibrate your G6 using values obtained from a blood glucose meter and fingersticks daily. You must calibrate immediately when the G6 notifies you. If you havent calibrated when notified, your G6 may not be accurate, so use your glucose meter to make treatment decisions until you calibrate your G6. Use Fingersticks Use fingertips to calibrate from your BG meter. Blood from other places may be less accurate and not as timely. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. 7.4 Calibrating Calibration Schedule If you didnt enter a sensor code, youll need to do daily calibrations after completing your initial calibrations. For example, you inserted your sensor Monday morning at 9:00. After 2-hour sensor warmup is finished, enter two calibrations Monday at 11:00 Enter a third calibration at 11 pm Enter a fourth calibration 12 hours later, at 11 am on Tuesday Enter calibrations once a day starting at 11:00 Tuesday for the rest of your sensor session Dexcom G6 System User Guide Chapter 7: Calibrate 96 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 96 2/5/19 9:26 AM Enter a Calibration Below are steps to enter your calibrations. First is calibrating in the app, then the receiver. If you didnt enter a sensor code, either tap the calibration icon or go to Settings >

Calibrations. If you entered a sensor code, there is no Calibration icon. If you choose to calibrate, go to Settings > Calibration to calibrate. App: Calibration STEP 1 of 8 App: Calibration Thoroughly wash and dry your hands with soap and water, not gel cleaners. STEP 2 of 8 App: Calibration Use meter to measure the BG from your fingertip. Dexcom G6 System User Guide Chapter 7: Calibrate 97 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 97 2/5/19 9:26 AM STEP 3 of 8 App: Calibration Tap Calibrate. The red circle shows when the G6 needs you to calibrate. What it means:

Sensor warmup is complete Ready for first calibration Tap icon to enter your blood glucose value or go to Menu > Calibrate. STEP 4 of 8 App: Calibration Enter meter value using number pad. This example uses 128 mg/dL. Tap Save. Dexcom G6 System User Guide Chapter 7: Calibrate 98 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 98 2/5/19 9:26 AM STEP 5 of 8 App: Calibration Verify number is correct. If correct, tap Confirm. If you dont tap Confirm, BG level isnt saved. If incorrect, tap Cancel and enter correct number. STEP 6 of 8 App: Calibration 1 Tap Calibrate to enter your second BG value. Follow steps 1-5 and enter second value. Calibrate What it means:

Sensor accepted first calibration Ready for second meter value STEP 7 of 8 App: Calibration 1 Calibration accepted: Calibrate icon has no red circle. Calibrate Dexcom G6 System User Guide Chapter 7: Calibrate 99 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 99 2/5/19 9:26 AM STEP 8 of 8 App: Calibration You get your first G6 readings after you enter your initial calibrations. Look for the number in the circle above the graph and dots on your trend graph. Each dot represents a single G6 reading taken every 5 minutes. Finished!

Twelve hours from now, 12 hours after that, and then every 24 hours for the rest of your sensor session, youll be notified to calibrate:

App Notification App 1 Calibrate Dexcom G6 System User Guide Chapter 7: Calibrate 100 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 100 2/5/19 9:26 AM If you didnt enter the sensor code, the red circle on the Calibrate icon reminds you to calibrate once every 24 hours. When notified to calibrate:

Tap Calibrate. Repeat steps 1-5 Receiver: Calibration If you didnt enter a sensor code, either tap the calibration icon or go to Menu >

Calibrations. If you entered a sensor code, there is no Calibration icon. If you choose to calibrate, go to Menu > Calibration to calibrate. STEP 1 of 9 Receiver: Calibration Thoroughly wash and dry your hands with soap and water, not gel cleaners. Dexcom G6 System User Guide Chapter 7: Calibrate 101 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 101 2/5/19 9:26 AM STEP 2 of 9 Receiver: Calibration Use meter to measure the BG from your fingertip. STEP 3 of 9 Receiver: Calibration Press power button briefly to wake up receiver screen. You wont see calibration notifications when screen is black. Tap OK. What it means:

Sensor warmup is done Ready for first calibration Dexcom G6 System User Guide Chapter 7: Calibrate 102 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 102 2/5/19 9:26 AM STEP 4 of 9 Receiver: Calibration Tap up/down arrows to enter meter value. This example uses 128 mg/dL. Tap Save. Sensor default value for calibration is dashes ( ) (or the most recent G6 reading). STEP 5 of 9 Receiver: Calibration Verify BG value is correct. If correct, tap Yes. If you dont tap Yes, the BG level isnt saved. If incorrect, tap No and re-enter. STEP 6 of 9 Receiver: Calibration Wait while BG value is accepted. Dexcom G6 System User Guide Chapter 7: Calibrate 103 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 103 2/5/19 9:26 AM STEP 7 of 9 Receiver: Calibration Sensor accepted calibration and is ready for second one. Follow steps 1-6 to enter second value. STEP 8 of 9 Receiver: Calibration The calibrate icon doesnt have a red circle, so your calibration was accepted and no more are needed for now. Dexcom G6 System User Guide Chapter 7: Calibrate 104 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 104 2/5/19 9:26 AM STEP 9 of 9 Receiver: Calibration Your G6 readings begin about 5 minutes after the device accepts your first two calibrations. Look for the dots on your home screen. Each dot represents a single G6 reading taken every 5 minutes. If you didnt enter a sensor code during your sensor setup, G6 will prompt you to calibrate in another 24 hours. When prompted, repeat steps 1-5. 1 Finished!

Sound/Vibration Prompts You get visual notifications, beeps, and/or vibrations when your system needs calibration. Smart device: You see all calibration notifications. Theres no sound or vibration for your daily calibration. G6 will beep once for other types of calibrations, like when youre setting up a new sensor or the G6 needs an extra calibration. Receiver: You see your daily calibration notifications without beeping or vibrating. When your system needs an extra calibration, you see the calibration notification. It also vibrates the first time, then vibrates/beeps every 5 minutes until cleared. For more information on setting your sound/vibration notifications and how to clear them, see Chapter 10. Dexcom G6 System User Guide Chapter 7: Calibrate 105 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 105 2/5/19 9:26 AM 7.5 Calibrate Without Prompts There are times when you may want to calibrate to align your G6 readings to your meter even if you entered a sensor code. Make sure you use good fingerstick technique to get a good meter result by following the steps in 7.3. You may choose to calibrate when your symptoms dont match your G6 readings. For example, your G6 reading is 120 mg/dL. At that glucose level, you expect to feel fine, but instead you are shaking and sweating. You feel as though your glucose is much lower. Pay attention to how you feel. If you feel low and your CGM tells you differently, thoroughly wash your hands with soap and water. Dry them. Then use your meter to confirm your glucose level. If your meter matches your symptoms, go ahead and treat based on the meter value. Then, if you want, calibrate to align your sensor with your meter. You don't have to calibrate, but you can. 7.6 Check In With Jake and Kelly Meet Jake and Kelly! They each manage their diabetes with a G6 and are happy to share their insights with you. When you see their pictures in this User Guide, check in with them and find out how they use their G6s in day-to-day life. First, a little background information: Jake is an adult. He manages his diabetes on his own, using his G6 and pens. Kelly, on the other hand, is a child. She and her parents work together to manage her diabetes using her G6 and a pump. Do either of these situations sound like yours?

Lets check in with Jake and Kelly to see what they do when their symptoms dont match their CGM information. Hi Jake here! Im feeling pretty woozy a pretty sure sign Im low but my CGM shows me at 100 and my trend arrow steady. Dexcom G6 System User Guide Chapter 7: Calibrate 106 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 106 2/5/19 9:26 AM Oh. I just stood up and went from woozy to lightheaded. I think its time to verify with my meter. My meter shows 65. Definitely time to drink some juice and think about calibrating my CGM. My meter shows 65. Well, my CGM reading is much higher. I want to enter a new calibration. Hi its Kelly! This morning I woke up starving! Instead of doing a fingerstick and putting it in my app first thing like I usually do, I ate breakfast. I usually wake up around 75, but because I had breakfast, my dad told me to expect it to be higher. My meter showed 360!

Dad! 360!

He ran right over and I handed him the meter. Ewww, Honey, your meters sticky. What is that?

Oh, sorry! Its probably from that banana I had for breakfast. OK. Before we decide what to do about your 360, how about you wash your hands and do the fingerstick again?

He was right I was really only 90 once my hands were clean!

Takeaways When Jakes and Kellys numbers didnt match how they felt, they figured out why so they could treat the real number. Calibrating? Remember to wash your hands well!

Dexcom G6 System User Guide Chapter 7: Calibrate 107 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 107 2/5/19 9:26 AM 7.7 What Was Covered and Whats Coming Now You Can:

Describe calibration Recognize how to get accurate meter values Enter calibrations into the G6 Understand precautions for when not to calibrate Whats Next?

Part 3: Next Steps will show you how to get the most out of your G6. Dexcom G6 System User Guide Chapter 7: Calibrate 108 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 108 2/5/19 9:26 AM Events Home Screen Alarm and Alerts Treatment Decisions Most Out of Your Dexcom CGM 3Next Steps Getting the Sharing Information with Your Support Team End Sensor and Transmitter Sessions Troubleshooting 2/5/19 9:26 AM LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 109 Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 110 2/5/19 9:26 AM Chapter 8 | Home Screen 8.1 Introduction In this chapter, youll learn how to read your home screen, identify Dexcom G6 Continuous Glucose Monitoring System (G6) readings and trends, and understand what they mean. After this chapter, youll be able to:

Navigate the home screen Locate your G6 reading Explain your glucose target range Recognize the importance of gray, yellow, and red colors Identify Low and High Alert levels on your graph Change graph views Explain differences between trend arrows 8.2 Home Screen Overview The home screen is where you spend most of your time. The Apple app, Android app, and receiver home screens show your sensor glucose information and give you ways to move to other screens to calibrate, add an event, and see the menu. Dexcom G6 System User Guide Chapter 8: Home Screen 111 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 111 2/5/19 9:26 AM The home screen below is from the Apple app. The Android app and receiver look similar. The only difference is where the Calibrate Icon, Settings Menu, and Event History/Add Event are. If you entered a sensor code during setup, you wont have the Calibration icon on the home screen.. Calibrate Icon Sensor Reading Trend Arrow Trend Graph Current Reading High Alert Level Low Alert Level Settings Menu Event History Dexcom G6 System User Guide Chapter 8: Home Screen 112 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 112 2/5/19 9:26 AM 8.3 Glucose Information This section shows you how to interpret your G6 reading, trend arrow, and graph. Sensor Glucose Reading Trend Arrow High Alert Level Low Alert Level Trend Graph Current Reading G6 Readings Starting at the top, the number shows where your sensor glucose is now in milligrams per deciliter (mg/dL). The background can be yellow, gray, or red. Yellow: Above target range Gray: Within target range Red: Below target range or in Urgent Low Soon Dexcom G6 System User Guide Chapter 8: Home Screen 113 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 113 2/5/19 9:26 AM When your most recent G6 reading is above 400 mg/dL or below 40 mg/dL, you wont get a number. Instead, your display device will say LOW or HIGH. The number comes with an arrow, too. It shows the direction your sensor glucose is going. Later in this chapter, well go over trend arrows in detail. Graphs and Events The graph shows where your G6 readings have been for the past 3 hours. It plots your G6 readings every 5 minutes. The most recent G6 reading is the white dot on the right. Black dots are past G6 readings. The numbers on the right show glucose level in mg/dL. The numbers on the bottom show the last 3 hours. The horizontal white lines show your High and Low Alert levels. Your glucose is:

High when your dots are in the yellow area of the graph. In your target range (between your high and low alert settings) when in the gray area. Low when in the red area. High Alert Level Low Alert Level Trend Dots Current Reading Dexcom G6 System User Guide Chapter 8: Home Screen 114 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 114 2/5/19 9:26 AM When the transmitter reconnects with the display device after a Signal Loss or similar issue, up to 3 hours of missed G6 readings can fill in on the graph. The app and receiver smooth all but your current G6 reading on your trend graph so that you can clearly see where your glucose is heading. It is expected for there to be some differences between the G6 reading you saw in real time (in the circle above the graph) and the G6 readings you see in the past on your graph (black dots). To see events with your graph and to see your graph over 1, 3, 6, 12, and 24 hours, turn your smart device on its side (for landscape view). Touch and hold a dot to see the time for a past G6 reading, or slide your finger across the screen to view G6 readings from other times. To switch between 1-, 3-, 6-, 12-, and 24-hour views on your receiver, tap the graph. Dexcom G6 System User Guide Chapter 8: Home Screen 115 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 115 2/5/19 9:26 AM 8.4 Navigation and Status Bar Now that youre familiar with the glucose information on your home screen, lets see how to get around. For example, how do you get to the calibration screen or the screen where you record an insulin dose, or how do you check your alert settings? The Apple app, Android app, and receiver home screens have slightly different ways to navigate to other screens. This section details those differences. Remember, if you entered a sensor code, you dont need to calibrate so there isnt a Calibrate icon on the home screen. Calibrate via Menu > Calibrate. Apple App Calibrate Icon Glucose Information Settings Menu Event History Dexcom G6 System User Guide Chapter 8: Home Screen 116 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 116 2/5/19 9:26 AM Android App Calibrate Icon Settings Menu Event History Dexcom G6 System User Guide Chapter 8: Home Screen 117 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 117 2/5/19 9:26 AM Receiver Bluetooth Battery Level Glucose Information Menu Add Event Calibrate Icon Calibrate icon: The blue drop is the calibrate icon. If you didnt enter a sensor code, a red circle shows on the drop when you need to enter a new calibration. To calibrate, tap on the blue drop and follow the steps. If you did enter a sensor code, theres no need to calibrate, so, there isnt a Calibrate icon on the home screen. Events/Add Event: Lets you record insulin, carbs, exercise, or health-related events. See Chapter 9 for more information. Settings/Menu: Edit alerts, find help, change settings, customize sounds, and use Share (app only). Dexcom G6 System User Guide Chapter 8: Home Screen 118 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 118 2/5/19 9:26 AM Trend Arrows Trend arrows show the speed and direction of your glucose trends based on your recent G6 readings. Use the arrows to know when to take action before youre too high or too low. Trend Arrow: Steady Changing:

Less than 1 mg/dL each minute Up to 15 mg/dL in 15 minutes Trend Arrow: Slowly Rising or Falling Changing:

1 2 mg/dL each minute Up to 30 mg/dL in 15 minutes Trend Arrow: Rising or Falling Changing:

2 3 mg/dL each minute Up to 45 mg/dL in 15 minutes Dexcom G6 System User Guide Chapter 8: Home Screen 119 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 119 2/5/19 9:26 AM Trend Arrow: Rapidly Rising or Falling Changing:

More than 3 mg/dL each minute More than 45 mg/dL in 15 minutes Trend Arrow: None System cant calculate the speed and direction of your glucose change. See Chapter 11 for information on using trend arrows to make treatment decisions. Dexcom G6 System User Guide Chapter 8: Home Screen 120 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 120 2/5/19 9:26 AM 8.5 What Was Covered and Whats Coming Now You Can:

Navigate using home screen icons Locate your G6 reading Explain your glucose target range Recognize the importance of gray, yellow, and red colors Identify Low and High Alert levels on your graph Change graph views Explain differences between trend arrows Whats Next?

Next youll learn how to enter events that affect your glucose levels. Track events so you and your HCP can reflect on patterns in your glucose levels. Dexcom G6 System User Guide Chapter 8: Home Screen 121 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 121 2/5/19 9:26 AM Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 122 2/5/19 9:26 AM Chapter 9 | Events 9.1 Introduction In this chapter, youll learn how to enter events, including insulin doses and carbs. You can track events to see how your actions or circumstances affect your glucose levels. After this chapter, youll be able to:

Define an event Describe each type of event Add events to the app and receiver 9.2 Events Overview Did you take a walk after lunch today? Are you feeling stressed? How much insulin did you take for your dinner meal? These are all events that can change your blood sugar. An event is an action or situation that affects your glucose levels. With the Dexcom G6 Continuous Glucose Monitoring System (G6), you can track your daily events so you can reflect on their effect on your glucose trends. Once entered into the app, or once you upload your receiver data, events can be viewed in Dexcom reports. The reports help you review how each event influenced your glucose trends. You can use the reports with your HCP to create a plan to manage your diabetes. Types of Events Your G6 lets you keep track of insulin, carbs, exercise, and health-related events. When you add an event in your app, it shows in Events and CLARITY reports. Dexcom G6 System User Guide Chapter 9: Events 123 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 123 2/5/19 9:26 AM 9.3 Enter Insulin Event This section shows how you can enter long-acting insulin doses. Following the app information, entering insulin on your receiver is covered. App: Enter Long-acting Insulin STEP 1 of 4 STEP 2 of 4 STEP 3 of 4 App: Enter Long-acting Insulin From the Home screen, tap Events. App: Enter Long-acting Insulin Then, tap Add Event. App: Enter Long-acting Insulin Tap Long-Acting Insulin. Dexcom G6 System User Guide Chapter 9: Events 124 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 124 2/5/19 9:26 AM STEP 4 of 4 App: Enter Long-acting Insulin How much insulin did you give?

You cant enter the type of insulin, only dosage. Enter insulin units for each dose, up to 100 units. Finished!

Dexcom G6 System User Guide Chapter 9: Events 125 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 125 2/5/19 9:26 AM Receiver: Entering Insulin The steps below show how to enter insulin on the receiver. Unlike the app, you can only log insulin, but not which type. STEP 1 of 6 Receiver: Entering Insulin Tap Add event. STEP 2 of 6 STEP 3 of 6 Receiver: Entering Insulin Tap Insulin. Receiver: Entering Insulin Tap arrows to enter Units, up to 100. When you tap the arrow, number starts at last number entered. This example uses 10.35 Units. Dexcom G6 System User Guide Chapter 9: Events 126 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 126 2/5/19 9:26 AM STEP 4 of 6 STEP 5 of 6 Receiver: Entering Insulin Tap Edit Date/Time. Receiver: Entering Insulin Tap each box to enter the date and time. Use the arrows to select the correct information. STEP 6 of 6 Receiver: Entering Insulin Tap Save. Finished!

Dexcom G6 System User Guide Chapter 9: Events 127 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 127 2/5/19 9:26 AM 9.4 Other Events Now that you can enter insulin on your app and receiver, lets go over the other events you can record: carbs, exercise, and health. Enter these on your app or receiver. Adding these events is very similar to adding insulin. You already know how to enter insulin, so you can also enter carbs! Below we go over some tips for entering events. Carbs: Add up all carb grams for the snack or meal, up to 999 grams. Exercise: You select each exercises intensity level and duration. Type of exercise isnt an option. Health-related events:

Illness: Is a cold, flu, or any other temporary illness affecting your well-being?

Stress: Are you under stress or feeling anxious?

High symptoms: Do you feel high BG symptoms?

Low symptoms: Do you feel low BG symptoms?

Cycle: Are you on your period?

Alcohol: Did you have a glass of wine, beer, or cocktail?

For your convenience, theres no need to stop everything and enter your events as theyre happening. When you have a moment, you can enter past events. Events are meant to be entered as individual occurrences: Dont enter daily totals; enter each event separately. Dexcom G6 System User Guide Chapter 9: Events 128 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 128 2/5/19 9:26 AM 9.5 App: Edit or Delete an Event Entered an event incorrectly? Maybe you entered the wrong number of insulin units, or forgot to change the time before you saved it. Use the Events screen to delete and re-enter incorrect events you entered on your app. You cannot edit or delete events entered on your receiver. App: Delete Event App: Delete Event STEP 1 of 4 Tap Events. STEP 2 of 4 App: Delete Event Events shows your recent events, newest on the top. Apple (shown left): Tap Edit. Android: Tap the pencil icon. After tapping your edit icon (differs based on your device), to delete an added event, use the red icon. Follow your smart devices prompts to delete an event. Dexcom G6 System User Guide Chapter 9: Events 129 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 129 2/5/19 9:26 AM STEP 3 of 4 App: Delete Event Apple (shown left): Red icon is a circle on the left. Android: Red icon is a trash can on the right. Apple (shown left): Delete appears on the right. Tap Delete. Dexcom G6 System User Guide Chapter 9: Events 130 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 130 2/5/19 9:26 AM STEP 4 of 4 App: Delete Event Tap Delete Event to confirm. Finished!

9.6 App: View Events Entering events wont change your glucose information, but they give you the big picture when reviewing information later, whether on your app, with your Followers, or with your HCP via CLARITY. Turn your smart device to landscape to view your events carbs, exercise, and health. At the bottom of the screen are the insulin doses you recorded. Touch and hold a spot on the screen to see detailed information for that time. Tap labels along top to change time scale. Touch and hold on graph to see details for that time. Dexcom G6 System User Guide Chapter 9: Events 131 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 131 2/5/19 9:26 AM Events entered into your receiver can only be viewed on a Dexcom report after uploading the information into CLARITY. There are no markers on your receiver screen and they do not transfer to your app. 9.7 What Was Covered and Whats Coming Now You Can:

Define an event Describe each type of event Add events to the app and receiver Whats Next?

Next, youll learn how your alarm/alerts help you monitor your glucose levels. Youll also learn how to tell when your system loses its signal and stops communicating with your transmitter. Dexcom G6 System User Guide Chapter 9: Events 132 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 132 2/5/19 9:26 AM Chapter 10 | Alarm and Alerts 10.1 Introduction This chapter shows you how alarm/alerts let you know when you need to take action. After this chapter, youll be able to:

Define alarm and alert Recognize different alarm/alerts Turn alerts on and off Describe what to do when you get a Signal Loss Alert Confirm an alert on your app and receiver Customize your alerts on your app and receiver Adjust your alert sounds Use Repeat to avoid insulin stacking 10.2 Alarm and Alerts Overview Dexcom G6 Continuous Glucose Monitoring System (G6) alarm/alerts can keep you safe from severe lows or highs. When your G6 reading goes from your target range to your alarm/alerts level, your display device tells you with a visual notification, and vibrations or sound, depending on the alarm/alert and your display device. Until you confirm the glucose-related alarm/

alert, every 5 minutes you get the alarm/alert screen along with a notification and a vibration. Until youre back in your target range, the alarm/alert information will stay on your home screen. If you use both your smart device and receiver, be sure to set up alerts on each one. Alerts you set up on your receiver only work on your receiver. The same is true of the app. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 133 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 133 2/5/19 9:26 AM Keep these things in mind if you use the app:

Vibrations: The app vibrations can feel the same as other notifications you get from other apps on your smart device. The only way to know if its from your G6 is to look at it. Volume/mute: The app allows your alarm and most important alerts to notify you even when your volume is set too low to hear or silenced. In these cases you may not hear sound on your first notification. You still get a screen notification and a vibration, if your device has a vibration feature. There are two exceptions:

Android: If using the most restrictive Do Not Disturb setting, you wont get any alarm/

alerts, including your Urgent Low Alarm. Apple: If silenced or on Do Not Disturb, you wont get the Signal Loss alert. Do you feel like youre getting too many alerts? Talk with your HCP about your alert settings. They may suggest changing them to different values. Alarm or Alert?

While there are a variety of alerts, theres just one alarm: the Urgent Low Alarm (alarm) at 55 mg/dL. The alarm cant be changed or turned off with one exception. If you have an Android phone, and you turned on Total Silence or No Exceptions, you wont get any alerts, including your Urgent Low. Otherwise, as long as your display device is getting G6 readings and notifications, youll get your alarm. An alert is a message telling you your glucose trend levels or CGM system needs attention. In this chapter, we focus on these customizable alerts:

Urgent Low Soon Low High Rise Rate Fall Rate Signal Loss Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 134 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 134 2/5/19 9:26 AM When making treatment decisions using your G6, its best to keep your alerts turned on. Your Urgent Low Soon, Low, High, and Signal Loss Alerts are on when you set up your display device. The Rise and Fall Rate Alerts are off. Later in this chapter, youll learn how to customize them. What you hear, feel, and see App first notification: If you have your smart device sound on, it vibrates and makes a noise on the initial alert. If you have turned off the sound, it only vibrates. Each alert has its own vibration pattern. Receiver first notification: For the receiver, unlike the app, the first alert does not make sound (it comes on the first re-alert). The exceptions are these four alarm/alerts that sound the first time:

Urgent Low Alarm Urgent Low Soon Alert Sensor Failed Alert Transmitter Error Alert WARNING Get Alarm/Alerts on Display Device You Use To get your alarm/alerts, set them on the display device you use. Your receiver wont get the alarm/alerts you set on your app. Likewise, your app wont get the alarm/

alerts you set on your receiver. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 135 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 135 2/5/19 9:26 AM If you use headphones, be sure to keep them in your ears. Otherwise, you wont hear alarm/alerts. WARNING Check Settings When using your smart device, you should confirm that your volume is turned up, your phone is not muted, and you do not have headphones plugged in. If your volume is not turned up, the device is muted, or headphones are plugged in, you will not hear the sound of any notifications, including important alarms. When you have headphones connected to your Android, alarm/alerts will sound through the headphones and the speaker. On your Apple, they will sound only in the headphones. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. Alarm/Alerts When Youre Low Urgent Low Alarm The alarm lets you know when your G6 reading drops to or below 55 mg/dL. Think of it as a safety net: Your glucose level is dangerously low take action now!

What you hear, feel, and see Initial alarm: Vibrates 4 times and beeps 4 times. Until confirmed: Vibrates and beeps 4 times every 5 minutes. App Notification Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 136 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 136 2/5/19 9:26 AM App Receiver Notification Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 137 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 137 2/5/19 9:26 AM Receiver Urgent Low Soon Alert This alert lets you know youre falling quickly, in fact so quickly that youll be at or below 55 mg/dL within 20 minutes, no matter where you are now even if youre in your target range. This gives you time to act before you go too low. What you hear, feel, and see Initial alert: Vibrates 6 times and beeps 6 times. Until confirmed: Vibrates and beeps 6 times every 5 minutes. Updates: 30 minutes later, you get another Urgent Low Soon Alert if youre still falling so quickly youll be at or below 55 mg/dL within 20 minutes. The default for update notifications is 30 minutes, however, you can set them to 15 minutes. App Notification Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 138 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 138 2/5/19 9:26 AM App Receiver Notification Receiver Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 139 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 139 2/5/19 9:26 AM Low Alert When your G6 reading is below the level you set, you get your Low Alert. What you hear, feel, and see Initial alert: Vibrates 3 times. Until confirmed: Vibrates and beeps 3 times every 5 minutes. App Notification App Receiver Notification Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 140 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 140 2/5/19 9:26 AM Receiver When Do You Get Which Alert?

You always get your Urgent Low Alarm. If you are an Android user, there is one exception. If your device is on the most restrictive Do Not Disturb setting, you will not get your Urgent Low Alarm. Depending on how quickly youll be at 55 mg/dL, you get either your Urgent Low Soon Alert or your Low Alert:

Within 20 minutes? You get the Urgent Low Soon Alert. Not that fast? You get the Low Alert. If you get one, you wont get the other for 30 minutes. High Alert This notifies you when your G6 readings are above your target glucose range. What you hear, feel, and see Initial alert: Vibrates 2 times. Until confirmed: Vibrates and beeps 2 times every 5 minutes. App Notification Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 141 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 141 2/5/19 9:26 AM App Receiver Notification Receiver Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 142 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 142 2/5/19 9:26 AM Other Customizable Alerts Rise Rate and Fall Rate Alerts You can turn on your Rise and Fall Rate Alerts to let you know when your glucose is rising or falling 2 or 3 mg/dL each minute. What you hear, feel, and see Rise Rate Alert Initial alert: Vibrates 2 times. Until confirmed: Vibrates and beeps 2 times every 5 minutes. Fall Rate Alert Initial alert: Vibrates 3 times. Until confirmed: Vibrates and beeps 3 times every 5 minutes. App Notification App Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 143 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 143 2/5/19 9:26 AM Receiver Notification Receiver Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 144 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 144 2/5/19 9:26 AM Signal Loss Alert This tells you when youre not getting G6 readings. Your display device may be too far from your transmitter or there may be something, such as a wall or water, between your transmitter and your display device. To fix this:

Keep your transmitter and display device within 20 feet of each other. Wait 30 minutes. App:

If that doesn't work, turn Bluetooth off and on. Wait 10 minutes. If that doesn't work, restart the smart device and reopen the Dexcom app. During signal loss, use your meter to check your glucose and make any treatment decisions. You choose how long to wait before you get the alert 20 to 200 minutes, or more if using the app. When the display device and transmitter connect after a signal loss or similar issue, up to 3 hours of missed G6 readings can fill in on the graph. Apple: Unlike other alerts, Signal Loss cant make a sound or vibrate if your smart device is Silenced or in Do Not Disturb mode. What you hear, feel, and see Initial alert: Vibrates once. Until confirmed: Vibrates and beeps once every 5 minutes. All other system alerts also vibrate and beep once. App Notification Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 145 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 145 2/5/19 9:26 AM App Receiver Notification Receiver There are many more alerts that you cant customize. See Appendix H. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 146 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 146 2/5/19 9:26 AM 10.3 Check In With Kelly How do these alarm/alerts work in day-to-day life? Lets check in with Kelly to see how her family uses them to fine-tune treatment decisions. Hi its Kate, Kellys mom. Around 6:30 this morning, just before Kelly usually gets up, she got an Urgent Low Soon. She was at 90, which isnt bad, but she had double-down arrows, which means she could drop to 45 in just 15 minutes. I gave her a granola bar with juice as a before-breakfast, in-bed snack. Her trend arrow evened out pretty quickly. Im happy to report she didnt even get the Urgent Low Soon update, much less the Urgent Low Alarm. And she was delighted to get to eat in bed!

I love the Urgent Low Soon! With it, I see when she is heading toward a low instead of just reacting to it afterwards. Its so much healthier for Kelly and so much less stressful for all of us. Takeaway Your alerts help you get back into your target range. Respond to them. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 147 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 147 2/5/19 9:26 AM 10.4 Confirming Alarm/Alerts Alarm/alerts require you to confirm them. How this is done depends on your display device. If using both display devices, you need to confirm the alarm/alert on each device separately. Due to its medical importance, the alarm is more persistent. Even after the alarm is confirmed, if your G6 readings remain at or below 55 mg/dL, the Urgent Low Alarm will sound every 30 minutes until G6 readings are above 55 mg/dL. During this 30 minutes, you wont get Low or Urgent Low Soon Alerts. Below is one example of confirming an alert. All alarm/alerts are confirmed the same way. Confirm Alarm/Alerts Example App: Open the app. Tap OK to confirm. Receiver: Tap OK to confirm. Once you confirm an alert, the home screen will show the alert. You only get the alert again if you go back into your target range and then re-enter the alert range. If you want to get repeated alerts when you stay in the alert range, use Repeat, as explained below. Your Urgent Low Alarm will always repeat, even after confirming, if your glucose levels don't return to your target range. You cant change your Urgent Low Alarm. App Notification App Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 148 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 148 2/5/19 9:26 AM Receiver Notification Receiver Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 149 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 149 2/5/19 9:26 AM 10.5 Customizing Your Alerts Check In With Jake It seemed like all I ever did I was clear alerts! I was often running high. My High alert was going off all the time. It was making me so crazy, I was thinking about turning all my alerts off!

Thank goodness, I spoke with my doctor before doing anything. He asked me if I ever changed my alerts after first setting up my G6. I hadnt. We took a look at where my alert settings were and made some changes. I understand its important to try and spend time in my target range. But my doctor told me sometimes I need to make changes based on my own situation. My doctors advice? Set the alert higher at the level where I need to do something. It worked! I dont get High alerts all the time, and when I do, I know I probably need to act. Takeaway You can customize your alerts to fit your situation. The receiver and app come with default glucose level alert settings, but maybe they dont reflect the glucose level that works best for you. Perhaps youre in a meeting and can only confirm an alert yet want to make sure your alert repeats, or continues, until youre able to take corrective measures. Maybe youd like to get a Rise/Fall Alert, but theyre off by default. How do you turn them on? And you might prefer a different schedule during the night. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 150 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 150 2/5/19 9:26 AM Earlier, you learned confirming an alert stops it from repeating unless you go back into your target range and then re-enter the alert range. But what if you stay in your alert range for a long time? If you want to continue to be re-alerted until your glucose levels are back in your target range, turn on the Repeat option in the alert. The default for repeat is off. Use Repeat with the High Alert to remind you to check your G6 reading later. This is your tool for watching and waiting and avoiding insulin stacking when your G6 reading is high. Before changing your alert levels, talk with your HCP. Changes you make to alerts in your app arent reflected in your receiver and vice versa. If you want the alerts to be the same, you need to make changes to both devices. Changing alert options differs between the app and receiver. First, lets take a look at personalizing your app, then well review the same process for the receiver. In the following example, well change your High Alert to 190 mg/dL with a repeat of 2 hours long enough for your insulin to work. That way, if you get a High Alert, you can confirm it and give yourself insulin. In 2 hours, if you never get back into your target zone, your High Alert repeats to let you know youre still high and might want to take more insulin. On the other hand, if the 2 hours pass and youre back in your target range, your High Alert wont repeat. Well also change your sound to Door Bell in the app and Normal in the receiver. App: Customizing Alerts STEP 1 of 15 STEP 2 of 15 App: Customizing Alerts Tap Settings. App: Customizing Alerts Tap Alerts. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 151 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 151 2/5/19 9:26 AM STEP 3 of 15 App: Customizing Alerts Your high alert level shows. If your high alert was off, it shows Off instead. Tap High to see its settings. STEP 4 of 15 App: Customizing Alerts This screen shows your current High alert settings. Alerts have:

On/off switch Notify me options Sound options STEP 5 of 15 App: Customizing Alerts Check High Alert is on:

On colored Off gray STEP 6 of 15 App: Customizing Alerts Tap Notify Me Above to set the High Alert level. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 152 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 152 2/5/19 9:26 AM STEP 7 of 15 App: Customizing Alerts Scroll selection wheel to level you want in this example, 190mg/dL. STEP 8 of 15 App: Customizing Alerts Save the new High Alert glucose level. Apple (shown left): Tap Back. Android: Tap Save. STEP 9 of 15 App: Customizing Alerts Tap Repeat to change how often your High Alert repeats after confirming. Repeats only if you stay above your high glucose level. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 153 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 153 2/5/19 9:26 AM STEP 10 of 15 App: Customizing Alerts Scroll selection wheel to the High Alert repeat interval you want in this example, 2 hours. Repeat range is 15 minutes to 4 hours. STEP 11 of 15 App: Customizing Alerts Save your new repeat time. Apple (shown left): Tap Back. Android: Tap Save. Repeat shows how often youll get notified. STEP 12 of 15 App: Customizing Alerts Tap Sound to customize alert sound. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 154 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 154 2/5/19 9:26 AM STEP 13 of 15 App: Customizing Alerts Tap option you want in this example, Door Bell to change and hear sample of sound setting. STEP 14 of 15 App: Customizing Alerts Save your new alert sound. Apple (shown left): Tap Back. Android: Tap Save. STEP 15 of 15 App: Customizing Alerts Tap the back arrow until you see your home screen. Finished!

Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 155 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 155 2/5/19 9:26 AM Receiver: Customizing Alerts Follow these steps to change your receiver alerts. In this example, well be changing the High Alert setting to 190 mg/dL, repeating every 2 hours. Later, well change the sound, too. STEP 1 of 12 Receiver: Customizing Alerts Tap Menu. STEP 2 of 12 STEP 3 of 12 STEP 4 of 12 Receiver: Customizing Alerts Tap Settings. Receiver: Customizing Alerts Tap Alerts. Receiver: Customizing Alerts Tap High. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 156 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 156 2/5/19 9:26 AM STEP 5 of 12 Receiver: Customizing Alerts Check High Alert is on. Description This screen shows your current High Alert settings. STEP 6 of 12 STEP 7 of 12 Receiver: Customizing Alerts Tap Level to set the High Alert level. Receiver: Customizing Alerts Tap arrows in this example, the down arrow, to 190mg/dL to change the High Alert. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 157 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 157 2/5/19 9:26 AM STEP 8 of 12 STEP 9 of 12 Receiver: Customizing Alerts Tap Save. Receiver: Customizing Alerts Tap Repeat to change how often your High Alert repeats after initial alert and confirm. STEP 10 of 12 Receiver: Customizing Alerts Tap arrows in this example, the up arrow to 120 minutes, or 2 hours. Repeat range is 15 minutes to 4 hours. STEP 11 of 12 Receiver: Customizing Alerts Tap Save. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 158 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 158 2/5/19 9:26 AM STEP 12 of 12 Receiver: Customizing Alerts Tap back arrow three times to return to the home screen. Finished!

Sounds Unlike the app, you change your receiver sounds through screens in the Sounds menu. Sounds determine the sound and volume of alarm/alerts on your receiver. The receiver lets you chose from several sounds, varying in volume as well as a vibrate mode, which is silent. If you choose Soft (see list below), all alerts are in Soft mode except the Urgent Low Alarm. This list shows the different alarm/alert sounds available on the receiver, starting with the quietest. Receiver Sound: Vibrate Vibration only. No sound (except your receiver vibrating). Exceptions: Urgent Low Glucose Alarm, Urgent Low Soon Alert, Sensor Failure, and Transmitter Failure always beep and vibrate. Receiver Sound: Soft Quiet beeps. Receiver Sound: Normal Medium volume beeps. Default sound. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 159 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 159 2/5/19 9:26 AM Receiver Sound: Attentive Rising melody for High and Rising Alerts. Dropping melody for Low and Falling Alerts. Receiver Sound: Hypo Repeat Repeats Urgent Low Alarm and Urgent Low Soon Alert every 5 seconds until confirmed or G6 reading improves. Medium volume beeps. Receiver: Test Sound Sample sound setting before selecting. This does not select your sound; it just lets you hear it. To select sound, see below. Customizing Sounds You can change your sound throughout the day depending on what lies ahead. In a meeting? Select Vibrate. Going to a ball game after work? Select Attentive. This list shows how to change your sound and try it out. STEP 1 of 6 Receiver: Customizing Alerts Tap Menu. STEP 2 of 6 Receiver: Customizing Alerts Tap Settings. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 160 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 160 2/5/19 9:26 AM STEP 3 of 6 STEP 4 of 6 Receiver: Customizing Alerts Tap Sounds. Receiver: Customizing Alerts Selected sound has checkmark. Default is Normal. Tap your choice. STEP 5 of 6 Receiver: Customizing Alerts Tap Test Sound to hear selected Sound. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 161 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 161 2/5/19 9:26 AM STEP 6 of 6 Receiver: Customizing Alerts Tap the alarm/alert to hear the selected sound for each one. Finished!

10.6 Why Customize Alerts?

What can customizing alerts do for you? Use your alerts to help you achieve your goals. Are you worried you go high too often? Or, you dont always feel your lows, so you want the G6 to let you know. Perhaps you want to set different alert levels during the night. Maybe you want to bring your average blood glucose down. Talk to your HCP about how to use your G6 alerts to reach your diabetes management goals. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 162 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 162 2/5/19 9:26 AM 10.7 Check In With Jake and Kelly What does customizing alerts do for day-to-day life? Lets check in with Jake and Kelly to see how they use it to manage their diabetes. Hi its Jake. I figured out how to use repeat with my high alert to avoid insulin stacking. I also worked with my endo and my high alert setting to bring down my average blood glucose!

I took insulin to cover dinner but then ended up having a couple bites of dessert, too. My high alert went off; I have it set to 275. What did I do? I set my repeat set to 2 hours, which gives the insulin I already took time to act. So I didnt take more insulin because I knew I could confirm the alert and it would remind me in 2 hours if I was still high. This not only helps me not stack, it also takes a lot of stress out of watching and waiting!

At our appointment a couple months ago, my endo said, So Jake, your average blood glucose is 275 mg/dL! Thats elevated almost seriously elevated. Almost seriously elevated? Thats bad. Then she gave me some tips for bringing that down. Let me tell you what I did!

The first month, I set my High Alert at 285 so I knew when I was just a little over my average and could take a walk to bring it down right then. I went on a lot of walks!

Seriously, I should get a dog. But it paid of at my last appointment, my endo told me my average blood glucose was down to 225!

Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 163 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 163 2/5/19 9:26 AM That went pretty well, so the next month, as planned, I lowered my High Alert to 235. That was tougher at first, but between the walks and insulin, I got it to work. And hey! Look at those results! Getting the information that I was a little high in time to do something about it made a huge difference over 2 months. Im sticking with this! I bet I can get my average to 220 for my next visit!

Hi! Its Kate, Kellys mom. Her dad and I are concerned because she doesnt seem to feel her lows. Last month, Kevin picked her up from school and immediately gave her one of the emergency juice boxes we keep in the car. She was wandering around, completely spacey. And no wonder she was at 65 mg/dL and falling. She got her low alert at 70 but hadnt done anything about it. What happened there?

That scared us enough to bring up her lows with her endocrinologist at her appointment last week. He was awesome about it, as usual. He showed us how we could use the Low Alert setting to get Kellys attention while she can still think clearly enough to act on it and while theres time for her to eat something to avoid a low. Based on his recommendation, we raised it to 80 mg/dL and rubber banded a PEZ dispenser to her iPhone. I spoke to her teachers about the candy being medically necessary, and Kevin let her know that she could share the PEZ with her friends as long as she was not in school. Its worked! This week, she has acted on her Low Alerts and hasnt gone below 70 mg/

dL since her appointment! Were so relieved!

Takeaway How you set up your alerts can help you reach your diabetes management goals. Work with your HCP to come up with the best alert customization for you and your goals. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 164 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 164 2/5/19 9:26 AM 10.8 App: Control When Alarm/Alerts Sound When you are at school or work, you may want your phone sounds to be more discreet. You may want to hear only critical G6 alarm/alerts and no other sounds from your phone, like calls or texts. Other times, like at night, you may want to hear all G6 alarm/

alerts but again, no other sounds from your phone. And still other times, you may want to hear all your phone sounds and your G6 alarm/alerts. Always Sound, combined with your phones mute/Do Not Disturb setting, lets you control when you hear your alarm/

alerts and your phones other noises. Icons on your Home screen show what you will hear. The mute/Do Not Disturb phone setting controls whether you hear phone noises, like text messages and phone calls. When Always Sound is on, you always hear your default and scheduled alerts, no matter what your phones mute/Do Not Disturb setting is. So at night, you can turn on both Always Sound and mute/Do Not Disturb to avoid hearing anything except your G6 alarm/alerts. These icons on your home screen show this state:

Default Alerts (those you established when you set up the app on your phone) Scheduled Alerts (described in the next section) When Always Sound is off, it matters whether your phone is set to mute/Do Not Disturb. If mute/Do Not Disturb is also off, you will hear default and scheduled alerts and see these icons on your home screen. Default Alerts Scheduled Alerts Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 165 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 165 2/5/19 9:26 AM However, if mute/Do Not Disturb is on, you hear only these three alarm/alerts:

Urgent Low Glucose Alarm, Transmitter Alert, and Sensor Failed Alert. You do not hear any other noises from your phone. This may be the right setting combination for you during the school or work day. These icons on your home screen show this state:

Default Alerts Scheduled Alerts Android only: No alarm/alert sounds when your phone is in the most restrictive Do Not Disturb settings. 10.9 App: Alert Schedule The app Alert Schedule lets you pick how your alarm/alerts notify you at different times and on different days. For example, you may choose loud alarm/alerts when youre not at work, but have them only vibrate during work hours. Alert Schedule lets you add one schedule. When you turn on the Alert Schedule for the first time, your glucose alert settings are copied into your schedule. The Alert Schedule guides you through creating an additional schedule. Follow the steps below to copy your glucose alert settings and change them for workdays. In this example, you add a night schedule for 10 pm through 7 am, all week long. During these times, your Low Alert will be at 70 mg/dL and your High Alert will be at 200 mg/dL and they will always sound, even if your mute or Do Not Disturb setting is on. During the day when this schedule is not in effect your alarm/alerts will make the sounds and notify you at the levels you set outside the Alert Schedule. We will set up your High and Low levels first then turn on Always Sound. That way, at night, you can switch your display device to mute or Do Not Disturb at night and only hear sounds from your CGM alarm/alerts. Your smart device may have different calendars, time, etc. and look different than the instructions below. Follow your device steps for choosing time and days. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 166 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 166 2/5/19 9:26 AM App: Set Up Alert Schedule STEP 1 of 14 STEP 2 of 14 STEP 3 of 14 STEP 4 of 14 App: Set Up Alert Schedule Tap Settings. App: Set Up Alert Schedule Tap Alerts. App: Set Up Alert Schedule Tap Alert Schedule switch to turn it on. App: Set Up Alert Schedule Tap Schedule Name. For this example, type Nights. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 167 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 167 2/5/19 9:26 AM STEP 5 of 14 App: Set Up Alert Schedule Nights schedule starts at 10 pm. Scroll to 10 pm. Tap Next. Android: Selecting a time looks different. STEP 6 of 14 App: Set Up Alert Schedule Scroll to 7 am, when you get up. Tap Next. Android: Selecting a time looks different. STEP 7 of 14 App: Set Up Alert Schedule Select Every Sunday through Every Saturday so the schedule covers all days. Tap Next. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 168 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 168 2/5/19 9:26 AM STEP 8 of 14 App: Set Up Alert Schedule Select 70 as your low glucose alert level for this schedule. At night, when this schedule is in effect, you will get your Low Alert when your G6 reading reaches 70 mg/dL. Tap Next. STEP 9 of 14 App: Set Up Alert Schedule Select 200 as your high glucose alert level for this schedule. At night, when this schedule is in effect, you will get your High Alert when your G6 reading reaches 200 mg/dL. Tap Next. STEP 10 of 14 App: Set Up Alert Schedule Turn Always Sound on so you will hear your alarm/

alerts even when your display device is on mute or Do Not Disturb. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 169 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 169 2/5/19 9:26 AM STEP 11 of 14 App: Set Up Alert Schedule Review the settings for your Alert Schedule. STEP 12 of 14 App: Set Up Alert Schedule When Alert Schedule is on, there are two groups of settings in the Alerts menu: Default and Scheduled. Default shows your regular, not scheduled settings. Scheduled shows any alerts you changed from your default settings. The default settings are copied into your schedule. Verify that your scheduled High Alert will make a sound. Tap High. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 170 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 170 2/5/19 9:26 AM

STEP 13 of 14 App: Set Up Alert Schedule Your scheduled High Alert will sound. STEP 14 of 14 App: Set Up Alert Schedule Tap Back until you see the home screen. Finished!

10.10 What Was Covered and Whats Coming Now You Can:

Define alarm and alerts Recognize different alarm/alerts Turn alerts on and off Describe what to do when you get a Signal Loss Alert Confirm an alert on your app and receiver Customize your alerts on your app and receiver Adjust your alert sounds Use Repeat to avoid insulin stacking Whats Next?

Next well talk about how to use your G6 to make treatment decisions. Dexcom G6 System User Guide Chapter 10: Alarm and Alerts 171 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 171 2/5/19 9:26 AM Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 172 2/5/19 9:26 AM Chapter 11 | Treatment Decisions 11.1 Introduction Follow the steps outlined in this chapter and youll have what you need to make treatment decisions using your Dexcom G6 Continuous Glucose Monitoring System

(G6). After this chapter, youll be able to:

Talk with your HCP about creating a personalized treatment plan Identify when you can treat using your G6 Describe the importance of alarm/alerts in treatment decisions Tell when you shouldnt make a treatment decision using the G6 Recognize when you should watch and wait before treating 11.2 How Do You Know Youre Ready?

Whether youre new to Dexcom or experienced, you should keep using your BG meter to make treatment decisions until you know how Dexcom works for you. Dont rush! It may take days, weeks or months for you to gain confidence in using your CGM to make treatment decisions. Confirm your G6 readings using your BG meter so you understand that:

The accuracy you experience with each newly inserted sensor may vary A sensor might work differently in different situations (meals, exercise, first day of use, etc.) There may be variations between sensors, so pay attention to how each newly inserted sensor is working for you when deciding whether to make treatment decisions based on your G6 readings. If your symptoms dont match your G6 readings, use your BG meter when making treatment decisions. If your G6 readings dont consistently match your symptoms or BG meter values, then talk to your healthcare professional about how you should be using the Dexcom G6 to help manage your diabetes. Your healthcare professional can help you decide how you should best use this device. Dexcom G6 System User Guide Chapter 11: Treatment Decisions 173 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 173 2/5/19 9:26 AM 11.3 Your HCP Is Your Partner Your HCP is your partner in personalizing your diabetes management plan and treatment decisions. Before you start making treatment decisions with your G6, work with your HCP and learn the basics:

When do you need to use a meter instead of relying on your G6?

How can you avoid insulin stacking?

Creating Personal Guidelines Working with your HCP, define your target glucose range and your alert settings. Discuss how to stay within your target using the G6. Let your HCP guide you through the system features, including adjusting your alert settings to match your needs and goals, working with G6 readings and trend arrows for treatment decisions, and managing your diabetes with the system. Learn from your HCP how changes:

To your insulin routine should be made cautiously and only under medical supervision To insulin strength, manufacturer, type, or method of administration may result in a need for a change in insulin dose Make a List Before meeting with your HCP, make a list of questions you have about treatment decisions and how to use your G6 in your decision-making process. Use the following list as a starting point for topics you may want to cover:

Whats your plan if your blood glucose is falling or rising rapidly?

Discuss different situations. When should you:

Take more insulin Eat fast-acting carbohydrates Watch and wait so you dont stack insulin How can you use G6 to make better meal dosing decisions?

Dexcom G6 System User Guide Chapter 11: Treatment Decisions 174 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 174 2/5/19 9:26 AM How can you use G6 for treatment decisions, including:

Setting your alerts Acting on alarm/alerts Acting on trend arrows Looking at your home screen for your most G6 recent readings Using G6 readings Looking at the last 24 hours:

What decisions worked?

How can you improve?

11.4 When to Use Your Meter There are times when you need to rely on your meter instead of your G6. When in Doubt, Get Your Meter Out Anytime you look at your home screen and think, Oh! That isn't the number I thought I would see,use your meter to determine your BG value before making treatment decisions. Sometimes your symptoms dont match your G6 readings or they arent what you expect them to be. For example:

You dont feel your lows or highs Youre a caregiver and your 2-year-old is behaving differently from what youd expect from their sensor number Youre new to diabetes and arent sure what your bodys telling you Dexcom G6 System User Guide Chapter 11: Treatment Decisions 175 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 175 2/5/19 9:26 AM WARNING Dont Ignore Low/High Symptoms Dont ignore how you feel. If your glucose alerts and G6 readings dont match what youre feeling, use your blood glucose meter (meter) to make diabetes treatment decisions or, if needed, seek immediate medical attention. When in doubt, get your meter out. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. When that happens, treat if you need to. Then if you want, calibrate to align your sensor with your meter. If you do calibrate, make sure you wash and dry your hands before taking a fingerstick. No Arrow, No Number, No G6 Treatment Decisions To make a treatment decision, make sure all the information is on your G6. Anytime you dont have a number and arrow on your home screen, use your meter to get a value to make treatment decisions. If your home screen shows Signal Loss or Low or High instead of a G6 reading, use your meter. Arrow Number 150 mg/dL You may have a number but not an arrow or vice versa. If that happens, use your meter. Dexcom G6 System User Guide Chapter 11: Treatment Decisions 176 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 176 2/5/19 9:26 AM WARNING No Number, No Arrow, No CGM Treatment Decision If your G6 doesnt show a number or arrow, or your G6 readings dont match your symptoms, use your meter to make diabetes treatment decisions. No number, no arrow, no treatment decision. When in doubt, get your meter out. Follow G6 instructions. If you dont, you could miss a severe low or high glucose event. 11.5 Watch and Wait Be patient. Insulin takes time to work. When your BG is high, think about when you last took insulin. Rapid-acting insulin doesnt start working until 15-30 minutes after dosing. It works best 1 or 2 hours later and stays in your system about 4 hours. If you take another corrective insulin dose within that time frame or stack insulin it could result in low BG. Watch and wait instead. Dont worry If you take insulin to cover what you eat, you aren't stacking insulin. And you do want to respond to a high G6 reading between meals; just be careful not to overcorrect. Talk with your HCP about what you should do if youre high between meals. 11.6 Using Your G6 for Treatment Decisions Alarm/Alerts Just got a G6 reading alarm/alert? You probably need to make a treatment decision!

Your HCP can help you set your alerts. Determine why you want to set an alert at a specific level. Do you want to know when you have gone too high or low? Or perhaps you want to set it at level where you typically make a treatment decision, like taking insulin. Find a good balance between getting too many High and Low Alerts and not having enough time to prevent a high or low when you get one. Talk with your HCP about your settings and how you should change them over time. Dexcom G6 System User Guide Chapter 11: Treatment Decisions 177 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 177 2/5/19 9:26 AM Trend Arrows Arrows show the speed and direction of your G6 readings so you can see where youre heading. Work with your HCP and use them to guide how much insulin to take. In general, with a down arrow, consider using less insulin, and with an up arrow, more. Remember it takes time for your insulin to work. Dont stack insulin by giving too much insulin in too short a period. Sometimes its best to watch and wait!

Below is an overview on how to use your trend arrows to fine-tune your treatment decisions, whether youre low, high, or in your target range. Treatment Decisions: Steady Arrow Actions to consider when you're:

Low: Eat High: Watch and wait if you took insulin recently. Otherwise, adjust insulin dose up In target range: No action needed Treatment Decisions: Arrows Going Up Actions to consider when you're:

Low: Watch and wait High: Watch and wait if you took insulin recently. Otherwise, adjust insulin dose up In target range: Watch and wait if you took insulin recently. Otherwise, adjust insulin dose up Dexcom G6 System User Guide Chapter 11: Treatment Decisions 178 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 178 2/5/19 9:26 AM Treatment Decisions: Arrows Going Down Actions to consider when you're:

Low: Eat. Did you have too much insulin or exercise?

High: Watch and wait. Did you have too much insulin or exercise?

In target range: Eat Treatment Decisions: No Arrow No arrow means you cant use your G6 to make a treatment decision. Use your meter. 11.7 Check In With Jake and Kelly How do you use the trend arrow? Lets check in with Jake and Kelly to see how they use it to fine-tune their treatment decisions. Hey Jake here! My G6 reading is 330 with an up arrow right now. Thats high for me. Im trying to figure out what to do. An hour ago, I ate lunch and took insulin for it. Dexcom G6 System User Guide Chapter 11: Treatment Decisions 179 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 179 2/5/19 9:26 AM I dont want to insulin stack, but I also dont want to be high for too long. I bet the insulin just hasnt gotten into my system yet, so Ill just watch it to see if it comes down in the next hour or so. If Im still high in an hour, Ill consider taking more insulin. Hi its Kelly! Im at 120 and I feel fine. Im supposed to be between 80 and 220 mg/dL, so no worries! But check out my trend arrow! Double down!

Yikes! That will take me down to 75 in 15 minutes!

Mom! I need some OJ!

Takeaway Your trend arrows point the way your number is heading. Use your trend arrow with your number to fine-tune your diabetes management decisions, like Jake and Kelly. Dexcom G6 System User Guide Chapter 11: Treatment Decisions 180 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 180 2/5/19 9:26 AM 11.8 You Decide!

Its your turn! Chances are, the two scenarios below are familiar to you. What would you do in each? Compare your answer to the actions to consider. Keep in mind theres no one correct answer. Treatment decisions are based on a number of personal factors. Discuss any questions you have with your HCP. In Target Range, But Going Down Fast An hour ago, you drank orange juice to treat a low G6 reading. Although youre within your target range, as you sit down for dinner, you look at your G6 and see your trend arrow pointing down. Using the number and arrow below, what treatment decision would you make?

Actions to Consider:

Eat fast-acting carbohydrates and adjust insulin to correct for a low pre-meal blood sugar. Consider taking less insulin based on your immediate plans, since your trend arrow is going down. Dexcom G6 System User Guide Chapter 11: Treatment Decisions 181 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 181 2/5/19 9:26 AM High and Getting Higher Right before lunch you look at your display device. The home screen shows your G6 reading is 150 mg/dL with a single arrow pointing up, so you know it is rising. After taking your normal insulin dose, you eat lunch. About 90 minutes later, you get a High Alert. Your display devices show your sensor glucose at 207 mg/dL with a single arrow going up. Not only is your glucose high, it is also rising. Using the number and arrow below, what treatment decision would you make?

Actions to Consider:

Watch and wait or consider taking a small correction dose because your glucose is still trending up. You know the insulin you took at dinner may not have fully kicked in, but your blood glucose is continuing to climb. General Guidelines During your daily life with diabetes, its important to learn from your treatment decisions: What worked to get you back to your target range and what kept you from reaching your target range? Think about why you were high or low. For lows:

Did you take too much insulin for a meal or snack?

Did you take too much insulin to correct for a high glucose level?

Did exercise lower your glucose levels?

Did you drink alcohol?

Did you accurately count carbohydrates?

Did you take too much insulin in too short a period?

Dexcom G6 System User Guide Chapter 11: Treatment Decisions 182 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 182 2/5/19 9:26 AM For highs:

Did you take too little insulin for a meal or snack?

Did you take too little insulin to correct a high glucose level?

Did your mood or stress levels change?

Did you think about what medications youre on?

Did you accurately count carbohydrates?

Did you give insulin earlier to help avoid post-meal high glucose levels?

These are just a few things to think about when learning how to make treatment decisions. Your HCP can help you personalize your specific diabetes management and treatment plan. Keep notes and share them with your HCP. 11.9 What Was Covered and Whats Coming Now You Can:

Talk with your HCP about creating a personalized treatment plan Identify when you can use your G6 in treatment decisions Describe the importance of alarm/alerts in treatment decisions Tell when you shouldnt make a treatment decision using the G6 Recognize when you should watch and wait before treating Whats Next?

Next lets talk about how to share your glucose information. Dexcom G6 System User Guide Chapter 11: Treatment Decisions 183 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 183 2/5/19 9:26 AM Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 184 2/5/19 9:26 AM Chapter 12 | App: Sharing Information With Your Support Team With the Share app, up to five people can follow you current Dexcom G6 Continuous Glucose Monitoring System (G6) readings and trends. Your loved ones will have more peace of mind, and so will you!

12.1 Introduction After this chapter, youll be able to:

Identify Share components Identify Share status by icon color Set up Share Invite Followers Determine which CGM information to share Change Follower settings Tell Followers how to set up Follow 12.2 Share and Follow Overview From your app, set up Share and invite up to five people (your Followers) to view your current G6 readings and trends. You control what information is shared, from just your current number and arrow to your whole trend graph. Part of setting up Share is inviting people to follow you. After receiving your invitation, they download the Dexcom Follow app from the app store. As long as your Follower has an internet connection, theyll receive your glucose data. Share helps your Followers support you. Remember, there are times when Share information may be out of sync with your G6 information. If your Follower lost their internet connection, there would be a gap in them receiving your information during that time. Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 185 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 185 2/5/19 9:26 AM Always depend on your G6 app to manage your diabetes, not your Followers. For example, a Follower contacted you saying you need to treat they saw you were trending low. Always confirm your glucose information on your app, receiver, or blood glucose meter, before making any treatment decision. Share isnt available on the receiver. Smart Devices for You and Followers For a list of compatible devices, go to: dexcom.com/compatibility. Recommended Settings When using Share or Follow, remember:

Battery: Keep display devices charged Internet:

Connect smart devices to the internet Airplane Mode is off You opted-in to send data to the cloud Voice and data at the same time:

Do the cellular service carriers support voice and data at the same time

(simultaneous voice and data)?

If not, Share wont send data during phone calls. Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 186 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 186 2/5/19 9:26 AM When your phone call is over, Share will fill in any missing glucose information Share and Follow wont work if there is no internet connection or if there is something wrong with the smart device. Refer to your smart devices instructions for troubleshooting. Set Up Share Follow the Share setup wizard:

STEP 1 of 11 Set Up Share STEP 2 of 11 Set Up Share Tap Share icon to start. Tap Lets Get Started. Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 187 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 187 2/5/19 9:26 AM STEP 3 of 11 Set Up Share Tap Next. Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 188 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 188 2/5/19 9:26 AM STEP 4 of 11 Set Up Share Android: In the next two screens, you give permission for the app to run in the background. Tap I Understand, then Yes. Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 189 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 189 2/5/19 9:26 AM STEP 5 of 11 Set Up Share Tap Next. Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 190 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 190 2/5/19 9:26 AM STEP 6 of 11 Set Up Share Tap Lets Get Started. Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 191 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 191 2/5/19 9:26 AM STEP 7 of 11 Set Up Share First, invite someone to become your Follower. Share then sends an invitation email. After opening the email on their smart device, your Follower installs the Dexcom Follow app. Tap Invite Followers. STEP 8 of 11 Set Up Share Enter the Followers nickname, email address, and confirm email address. They must open your email and install the Dexcom Follow app on the device theyll use to follow you. Tap Next. Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 192 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 192 2/5/19 9:26 AM STEP 9 of 11 Set Up Share Do you want your Follower to see your past G6 readings on a graph? If not, tap switch to turn off. Tap Next. Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 193 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 193 2/5/19 9:26 AM STEP 10 of 11 Set Up Share Your Follower gets your Urgent Low Alarm when your G6 reading is at or below 55 mg/dL. Dont want to share this? Tap Urgent Low switch to off. All other alerts are off by default. If you want your Follower to get notified, turn the alerts on in the Followers Settings menu. Their alert notifications are separate from your own Low and High Alerts. If youre sharing with a Follower, the Follower has access to your G6 readings and can also set up their own notifications. You pick what your Follower can see in the Follower Settings screen, however, they can change their settings. For example, you set up Share to notify your Follower when your G6 readings go below 90 mg/dL for more than half an hour. Your Follower can change it to notify themselves when your G6 reading goes below 75 mg/dL for 45 minutes. If your Follower doesnt get any data for an hour, theyll be notified there is some type of communication problem. Tap the No More Data switch or the For More Than to customize these settings. Tap Next. Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 194 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 194 2/5/19 9:26 AM STEP 11 of 11 Set Up Share Review Followers settings. Tap Send Invitation. Finished!

Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 195 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 195 2/5/19 9:26 AM Manage Followers Follower Status The Followers List shows the status of your Followers and lets you invite new ones. Followers List Icons Invite New Follower Follower Didnt Accept Invitation Yet Follower Didnt Accept Invitation Within 7 Days. To re-invite, tap Add Follower. Follower Gets Notification(s) Follower Sees Trend Graph Follower Stopped Following You Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 196 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 196 2/5/19 9:26 AM Are You Sharing?

For your Followers to get your information, make sure you opted-in to send data to the cloud, Sharing is on, and your Share app is connected to the internet. If it isnt connected to the internet, you wont have any active Followers. When connected, your sensor information is shared with your Followers. No Active Followers Share is On See Chapter 14 for information on troubleshooting Share and Follow. Editing and Removing Followers Tap a Follower to remove them, edit their nickname, or stop or start sharing your graph. Remove a Follower by tapping Remove Follower. Once removed, they wont get glucose information or notifications. Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 197 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 197 2/5/19 9:26 AM Start or Stop Sharing Turn off the Sharing switch to temporarily stop sharing with your Followers. While Sharing is off, they wont get G6 readings or notifications. Their dashboard shows you stopped sharing. To restart sharing, tap the On switch. Dexcom Follow Follow Description To share your information, your Follower must download the Dexcom Follow app and have internet connection. Your Share invitation includes a link to the app, or they can download it from their smart devices app store. Recommended Settings To set up and run Follow, use these tips:

Battery: Keep display devices charged Internet:

Smart devices are connected to the Internet Airplane Mode is off Volume:

Do Not Disturb is off Sound is on Voice and data at the same time: Do the cellular service carriers support voice and data at the same time (simultaneous voice and data)? If not, Share wont send data during phone calls When your phone call is over, Share will fill in any missing glucose information Share and Follow wont work if there is no internet connection or if there is something wrong with the smart device. Refer to your smart devices instructions for troubleshooting. Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 198 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 198 2/5/19 9:26 AM Follow Setup Follower gets and opens your email invitation on the smart device theyll use to follow you. They install and set up the Dexcom Follow app on their smart device. Now your Follower sees your sensor information!

They will also see when you turn off Share, if they have been deleted, or if sharing stops for any another reason. If sharing stops due to communication issues, you wont know unless your Follower tells you. What Followers See Remember, you can share just your number and arrow, or, also include your graph. Number and Arrow Only Sharers Picture 1 Last Updated Trend Arrow Sensor Reading Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 199 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 199 2/5/19 9:26 AM Trend Graph Home Icon Sharers Picture Sensor Reading High Alert Level Low Alert Level Sharers Name 1 Settings Icon Last Updated Trend Arrow History Shown Trend Graph Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 200 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 200 2/5/19 9:26 AM Readings Below 20 mg/dL and Above-600 mg/dL Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 201 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 201 2/5/19 9:26 AM Your Follower can customize notifications. For example, they want to change their settings so they can know when you go below 70 mg/dL for more than 30 minutes. They can also change it to get notified every 2 hours if you stay under 70. Follower Notification Settings Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 202 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 202 2/5/19 9:26 AM 12.3 Check In With Jake and Kelly How does having your loved ones know your CGM information affect your day-to-day life? Lets check in with Jake and Kelly to see how it works for their support teams. Hi Jake here! Vegas rocks! I was there last weekend for a bachelor party for one of my buddies. Saturday night, some of us were playing blackjack at the casino. I noticed I was low and dropping. I planned to just finish off the Blackjack hand I was playing and then get some food, but the groom came by and we started talking so I played an extra hand or two. Basically, I got distracted. Dont judge me theres a lot to be distracted by in Vegas!

Ten minutes must have passed, and my phone started buzzing with texts. Three of my Followers were texting me, telling me to check my Dex, get food, and text them back that I was OK. I checked and they were right Oops. My bad. Id dropped. I popped a couple of glucose tabs, excused myself from my friend and the blackjack table, went straight to the casinos store, and texted everyone back once Id bought a snack. Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 203 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 203 2/5/19 9:26 AM Hi its Kate, Kellys mom. I just got off the phone with her school principal. He called because Kelly fell on the playground and scraped herself up. Nothing a few Band-Aids wont cover, but shes upset. Shed like to talk to you. Of course, the first thing I did was check Follow so I could see what her number and arrow said. Was this a collapse because she was too low? Thank goodness, she was 120 and steady well within her target range. She was crying when he put her on the phone. With the Follow information, I didnt need to start the conversation telling her to get a BG value and grilling her about when she last ate and whether her pump was working (although, I did ask the principal to help confirm my Follow information matched her current G6 reading since it may have changed). It was so great to be able to just be her mom, not her diabetes care police. Sweetheart! Im so sorry youre hurt! Mr. Wong told me hes going to get you some ice for your knee. Sit down honey and tell me what happened!

Takeaway When your loved ones know your numbers, they dont need to ask about them. With Follow, they can be your loved ones when thats what you need and be your support team only when you need it!

Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 204 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 204 2/5/19 9:26 AM 12.4 What Was Covered and Whats Coming Now You Can:

Identify Share components Identify Shares status by icon color Set up Share Invite Followers Determine which CGM information to share Change Follower settings Tell Followers how to set up Follow Whats Next?

In the next chapter, youll learn how to end a typical 10-day sensor session, along with removing the sensor and transmitter. Dexcom G6 System User Guide Chapter 12: Share Information with Your Support Team 205 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 205 2/5/19 9:26 AM Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 206 2/5/19 9:26 AM Chapter 13 | End Sensor and Transmitter Sessions 13.1 Introduction This chapter reviews what to expect when your sessions end and how to remove the sensor and transmitter. After this chapter, youll be able to:

Identify Replace Sensor notifications at the end of your sensor session Remove your sensor and save your transmitter if needed Replace and pair transmitter 13.2 End Your Sensor Session When your 10-day sensor session is almost over, you get notifications letting you know your sensor session is ending. Before you start a new sensor session, you must remove your existing sensor. Notifications for End of 10-Day Sensor Session 6 Hours, 2 Hours, and 30 Minutes Ahead App: Open app to confirm. Receiver: Tap OK to confirm. What it means:

Notifications let you know your sensor session is ending soon. You get three notifications before the session ends: 6 hours before (shown below), 2 hours before, and 30 minutes before Clock counts down until session ends Continue to get alarm/alerts and G6 readings You can end session early or wait Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 207 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 207 2/5/19 9:26 AM App Notification App Receiver Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 208 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 208 2/5/19 9:26 AM Sensor Session Over App: Open app to confirm. Receiver: Tap OK to confirm. What it means:

Sensor session is over You wont get alarm/alerts or Dexcom G6 Continuous Glucose Monitoring System

(G6) readings until you replace sensor App Notification App Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 209 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 209 2/5/19 9:26 AM Receiver Sound and Vibration Prompts Both the smart device and receiver beep/vibrate to remind you your sensor session will end in 30 minutes, it has just ended, or your sensor failed and you need to start a new session. The initial notification is one vibration. If not confirmed, you receive a vibration and beep twice, 5 minutes apart. Once a sensor session has expired, remove your sensor and then start a new session. 13.3 Remove Sensor and Transmitter When you remove your sensor, your transmitter comes off too. Remember, your transmitter is reusable; dont throw it away until its battery has died. It has a battery life of 90 days, so you can use the same transmitter over a number of sensor sessions. You receive notifications as it nears the end of its battery life. PRECAUTION Reuse Dont Throw Away When ending a session, dont throw away the transmitter. The transmitter is reusable until the G6 notifies you that the transmitter battery is about to expire. Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 210 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 210 2/5/19 9:26 AM Remove Sensor and Transmitter STEP 1 of 5 Remove Sensor and Transmitter Pull patch off like a Band-Aid. The transmitter, holder, and sensor all come off with the patch. STEP 2 of 5 Remove Sensor and Transmitter Don't remove the transmitter from the holder until youve peeled the patch off your skin. Grasp the wide rounded edge of the holder. Bend holder edge down to break it and release the transmitter. Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 211 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 211 2/5/19 9:26 AM STEP 3 of 5 Remove Sensor and Transmitter Pull transmitter straight out. STEP 4 of 5 Remove Sensor and Transmitter Keep transmitter to use with next sensor. STEP 5 of 5 Remove Sensor and Transmitter Throw away patch, with the holder and sensor attached, following your local guidelines for disposal of blood-contacting components. Finished!

Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 212 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 212 2/5/19 9:26 AM Start New Sensor Session After removing the sensor from your body and the transmitter from the transmitter holder, youre ready to start a new sensor session. You wont have to pair your transmitter to your display device. The transmitter stays paired to your display device until its battery life is over. Youll need to enter a new sensor code because the code is specific to each sensor. What it means:

Insert new sensor and start new sensor You wont get alarm/alerts or G6 readings until your sensor warmup is done App and Receiver Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 213 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 213 2/5/19 9:26 AM 13.4 End of Transmitter Battery The transmitter battery is good for up to 3 months. How do you know if your transmitter battery will last through your next session? If you havent received your final 10-day transmitter battery life warning, you can reuse the transmitter for your next session. Starting at 3 weeks before the end of its battery life, the warnings count down the transmitter battery life until it has only 10 days one sensor session left. If the transmitter battery has 10 days or less remaining, you wont be able to start a new session. See Chapter 14 Troubleshooting for more information. Transmitter Sound/Vibration Notifications In case you cant look at your screen, both the smart device and receiver provide beeps/vibrations to tell you your transmitter battery is low or the transmitter failed. App: Your smart device notifies you with a triple beep. If not cleared, you receive the triple beep twice, 5 minutes apart Receiver: The receiver initially notifies you by vibrating. If not cleared, you receive a vibration/beep twice, 5 minutes apart See Appendix H for information about notifications that sound while smart device is silenced/muted. 13.5 Pair New Transmitter You get a notification when the transmitter battery has died or the system detects a problem. The system guides you through pairing your new transmitter:

1. Enter your sensor code and transmitter SN 2. Insert sensor, attach transmitter, and wait for pairing confirmation. 3. Start your new sensor session Remember, if you use both display devices, make sure you start the sensor session in one before pairing the transmitter in the other. Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 214 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 214 2/5/19 9:26 AM App: Pair New Transmitter STEP 1 of 5 App: Pair New Transmitter Tap OK. Or go to Settings > Transmitter. Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 215 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 215 2/5/19 9:26 AM STEP 2 of 5 App: Pair New Transmitter Tap Pair. Or Pair New. Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 216 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 216 2/5/19 9:26 AM STEP 3 of 5 App: Pair New Transmitter Enter Sensor Code just like you have in earlier sensor sessions. Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 217 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 217 2/5/19 9:26 AM STEP 4 of 5 App: Pair New Transmitter After entering your sensor code, enter transmitter SN. Enter transmitter SN by either taking a photo of the barcode on your box, or entering it manually. Photo instructions:

a. Get your transmitter box. Tap Take Photo. b. Turn transmitter box so barcodes face up. c. Checkmark confirms you entered the SN correctly. Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 218 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 218 2/5/19 9:26 AM Manual instructions:

a. Tap Enter Manually. b. Use keyboard to enter transmitter SN. Find your transmitter SN on the transmitter box or the back of the transmitter. c. Confirm correct SN. Tap Save. d. Checkmark confirms you entered SN correctly. Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 219 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 219 2/5/19 9:26 AM STEP 5 of 5 App: Pair New Transmitter Insert sensor, attach transmitter, wait for your pairing confirmation, then start your new sensor session. If you want to, youre now ready to pair the transmitter to your receiver. See Chapter 6 for more information. Finished!

Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 220 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 220 2/5/19 9:26 AM Receiver: Pairing New Transmitter If you are pairing two display devices, make sure you have done all of the steps, including starting a new sensor session, in one before pairing a new transmitter in the other. Just like the app, follow onscreen prompts to pair a new transmitter or go to Menu > Settings > Transmitter > Pair New. System lets you know when its time to pair a new transmitter. STEP 1 of 7 Receiver: Pairing New Transmitter Tap OK. Or Menu > Settings > Transmitter. STEP 2 of 7 Receiver: Pairing New Transmitter Tap Pair. Or Menu > Settings > Transmitter > Pair New. Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 221 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 221 2/5/19 9:26 AM STEP 3 of 7 Receiver: Pairing New Transmitter Enter Sensor Code just like you have in earlier sensor sessions. STEP 4 of 7 Receiver: Pairing New Transmitter After entering your sensor code, enter transmitter SN. Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 222 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 222 2/5/19 9:26 AM STEP 5 of 7 Receiver: Pairing New Transmitter Find transmitter SN on back of box or transmitter. STEP 6 of 7 Receiver: Pairing New Transmitter Enter your transmitter SN. Tap Save. Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 223 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 223 2/5/19 9:26 AM STEP 7 of 7 Receiver: Pairing New Transmitter Insert sensor, attach transmitter, wait for your pairing confirmation, then start your new sensor session. See Chapter 6 for more information. If you have already paired your transmitter and started a sensor session in another device, you will join the current session. Finished!

13.6 What Was Covered and Whats Coming Now You Can:

Identify Replace Sensor and Transmitter notifications at the end of your sensor session Remove your sensor and save your transmitter if needed Replace and pair transmitter Whats Next?

In the next chapter, well talk about solutions to common issues. Dexcom G6 System User Guide Chapter 13: End Sensor and Transmitter Sessions 224 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 224 2/5/19 9:26 AM Chapter 14 | Troubleshooting 14.1 Introduction Patch not sticking? Notification wont go away? Not getting your Dexcom G6 Continuous Glucose Monitoring System (G6) readings? This chapter will help you figure it out!

Troubleshooting sections are categorized by function or system component. The solutions here are meant to be brief and not all-inclusive. References to specific chapters means more detailed answers or preventative measures are explained there. After looking at this chapter, are you still not sure what to do? If your problem isnt listed, or the solution here doesnt fix it, contact Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 These issues are grouped by function or component. Find for your issue below, then read about how to fix it. 14.2 Alarm/Alerts and G6 Readings Missing Lows: Getting Either Low Alert or No Urgent Low Soon Alert, Not Both Problem Getting Low Alert, then not getting Urgent Low Soon Alert when nearing 55 mg/dL Getting Urgent Low Soon Alert, then not getting Low Alert when your G6 reading reaches Urgent Low level Dexcom G6 System User Guide Chapter 14: Troubleshooting 225 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 225 2/5/19 9:26 AM Solution Its working the way it is supposed to. Depending on how soon youll be at 55 mg/dL, you either get your Urgent Low Soon Alert or your Low Alert:

At 55 mg/dL within 20 minutes? You get the Urgent Low Soon Alert. Not that fast but going lower than your Low Alert setting? You get the Low Alert. If you get one of these alerts, you wont get the other alert for 30 minutes. See Chapter 10. Alarm/Alerts Sound While Display Device Is Muted/

Silenced Is your smart device muted/silenced? To make sure you do not miss a high or low, your alarm/alerts sound anyway. Exception: If your Apple smart device is silenced, you will not get the Signal Loss alert. Cannot Hear Alarm/Alerts Your display device beeps, vibrates, and displays a message when you first get an alarm/alert. If you cannot hear your alarm/alerts on your app, verify that the app, Bluetooth, volume, and notifications are on. If you restart your smart device, reopen the Dexcom app. If you cannot hear your alarm/alerts on your receiver, change your alarm/alerts sounds in Menu > Sounds. Use Menu > Sounds > Test Now to try out the selected sound to make sure you can hear it easily. Dexcom G6 System User Guide Chapter 14: Troubleshooting 226 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 226 2/5/19 9:26 AM No G6 Readings: No Readings Alert Problem Not getting G6 readings for the last 20 minutes Solution No glucose alarm/alerts or G6 readings until fixed. Use meter. In app, tap alert to get more information. Check transmitter: Is it snapped into the holder?

Wait up to 3 hours while the system fixes itself. If not corrected after 3 hours, contact Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 App Notification App Dexcom G6 System User Guide Chapter 14: Troubleshooting 227 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 227 2/5/19 9:26 AM Receiver No G6 Readings: Sensor Error Problem Not getting G6 readings Solution No glucose alarm/alerts or G6 readings until fixed. Use meter. Tap alert to get more information. Make sure your sensor is secure and your transmitter is snapped flat in its holder. Wait up to 3 hours while the system fixes itself. If not corrected after 3 hours, youll see Sensor Failed. Contact Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 App Dexcom G6 System User Guide Chapter 14: Troubleshooting 228 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 228 2/5/19 9:26 AM Receiver No G6 Readings: Sensor Failed Alert Problem Not getting G6 readings Solution No glucose alarm/alerts or G6 readings. Use meter. Tap alert to get more information. If your sensor doesnt work, contact Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 App Notification Dexcom G6 System User Guide Chapter 14: Troubleshooting 229 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 229 2/5/19 9:26 AM App Receiver Dexcom G6 System User Guide Chapter 14: Troubleshooting 230 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 230 2/5/19 9:26 AM

No G6 Readings: Signal Loss Alert Problem Not getting G6 readings Display device and transmitter not connecting Solution Use meter. No glucose alarm/alerts or G6 readings until fixed. For more information see Chapter 10. Tap alert to get more information. Keep your transmitter and display device within 20 feet of each other. Wait 30 minutes. App:

If that doesn't work, turn Bluetooth off and on. Wait 10 minutes. If that doesn't work, restart the smart device and reopen the Dexcom app. Wait up to 30 minutes. System may correct problem itself and continue to show G6 readings. More than 30 minutes? Contact Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 Dexcom G6 System User Guide Chapter 14: Troubleshooting 231 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 231 2/5/19 9:26 AM App Notification App Receiver PRECAUTION Keep Transmitter Close to Display Device Keep your transmitter and display device within 20 feet with no obstacles (like walls or metal) between them. Otherwise, they might not be able to communicate. If water is between your transmitter and the display device for example, if youre showering or swimming keep them closer to each other. The range is reduced because Bluetooth doesnt work as well through water. Follow G6 instructions. If you dont, you could miss a severe low or high glucose event. Dexcom G6 System User Guide Chapter 14: Troubleshooting 232 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 232 2/5/19 9:26 AM No G6 Reading: Low or High Instead of G6 Reading Problem System shows Low or High instead of G6 reading Solution System is working as it should. Use your meter and treat your high or low. When your G6 reading is between 40 and 400 mg/dL your G6 will display your G6 reading instead of Low or High. Below 40 mg/dL Above 400 mg/dL Dexcom G6 System User Guide Chapter 14: Troubleshooting 233 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 233 2/5/19 9:26 AM Receiver Only: Cant See Screen Because of Lock Screen Problem Information is blocked by lock screen Solution It's working the way it is supposed to. Your receiver screen locks so you dont accidentally change something without noticing it. Tap 1 then 2 to unlock the lock screen. If you dont tap quickly, or you tap several times outside the buttons, the screen goes to sleep. Receiver Dexcom G6 System User Guide Chapter 14: Troubleshooting 234 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 234 2/5/19 9:26 AM 14.3 Applicator Orange Button Stuck Problem Cant push the applicator orange button in Solution Fold and break off safety guard before pushing orange button See Chapter 6 Dexcom G6 System User Guide Chapter 14: Troubleshooting 235 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 235 2/5/19 9:26 AM Adhesive Backing Wont Come Off Problem Backing wont come off the patch Solution Lift the backing by the tab Dexcom G6 System User Guide Chapter 14: Troubleshooting 236 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 236 2/5/19 9:26 AM Adhesive Patch Wont Stick Problem The adhesive patch wont stay on your skin for the entire sensor session Solution Before applying sensor: Use an optional skin adhesive (such as Mastisol or SkinTac) After applying sensor: Put overpatch or tape over patch Order overpatches at dexcom.com/order Tape brand names include Blenderm, Tegaderm, Smith & Nephew IV3000, and 3M See Chapter 5 Applying Overpatch Applying tape Dexcom G6 System User Guide Chapter 14: Troubleshooting 237 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 237 2/5/19 9:26 AM Applicator Sticks to You Problem The applicator wont come off your skin after you push the button to insert the sensor Solution Dont panic!

Remove applicator and adhesive patch:

1. Gently pull applicator up until you see adhesive patch 2. Using your finger or thumb, hold front edge of patch and peel from skin Dexcom G6 System User Guide Chapter 14: Troubleshooting 238 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 238 2/5/19 9:26 AM 3. While holding the front edge of the adhesive patch, gently rock back applicator, away from your body 4. Check insertion site to make sure the sensor isnt left on the skin 5. Dont try to reuse applicator 6. Contact Sales Support:

Email: CustomerService@dexcom.com Toll free: 1.888.738.3646 Toll: 1.858.200.0200 Dexcom G6 System User Guide Chapter 14: Troubleshooting 239 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 239 2/5/19 9:26 AM 14.4 App Cant Download App Problem You got a new smart device and cant download the Dexcom app Solution Check dexcom.com/compatibility for a list of smart devices that work with the G6 app. If it's a compatible device, and youre not using your receiver, stop your sensor session on your current smart device. See Chapter 13. Install the app on your new smart device. See Chapter 5. Follow the app screens to get the app set up on your new smart device. Your glucose history and settings will display on your new smart device. 14.5 Receiver Wont Turn On Battery Dead Problem The receiver wont turn on because the battery is dead Solution Charge receiver using electrical outlet, not computer/laptop Full charge may take up to 3 hours Dexcom G6 System User Guide Chapter 14: Troubleshooting 240 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 240 2/5/19 9:26 AM Wont Turn On Battery Charged Problem The receiver wont turn on but battery is fully charged Solution See Chapter 5 Reset receiver:

Press and hold power button for 10 seconds Release power button Press and hold power button for 2 seconds to turn back on Connect receiver to charger this turns it on Dexcom G6 System User Guide Chapter 14: Troubleshooting 241 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 241 2/5/19 9:26 AM Cant See Screen Change Brightness Problem The receiver screen is too dim or bright Solution Go to Menu > Brightness and change it. No Beep or Vibration Speaker Test Problem Dont hear or feel alarm/alerts or notifications Solution Test your speaker and vibrations using steps below. If receiver speaker/vibrations dont work, you wont hear alarm/alerts. Use app until issue is fixed. Contact Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 Dexcom G6 System User Guide Chapter 14: Troubleshooting 242 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 242 2/5/19 9:26 AM 1. Plug receiver into wall to charge. The light shows the receiver is charging. 2. Tap Test Now quickly before screen disappears. If screen disappears too quickly, go to first step. 3. Receiver will beep and vibrate. Listen for the beeps and feel for the vibrations. Is your receiver Sound set to Vibrate or Soft? If your speaker and vibrations work, this test makes your receiver beep and vibrate anyway. Dexcom G6 System User Guide Chapter 14: Troubleshooting 243 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 243 2/5/19 9:26 AM 4. Did your receiver beep and vibrate?

Yes? Tap Yes and go to next step. No? Tap No and go to Step 6. 5. Congratulations! You tested your speaker and vibrations and determined they work! Youll hear your alarm/alerts. Youre done. Dont go on to the next step. Dexcom G6 System User Guide Chapter 14: Troubleshooting 244 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 244 2/5/19 9:26 AM 6. Uh-oh. You tested your speaker and vibrations and determined that they dont work. You wont hear alarm/alerts. Contact Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 Use app until issue is fixed. Tap Try Again to retry and go to Step 3. Or, tap Cancel to return to your Home screen. PRECAUTION Test Speaker and Vibrations You have to hear or feel alarm/alerts to react to them, so test your receiver speaker and vibrations regularly. To make sure the speaker and vibrations work, plug in the receiver to charge. The Speaker Test screen appears for a few seconds. Follow the directions on the screen to test the speaker and vibrations. If you hear and feel them, great! But if it doesnt beep and vibrate perhaps it got wet or was dropped contact Technical Support and use your app until the receiver is fixed. Follow G6 instructions. If you dont, you could miss a severe low or high glucose event. Dexcom G6 System User Guide Chapter 14: Troubleshooting 245 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 245 2/5/19 9:26 AM Low Battery Problem Receiver displays low battery notification and icon. Appears when 20% remains

(shown below) and when 10% remains. Solution Charge receiver Prevention:

To conserve battery power, you can power off the receiver by tapping Menu >

Shutdown. You wont get alarm/alerts or G6 readings, but your sensor session remains active. When the receiver and transmitter reconnect after a temporary shutdown, Signal Loss, or similar issue, up to 3 hours of missed G6 readings can fill in on the graph. Shutting down the receiver does not extend your sensor session past the 10 days. Dexcom G6 System User Guide Chapter 14: Troubleshooting 246 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 246 2/5/19 9:26 AM Unexpected Dexcom Stripe Screen System Check Problem Dexcom stripe screen displays for no reason Solution Wait a few seconds If Dexcom stripe screen (see below) displays for more than 3 minutes, contact Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 Dexcom G6 System User Guide Chapter 14: Troubleshooting 247 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 247 2/5/19 9:26 AM System Check Passed Screen Problem System check results Solution Do nothing. Receiver recovered from an error and continues to work. Dexcom G6 System User Guide Chapter 14: Troubleshooting 248 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 248 2/5/19 9:26 AM Call Tech Support Screen Problem Screen is locked Solution Use your meter. No alarm/alerts or G6 readings until fixed. If same code displays again, write it down and contact Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 Dexcom G6 System User Guide Chapter 14: Troubleshooting 249 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 249 2/5/19 9:26 AM 14.6 Recalibration Alert Problem System didnt accept calibration Solution Use your meter. No alarm/alerts or G6 readings until fixed. Follow instructions on screen. It asks you to recalibrate in 15 minutes. For more information:

See Chapter 7. App: Tap Help. Receiver:

If you calibrate again and still get this error, enter one more meter value. Wait 15 minutes. If no G6 readings appear on the display, the sensor needs to be replaced. Contact Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 App Notification Dexcom G6 System User Guide Chapter 14: Troubleshooting 250 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 250 2/5/19 9:26 AM App Receiver Dexcom G6 System User Guide Chapter 14: Troubleshooting 251 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 251 2/5/19 9:26 AM 14.7 Transmitter Transmitter Not Found Alert Problem Transmitter didnt pair with display device Solution Use your meter. No alarm/alerts or G6 readings until fixed. Make sure Transmitter SN in Settings matches the Transmitter SN on the transmitter box. Make sure transmitter is snapped into holder. App: For more information, tap Help. If these solutions dont fix the issue, sensor may not be inserted correctly. Contact Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 App Notification Dexcom G6 System User Guide Chapter 14: Troubleshooting 252 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 252 2/5/19 9:26 AM App Receiver Dexcom G6 System User Guide Chapter 14: Troubleshooting 253 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 253 2/5/19 9:26 AM 14.8 Sensor Problem You need to end your sensor session early because of:

Personal reasons Error notifications telling you to end sensor session Unresolved calibration issues Error or wait screens that wont go away Sensor coming out of body WARNING Wire Breaks Off Dont ignore broken or detached sensor wires. A sensor wire could remain under your skin. If this happens, please contact our 24/7 Technical Support. If a sensor wire breaks off under your skin and you cant see it, dont try to remove it. Contact your HCP. Also seek professional medical help if you have symptoms of infection or inflammation redness, swelling, or pain at the insertion site. Follow G6 instructions. If you dont, you could miss a severe low or high glucose event. Solution If you see error notifications, before stopping a sensor session early, always contact Technical Support. If youre using both the app and receiver, you only need to stop the sensor session in one. The other display will know the session has stopped. To end the sensor session early in the app, go to Stop Sensor in the Settings menu. To end the sensor session early in the receiver, go to Stop Sensor in the Menu. Once stopped, you cant restart the current sensor session. After youve stopped your sensor, you can remove it. See Chapter 13 for detailed instructions. To get G6 readings, alarm and alerts, insert a new sensor and start a new sensor session. Dexcom G6 System User Guide Chapter 14: Troubleshooting 254 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 254 2/5/19 9:26 AM Stopping sensor problems Make sure:

Sensor hasnt expired You selected a good insertion site (see Chapter 6) Nothing is rubbing against transmitter holder, like a seatbelt or waistband Insertion site is clean and dry before sensor insertion Transmitter is snapped securely in transmitter holder Transmitter holder isnt dislodged and patch isnt peeling App Receiver 14.9 Share Troubleshooting Share Status Issues The Share status bar is a useful tool. It can help identify if theres a problem and Dexcom Share is not working. See below for troubleshooting tips for the Share status bar. Whether or not Dexcom Share is working and your Followers are getting glucose alarm/

alerts, always use your G6 display device for your G6 readings, alarm, alerts, and treatment decisions. Dexcom G6 System User Guide Chapter 14: Troubleshooting 255 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 255 2/5/19 9:26 AM No Active Followers Status Problem No Followers accepted your invitation or you havent invited anyone Solution If you invited a Follower, ask them to look for your invitation email Share App If the invitation expired, re-invite them by tapping Add Follower (see Chapter 12). If they stopped following you, their status shows Removed. If you turn off sharing for a Follower, their status shows Paused. Dexcom G6 System User Guide Chapter 14: Troubleshooting 256 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 256 2/5/19 9:26 AM Server Unavailable Status Problem Share isnt sharing because Dexcom server is offline Solution Wait. Dexcom will fix the issue as soon as possible. For more information, contact your local Dexcom representative. Share App 14.10 Accuracy G6 Reading Meter Value Problem G6 reading and meter value dont match Solution Different body fluids give different numbers:

Meter measures glucose from blood. Sensor measures glucose from interstitial fluid. Calibrating may help align your G6 readings to your meter values. See Chapter 7. Dexcom G6 System User Guide Chapter 14: Troubleshooting 257 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 257 2/5/19 9:26 AM G6 Readings Do Not Match Symptoms Problem G6 readings don't match how you feel Solution Wash your hands with soap and water. Dry them. Then take a fingerstick with your meter. If your meter value matches your symptoms, use it to take treatment decisions. Calibrating may help align your G6 readings to your meter values. See Chapter 7. 14.11 Calibration Prompts Calibration Error/Recalibration Alert Problem Displays when you enter a calibration outside the expected range. Solution G6 needs you to calibrate. App Dexcom G6 System User Guide Chapter 14: Troubleshooting 258 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 258 2/5/19 9:26 AM Receiver 14.12 What Was Covered and Whats Coming Now You Can:

Troubleshoot a variety of issues. Whats Next?

Congratulations! Great job working your way through this guide! Make sure to check out the appendices for additional information that may be useful to you. And remember, you can always refer back to this guide as you get used to your G6 or if you have any questions in the future. Dexcom G6 System User Guide Chapter 14: Troubleshooting 259 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 259 2/5/19 9:26 AM Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 260 2/5/19 9:26 AM Warranty Care of G6 Peripherals Security and Air Travel Need Help? You're Not Alone 4Everything Else G6 Technical Information Alarm/Alert Sounds Label Symbols and Vibrations 2/5/19 9:27 AM Index LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 261 Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 262 2/5/19 9:27 AM Appendix A | Need Help? Youre Not Alone!

Dexcom has three support teams to help you, each with their own specialty:

Dexcom Technical Support Team Dexcom Patient Care Team Dexcom Sales Support Team A.1 Dexcom Technical Support Team This team helps you with all CGM system-related issues as well as software-related issues. They provide replacement units, resolve technical issues, and take product complaints. They dont offer medical advice. Contact Information Web: dexcom.com/tech-support Please include:

Patient name, date of birth, address, and phone number Description of technical problem What happened and when (date and time) Item SKU number and name (for example: applicator) Lot and/or serial numbers of problematic devices Your contact information (for example: call 555-555-5555 after 5 pm Pacific Time) Phone: Available 24 hours a day, 7 days a week Toll Free: 1.888.738.3646 Toll: 1.858.200.0200 Dexcom G6 System User Guide Appendix A: Need Help? You're Not Alone 263 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 263 2/5/19 9:27 AM A.2 Dexcom Patient Care Team The Dexcom Patient Care Team is a group of Certified Diabetes Educators (CDE) and Registered Nurses (RNs) offering you customer care and individualized education services around Dexcom CGM, including:

Product training both initial and ongoing (for example, how to use a specific feature) Regularly scheduled webinars at dexcom.com/web-based-education How to optimize your Dexcom CGM use Using Dexcom CGM reporting software and features, including interpreting reports Contact Information Internet: dexcom.com/dexcom-care Email: PatientCare@dexcom.com Please include:

Patient name and date of birth Your contact information (for example: call 555-555-5555 after 5 pm Pacific Time) Description of question or training needed Phone: Available Monday Friday, 5:30 am 8:00 pm PST (subject to change) Toll Free: 1.888.738.3646 Toll: 1.858.200.0200 Dexcom G6 System User Guide Appendix A: Need Help? You're Not Alone 264 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 264 2/5/19 9:27 AM A.3 Dexcom Sales Support Team The Dexcom Inside Sales Support Team helps with:

First-time orders and re-orders Tracking shipments Locating a local Dexcom representative Contact Information Internet: dexcom.com/order Email: CustomerService@dexcom.com Phone:

Toll Free: 1.888.738.3646 Toll: 1.858.200.0200 Fax: 1.877.633.9266 A.4 Corporate Internet: dexcom.com Address:

6340 Sequence Drive San Diego, CA 92121 Dexcom G6 System User Guide Appendix A: Need Help? You're Not Alone 265 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 265 2/5/19 9:27 AM Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 266 2/5/19 9:27 AM Appendix B | Security and Air Travel The Dexcom G6 Continuous Glucose Monitoring System (G6) can be a great travel companion you can go through metal detectors and hand-wanding and even keep your receiver on during your flight. B.1 Security Going through security often means you and your belongings go through a metal detector, x-ray machine, or even a body scanner. In this section, youll find out which are OK for your G6 components and which havent been tested and should be avoided. Security Equipment to Use Hand-wanding, pat-downs, visual inspection, and walk-through metal detectors: You can use any of these methods without worrying about damaging your G6 components, whether youre wearing or carrying them. Security Equipment to Avoid Body scanners: Dont go through an advanced imaging technology (AIT) body scanner, like the millimeter wave scanners. X-Ray machines: Dont put your G6 components through x-ray machines. Place all components in a separate bag before handing over to the Security Officer. For other medical supplies, such as medications, meters, and strips, check manufacturer instructions or the Transportation Security Administration (TSA) website. If youre concerned about the security equipment, the TSA requests you tell the Security Officer youre wearing a continuous glucose monitor and want to be hand-

wanded or get a full-body pat-down with a visual inspection of your sensor and transmitter. Let the Security Officer know you cant remove the sensor because its inserted under your skin. Dexcom G6 System User Guide Appendix B: Security and Air Travel 267 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 267 2/5/19 9:27 AM PRECAUTION Going Through Security Check Point When wearing your G6, ask for hand-wanding or full-body pat-down and visual inspection instead of going through the Advanced Imaging Technology (AIT) body scanner (also called a millimeter wave scanner) or putting any part of the G6 in the baggage x-ray machine. You can wear the G6 for the walk-through metal detector. If you do, use your meter for treatment decisions until you leave the security area. Because we havent tested every x-ray and scanner, we dont know if they damage the G6. Not sure what kind of machine it is? Be safe either ask the TSA officer, request hand-wanding, or request full-body pat-down. Follow G6 instructions. If you dont, you could have a severe low or high glucose event. B.2 On the Plane To use your smart device or receiver to get sensor glucose information while on the plane:

Smart device: Switch to airplane mode, then turn Bluetooth on Receiver: Keep receiver on Contact your airline for their policies. B.3 Still Have Questions?

Visit the TSA website at tsa.gov. Email: TSA-ContactCenter@tsa.dhs.gov Phone: 1.855.787.2227 Dexcom G6 System User Guide Appendix B: Security and Air Travel 268 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 268 2/5/19 9:27 AM Appendix C | Extend Your App With your Dexcom G6 Continuous Glucose Monitoring System (G6) app, you see notifications from your lock screen or smart watch. Not seeing any data? Open your app. C.1 Today View (Apple) Check your CGM information in the Today view, even when your smart device is locked. From the left edge of your Home or Lock screen, swipe right. To add G6 1. Scroll to the bottom 2. Tap Edit See your smart device instructions for details. Images below are representational only, your screen may look different. Today View Sensor Reading Trend Arrow Dexcom G6 System User Guide Appendix C: Extend Your App 269 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 269 2/5/19 9:27 AM Tap Show More to show your graph. Sensor Reading Trend Arrow Shows Past 3 hours High Alert Level Low Alert Level Current Reading Trend Graph Dexcom G6 System User Guide Appendix C: Extend Your App 270 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 270 2/5/19 9:27 AM C.2 Quick Glance (Android) Check your G6 on your lock screen or swipe down from the top. Quick Glance Drag down on the lower edge of Quick Glance to show your graph. Sensor Reading Trend Arrow High Alert Level Low Alert Level Trend Graph Current Reading Shown Past 3 hours Quick Glance is on by default. Turn it off in the app: Settings > Quick Glance. Dexcom G6 System User Guide Appendix C: Extend Your App 271 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 271 2/5/19 9:27 AM C.3 Smart Watches Check your G6 on your Apple or Android smart watch. Suggested Use Using a smart watch with your system may change how you get alarm/alerts. Your smart watch only communicates with your smart device, not the transmitter. You wont get alarm/alerts or G6 readings on your watch unless its connected to your smart device. Make sure you understand how you get notifications when a watch is connected. You must wear the watch to see alerts and feel their vibrations. In your smart device settings, make sure notifications are sent to both your smart device and watch. Dont disable or block notifications from the app. Waking up your watch updates your current CGM data from your smart device. There may be a brief delay before your watch app shows current information. Go to dexcom.com/compatibility to make sure your watch works with your G6. Apple Watch Setup (iPhone) To install the app, use the Watch app on your iPhone. See your watch instructions for details about installing apps. Dexcom G6 System User Guide Appendix C: Extend Your App 272 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 272 2/5/19 9:27 AM Android Wear Setup Using the Dexcom G6 watch face, check your G6 information. See your watch instructions for details. Android Wear Trend Arrow Sensor Reading Shown Past 3 hours High Alert Level Low Alert Level Current Time Trend Graph Current Reading Dexcom G6 System User Guide Appendix C: Extend Your App 273 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 273 2/5/19 9:27 AM Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 274 2/5/19 9:27 AM Appendix D | Take Care of Your G6 D.1 G6 Maintenance Applicator/Sensor Keep in sterile package until ready for use Dont use if sensor has expired May provide inaccurate Dexcom G6 Continuous Glucose Monitoring System

(G6) readings May be unsterile Expiration date is on package in year-month-day format Dont use lotions, sunscreen, insect repellent, or similar items on the sensor Transmitter Keep in box until ready for use. Check transmitter and dont use if damaged. Transmitter is reusable but cant be transferred to another person. Never share your transmitter. Transmitter is water resistant. Dont use lotions, sunscreen, insect repellent, or similar items on the transmitter. Between sessions, clean outside of the transmitter with isopropyl alcohol. Let dry before use or storage. When not in use:

Protect transmitter by returning to its packaging or another safe place. Store between 32F and 113F. Dexcom G6 System User Guide Appendix D: Take Care of Your G6 275 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 275 2/5/19 9:27 AM Receiver Check receiver casing. If cracked or damaged, dont use or you may get an electric shock. Dont open casing. Dont put anything in the casings openings. Keep receiver dry it is only splash resistant. Dont submerge in liquid. Dont spill fluids on receiver. Dont use lotions, sunscreen, insect repellent, or similar items on the receiver. Use the supplied case to protect receiver from bumps and falls. When putting case on, make sure the speaker holes align with receiver speaker. Keep battery charged. Only use Dexcom USB charging/download cable. To wipe off receiver, use a soft, dry, lint-free cloth. Dont use abrasive cloths, towels, paper towels, or similar items. Dont get moisture into any openings. Dont use aerosol sprays, solvents, alcohol wipes, or abrasives. Turn off and unplug from USB cable before wiping. All G6 Components To keep your G6 working safely, do not change any G6 component. Each part comes in its own package. Keep the packaging until you're no longer using its contents. Charging Receiver Battery The battery icon on the receiver status bar shows how much charge is left and notifies you when the battery is getting low. While the receiver is being charged, you continue to get your G6 readings if the transmitter and receiver are within 20 feet of each other. Dexcom G6 System User Guide Appendix D: Take Care of Your G6 276 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 276 2/5/19 9:27 AM Each charge lasts approximately 2 days. If your receiver battery was drained prior to charging, then after charging you may need to reset its time and date. If this is required, the system tells you to reset and takes you to the applicable screens. STEP 1 of 4 Receiver: Charging Battery Tap OK. STEP 2 of 4 Receiver: Charging Battery Plug Micro USB cable into Micro USB port and wall charger. Plug wall charger into electrical outlet. Dexcom G6 System User Guide Appendix D: Take Care of Your G6 277 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 277 2/5/19 9:27 AM STEP 3 of 4 Receiver: Charging Battery Light in upper right corner goes on when charging. When you plug in the receiver to charge, the Speaker Test screen displays. See Chapter 14 for more information. Tap Skip Test to return to the Home screen. Keep charging until home screen displays battery icon filled in. STEP 4 of 4 Receiver: Charging Battery Unplug wall charger from outlet when fully charged. Home screen displays battery icon filled in when battery is charged. Finished!

Dexcom G6 System User Guide Appendix D: Take Care of Your G6 278 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 278 2/5/19 9:27 AM Peripherals Parts: Use only Dexcom-supplied parts (including cables and chargers). Use of non-

Dexcom-supplied parts may affect safety and performance. Charging: Charge battery before each new sensor session. Battery can only be charged using the Dexcom adapter/wall charger dont use a computer port or an external USB hub. Only use the Dexcom cable and charger to charge the Dexcom receiver. Dont block access to the charger. Cable: Insert cable only as directed. Dont force cable into place. Check cable. Dont use if worn or damaged. There is no repair service available for any G6 parts. If you experience problems, report the issue to Technical Support (available 24/7) at:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 D.2 Storage Storing your G6 correctly helps prevents system failures. Sensor Keep in its sterile packaging until youre ready to use it. Store at temperatures between 36F and 86F. Storing outside this range may cause inaccurate G6 readings. May store sensor in refrigerator if its within temperature range. Store sensors in a cool, dry place. Dont store in parked car on a hot day or in freezer. Dexcom G6 System User Guide Appendix D: Take Care of Your G6 279 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 279 2/5/19 9:27 AM Transmitter Keep protected when not in use Store at temperatures between 32F and 113F Store between 10% and 95% relative humidity Receiver Keep protected when not in use Fully charge the battery before storing for over 3 months Store at temperatures between 32F and 104F Store between 10% and 95% relative humidity D.3 Checking System Information You can check your app or receiver for information about your CGM system any time. App: Check CGM Settings STEP 1 of 2 App: Check CGM Settings Tap Settings. Dexcom G6 System User Guide Appendix D: Take Care of Your G6 280 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 280 2/5/19 9:27 AM STEP 2 of 2 App: Check CGM Settings You can update and/or check:

CGM information: Insertion date and time, last calibration, transmitter SN, when sensor expires Software versions: Transmitter and receiver Support: Online help, account, and contact information Finished!

Dexcom G6 System User Guide Appendix D: Take Care of Your G6 281 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 281 2/5/19 9:27 AM Receiver: Check CGM Settings STEP 1 of 3 Receiver: Check CGM Settings Tap Menu. STEP 2 of 3 STEP 3 of 3 Receiver: Check CGM Settings Tap Settings. Receiver: Check CGM Settings You can update and/or check:

Alerts and sounds: Customize how and when you get alerts Transmitter information: Transmitter SN and battery life Sensor information: Insertion date and time; last calibration date, time, and value; when sensor expires Receiver information: Receiver SN and battery life D.4 System Disposal Different places have different requirements for disposing of electronics (receiver and transmitter) and parts that have come in contact with blood or other bodily fluids

(sensor). Follow your areas local waste management requirements. Dexcom G6 System User Guide Appendix D: Take Care of Your G6 282 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 282 2/5/19 9:27 AM Appendix E | Warranty Sometimes stuff happens. Dexcom has you covered!

This appendix covers our warranty information outlining what we cover and for how long. E.1 Dexcom Receiver Limited Warranty Whats Covered and for How Long?

Dexcom, Inc. (Dexcom) provides a limited warranty to the original purchaser (you or Purchaser) that the Dexcom receiver (the receiver) is free from defects in material and workmanship under normal use (Limited Warranty) for the period starting from the date of shipment to you and continuing for a year following the shipment date (Warranty Period). Note: If you received this receiver as a replacement for an in-warranty receiver, the Limited Warranty for the replacement receiver shall continue for the remaining Warranty Period on the original receiver, but the replacement is not subject to any other warranty. What Isn't Covered?

This Limited Warranty is based on the Purchaser properly using the CGM system in accordance with the documentation provided by Dexcom. You are not permitted to use the CGM system otherwise. Misusing the CGM system, improperly accessing it or the information it processes and transmits, jailbreaking your CGM system or cell phone, and taking other unauthorized actions may put you at risk, cause the CGM system to malfunction, are not permitted, and void your Limited Warranty. This Limited Warranty doesn't cover:

Defects or damage resulting from accident, misuse, abuse, neglect, unusual physical, electrical or electromechanical stress, modification of any part of the product, or cosmetic damage. Equipment with the ID number removed or made illegible. All surfaces and other externally exposed parts that are scratched or damaged due to normal use. Dexcom G6 System User Guide Appendix E: Warranty 283 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 283 2/5/19 9:27 AM Malfunctions resulting from the use of the receiver in conjunction with accessories, ancillary products, and peripheral equipment, whether hardware or software, not furnished or approved by Dexcom. Defects or damage from improper testing, operation, maintenance, installation, or adjustment. Installation, maintenance, and service of products or services other than the CGM system (which may be subject to a separate limited warranty), whether provided by Dexcom or any other party; this includes your cell phone or smart device and your connection to the Internet. A receiver which has been taken apart physically or which has had any of its software accessed in any unauthorized manner. Water damage to the receiver. The receiver is not water resistant. Do not get the receiver wet at any time. Dexcoms Obligations Under the Limited Warranty During the Warranty Period, Dexcom will replace, without charge to purchaser, any defective receiver. To return, you must send the receiver to an authorized Dexcom Technical Support Department. Make sure you package the receiver adequately for shipping. The return package needs to include:

Receiver Sales receipt or comparable substitute proof of sale showing the date of purchase Receiver serial number Sellers name and address Purchasers name and address for Dexcom to ship the replacement Dexcom G6 System User Guide Appendix E: Warranty 284 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 284 2/5/19 9:27 AM Contact Dexcom Technical Support Department for delivery information help:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 Upon receipt by Dexcom of a defective receiver covered by this Limited Warranty, Dexcom will promptly replace the defective receiver. If Dexcom determines the receiver isnt covered by this Limited Warranty, Purchaser must pay all shipping charges for the receivers return by Dexcom. Limits on Dexcoms Warranty and Liability Obligations The Limited Warranty described above is the exclusive warranty for the receiver, and in lieu of all other warranties, expressed or implied, either in fact or by operation of law, statutory or otherwise. Dexcom expressly excludes and disclaims all other warranties, express or implied, including without limitation any warranty of merchantability, fitness for a particular purpose, or non-infringement, except to the extent prohibited by applicable law. Dexcom shall not be liable for any special, incidental, consequential, or indirect damages, however caused, and on any theory of liability, arising in any way out of the sale, use, misuse, or inability to use, any Dexcom G6 Continuous Glucose Monitoring System (G6) or any feature or service provided by Dexcom for use with the Dexcom G6. These limits on Dexcoms warranty and liability obligations apply even if Dexcom, or its agent, has been advised of such damages and notwithstanding any failure of essential purpose of this Limited Warranty and the limited remedy provided by Dexcom. This Limited Warranty is only provided to the original Purchaser and cant be transferred to anyone else, and states Purchasers exclusive remedy. If any portion of this Limited Warranty is illegal or unenforceable by reason of any law, such partial illegality or enforceability shall not affect the enforceability of the remainder of this Limited Warranty. This Limited Warranty will be enforced to the maximum extent permitted by law. Dexcom G6 System User Guide Appendix E: Warranty 285 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 285 2/5/19 9:27 AM E.2 Dexcom Transmitter Limited Warranty Whats Covered and for How Long?

Dexcom, Inc. (Dexcom) provides a limited warranty to the original purchaser (you or Purchaser) that the Dexcom G6 transmitter (the transmitter) is free from defects in material and workmanship under normal use (Limited Warranty) for the period commencing on the date of first use by the original purchaser (the Date of First Use) and expiring three (3) months thereafter; provided, that, the Date of First use occurs within five (5) months of the date of shipment (or disbursement) of the transmitter to you (Warranty Period). Note: If you received this transmitter as a replacement for an in-warranty transmitter, the Limited Warranty for the replacement transmitter shall continue for the remaining Warranty Period on the original transmitter, but the replacement is not subject to any other warranty. What Isn't Covered?

This Limited Warranty is based on the Purchaser properly using the CGM system in a timely manner and in accordance with the documentation provided by Dexcom. You are not permitted to use the CGM system otherwise. Misusing the CGM system, improperly accessing it or the information it processes and transmits, jailbreaking your CGM system or cell phone, and taking other unauthorized actions may put you at risk, cause the CGM system to malfunction, are not permitted and void your Limited Warranty. This Limited Warranty doesn't cover:

Defects or damage resulting from accident, misuse, abuse, neglect, unusual physical, electrical or electromechanical stress, modification of any part of the product, or cosmetic damage. Equipment with the ID number removed or made illegible. All surfaces and other externally exposed parts that are scratched or damaged due to normal use. Malfunctions resulting from the use of the transmitter in conjunction with accessories, ancillary products, and peripheral equipment, whether hardware or software, not furnished or approved by Dexcom. Dexcom G6 System User Guide Appendix E: Warranty 286 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 286 2/5/19 9:27 AM Defects or damage from improper testing, operation, maintenance, installation, or adjustment. Installation, maintenance, and service of products or services other than the CGM system (which may be subject to a separate limited warranty), whether provided by Dexcom or any other party; this includes your cell phone or smart device and your connection to the Internet. A transmitter which has been taken apart physically or which has had any of its software accessed in any unauthorized manner. Water damage to transmitter Beyond specifications listed in the Dexcom G6 User Guide Your options to get the User Guide:

Download or view: dexcom.com/guides Online request form to receive a free printed copy: dexcom.com/guides Request a free copy by mail Request a free copy by phone:

Toll free: 1.888.738.3646 Toll: 1.858.200.0200 Dexcoms Obligations Under the Limited Warranty During the Warranty Period, Dexcom will replace, without charge to purchaser, any defective transmitter. To return, you must send the transmitter to an authorized Dexcom Technical Support Department. Make sure you package the transmitter adequately for shipping. The return package needs to include:

Transmitter Sales receipt or comparable substitute proof of sale showing the date of purchase Transmitters serial number Sellers name and address Purchasers name and address for Dexcom to ship the replacement Dexcom G6 System User Guide Appendix E: Warranty 287 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 287 2/5/19 9:27 AM Call Dexcom Technical Support Department for delivery information or help:

Web: dexcom.com/tech-support Toll free: 1.888.738.3646 Toll: 1.858.200.0200 Upon receipt by Dexcom of a defective transmitter covered by this Limited Warranty, Dexcom will promptly replace the defective transmitter. If Dexcom determines the transmitter isnt covered by this Limited Warranty, Purchaser must pay all shipping charges for the transmitters return by Dexcom. Limits on Dexcoms Warranty and Liability Obligations The Limited Warranty described above is the exclusive warranty for the transmitter, and in lieu of all other warranties, expressed or implied, either in fact or by operations of law, statutory or otherwise. Dexcom expressly excludes and disclaims all other warranties, express or implied, including without limitation any warranty of merchantability, fitness for a particular purpose, or non-infringement, except to the extent prohibited by applicable law. Dexcom shall not be liable for any special, incidental, consequential, or indirect damages, however caused, and on any theory of liability, arising in any way out of the sale, use, misuse, or inability to use, any Dexcom G6 or any feature or service provided by Dexcom for use with the Dexcom G6. These limits on Dexcoms warranty and liability obligations apply even if Dexcom, or its agent, has been advised of such damages and notwithstanding any failure of essential purpose of this Limited Warranty and the limited remedy provided by Dexcom. This Limited Warranty is only provided to the original Purchaser and cant be transferred to anyone else, and states Purchasers exclusive remedy. If any portion of this Limited Warranty is illegal or unenforceable by reason of any law, such partial illegality or enforceability shall not affect the enforceability of the remainder of this Limited Warranty. This Limited Warranty will be enforced to the maximum extent permitted by law. Dexcom G6 System User Guide Appendix E: Warranty 288 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 288 2/5/19 9:27 AM Appendix F | Technical Information F.1 Device Performance Characteristics NOTE: We recommend that you review the information in this chapter with your healthcare professional to understand how well the Dexcom G6 Continuous Glucose Monitoring System (G6) performs. The Dexcom G6 (G6) uses a glucose sensor to continuously measure and monitor your glucose levels. Once the sensor code is entered, the G6 reports glucose readings up to every 5 minutes. The G6s performance was evaluated in clinical studies in which G6 readings were assessed against blood glucose values tested by a laboratory reference method for subjects 6 years of age and older and by fingerstick blood glucose meter for pediatric subjects 2 to 5 years of age. The performance characteristics of the G6 presented in the following sections conform to the guidance for devices in the same classification. Clinical Study Overview To demonstrate the performance of the G6, two prospective clinical studies were conducted at 11 centers across the United States. The studies included both adult

(18 years and older) and pediatric (2 to 17 years) participants. The studies evaluated the G6 performance, in terms of its safety, effectiveness, and precision. The studies enrolled a total of 380 participants with 99% having Type 1 diabetes mellitus and 1%

having insulin using Type 2 diabetes mellitus. Participants wore either one or two sensors for up to 10 days. A subset of participants wore two sensors for the precision study to compare variability of readings between sensors. Adult participants wore their G6(s) in the abdomen only; pediatric subjects had the choice of either abdomen or upper buttocks. Clinic session(s) took place at the beginning (Day 1, 2), middle (Day 4, 5), and end (Day 7, 10) of the G6 lifecycle. Dexcom G6 System User Guide Appendix F: Technical Information 289 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 289 2/5/19 9:27 AM Depending on the participants age, they participated in either 1, 2 or 3 clinic sessions of varying duration. Adult subjects: two (2) or three (3) 12-hour clinic sessions Pediatric subjects 13-17 years of age: one (1) 12-hour clinic session Pediatric subjects 6-12 years of age: one (1) 6-hour clinic session Pediatric subjects 2-5 years of age: one (1) 4-hour clinic session (compared to fingerstick blood glucose meter measurements only). While using the G6 in the clinic, subjects had their blood glucose measured every 15 minutes with a laboratory reference method, the Yellow Springs Instrument 2300 STAT Plus Glucose Analyzer. This instrument is referred to as the YSI. Readings from the G6 were reported every 5 minutes and paired with YSI values in order to characterize the accuracy of the G6s glucose reading. No venous sampling was obtained for 14 pediatric subjects aged 2 to 5 years. In Study 1, under close observation by the study investigator staff, the participants glucose levels were deliberately manipulated per a protocol to raise or lower glucose to achieve YSI glucose samples within target glucose bins. Glucose manipulations were done to assess performance over the range that CGM measures glucose (40-400 mg/

dl). In Study 2, participants managed their glucose as they normally do; glucose was not deliberately manipulated. The data from these prospective clinical studies were further processed and analyzed at Dexcom to assess performance of factory calibration. Accuracy Accuracy of the G6 is characterized by assessing its readings against blood glucose values from YSI. Accuracy of the G6 was assessed with paired G6 readings to YSI blood glucose values. For blood glucose values less than or equal to 70 mg/dL, the absolute difference in mg/dL between the two glucose results was calculated. For values greater than 70 mg/dL, the absolute difference (%) relative to the YSI values was calculated. In addition, the mean absolute relative difference (MARD) shows the average amount the sensor readings differ from the YSI glucose. The percentages of total readings within 20 mg/dL or 20% (20/20%) are provided in Tables 1-A. The tables are further categorized within CGM glucose ranges, within age groups, and sensor Dexcom G6 System User Guide Appendix F: Technical Information 290 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 290 2/5/19 9:27 AM wear locations (Tables 1-B to 1-E) and categorized within YSI glucose ranges (Tables 1-F to 1-I). When you see a CGM reading on your receiver or mobile application, these tables show you how likely that reading matches your blood glucose level (measured by YSI in the study). These tables include overall pooled data from both G6 studies. For example, the total number of data pairs considered in the analysis was 25,101. Of these, 91.7% of the G6 readings fall within 20 mg/dL of the YSI blood glucose values

< 70 mg/dL and within 20% of YSI blood glucose values 70 mg/dL. Table 1-A. G6 Accuracy to YSI (n=324) Patient Population Number of subjects Total number of paired CGM-YSI Percent within 20/20%

YSI

% (95% LB) Overall Adults

(18+ YO) Pediatrics

(6-17 YO) Pediatrics

(2-5 YO)*

324 159 165 8 25,101 91.7 (90.6) 19,329 91.6 (90.3) 5,772 92.0 (89.8) 90.2 82 92.7 (86.6) NA Day 1 Percent within 20/20%

YSI 87.8 87.1 MARD

(%) 9.8 9.9 9.6 9.9

* No YSI measurements were taken for this age group; results presented are from in-clinic CGM-SMBG matched paired measurements. Dexcom G6 System User Guide Appendix F: Technical Information 291 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 291 2/5/19 9:27 AM 1CGM readings are within 40-400 mg/dL, inclusive. Table 1-B. G6 Accuracy to YSI within CGM Glucose Ranges (Adults; n=159) CGM Glucose Range1

(mg/dL) Number of paired CGM-YSI Percent within 15 mg/dL YSI Percent within 20 mg/dL YSI Percent within 40 mg/dL YSI Percent within 15%

YSI Percent within 20%

YSI Percent within 40%

YSI Mean bias

(mg/dL) MARD

(%)

<54 383 84.3 54-69 1,537 89.6 90.6 95.1 98.4 99.5

-6.9 13.8

-0.5 11.5 70-180 9,453 181-250 4,093

>250 3,863 73.9 86.6 99.3

-2.8 10.9 80.2 92.1 99.9

-10.0 91.1 97.7 100.0

-3.8 9.3 7.1 1CGM readings are within 40-400 mg/dL, inclusive. Table 1-C. G6 Accuracy to YSI within CGM Glucose Ranges (Pediatrics*; n=165) CGM Glucose Range1

(mg/dL) Number of paired CGM-YSI Percent within 15 mg/dL YSI Percent within 20 mg/dL YSI Percent within 40 mg/dL YSI Percent within 15%

YSI Percent within 20%

YSI Percent within 40%

YSI Mean bias

(mg/dL) MARD

(%)

<54 90 54-69 262 48.9 85.5 62.2 88.5 85.6 96.6

-20.0 26.0

-5.9 13.3 70-180 3,144 181-250 1,360

>250 916 79.8 90.8 99.5

-0.3 83.4 93.5 99.9

-1.2 89.3 95.9 99.9 9.2 9.7 8.9 7.4

* Includes pediatric subjects 6-17 years of age; no YSI measurements were taken for pediatric subjects 2-5 years of age. 1 CGM readings are within 40-400 mg/dL, inclusive. Dexcom G6 System User Guide Appendix F: Technical Information 292 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 292 2/5/19 9:27 AM Table 1-D. G6 Accuracy to YSI within CGM Glucose Ranges

(Pediatrics*, Abdomen; n=99) CGM Glucose Range1

(mg/dL) Number of paired CGM-YSI Percent within 15 mg/dL YSI Percent within 20 mg/dL YSI Percent within 40 mg/dL YSI Percent within 15%

YSI Percent within 20%

YSI Percent within 40%

YSI Mean bias

(mg/dL) MARD

(%)

<54 60 54-69 177 40.0 87.0 51.7 88.1 80.0 96.0

-24.1 28.9

-6.3 13.4 70-180 1,910 181-250 775

>250 574 80.5 91.0 99.5

-1.1 81.9 95.0 100.0

-2.3 89.2 96.5 99.8 8.0 9.7 9.1 7.5

* Includes pediatric subjects 6-17 years of age; no YSI measurements were taken for pediatric subjects 2-5 years of age. 1 CGM readings are within 40-400 mg/dL, inclusive. Table 1-E. G6 Accuracy to YSI within CGM Glucose Ranges

(Pediatrics*, Buttocks; n=66) CGM Glucose Range1

(mg/dL) Number of paired CGM-YSI Percent within 15 mg/dL YSI Percent within 20 mg/dL YSI Percent within 40 mg/dL YSI Percent within 15%

YSI Percent within 20%

YSI Percent within 40%

YSI Mean bias

(mg/dL) MARD

(%)

<54 54-69 30 85 66.7 82.4 83.3 89.4 96.7 97.6

-11.7 20.1

-5.2 13.2 70-180 1,234 181-250 585

>250 342 78.8 90.4 99.4 85.3 91.6 99.8 0.9 0.1 89.5 94.7 100.0 11.1 9.7 8.5 7.3

* Includes pediatric subjects 6-17 years of age; no YSI measurements were taken for pediatric subjects 2-5 years of age. 1 CGM readings are within 40-400 mg/dL, inclusive. Dexcom G6 System User Guide Appendix F: Technical Information 293 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 293 2/5/19 9:27 AM Table 1-F. G6 Accuracy to YSI within YSI Glucose Ranges (Adults; n=159) YSI Glucose Range

(mg/dL) Number of paired CGM-YSI Percent within 15 mg/dL YSI Percent within 20 mg/dL YSI Percent within 40 mg/dL YSI Percent within 15%

YSI Percent within 20%

YSI Percent within 40%

YSI Mean bias

(mg/dL) MARD

(%)

<54 483 88.2 54-69 1,783 88.8 95.9 96.1 99.8 99.9 6.0 4.0 15.8 12.4 70-180 8,713 181-250 3,940

>250 4,410 76.8 89.0 99.6

-0.8 10.3 83.0 92.7 99.8

-7.2 83.4 93.3 99.8

-13.5 8.8 8.6 Table 1-G. G6 Accuracy to YSI within YSI Glucose Ranges (Pediatrics*; n=165) YSI Glucose Range

(mg/dL) Number of paired CGM-YSI Percent within 15 mg/dL YSI Percent within 20 mg/dL YSI Percent within 40 mg/dL YSI Percent within 15%

YSI Percent within 20%

YSI Percent within 40%

YSI Mean bias

(mg/dL) MARD

(%)

<54 47 54-69 309 95.7 86.1 100.0 100.0 95.1 100.0 70-180 3,099 181-250 1,401

>250 916 5.0 2.8 1.7 79.9 90.4 98.8 84.9 93.3 99.8

-0.8 85.2 94.0 100.0

-3.3 11.8 13.7 9.8 9.0 8.0

* Includes pediatric subjects 6-17 years of age; no YSI measurements were taken for pediatric subjects 2-5 years of age. Dexcom G6 System User Guide Appendix F: Technical Information 294 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 294 2/5/19 9:27 AM Table 1-H. G6 Accuracy to YSI within YSI Glucose Ranges

(Pediatrics*, Abdomen; n=99) YSI Glucose Range

(mg/dL) Number of paired CGM-YSI Percent within 15 mg/dL YSI Percent within 20 mg/dL YSI Percent within 40 mg/dL YSI Percent within 15%

YSI Percent within 20%

YSI Percent within 40%

YSI Mean bias

(mg/dL) MARD

(%)

<54 28 100.0 100.0 100.0 54-69 201 90.0 96.0 100.0 70-180 1,904 181-250 761

>250 602 4.2 3.0 0.4 79.3 89.5 98.5 84.9 94.9 99.6

-1.4 85.4 95.8 100.0

-3.9 11.3 12.8 10.2 9.1 8.1

* Includes pediatric subjects 6-17 years of age; no YSI measurements were taken for pediatric subjects 2-5 years of age. Table 1-I. G6 Accuracy to YSI within YSI Glucose Ranges

(Pediatrics*, Buttocks; n=66) YSI Glucose Range

(mg/dL) Number of paired CGM-YSI Percent within 15 mg/dL YSI Percent within 20 mg/dL YSI Percent within 40 mg/dL YSI Percent within 15%

YSI Percent within 20%

YSI Percent within 40%

YSI Mean bias

(mg/dL) MARD

(%)

<54 19 89.5 100.0 100.0 54-69 108 78.7 93.5 100.0 70-180 1,195 181-250 640

>250 314 6.2 2.4 3.8 80.8 92.0 99.2 84.8 91.4 100.0

-0.1 84.7 90.4 100.0

-2.1 12.6 15.2 9.3 8.8 7.8

* Includes pediatric subjects 6-17 years of age; no YSI measurements were taken for pediatric subjects 2-5 years of age. Dexcom G6 System User Guide Appendix F: Technical Information 295 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 295 2/5/19 9:27 AM Agreement When CGM Reads LOW or HIGH The G6 reports glucose readings between 40 and 400 mg/dL. When the G6 determines the glucose reading is below 40 mg/dL, it displays LOW in the Receiver or Mobile Application Status Box. When the G6 determines that the glucose level is above 400 mg/dL, it displays HIGH in the Receiver or Mobile Application Status Box. Because the System does not display glucose values below 40 mg/dL or above 400 mg/dL, the comparisons to the actual blood glucose levels (as determined by the YSI analyzer) when CGM is classified as LOW or HIGH are included separately in Table 2 (data is combined from Study 1 and Study 2). The tables include the numbers and the cumulative percentages when YSI values were less than certain glucose levels (for LOW), and when YSI values were greater than certain glucose levels (for HIGH). For example, when the G6 displayed LOW (139 occasions), 84% (117 out of 139) of the YSI values were less than 80 mg/dL. When the G6 displayed HIGH (54 occasions), 100% (54 out of 54) of the YSI values were greater than 280 mg/dL. Table 2. Distribution of YSI Values When CGM Readings are LOW or HIGH CGM Readings CGM-YSI Pairs YSI (mg/dL)

< 55

< 60

< 70

< 80 80 Total n 65 80 95 117 22 139 LOW Cumulative Percent 47%

58%

68%

84%

16%

CGM Readings CGM-YSI Pairs YSI (mg/dL)

> 340

> 320

> 280

> 250 250 Total n 53 53 54 54 0 54 HIGH Cumulative Percent 98%

98%

100% 100%

0%

Dexcom G6 System User Guide Appendix F: Technical Information 296 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 296 2/5/19 9:27 AM Concurrence of G6 and Laboratory Reference Tables 3-A to 3-D categorize concurrence by CGM reading and YSI values. Tables 3-A and 3-B describe, (row percent), for each range of CGM glucose readings, what percentage of paired YSI values was in the same glucose range (shaded) or in glucose ranges above and below the paired CGM readings. For example, Table 3-A shows that for adults, when CGM readings are within 81 to 120 mg/dL, you can expect your blood glucose levels are within 81 to 120 mg/dL 70 % of time. Tables 3-C and 3-D describe (column percent), for each range of YSI values, what percentage of paired CGM readings was in the same glucose range (shaded) or in glucose ranges above and below the paired YSI values. For example, Table 3-D shows that for pediatrics, when YSI values are within 81 to 120 mg/dL, you can expect your CGM readings to be within 81 to 120 mg/dL 78% of time. Dexcom G6 System User Guide Appendix F: Technical Information 297 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 297 2/5/19 9:27 AM Table 3-A. Concurrence of G6 CGM Readings and YSI Values by CGM Glucose Range (Adults; n=159) CGM Glucose Range 1

(mg/dL) YSI (mg/dL)

< 40 40-

60 61-

80 81-

120 121-

160 161-

200 201-

250 251-

300 301-

350 351-

400

>

400 Total

<40 13.5% 56.7% 24.0% 3.8% 1.9%

. 40- 60 1.2% 67.8% 27.9% 2.7% 0.2% 0.1%

61- 80 0.1% 21.3% 61.4% 16.9% 0.3% 0.1%

. 104 917 2,275 3,782 3,026 2,597 2,869 2,268 0.4% 13.6% 70.3% 15.1% 0.6% 0.0%

0.0% 14.2% 64.3% 20.1% 1.3% 0.0% 0.0%

0.1% 14.5% 56.7% 26.9% 1.5% 0.2% 0.0%

0.2% 12.1% 59.4% 25.4% 2.9% 0.0%

0.1% 13.7% 59.1% 25.3% 1.9%

81- 120 121- 160 161- 200 201- 250 251- 300 301- 350 351- 400

>400

. 0.2% 22.3% 63.4% 13.7% 0.5% 1,212

. 0.8% 43.9% 52.5% 2.9% 383

. 5.9% 76.5% 17.6% 34 1CGM readings are within 40 to 400 mg/dL, inclusive. Dexcom G6 System User Guide Appendix F: Technical Information 298 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 298 2/5/19 9:27 AM Table 3-B. Concurrence of G6 CGM Readings and YSI Values by CGM Glucose Range (Pediatrics*; n=165) CGM Glucose Range 1

(mg/dL) YSI (mg/dL)

< 40 40-

60 61-

80 81-

120 121-

160 161-

200 201-

250 251-

300 301-

350 351-

400

>

400 Total

<40 2.9% 22.9% 28.6% 42.9% 2.9%

. 40- 60 0.6% 37.9% 43.5% 13.7% 3.7% 0.6%

11.5% 65.8% 20.4% 1.9% 0.4%

0.2% 12.5% 76.3% 10.5% 0.6%

. 35 161 485 1,282 1,013 1,087 828 544 287 13.6% 71.9% 13.6% 0.9%

0.2% 18.6% 59.4% 20.2% 1.6%

0.1% 19.2% 63.8% 15.7% 1.2%

0.2% 28.1% 59.6% 11.8% 0.4%

1.0% 32.8% 56.4% 9.8%

. 5.9% 52.9% 38.8% 2.4%

85

. 5.0% 55.0% 40.0% 20 61- 80 81- 120 121- 160 161- 200 201- 250 251- 300 301- 350 351- 400

>400

.

* Includes pediatric subjects 6-17 years of age; no YSI measurements were taken for pediatric subjects 2-5 years of age. 1CGM readings are within 40 to 400 mg/dL, inclusive. Dexcom G6 System User Guide Appendix F: Technical Information 299 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 299 2/5/19 9:27 AM Table 3-C. Concurrence of G6 CGM Readings and YSI Values by YSI Glucose Range (Adults, n=159) CGM Glucose Range 1

(mg/dL) YSI glucose range (mg/dL)

< 40 40-

60 61-

80 81-

120 121-

160 161-

200 201-

250 251-

300 301-

350 351-

400

>

400

<40 51.9% 5.0% 1.1% 0.1% 0.1%

. 40- 60 40.7% 52.7% 11.7% 0.7% 0.1% 0.0%

61- 80 7.4% 41.0% 63.7% 11.0% 0.2% 0.1%

. 1.3% 23.4% 75.8% 19.7% 1.0% 0.0%

0.0% 12.2% 66.9% 24.8% 1.4% 0.0% 0.1%

0.1% 13.0% 59.9% 25.3% 1.7% 0.4% 0.2%

0.2% 14.1% 61.9% 30.6% 5.1% 0.2%

0.1% 11.3% 56.2% 35.9% 9.6%

. 0.1% 11.3% 48.0% 38.0% 26.1%

. 0.1% 10.5% 46.0% 47.8%

. 0.1% 5.9% 26.1%

. 81- 120 121- 160 161- 200 201- 250 251- 300 301- 350 351- 400

>400 Total 27 1,180 2,191 3,503 2,910 2,457 2,755 2,383 1,601 437 23 1CGM readings are within 40 to 400 mg/dL, inclusive. Dexcom G6 System User Guide Appendix F: Technical Information 300 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 300 2/5/19 9:27 AM

Table 3-D. Concurrence of G6 CGM Readings and YSI Values by YSI Glucose Range (Pediatrics*; n=165) CGM Glucose Range 1

(mg/dL) YSI glucose range (mg/dL)

< 40 40-

60 61-

80 81-

120 121-

160 161-

200 201-

250 251-

300 301-

350 351-

400

>

400

<40 50.0% 6.3% 1.8% 1.2% 0.1%

. 40- 60 50.0% 48.0% 12.5% 1.8% 0.6% 0.1%

44.1% 57.1% 7.9% 0.8% 0.2%

1.6% 28.6% 78.0% 12.4% 0.8%

. 11.0% 67.3% 14.5% 1.0%

0.2% 18.7% 67.6% 24.1% 3.0%

0.1% 16.6% 57.8% 22.8% 3.5%

0.1% 16.8% 56.8% 22.7% 2.7%

0.3% 16.5% 57.4% 37.8%

. 0.9% 16.0% 44.6% 20.0%

. 0.4% 14.9% 80.0%

. 61- 80 81- 120 121- 160 161- 200 201- 250 251- 300 301- 350 351- 400

>400 Total 2 127 559 1,254 1,081 955 913 570 282 74 10

* Includes pediatric subjects 6-17 years of age; no YSI measurements were taken for pediatric subjects 2-5 years of age. 1 CGM readings are within 40 to 400 mg/dL, inclusive. Dexcom G6 System User Guide Appendix F: Technical Information 301 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 301 2/5/19 9:27 AM Trend Accuracy Trend accuracy explains how well the G6 captures the time-dependent characteristics of glucose fluctuation. The following examples quantify G6s Trend Accuracy:

3. When the G6 CGM rate of change is rapidly rising ( 2 mg/dL/min), how often is reference glucose also rising? The answer is 71.3% of the time for adults and 67.1% for pediatrics. 4. When the G6 CGM rate of change is rapidly falling ( 2 mg/dL/ min), how often is reference glucose also falling? The answer is 98.0% of the time. 5. When the G6 CGM rate of change is stable ( -1 mg/dL/min and 1 mg/dl/ min), how often is glucose changing rapidly ( 2 mg/dL/min or 2 mg/dL/ min)? The answer is only 1.9% of the time. Table 4-A. Trend Accuracy Rate of Change (Adults; n=159) CGM Rate Range

(mg/dL/min)

<-2

[-2,-1)

[-1,0)

[0,1]

(1,2]

>2 YSI glucose range (mg/dL)

<-2

[-2,-1)

[-1,-0)

[0,1]

(1,2]

>2 CGM-YSI Pairs

(n) 53.3%

35.0%

9.9%

1.5%

0.0%

0.2%

463 7.4%

56.9%

32.5%

2.9%

0.3%

0.0%

2,077 0.4%

9.5%

76.9%

12.5%

0.6%

0.1%

7,986 0.1%

1.0%

26.2%

60.6%

10.6%

1.6%

5,199 0.0%

0.4%

3.1%

26.8%

52.9%

16.8%

1,734 0.1%

0.1%

0.8%

5.6%

22.1%

71.3%

1,367 Dexcom G6 System User Guide Appendix F: Technical Information 302 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 302 2/5/19 9:27 AM Table 4-B. Trend Accuracy Rate of Change (Pediatrics*; n=165) CGM Rate Range

(mg/dL/min)

<-2

[-2,-1)

[-1,0)

[0,1]

(1,2]

>2 YSI glucose range (mg/dL)

<-2

[-2,-1)

[-1,-0)

[0,1]

(1,2]

>2 47.9%

37.0%

12.8%

1.9%

0.0%

0.5%

6.6%

55.5%

33.8%

3.4%

0.6%

0.1%

CGM-YSI Pairs

(n) 211 686 0.5%

8.9%

73.7%

15.8%

1.0%

0.0%

2,048 0.0%

0.8%

25.5%

62.9%

10.0%

0.8%

1,666 0.0%

0.4%

4.4%

35.9%

48.0%

11.4%

0.0%

0.5%

1.7%

7.1%

23.6%

67.1%

546 423

* Includes pediatric subjects 6-17 years of age; no YSI measurements were taken for pediatric subjects 2-5 years of age. Dexcom G6 System User Guide Appendix F: Technical Information 303 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 303 2/5/19 9:27 AM Hypoglycemia and Hyperglycemia Alerts Low and High Glucose Alerts The ability of the G6 to detect high and low glucose levels is assessed by comparing G6 results to YSI results at low and high blood glucose levels and determining if the alert may have sounded. The G6 and YSI values were compared by pairing the G6 reading and the YSI value within before or after 15 minutes of each other. We suggest that you ask your doctor what alert settings would be best for you. The Low Glucose Alert Estimates of how well the adjustable Low Glucose Alert performs are presented in Tables 5-A and 5-B. Tables 5-A and 5-B represent the hypoglycemic alert evaluation within 15 minutes of the YSI value in the study and the hypoglycemic event evaluation within 15 minutes of each hypoglycemic alert for adults and pediatrics, respectively. Hypoglycemic Alert Rate The Alert Rate shows how often the alert is right or wrong. The True Alert Rate is the

% of time the device alarmed when the blood glucose level was at or below the alert setting within 15 minutes before or after the device alarmed. The False Alert Rate is the % of time the device alarmed when the blood glucose level was above the alert setting within 15 minutes before or after the device alarmed. For example, if you set the Low Glucose Alert to 70 mg/dL and your alarm sounds, how often can you expect your blood sugar to actually be low? Based on results for adults in the G6 Study (Table 5-A), when your alarm sounds, you can expect your blood sugar to be below 70 mg/dL approximately 85.5% of the time and above 70 mg/dL approximately 14.5% of the time within the 15 minute period before or after your alarm sounds. When the hypoglycemic alert rate was set at 55 mg/dL, and an alert was provided, glucose was <70 mg/dL 85% of the time within 15 minutes of the alert. (Data not presented in table.) When the hypoglycemic alert rate was set at 60 mg/dl, and an alert was provided, glucose was <70 mg/dl 87% of the time within 15 minutes of the alert. (Data not presented in table.) Dexcom G6 System User Guide Appendix F: Technical Information 304 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 304 2/5/19 9:27 AM Hypoglycemic Detection Rate The Detection Rate is the % of time the device alarmed when the blood glucose level was at or below the alert setting within 15 minutes before or after the hypoglycemic event. The Missed Detection Rate is the % of time the device did not alarm when the blood glucose level was at or below the alert setting within 15 minutes before and after the hypoglycemic event. For example, if you set the Low Glucose alert to 70 mg/dL, how often will your alarm alert you if your blood glucose goes below 70 mg/dL? Based on results for pediatrics in the G6 Study (Table 5-B), when your blood sugar goes below 70 mg/dL, you can expect your alarm to sound 81.6% of the time and not to sound approximately 18.4% of time within the 15 minute period before or after your blood sugar goes below 70 mg/dL. Table 5-A. Hypoglycemic Alert and Detection Rate Evaluations (Adults, n=1591) Hypoglycemic Alert Level

(mg/dL) Alerts Detections

# of alerts True Alert

(n) Rate (%) False Alert Rate (%)

# of events

(n) Correct Detection Rate (%) Missed Detection Rate (%) 55 60 70 80 90 1,408 66.6 33.4 642 63.9 2,370 74.6 25.4 1,158 74.1 5,079 85.5 14.5 2,365 86.0 8,187 89.1 10.9 3,372 92.7 11,147 89.4 10.6 4,287 94.6 36.1 25.9 14.0 7.3 5.4 1 All subjects were considered in the analysis; however, not all subjects experienced hypo event. Dexcom G6 System User Guide Appendix F: Technical Information 305 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 305 2/5/19 9:27 AM Table 5-B. Hypoglycemic Alert and Detection Rate Evaluations

(Pediatrics*, n=1651) Alerts Detections

# of alerts True Alert

(n) Rate (%) False Alert Rate (%) 358 31.6 68.4

# of events

(n) 66 68.2 Correct Detection Rate (%) Missed Detection Rate (%) 521 44.1 55.9 119 73.1 1,054 68.0 32.0 369 81.6 1,794 80.5 19.5 671 88.1 31.8 26.9 18.4 11.9 Hypoglycemic Alert Level

(mg/dL) 55 60 70 80 90 2,746 86.3 13.7 1,030 92.8 7.2

* Includes pediatric subjects 6-17 years of age; no YSI measurements were taken for pediatric subjects 2-5 years of age. 1 All subjects were considered in the analysis; however, not all subjects experienced hypo event Dexcom G6 System User Guide Appendix F: Technical Information 306 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 306 2/5/19 9:27 AM The High Glucose Alert Estimates of how well the adjustable High Glucose Alert performs are presented in Tables 5-C and 5-D. Tables 5-C and 5-D represent the hyperglycemic alert evaluation within 15 minutes of the YSI value in the study and the hypoglycemic event evaluation within 15 minutes of each hyperglycemic alert for adults and pediatrics, respectively. Hyperglycemic Alert Rate The Alert Rate shows how often the alert is right or wrong. The True Alert Rate is the

% of time the device alarmed when the blood glucose level was at or above the alert setting within 15 minutes before or after the device alarmed. The False Alert Rate is the % of time the device alarmed when the blood glucose level was below the alert setting within 15 minutes before or after the device alarmed. For example, if you set the High Glucose alert to 200 mg/dL and your alarm sounds, how often can you expect your blood sugar to actually be high? Based on results for adults in the G6 Study (Table 5-C), when your alarm sounds, you can expect your blood sugar to be at or above 200 mg/dL approximately 96% of the time and not be above 200 mg/dL approximately 4% of the time within the 15 minute period before or after your alarm sounds. Hyperglycemia Detection Rate The Detection Rate is the % of time the device alarmed when the blood glucose level was at or above the alert setting within 15 minutes before or after the hyperglycemic event. The Missed Detection Rate is the % of time the device did not alarm when the blood glucose level was at or above the alert setting within 15 minutes before and after the hyperglycemic event. For example, if you set the High Glucose alert to 240 mg/dL and your blood sugar rises above 240 mg/dL, how often can you expect your device to correctly alarm you? Based on results for pediatrics in the study (Table 5-D), if your blood sugar was at or above 240 mg/dL, you can expect your alarm to sound approximately 90.2% of the time within 15 minutes and an alarm not to sound approximately 9.8% of the time. Dexcom G6 System User Guide Appendix F: Technical Information 307 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 307 2/5/19 9:27 AM Table 5-C. Hyperglycemic Alert and Detection Rate Evaluations (Adults, n=159) Hyperglycemic Alert Level

(mg/dL) Alerts Detections

# of alerts True Alert

(n) Rate (%) False Alert Rate (%)

# of events

(n) Correct Detection Rate (%) Missed Detection Rate (%) 120 140 180 200 220 240 300 37,061 97.5 2.5 12,664 97.6 32,148 97.2 2.8 11,175 96.8 23,424 96.6 3.4 8,455 95.2 19,586 96.0 4.0 7,265 93.6 15,689 95.6 12,279 94.6 4.4 5.4 6,143 91.2 5,007 88.7 4,211 85.9 14.1 2,095 74.8 2.4 3.2 4.8 6.4 8.8 11.3 25.2 Dexcom G6 System User Guide Appendix F: Technical Information 308 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 308 2/5/19 9:27 AM Table 5-D. Hyperglycemic Alert and Detection Rate Evaluations

(Pediatrics*, n=165) Hyperglycemic Alert Level

(mg/dL) Alerts Detections

# of alerts True Alert

(n) Rate (%) False Alert Rate (%)

# of events

(n) Correct Detection Rate (%) Missed Detection Rate (%) 120 140 180 200 220 240 300 11,683 97.3 10,113 96.2 6,821 93.4 2.7 3.8 6.6 3,930 97.8 3,388 97.7 2,366 94.7 5,190 93.3 6.7 1,874 91.2 4,096 90.4 9.6 1,453 91.7 3,068 86.9 13.1 1,093 90.2 2.2 2.3 5.3 8.8 8.3 9.8 1,010 77.2 22.8 374 84.8 15.2

* Includes pediatric subjects 6-17 years of age; no YSI measurements were taken for pediatric subjects 2-5 years of age. Dexcom G6 System User Guide Appendix F: Technical Information 309 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 309 2/5/19 9:27 AM Sensor Stability Sensors can be worn for up to 10 days. Performance was estimated by calculating the percentage of G6 readings within 15 mg/dL or 15% (15/15%), 20 mg/dL or 20%

(20/20%), and 40 mg/dL or 40% (40/40%), of the YSI values at the beginning (Day 1, 2), middle (Day 4, 5) and end (Day 7, 10) of the G6 lifecycle. For blood glucose values less than or equal to 70 mg/dL, the absolute difference in mg/dL between the two glucose results was calculated. For values greater than 70 mg/dL, the absolute difference (%) relative to the YSI values was calculated. In addition, the mean absolute relative difference (MARD) shows the average amount the sensor readings differ from the YSI glucose. The MARD values included in Table 6-A and 6-B show consistent accuracy and sensor stability over the 10-day life of the sensor. Table 6-A. Sensor Stability Relative to YSI (Accuracy over Time1) (Adults; n=159) Wear Period Number of paired CGM-YSI MARD

(%) Beginning 6,696 10.9 Middle 6,464 End 6,169 9.2 9.6 Percent within Percent within Percent within 15/15% YSI 20/20% YSI 40/40% YSI

(%) 76.5 84.3 82.3

(%) 88.0 94.6 92.4

(%) 99.6 99.8 99.8 1 CGM readings are within 40-400 mg/dL, inclusive. Dexcom G6 System User Guide Appendix F: Technical Information 310 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 310 2/5/19 9:27 AM Table 6-B. Sensor Stability Relative to YSI (Accuracy over Time1)

(Pediatrics*; n=165) Wear Period Number of paired CGM-YSI MARD

(%) Beginning 2167 Middle 1268 End 2337 9.9 9.1 9.4 Percent within Percent within Percent within 15/15% YSI 20/20% YSI 40/40% YSI

(%) 81.2 83.1 83.1

(%) 92.1 93.7 91.1

(%) 99.8 99.8 98.5

* Includes pediatric subjects 6-17 years of age; no YSI measurements were taken for pediatric subjects 2-5 years of age. 1 CGM readings are within 40-400 mg/dL, inclusive. Sensor Life Sensors can be worn for up to 10 days (238 hours; 240 hours less 2 hours warm-up period). To estimate how long a sensor will work over 10 days, all sensors worn were evaluated to determine how many days/hours of readings each sensor provided. For adults, a total of 164 sensors were evaluated. Ninety-four percent (94%) of the sensors lasted through the end of the entire wear period (e.g., Day 10) (see Figure 1-A). Among the 164 sensors evaluated, 8 sensors (4.9%) had early sensor shut-off where the sensor algorithm would have detected sensors that did not function as intended and shut them off. For pediatrics, a total of 210 sensors were evaluated. Seventy-seven percent (77%) of the sensors lasted through the end of the entire wear period (e.g., Day 10) (see Figure 1-B). Among the 210 sensors evaluated, 28 sensors (13.3%) had early sensor shut-

off where the sensor algorithm would have detected sensors that did not function as intended and shut them off. Dexcom G6 System User Guide Appendix F: Technical Information 311 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 311 2/5/19 9:27 AM Table 7-A. Sensor Survival Rate by Wear Day (Adults; n=164) Wear Day Number of Sensors Survival Rate (%) 1 2 3 4 5 6 7 8 9 162 160 158 155 154 154 150 146 144 10 139*

99.4%

98.8%

98.8%

98.8%

98.1%

98.1%

96.8%

96.2%

94.9%

93.5%

* Includes sensors that survived more than 9.5 days (228 hours) of wear. Dexcom G6 System User Guide Appendix F: Technical Information 312 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 312 2/5/19 9:27 AM 1.0 0.8 0.6 0.4 0.2 y t i l i b a b o r P l a v i v r u S

# at Risk

# of Failures

# of Censored 0.0 164 162 160 158 155 154 154 150 146 144 139 1 1 1 1 0 2 0 3 1 0 0 0 2 2 1 3 2 0 2 3 0 1 2 3 4 5 6 7 8 9 10 Sensor Day Figure 1-A. Kaplan Meier Curve of Sensor Life (Adults; N = 164) Note: # of Censored refers to sensors excluded from the survival analysis due to reasons not related to the device (e.g., subject dropped out of study) Dexcom G6 System User Guide Appendix F: Technical Information 313 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 313 2/5/19 9:27 AM Table 7-B. Sensor Survival Rate by Wear Day (Pediatrics; n=210) Wear Day Number of Sensors Survival Rate (%) 1 2 3 4 5 6 7 8 9 206 204 196 193 184 175 164 157 146 10 142*

99.0%

99.0%

97.1%

95.6%

91.1%

88.6%

85.5%

83.4%

79.2%

76.8%

* Includes sensors that survived more than 9.5 days (228 hours) of wear. Dexcom G6 System User Guide Appendix F: Technical Information 314 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 314 2/5/19 9:27 AM 1.0 0.8 0.6 0.4 0.2 y t i l i b a b o r P l a v i v r u S

# at Risk

# of Failures

# of Censored 0.0 210 206 204 196 193 184 175 164 157 146 142 2 2 0 2 4 4 3 0 9 0 5 4 6 5 4 3 8 3 4 0 0 1 2 3 4 5 6 7 8 9 10 Sensor Day Figure 1-B. Kaplan Meier Curve of Sensor Life (Pediatrics; N = 210) Note: # of Censored refers to sensors excluded from the survival analysis due to reasons not related to the device (e.g., subject dropped out of study) Dexcom G6 System User Guide Appendix F: Technical Information 315 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 315 2/5/19 9:27 AM Number of Readings Provided The G6 is capable of providing a reading every 5 minutes, or up to 288 readings per day. For a variety of reasons, the G6 may not display a glucose reading and readings are skipped. The percentage of readings you can expect to receive from the G6 over the sensor life is 98.6%. More than 97% of the sensors captured readings at least 90% of the time. For the G6 with auto-applicator, approximately 99% of the sensors displayed reading every 5 minutes at least 90% of the time. Table 8 below describes the reading captured rate by each wear day over the sensor life. Table 8. Reading Capture Rate by Wear Day (n=374) Wear Day Number of Sensors Capture Rate (%) 1 2 3 4 5 6 7 8 9 10 374 368 364 354 348 338 329 314 303 290 97.6 98.6 98.7 98.6 98.5 98.5 98.2 97.8 97.0 96.4 Dexcom G6 System User Guide Appendix F: Technical Information 316 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 316 2/5/19 9:27 AM Precision of System Readings A subset of randomly selected subjects wore two Systems at the same time (n=67). This was to look at how similarly two Systems function on the same subject (sensor precision) under the same condition. Precision was evaluated by comparing the glucose readings from the two Systems worn on the same subject at the same time on the same location. Table 9 shows that the readings from the two sensors generally agreed with each other. For adults (18+ years old) on abdomen, absolute relative difference (ARD) between the two Systems was 8.9% with coefficient of variation (CV) of 7.9%. For pediatrics (2-5 years old) on upper buttocks, paired ARD was 5.2% with CV of 4.8%. Table 9. Precision by Wear Location Adults

(18+ YO) Abdomen Pediatrics

(6-17 YO) Abdomen Pediatrics

(6-17 YO) Upper Buttocks Pediatrics

(2-5 YO) Upper Buttocks 23,019 1,255 12,230 2,638 14.0 14.5 8.9 7.9 9.4 7.6 16.4 10.7 8.5 9.4 5.2 4.8 CGM-CGM Matched Pairs (n) Paired Absolute Difference (mg/dL) Paired Absolute Relative Difference (%) Coefficient of Variation (%) Dexcom G6 System User Guide Appendix F: Technical Information 317 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 317 2/5/19 9:27 AM Study 2 Overview The purpose of the Study 2 was to assess the performance of the System with an automatic sensor applicator, which is the final G6 CGM System configuration. The automatic applicator was designed to provide more consistent sensor insertions. The study was a prospective, multi-center, single-arm study that enrolled 76 subjects at four (4) US clinical sites. No glucose manipulations were performed in this sub-

study. Subjects participated in assigned clinic sessions (Day 1, 2, 4-5, 7 and/or 10):

Adult subjects: two (2) 12-hour clinic sessions Pediatric subjects 13-17 years of age: one (1) 12-hour clinic session Pediatric subjects 6-12 years of age: one (1) 6-hour clinic session. The data from Study 2 was also further processed at Dexcom to assess performance of factory calibration. Accuracy (Study 2 - Automatic Applicator) Accuracy of the G6 is characterized by assessing its readings against blood glucose values from YSI. Accuracy of the G6 was assessed with paired G6 readings to YSI blood glucose values. For glucose value less than or equal to 70 mg/dL, the absolute difference in mg/dL between the two glucose results was calculated. For glucose value greater than 70 mg/dL, the absolute difference (%) relative to the YSI values was calculated. The percentages of total readings within 20 mg/dL or 20% over the System lifecycle and on Day 1 are provided in Table 10. The results are also presented for pediatrics and adults separately. For example, the total number of data pairs considered in the analysis was 3,532. Of these, 92% of the System readings fall within 20 mg/dL of the YSI blood glucose values < 70 mg/dL and within 20% of YSI blood glucose values 70 mg/dL for adults and 96% readings fall within 20/20% for pediatrics. Dexcom G6 System User Guide Appendix F: Technical Information 318 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 318 2/5/19 9:27 AM Table 10. G6 Accuracy to YSI (n=62) Number Total number Percent within of subjects of paired CGM-YSI 20/20%

YSI Day 1 Percent within 20/20%YSI MARD

(%) 62 25 37 3,532 93.5 (89.9) 2,145 91.9 (86.6) 91.1 91.0 1,387 95.8 (92.3) 91.3 9.0 9.8 7.7 Patient Population Overall Auto-app

(18 years) Auto-app

(6-17 years old) Patient Comfort (Study 2 - Automatic Applicator) Enrolled patients were asked to complete questionnaires on comfort and ease of use of the G6 with automatic applicator. The questionnaires were completed by the subjects or their parents/guardians. Subjects were asked to focus on ease or difficulty with their initial experience of sensor insertion and transmitter attachment. Eighty-four percent (84%) of subjects felt the automatic sensor applicator was painless. All reported subjects (100%) found that the automatic applicator was easy to use and the IFU was easy to understand. Table 11. Survey on Automated Applicator (n=76) Question Number of subjects (n) Percent (95% LB) Comfort: Painless (mild, no pain) Ease of use: easy

(somewhat or very) IFU ease of use: easy

(somewhat or very) 76 76 61 84%

100%

100%

Dexcom G6 System User Guide Appendix F: Technical Information 319 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 319 2/5/19 9:27 AM Adverse Events No serious adverse events (AEs) or device-related serious adverse events occurred during the studies. There was a total of 24 mild to moderate AEs which occurred during the studies (among 374 sensors). 13 of these AEs occurred due to either skin irritation, such as erythema (redness) or edema (swelling), at the sensor needle insertion area or around the adhesive area, or mild to moderate excoriation and infection. F.2 Product Specifications WARNING: Use of accessories, cables, adapters, and chargers other than those specified or provided by the manufacturer of this equipment could result in increased electromagnetic emissions or decreased electromagnetic immunity of this equipment and result in improper operation. WARNING: Portable RF communications equipment (including peripherals such as antenna cables and external antennas) should be used no closer than 12 inches to any part of the G6 CGM system including cables specified by the manufacturer. Otherwise, degradation of the performance of this equipment could result. WARNING: Misuse of the USB cable can present a strangulation risk. No cleaning methods are recommended or tested for the receiver. Only wipe with a clean, dry cloth. CAUTION: If you have difficulty reading your receiver in bright sunlight, you may need to seek a shady location. Sensor Product Specifications Glucose Range 40 400 mg/dL Sensor Useful Life Up to 10 days Storage and Transport Conditions Temperature: 36F 86F Store sensors in a cool, dry place Sterilization Sterile by radiation Dexcom G6 System User Guide Appendix F: Technical Information 320 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 320 2/5/19 9:27 AM Transmitter and Receiver Product Specifications Model G6 Transmitter Dexcom Receiver Memory Storage N/A 30 days of glucose data 7 days of tech support data Electrical Safety Class Battery Longevity

(Typical) Battery Charging Time Internally Powered Internally Powered 3 months 2 days Non-rechargeable 3 hours Operational Conditions Maximum Enclosure Temperature Storage and Transport Conditions Operating Altitude Ingress Protection Ambient temperature is 50F107.6F Humidity: 10%95% RH Temperature: 32F104F Humidity: 15%95% RH 109F N/A Temperature: 32F113F Temperature: 32F104F Humidity: 10%95% RH Humidity: 10%95% RH

-1,300 feet to 13,800 feet

-1,200 feet to 13,500 feet IP28: Protection against insertion of large objects and immersion in water for up to 8 feet for 24 hours IP22: Protection against insertion of large objects and vertically falling water drops Protection Against Electrical Shock Type BF applied part N/A Dexcom G6 System User Guide Appendix F: Technical Information 321 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 321 2/5/19 9:27 AM Transmitter and Receiver Product Specifications Model G6 Transmitter Dexcom Receiver Alarm Audible Output TX/RX Frequencies N/A 50 dBSPL at 3 feet 2.4022.480 GHz Bandwidth 1.07 MHz 1.39 MHz Maximum Output Power 1.0 mW EIRP 2.4 mW EIRP Modulation Gaussian Frequency-Shift Keying Data Rate 1 Mbps Data Communication Range 20 feet USB Charging/Download Cable* Specifications Input/Output 5 V DC, 1A Type Length USB A to USB micro B 3 feet Power Supply/Charger Specifications Class Input II AC Input 100240 Vac, 50/60Hz, 0.2A, 0.2A rms at 100 Vac DC Output 5V DC, 1A (5.0 Watts) Dexcom G6 System User Guide Appendix F: Technical Information 322 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 322 2/5/19 9:27 AM Electromagnetic Immunity and Emissions Declaration and Guidance The transmitter and receiver are intended for use in the electromagnetic environment specified in the next table. The customer or the user of the transmitter should ensure that it is used in such an environment. Immunity Test Electrostatic Discharge (ESD) IEC 61000-4-2 Magnetic Field (50Hz) IEC 61000-4-8 Electrical Fast Transient/Burst IEC 61000-4-4 Surge IEC 61000-4-5 Voltage Dips and Interruptions IEC 61000-4-11 IEC 60601-1-11 Conducted Fields Disturbance IEC 61000-4-6 Radiated Fields Disturbance IEC 61000-4-3 Transmitter Compliance Level Receiver Compliance Level 8 kV Contact 15 kV Air 30 A/m N/A N/A N/A N/A 2 kV for power supply lines 1 kV line(s) to line(s) 0% 230V for 1 cycle 0% 230V for 0.5 cycle at 8 phase angles 70% 230V (30% dip in 230V) for 25 cycles 0% 230V for 250 cycles 6 Vrms 150 kHz to 80 MHz 10 V/m at 80 MHz to 2700 MHz (AM Modulation) Dexcom G6 System User Guide Appendix F: Technical Information 323 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 323 2/5/19 9:27 AM Immunity Test Radiated and Conducted Fields Aircraft use Transmitter Compliance Level Receiver Compliance Level FAA RTCA /DO-160 edition G Section 20 Category T. Can be used on aircraft according to the directions provided by the operator of the aircraft Electromagnetic interference can still occur in the home health care environment as control over the EMC environment cannot be guaranteed. An interference event can be recognized by gaps in G6 readings or gross inaccuracies. The user is encouraged to try to mitigate these effects by one of the following measures:

If the G6 reading changes by 30% or more in 5 minutes and the change does not reflect symptoms or recent actions, take a meter reading. Compare the two readings and contact Technical Support if they do not follow the 30/30 rule. The 30/30 rule is the following: If the meter shows less than 70 mg/dL, CGM should read within 30 points. If the meter shows 70 mg/dL and above, the CGM should read 30%. Example: a 202 mg/dL sensor reading and a 188 mg/dL glucose meter value = a 7% difference (this is still considered accurate). If a reading is outside of the 30/30 rule, if you want, calibrate again to more closely align your CGM and meter. If display device misses 20 minutes of sensor glucose data (4 readings), the Signal Loss error displays. To resolve, see Chapter 14 Troubleshooting. If display device shows the loading screen unexpectedly and does not display the trend screen within 3 minutes, contact Technical Support. For more information, see Chapter 14 Troubleshooting. If your receiver touch panel does not work for 6 minutes, contact Technical Support. Dexcom G6 System User Guide Appendix F: Technical Information 324 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 324 2/5/19 9:27 AM Electromagnetic Emissions Specifications Emissions Test Compliance Radio Frequency Emissions CISPR 11/FCC part 15 Group 1, Class B Radio Frequency Emissions Aircraft Use Meets FAA RTCA /DO-160 edition G Section 21, Category M for in-cabin use. F.3 FCC Compliance Statements This G6 CGM transmitter and receiver comply with Part 15 of the FCC Rules. Operation is subject to the following two conditions:

1. This device may not cause harmful interference, and 2. This device must accept any interference received, including interference that may cause undesired operation G6 Transmitter FCC ID Transmitter Part Number 9445-02 FCC ID PH29588 9445-18 PH29688 Dexcom G6 System User Guide Appendix F: Technical Information 325 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 325 2/5/19 9:27 AM Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 326 2/5/19 9:27 AM Appendix G | Label Symbols Symbols may be found on the sensor, transmitter, and receiver package labels. These symbols tell you about the proper and safe use of the Dexcom G6 Continuous Glucose Monitoring System (G6). For a listing of what they mean, see below. You may also reference theSymbols Glossary at dexcom.com/symbols.

~ Alternating Current Batch/Lot Number Bluetooth REF Catalog Number Caution Class II Equipment Consult Instructions for Use Date of Manufacture Direct Current Dexcom G6 System User Guide Appendix G: Label Symbols 327 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 327 2/5/19 9:27 AM Do Not Reuse Do Not Use if Package Is Damaged Electrical Equipment Designed Primarily for Indoor Use Humidity Limitation Input IP22: Protection Against Insertion of Large Objects and Dripping Water IP28: Protection Against Insertion of Large Objects and Immersion in Water Keep Away from Heat Keep Dry Manufacturer MR MR Unsafe Dexcom G6 System User Guide Appendix G: Label Symbols 328 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 328 2/5/19 9:27 AM PN Part Number Prescription Required Refer to Instruction Manual/Booklet SN Serial Number STERILE R Sterile by Radiation Temperature Limitation Type BF Applied Part Use By Date Dexcom G6 System User Guide Appendix G: Label Symbols 329 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 329 2/5/19 9:27 AM Page intentionally left blank LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 330 2/5/19 9:27 AM Appendix H | Alarm/Alerts Vibrations and Sounds H.1 App: System Alerts Screen Default On Default Sound Default Vibration Change Settings Override Mute YES YES YES Fixed Alert Beep Fixed Alert Beep Fixed Alert Beep YES Silent Alert YES Fixed Alert Beep YES NO YES YES NO YES YES NO YES NO NO NO YES NO YES Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 331 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 331 2/5/19 9:27 AM Screen Default On Default Sound Default Vibration Change Settings Override Mute YES Fixed Alert Beep YES NO NO YES Silent Alert NO NO NO YES Silent Alert NO NO NO YES YES Fixed Alert Beep Fixed Alert Beep YES NO NO YES NO YES Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 332 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 332 2/5/19 9:27 AM Screen Default On Default Sound Default Vibration Change Settings Override Mute YES YES YES Fixed Alert Beep Fixed Alert Beep Fixed Alert Beep YES NO YES YES NO NO YES NO NO YES Silent Alert NO NO NO Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 333 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 333 2/5/19 9:27 AM Screen Default On Default Sound Default Vibration Change Settings Override Mute YES Silent Alert NO NO NO YES Fixed Alert Beep YES Fixed Alert Beep YES NO YES YES NO YES Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 334 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 334 2/5/19 9:27 AM Screen Default On Default Sound Default Vibration Change Settings Override Mute YES Fixed Alert Beep YES NO YES H.2 App: Glucose and No Data Alerts Screen Default On Default Sound Default Vibration Editable Settings Override Mute YES Urgent Low YES YES Urgent Low YES Notify Below

(default is 55 mg/dL) Repeat (default is 30 minutes) Sound (default is Urgent Low) Enable/Disable

(default is disabled) Repeat (default is 30 minutes) Sound (default is Urgent Low) YES YES Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 335 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 335 2/5/19 9:27 AM Screen Default On Default Sound Default Vibration Editable Settings Override Mute YES Low Alert YES YES High Alert YES NO Rise Rate YES Enable/Disable

(default is enabled) Notify Below

(default is 80 mg/dL) Repeat (default is Never) Sound (default is Low Alert) Enable/Disable

(default is enabled) Notify Above

(default is 200 mg/dL) Repeat (default is Never) Sound (default is High Alert) Enable/Disable

(default is disabled) Notify Above

(default is 3 mg/dL/min) Sound (default is Rise Rate) YES YES YES Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 336 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 336 2/5/19 9:27 AM Screen Default On Default Sound Default Vibration Editable Settings Override Mute NO Fall Rate YES YES YES Signal Loss Alert Signal Loss Alert NO YES Enable/Disable

(default is disabled) Notify Below

(default is 3 mg/dL/min) Sound (default is Fall Rate) YES Enable/Disable Android YES Apple NO YES Sound (default is Signal Loss Alert) Enable/Disable

(default is disabled) Sound (default is Signal Loss Alert) H.3 Receiver: System Alerts No editable settings. Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 337 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 337 2/5/19 9:27 AM Screen Default On Default Vibration Default Sound Notes Yes 1 1 second vibe 1 1 second medium tone beep Yes 1 1 second vibe 1 1 second medium tone beep Sensor warmup is done. No need to calibrate to get G6 readings. Yes Silent Silent Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 338 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 338 2/5/19 9:27 AM Screen Default On Default Vibration Default Sound Notes Yes 1 1 second vibe 1 1 second medium tone beep Yes 1 1 second vibe 1 1 second medium tone beep Yes 1 1 second vibe 1 1 second medium tone beep Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 339 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 339 2/5/19 9:27 AM Screen Default On Default Vibration Default Sound Notes Yes 1 1 second vibe 1 1 second medium tone beep Pairing Failed Yes 1 1 second vibe 1 1 second medium tone beep First notification includes sound for:

Urgent Low Alarm Urgent Low Soon Alert Sensor Failed Alert Transmitter Alert Yes Silent Silent Silent Sensor Shutoff Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 340 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 340 2/5/19 9:27 AM Screen Default On Default Vibration Default Sound Notes Yes 1 1 second vibe 1 1 second medium tone beep Sensor Shutoff Yes 1 1 second vibe 1 1 second medium tone beep Cant restart sensor once it has been stopped. After trying to restart, transmitter determines if sensor has been restarted and stops it if it has. Yes 1 1 second vibe 1 1 second medium tone beep Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 341 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 341 2/5/19 9:27 AM Screen Default On Default Vibration Default Sound Notes Yes 1 1 second vibe 1 1 second medium tone beep Yes 1 1 second vibe 1 1 second medium tone beep First notification includes sound for:

Urgent Low Alarm Urgent Low Soon Alert Sensor Failed Alert Transmitter Alert Yes Silent Silent Recoverable error Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 342 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 342 2/5/19 9:27 AM Screen Default On Default Vibration Default Sound Notes Yes 1 1 second vibe 1 1 second medium tone beep Set time alarm H.4 Receiver: Glucose and Signal Loss Alerts Screen Default On Default Vibration Default Sound Editable Settings Yes 2 1/2 second vibes, 1/2 second apart 2 1/2 second high tone beeps, 1/2 second apart Can be turned on/off by the user EGV >= High alarm level value Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 343 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 343 2/5/19 9:27 AM Screen Default On Default Vibration Default Sound Editable Settings Yes 3 1/3 second vibes, 1/3 seconds apart 3 1/3 second low tone beeps, 1/3 seconds apart Can be turned on/off by the user EGV <= Low alarm level value Yes 6 vibes, progressively shorter in length 6 beeps, progressively shorter in length Can be turned on/off by the user First notification includes sound for:

Urgent Low Alarm Urgent Low Soon Alert Sensor Failed Alert Transmitter Alert No 2 1/2 second vibes, 1/2 second apart 2 1/2 second high tone beeps, 1/2 second apart Can be turned on/off by the user Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 344 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 344 2/5/19 9:27 AM Screen Default On Default Vibration Default Sound Editable Settings No 3 1/3 second vibes, 1/3 seconds apart 3 1/3 second low tone beeps, 1/3 seconds apart Can be turned on/off by the user Yes 1 1 second vibe 1 1 second medium tone beep Can be turned on/off by the user Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 345 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 345 2/5/19 9:27 AM Screen Default On Default Vibration Default Sound Editable Settings Yes 1 1 second vibe 1 1 second medium tone beep Can be turned on/off by the user Yes 4 200 ms vibes 4 1/4 second low tone beeps, 1/4 seconds apart EGV <= 55 mg/dL First notification includes sound for:

Urgent Low Alarm Urgent Low Soon Alert Sensor Failed Alert Transmitter alert Dexcom G6 System User Guide Appendix H: Alarm/Alerts Vibrations and Sounds 346 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 346 2/5/19 9:27 AM Index Alarm Calibration App recommended settings, 150 Entering into app, 97 Confirming, 148 Notifications, 133 Entering into receiver, 101 Errors, 331 Receiver beeps and vibrations, 159 Notifications, 331, 338 What is an, 133 Alarm and alerts Changing receiver, 283 Customizing, 150 Alerts Confirming, 148 Default, 150 Overview, 93 Preparing for, 95 What is, 93 When to calibrate, 94 Why is calibration important, 93 CGM System Basic maintenance, 275 Low/High Glucose, 140, 141 Different monitoring methods, 257 Low Repeat/High Repeat, 150 Receiver, 133 Rise Rate/Fall Rate, 143 Disposal, 282 Overview, 43 Storage, 279 Rise Rate/Fall Rate/Repeat, 150 Error messages, 331 Signal Loss, 145 What are, 133 Event Categories, 123 Definition, 123 Entering, 124, 128 Viewing, 131 Dexcom G6 System User Guide Index 347 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 347 2/5/19 9:27 AM Follower Alerts, 196 Glucose Information Rate of change arrows, 119 Trend screen, 113 Rate of change arrows, 119 Receiver Initial setup, 63 Trend screen, 118 Safety statement Contraindications, 20 Indications, 20 Warnings, 21 Sensor Insertion Choosing site, 73 Sensor Session Attaching transmitter, 81 Definition, 16 Ending, 207 Ending 10-day, 207 Ending early, 254 Inserting sensor, 75 Prepping for sensor insertion, 71 Preventing sensor failures, 279 Receiver: starting a Session, 87 Starting a, 85 Starting with app, 86 Warmup, 85 Share Followers, 185 Settings, 186 Setup, 187 Troubleshooting, 255 What is, 185 Signal Loss Alert, 145 Dexcom G6 System User Guide Index 348 LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 348 2/5/19 9:27 AM 2018 Dexcom, Inc. All rights reserved. Covered by patents dexcom.com/patents. Dexcom, Dexcom G4, Dexcom G5, Dexcom G5 Dexcom, Dexcom G6, Dexcom SHARE, SHARE, Dexcom FOLLOW, Dexcom CARE, and Dexcom CLARITY are either registered trademarks or trademarks of Dexcom, Inc. in the United States and/or other countries. Bluetooth is a registered trademark owned by Bluetooth SIG. Apple is a registered trademark owned by Apple Inc. Android is a registered trademark owned by Alphabet Inc. All other product or company names that may be mentioned in this publication are trade names, trademarks or registered trademarks of their respective owners. LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 349 2/5/19 9:27 AM Dexcom, Inc. 6340 Sequence Drive San Diego, CA 92121 USA Phone: 1.858.200.0200 Tech Support: 1.888.738.3646 Web: dexcom.com LBL014003 Rev XXX MT23976 2018 Dexcom, Inc. All rights reserved. LBL014003 Rev XXX Artwork, G6 CGM System User Guide US.indd 350 2/5/19 9:27 AM

Dexcom requests the permission of not marking FCC ID on product label due to size limitation. We instead place the FCC ID in the manual and package label. Our new transmitter size is preventing us from printing the FCC ID on its labeling side, see image below. The printable area (the shaded area right handside) on the device is only 12 mm x 15 mm and there is just barely enough space to place the serial number (X12345 in below picture) and part number (9445-

18) of the device. The lefthand side half of the product is the area that interfaces the sensor where perfect water tight seal is required. So no label can be put there. Since the font size required to make our FCC ID PH29688 legible does not fit on the portion of the transmitter for label, we would like to request approval for placing our FCC ID in the user manual and on packaging label instead. Packaging label:

6340 Sequence Drive D 4 C O Mm San Diego, CA 92121 www.dexcom.com Date: August 24, 2018 DEXCOM, INC 6340 Sequence Drive San Diego, CA 92121 FCC ID: PH29688 Dear Sir or Madam, We, Dexcom, Inc., 6340 Sequence Drive San Diego, CA 92121, hereby authorize Gang Chen from Dexcom, Inc., 6340 Sequence Drive San Diego, CA 92121, Phone: 858-529-4038 to act as our agent in all matters relating to applications for equipment authorization, including the signing of all documents relating to these matters. This authorization expires on December 315, 2018 Sincerely, Rogelio Director of Enginering Dexcom, Inc. 954-391-4880 rbasnuevo@dexcom.com

bexcom

6340 Sequence Drive San Diego, CA 92121 1-888-738-3646 www dexcom com One Step Aheaa Date 10/19/2018 Federal Communications Commission Equipment Authorization Branch 7435 Oakland Mills Road Columbia, MD 21046 Confidentiality Request FCC ID: PH29688 Pursuant to Sections 0.457(d)(1)(ii) and 0 459 of the Commission's Rules, Dexcom, Inc. hereby requests permanent confidential treatment of information accompanying this application as outlined below:

Schematics Bill of Materials/Parts List Block Diagrams Ties me) el-tee ite) Dexcom, Inc. also hereby requests short-term confidential treatment of information accompanying this application as outlined below for a period of 180 days:

Internal Photos

=o 4(TEt Te at B10) COs) OY MV ETEEEL Test Set-up Photographs The above materials contain trade secrets and proprietary information not customarily released to the public. The public disclosure of these matters might be harmful to the Applicant and provide unjustified benefits to its competitors. The Applicant understands that pursuant to Rule 0.457(d)(1)(ii), disclosure of this Application and all accompanying materials will not be made before the date of the Grant for this Application. Yours sincerely, Name Gang Chen a Lice l ic lime late aX-1 a