This content material initially appeared on diaTribe. Republished with permission.
By April Hopcroft
Steady glucose monitoring (CGM) can dramatically enhance glucose administration – however these units may deliver their very own set of challenges, particularly when you’ve got delicate pores and skin. Fortunately, there are a number of merchandise that will help you make insertion simpler.
If you happen to’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 influence high quality of life and even result in gadget discontinuation. In a current research, about one in 4 CGM customers reported pores and skin reactions, and about 3% stopped sporting their sensor on account of reactions.
Nonetheless, there are a number of merchandise designed to make these units extra snug and efficient. Plus, CGM corporations are regularly innovating their sensors and adhesives to make them extra snug, correct, and longer-lasting.
Who’s in danger for pores and skin irritation?
Individuals use CGM in numerous methods and for various causes. These with insulin-dependent diabetes sometimes use CGM day by day, whereas folks with much less extreme diabetes might use CGM a couple of instances a 12 months to assist wholesome life-style decisions.
Sarah Hormachea, a registered dietitian and Licensed Diabetes Care and Training Specialist (CDCES) at Nourish, famous that intermittent customers are likely to have fewer skin-related points since they’ve much less publicity to the sensors, adhesives, and years of insulin injections. If you happen to use CGM intermittently, you might have extra flexibility within the collection of your CGM insertion web site, Hormachea stated. In the meantime, when you use CGM day by 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 situations may additionally be at a better danger of creating 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.
Skilled 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 precise sensor web site
There are a lot of totally different CGM fashions, every with professionals and cons – together with the place they are often worn. You may must do some trial and error to seek out one of the best sensor web site for you.
When you’ve decided the place in your physique to put the gadget, 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 lots of weight reduction generally 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 units from sticking.
Whereas every CGM mannequin is accepted for particular software websites, Hormachea stated in actuality, she has seen sensors worn in many alternative locations. Individuals who have been sporting CGM for a few years might begin to run out of area; they could want to choose a extra uncommon place, such because the decrease again, hips, or thighs.
Some folks discover it tough 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 accepted sensor areas
| CGM | Accredited sensor areas for adults | Accredited sensor areas for youngsters |
|---|---|---|
| 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) |
Be aware that placement areas may additionally fluctuate relying on the place you reside – the desk above exhibits areas accepted to be used throughout the US. Seek the advice of along with your healthcare supplier when you’ve got questions relating to sensor websites.
2. Hygiene is essential
When inserting a sensor, you’ll want to first wash your fingers with cleaning soap and water. When you’ve got 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 utterly earlier than making use of the gadget. 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 training 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 properly.
“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 reside in chilly areas the place the warmth dries out the pores and skin and others reside 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
If you happen to’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 urged spraying your CGM web site a few instances to create a contact barrier, which may forestall rashes. You should buy the generic model over-the-counter for about $25.
You can even take into account 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 urged making use of TegadermHP after which putting the sensor by the dressing – that manner, the sensor received’t contact your pores and skin straight. 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 lot 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 kids with kind 1 diabetes.
“Some folks urged ‘off-gassing’ the sensor, or unpeeling the backing paper off the sensor and letting the adhesive facet air out for twenty-four hours prematurely of making use of it to the pores and skin,” Chen stated. “I personally discovered that to be actually helpful.”
4. Think about additional adhesives
Some folks have a tough time protecting 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 units to fall off.
If you happen to’re vulnerable to shedding sensors, Hormachea urged first re-evaluating your gadget placement. Is your CGM on a physique half that’s typically being stretched or bumped? Do you are likely to sweat rather a lot in that space? In that case, take into account switching your sensor web site.
For example, 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, it’s possible you’ll wish to keep away from these areas as they might end in compression lows.
There are additionally several types of merchandise that may assist maintain your CGM in place:
- Wipes or sprays that make your pores and skin additional sticky, like Pores and skin Tac or Pores and skin-Prep
- Overlay patches that present additional safety (many are available in enjoyable colours and designs!)
- Holsters or harnesses that include a stretchy band and a plastic cap that covers the sensor
5. Rotate, rotate, rotate
It’s vital to offer your pores and skin time to heal when utilizing a CGM, insulin pump, or injections. Rotating between totally different websites will help enhance the CGM’s accuracy and scale back your danger of pores and skin irritation or issues.
There are a number of totally different methods that will help you monitor and rotate your CGM:
- Think about a clock on the sensor web site. Begin by putting the gadget within the 12 o’clock place, then change 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 properly) onto the physique half the place you place your sensor. Begin with one quadrant of the grid and step by step rotate your sensor by all of the potential bins.
6. Take care when eradicating your sensor
Hormachea really useful eradicating a CGM like a Band-Help. “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.
If you happen to’re having a tough time eradicating your sensor, think about using a product to loosen the adhesive. Medical grade wipes (like Uni-Clear up) will help soften residue from the adhesive. You can even use child oil or every other oily product (similar to micellar water) to loosen the adhesive.
The underside line
CGMs are a robust 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 components of diabetes care, it’s possible you’ll must experiment with trial and error to seek out the sensor location, rotation sample, and adhesive merchandise that work greatest for you.
If you happen to proceed to battle 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 expertise or medicines.
“A CDCES or diabetes-trained dietitian or nurse can typically take a look at somebody immediately and say ‘let’s do this,’ and provide you with custom-made pointers,” Hormachea stated. “Assembly with an expert can actually improve your CGM expertise.”
