6 Issues to Know About Carrying a Steady Glucose Monitor

This content material initially appeared on diaTribe. Republished with permission.

By April Hopcroft

Steady glucose monitoring (CGM) can dramatically enhance glucose administration – however these gadgets also can convey their very own set of challenges, particularly if in case you have delicate pores and skin. Fortunately, there are a number of merchandise that can assist you make insertion simpler.

In the event you’ve ever skilled pores and skin irritation when sporting a steady glucose monitor (CGM), you’re not alone. From a minor rash to a painful allergic response, pores and skin issues aren’t any enjoyable – they will negatively affect high quality of life and even result in machine discontinuation. In a latest research, about one in 4 CGM customers reported pores and skin reactions, and about 3% stopped sporting their sensor as a consequence of reactions.

Nonetheless, there are a number of merchandise designed to make these gadgets extra comfy and efficient. Plus, CGM corporations are frequently innovating their sensors and adhesives to make them extra comfy, correct, and longer-lasting.

Who’s in danger for pores and skin irritation?

Individuals use CGM in several methods and for various causes. These with insulin-dependent diabetes sometimes use CGM each day, whereas folks with much less extreme diabetes might use CGM a couple of occasions a 12 months to assist wholesome life-style selections.

Sarah Hormachea, a registered dietitian and Licensed Diabetes Care and Schooling Specialist (CDCES) at Nourish, famous that intermittent customers are inclined to have fewer skin-related points since they’ve much less publicity to the sensors, adhesives, and years of insulin injections. In the event you use CGM intermittently, you could have extra flexibility within the number of your CGM insertion web site, Hormachea stated. In the meantime, when you use CGM each day for a few years of your life, it’s a good suggestion to be extra prudent with insertion, rotation, and elimination.

Individuals with delicate pores and skin, a historical past of eczema, or different pores and skin barrier circumstances might also be at the next danger of growing a contact rash. Likewise, analysis suggests individuals who use each CGM and insulin pumps usually tend to report irritation, in comparison with those that solely use pumps.

Knowledgeable tricks to keep away from pores and skin irritation when sporting a CGM

Whereas correct CGM insertion can appear overwhelming at first – so many steps and particulars to maintain monitor of! – there are a number of tricks to make the method smoother.

1. Select the correct sensor web site

There are various completely different CGM fashions, every with professionals and cons – together with the place they are often worn. You may have to do some trial and error to search out the very best sensor web site for you.

When you’ve decided the place in your physique to put the machine, search for the next traits for a sensor web site. An space:

  • A minimum of 3 inches away out of your insulin pump or injection web site
  • Away from bones, irritation (like stretch marks or eczema), waistbands, scars, and tattoos
  • Unlikely to be bumped or laid on whereas asleep
  • With sufficient “padding” or fats

Hormachea famous that individuals who have skilled plenty of weight reduction typically have a tough time discovering CGM websites. Pores and skin elasticity can lower after weight reduction, making the pores and skin much less agency and stopping gadgets from sticking.

Whereas every CGM mannequin is authorized for particular software websites, Hormachea stated in actuality, she has seen sensors worn in many various locations. Individuals who have been sporting CGM for a few years might begin to run out of area; they could want to select a extra uncommon place, such because the decrease again, hips, or thighs.

Some folks discover it troublesome to insert a brand new sensor into the again of the arm by themselves. If that’s the case, they need to ask a trusted caregiver, member of the family, or buddy for assist.

CGM fashions and authorized sensor areas

CGM Permitted sensor areas for adults Permitted sensor areas for kids
Dexcom G6 Stomach or again of the higher arm Again of the higher arm (ages 2+), higher buttocks (ages 2-17)
Dexcom G7 Again of the higher arm Again of the higher arm (ages 2+) or higher buttocks (ages 2-6)
FreeStyle Libre 14 Day Again of the higher arm N/A – ages 18+ solely
FreeStyle Libre 2 Again of the higher arm Again of the higher arm (ages 4+)
FreeStyle Libre 2 Plus Again of the higher arm Again of the higher arm (ages 2+)
FreeStyle Libre 3 Again of the higher arm Again of the higher arm (ages 4+)
Guardian 3 Stomach or again of the higher arm Stomach or buttocks (ages 7-13)

Stomach or arm (ages 14+)

Guardian 4 Again of the higher arm Stomach or buttocks (ages 7-13)

Stomach or arm (ages 14+)

Simplera Again of the higher arm Again of the higher arm or higher buttock (ages 2-17)

Notice that placement areas might also differ relying on the place you reside – the desk above reveals areas authorized to be used throughout the US. Seek the advice of along with your healthcare supplier if in case you have questions concerning sensor websites.

2. Hygiene is vital

When inserting a sensor, you’ll want to first wash your arms with cleaning soap and water. When you have thick hair, you’ll want to shave close to the sensor web site. Getting hair caught between the adhesive and pores and skin could make CGM elimination painful and trigger irritation.

Clear the sensor web site and let your pores and skin dry fully earlier than making use of the machine. CGM producers suggest utilizing alcohol wipes, although Hormachea famous that this may be drying and aggravating for some folks.

“You don’t have to make use of alcohol so long as you’re practising good hygiene utilizing cleaning soap and water,” she stated.

Nonetheless, you’ll want to avoid moisturizing or scented cleaning soap, as these merchandise may cause sensors to not stick as nicely.

“All moisturizing soaps and lotions are the bane of my existence,” stated Natalie Bellini, DNP, an endocrine nurse practitioner and Program Director of Diabetes Expertise at College Hospitals in Cleveland, Ohio.

“Many individuals dwell in chilly areas the place the warmth dries out the pores and skin and others dwell in heat areas the place the air con dries out the pores and skin and each teams use moisturizer. Moisturizer creates points with each pumps and infusion units round adhesives to the pores and skin.”

3. Stop contact rashes

In the event you’re vulnerable to irritation, some healthcare suppliers suggest utilizing a nasal spray like Flonase, which is a topical steroid that helps calm the pores and skin. Bellini prompt spraying your CGM web site a few occasions to create a contact barrier, which may stop rashes. You should buy the generic model over-the-counter for about $25.

You too can contemplate making a bodily barrier utilizing a product just like the sticky patch TegadermHP, which blocks liquids, viruses, micro organism, and different contaminants from touching the pores and skin. Bellini prompt making use of TegadermHP after which putting the sensor by the dressing – that manner, the sensor received’t contact your pores and skin instantly. A field of 100 dressings prices about $60.

Many who belong to on-line diabetes communities have felt extra comfy realizing they aren’t alone in having pores and skin reactions to sporting a CGM. Susannah Chen, a managing editor at diaTribe who makes use of the Dexcom G6, skilled a variety of pores and skin reactions when beginning on CGM with an AID system, even after talking along with her endocrinologist and dermatologist. She in the end discovered essentially the most useful recommendation in a Fb group for adults and caretakers of youngsters with kind 1 diabetes.

“Some folks prompt ‘off-gassing’ the sensor, or unpeeling the backing paper off the sensor and letting the adhesive facet air out for twenty-four hours upfront of making use of it to the pores and skin,” Chen stated. “I personally discovered that to be actually useful.”

4. Think about further adhesives

Some folks have a tough time retaining their CGM in place for the complete one to 2 weeks. Humid climate, intense bodily exercise, and even bumping your sensor whereas getting dressed can all trigger gadgets to fall off.

In the event you’re vulnerable to shedding sensors, Hormachea prompt first re-evaluating your machine placement. Is your CGM on a physique half that’s usually being stretched or bumped? Do you are inclined to sweat so much in that space? If that’s the case, contemplate switching your sensor web site.

As an illustration, the flank (the areas on the edges of the stomach) are a preferred sensor web site for Dexcom G6 customers. Nonetheless, when you’re a frequent facet sleeper, you might wish to keep away from these areas as they might lead to compression lows.

There are additionally several types of merchandise that may assist hold your CGM in place:

  • Wipes or sprays that make your pores and skin further sticky, like Pores and skin Tac or Pores and skin-Prep
  • Overlay patches that present further safety (many are available in enjoyable colours and designs!)
  • Holsters or harnesses that encompass a stretchy band and a plastic cap that covers the sensor

5. Rotate, rotate, rotate

It’s necessary to offer your pores and skin time to heal when utilizing a CGM, insulin pump, or injections. Rotating between completely different websites may help enhance the CGM’s accuracy and scale back your danger of pores and skin irritation or issues.

There are a number of completely different methods that can assist you monitor and rotate your CGM:

  • Think about a clock on the sensor web site. Begin by putting the machine within the 12 o’clock place, then swap to three o’clock, 6 o’clock, and so forth.
  • Visualize the letter M or W and use every level of the letter as an insertion level.
  • Map out a grid sample (2×2, 3×3, and 4×4 work nicely) onto the physique half the place you place your sensor. Begin with one quadrant of the grid and steadily rotate your sensor by all of the potential bins.

6. Take care when eradicating your sensor

Hormachea really helpful eradicating a CGM like a Band-Assist. “Use one hand as assist and the second hand to peel the sensor away from the pores and skin in a single movement,” she stated.

In the event you’re having a tough time eradicating your sensor, think about using a product to loosen the adhesive. Medical grade wipes (like Uni-Remedy) may help soften residue from the adhesive. You too can use child oil or another oily product (reminiscent of micellar water) to loosen the adhesive.

The underside line

CGMs are a strong instrument for diabetes administration which have been proven to extend time in vary, scale back hypoglycemia, and enhance high quality of life. As with all elements of diabetes care, you might have to experiment with trial and error to search out the sensor location, rotation sample, and adhesive merchandise that work finest for you.

In the event you proceed to wrestle with sporting a CGM, contact your healthcare supplier or CDCES for extra assist – they’re a invaluable useful resource for any questions you might need about diabetes know-how or medicines.

“A CDCES or diabetes-trained dietitian or nurse can usually have a look at somebody instantly and say ‘let’s do that,’ and provide you with personalized pointers,” Hormachea stated. “Assembly with an expert can actually improve your CGM expertise.”

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