Bean poles with sensors, unite!

I’m T1 for 24 years, pumping with Medtronic the last 11. I’m also 5’6" (1.7m): and 112 pounds (50.8kg) soaking wet.

My endo, who I love dearly, has mentioned several times wanting me to go on a CGM, and is over the moon excited about Closed Loop.

Skinny CGM’ers, talk to me. How much trouble do you have getting good sites for the CGM? Favorite spots to place it?

Anybody else, here’s my other thing: I already don’t do everything the way I’m supposed to every day. I just don’t think it’s humanly possible for me to do every single thing about this disease exactly according to “rules” every single day. Sensoring and Closed Loop appear to me to be even more work that has to be put in every day in exchange for the other kinds of freedom it offers. What are your thoughts on that aspect based on experience?

I have no trouble getting a good site for my CGM…the wire that is inserted is so tiny. I find it easier to get a good site than with my pump. I use my stomach and upper abdomen mainly but have also used the back of m arm.

I’m not skinny so I can’r speak to that issue but I can tell you that my CGM solves many more problems than it creates. I don’t know how anyone who uses insulin can safely navigate life while “flying blind.”

Now, I know there are exceptions and I once believed I was one of them. After eight years of using a CGM, I can look back and see, for me, I was very wrong. My life is better and safer using a CGM. It’s not even a close call.

I would give your doctor’s excitement about the CGM (and closed-loop systems) careful consideration. Good luck!

I had that same resistance toward switching to a pump from MDI. When my endo finally pushed me into it I found it was actually true–I did have to spend more time thinking about it, but the pluses have definitely outweighed the minuses. As for CGM, again I’m much more aware every twitch and spike of my BG but it’s actually made things like dealing with exercise and postprandial spikes easier because it shows you an ongoing trend where a BG meter just gives a snapshot with no sense of where you were and where you’re going unless you’re testing 30 times a day.

I recently signed on for the 670G hybrid closed-loop pump. Part of what convinced me was reading accounts from people in the trials who said that after the initial calibration period they were spending a lot less time thinking about this stuff than before. Guess I’ll find out.

Every time I call Dexcom with a problem, they ask me “Are you thin?”. When I tell them I am, they give that “Oh, okay! Well no wonder…” answer that tells me that Dexcom clearly knows that thin people have more of a problem with CGM than non-thin people.

It is frequently way off for me. It is also slow to pick up BG changes, and slow to get to my actual BG.

I’d never dose off it. Trusting my basal to my CGM readings would be a big step backward for me.

So it really depends on you. For some people it works great. For them, the closed loop is a great thing, as long as they don’t mind targeting 120.

I don’t target as high as 120, and CGM doesn’t work well, so for me it makes no sense.

I’ve done incredibly well breaking the rules. You just have to make your own.

I’ve had the 'beetus for seventeen years (as of May 5th!) and have ALWAYS had trouble with sites, both for my pump and for sensors. When I went on the sensor for the first time, I was unable to get the thing to work. At all. No matter what I did, I could not get it set properly. I was using my stomach. When I did actually get the sensor to stick in my skin, I would not get accurate readings. I’m 5’6" and about 115-120 give or take, so I kind of equate this to two things. One, I have a lot of scar tissue on my stomach. Two, even my sensor rep said this, I don’t have a lot of real estate on my stomach. Since then, I’ve moved to my upper thighs. I use the tops of them (as opposed to the backs or outer edges.) Not only am I getting much better absorbtion, but my CGM is working GREAT. If you’ve got real estate on your thighs, I suggest it!

I’m quite lean and only on my third Dexcom sensor, but I don’t foresee being able to use any site other than upper abdomen. Given that the filament is so thin it’s not that I’m concerned about not having enough “fat” in a few other spots but it’s moreso that I can’t see how I could avoid putting a lot of pressure on it when sleeping if it were anywhere else (inlcuding anywhere on my arm) since the G5 sensor+transmiter is quite “tall”. Even using a fairly central spot on my abdomen, I have experienced the “false pressure low” when sleeping on my side.

Frustratingly, I feel like the universe of usable sites is really limited to a 6" wide strip along my upper abdomen. Admittedly this isn’t particularly related to my being a bean pole though.

I’m pretty thin also and have no problem when I put it on my abdomen or behind my arm. I don’t even feel it.

I avoided this type of problem, when my first pump order was being processed, by intentionally gaining 10 pounds. It went exactly where I wanted it–my abdomen. The layer of fat has only increased in thickness because of slow muscle decrease with ageing, so I don’t see it as a disadvantage. But my age now is 74 and when I got my first pump I was 59, so appearance wasn’t much of an issue for me. As an earlier poster suggested, look around for real estate that is reachable and usable. If none is to be found, then I see two choices–create a little more thickness or give up the use of a cgm. My own choice was to continue to have enough area to hold the infusion sets and sensors, since I’ve been dealing with type 1 for 58 years without problems, and hope to continue for a while longer.
My luck has been mostly good through the years, and the pump and cgm seem to be improving it even further.
Don’t give up trying to find the right answer to the cgm problems.

I would give anything to be able to add real estate. I can’t keep weight on for love nor money. I celebrate when I’m Over 110 because I feel more “officially three digits” than when I’m one-oh-something.

I am not super skinny but skinny enough I think to chime in. I have been pumping for almost 27 years now and like when I was on injections, it was beat into my head to rotate. And I do and I don’t have absorption issues with pump sites. I do use just about everything available. Thighs inside and outer. Arms back side and under side. Hips, buttocks, lower & upper ab. I also try to put infusion site and CGM site on same side, so if I’m sleeping, I try to sleep on other side. I also find a small pillow helps, if I need to raise an arm or leg to keep pressure off site. Bit I really don’t have much of that pressure false alarms. But I also don’t get results from my Dexcom as close as I’d like and I also am one who doesn’t dose from it. But wouldn’t give it up. I love my trend arrows as I really gives me more knowledge on if I should dose some insulin or take a small carb snack. Love my arrows!
So skinny people unite and fire them up. It can be done!

Ok here’s my thing about how much added work it sounds like. And I feel like I’m just going to sound lazy saying this, but it is what it is and I can’t change what I don’t own.

I already don’t always get all 4 BG checks in every day. I already don’t use the Wizard on a without-fail basis. I easy bolus frequently and usually post bolus so I can decide how much I’m going to eat as I eat it. I can’t fathom splitting a bolus in a way anymore complicated than 50-50 dual wave, or taking action based on a 1-hour post prandial of 160. That last one literally frightens me because my brain is stuck on my body’s sometimes 4 hour insulin tail.

If I’m already missing the mark in so many ways, after 24 years of doing this disease, do I really think I’m going to get it in gear enough to make the most of a sensor? Let alone closed loop, which sounds even MORE involved?? If not it seems like such an incredible waste of time, psychic energy and money. I’m not sure I trust myself to stick with the front end dedication long enough to reach the back end freedom.

I hear you about not wanting to add to the already packed full diabetes “must do” list. It can be a nightmare. My thinking here is that once the sensor goes it, it could free you from having to test. Many, many people use it safely for doses. That means just testing to calibrate. Less things to do is always a good thing.
I also suggest to just do one thing. Just because you have a CGM, doesn’t mean you have to change everything. Just pick one thing like review the results every week or every 2 weeks and make changes if needed. Don’t think you need to change everything and if you do, the likely hood is all if it will stop. So little baby’s steps and pick one thing that you will get the biggest bang for your buck. The CGM will give you info you never had before and remember it’s not the answer to all your problems and you don’t have to keep using it. Give it a try and see if it helps make things easier. Just remember alarm fatigue can be nightmarish, so you need to set them carefully. Good luck and keep asking questions. Let us know what you decide.

I use injections, no pump. I have always been slim 5’8 and 145ish. I have tried Dexcom and Freestyle. I inserted Dexcom in my stomach and it worked fine most of the time there were a few occasions with sensors not inserting properly and Dexcom replaced them. I use Freestyle Libre on the back of my arm. I was unsure if there was enough tissue there but it has worked well for more than 6 months. Comparing the 2 for comfort I find the Libre insertion much quicker and more comfortable than Dexcom. Very little difference after they are inserted.

1 Like

@auntlisa1103 I guess I was a bit like you. I didn’t even go to a doctor for years and had no idea what my a1c was. I rarely even tested with fingerstick. My neighbor actually convinced me into going to a doctor who happened to be her friend. This was about two years ago. I’m now on the pump and Dexcom. Like @Eric2 said, whenever I call Dexcom with a problem they seem to say, yes, that happens if you are too thin. I don’t always get accurate numbers from the sensor, but it is extremely helpful for trends, and also helps to keep me involved and aware. I know, it would be nice to ignore our diabetes, and I did just that for years, but I actually find using both pump and sensor helps me to stay engaged, more so than fingerstick and mdi. My advice would be to definitely give them a try. I usually wear my pump on the back of my upper arm, and sensor on my abdomen. You have to rotate the spots but usually I don’t even notice I have then attached.

I can sympathize with not having sufficient real estate to move the CGM sensor around your body. I can only use it on my abdomen as I don’t have enough fat on my arms or legs to make it work. But I’ve never had problems with it not working well. The one problem I had was with my second sensor ever. I don’t think I pinched enough skin when inserting the sensor and it went in too far. It would read all over the board and I would get acute pain in my stomach fairly regularly. So now whenever I have to put one in, I make sure to pinch as much skin as I can, even though there isn’t much there to pinch.

I had the same hesitations to start on a CGM, but as I tried different spots I found you don’t need much cushion. My favorite are so far is the upper glutes, just enough fat to keep the sensor from pinching and pretty easy to hide.