CGM Insertion Site Issues

I feel like everyone who uses a Continuous Glucose Monitor (CGM) loves it. I have not been so lucky. One of the main issues I have with my Minimed CGM is that whenever I go to insert the new sensors using the insertion device the sensor needle CANNOT penetrate the surface of my skin. I click the button and the needle pushes up against my skin but will NOT go in. I try manually pushing in the needle slowly and painfully and..... nothing. Maybe the circumference of the needle is too large or my skin is too taut but it is terrible and I usually give up. Sometimes the metal sensor catheter will even bend :(.
Also I can't stand when it is inserted and functioning and it is constantly beeping and sending alerts. I try to push the ACT ESC to "accept" the warnings and they just keep going off and off and vibrating and beeping... all while I am trying to work. Anyway.. I was wondering if anyone else is having the same issue or if they have any advice for how to get the giant CGM insertion needle to penetrate the skin. Thank-you! -Amy

Ouch! That sounds brutal! I had a few of those and sort of fixed the "firing" problem by rolling the button more towards my nail on my finger, where it's harder and seems to push "cleaner" and that seems to be helping insertions. It is really hard when it doesn't go in. One person in the Flatliners' Club mentioned having shots of vodka before she inserted but I usually do it in the morning so I haven't tried that.

Re the warnings, I have my range set to alert me at 60 and 130 and it leaves me alone pretty well. It sort of babysits me and I work to keep it there so it doesn't go off.

Hi Amy,
actually several users have commented on the 'harpoon' insertion for the MM CGMS, but don't recall hearing it not penetrating. I used MM CGMS for 2+ years but now use Dexcom CGMS.

I think when I used MM CGMS on my stomach, it would sometimes be slower at going in, and I switched to using my thigh with better luck. I would also pinch up my skin and that helped too.

Have you called MM tech support ? You should be able to get replacements for the sensors that don't go in. Possibly you need a new insertion device ?

You might also consider Dexcom if you don't mind having a separate device (receiver). Check the Dexcom Users group for additional information.

Try stretching the skin tight between the inserter legs with your other hand when inserting, this should fix the problem. You can also silence your high/low or both alarms, second option on the sensor menu screen. Be patent it can take some time, there is a steep learning curve when first starting to use the MM/CGMS.

Wow. I've never had that particular problem, but if I did I would try calling MM to see if I needed a new inserter. I don't think the issue is your skin, I think it's the (lack of) speed of the needle travel.

The other comments are correct though. You need to set the limits on the sensor high and low enough that that they warn you when appropriate but leave you alone the rest of the time. All you really want is to know when you are straying from the straight and narrow...

John's suggestion works --stretching the skin before insertion is how I was taught. I only have had non-penetration of the needle once in many years of use.

If you are accepting the alerts they should go off--if not call MM for assistance. Remember that you set the frequency of alert repeats when you created your "Edit Settings" in the sensor menu. I recently changed my low glucose from 15 minutes to 30, as I found it was taking a little longer for my BG to rise.

I had given up the CGM for a while last winter; then I had a really horrible low, so I went back to it. However, I have it set only to alert me if my readings are 60 or below. I completely turned of the high alerts. I test so much that I really wear the CGM for night time alerts. I can deal with a high without involving the paramedics. Lows are more problematic.

Hi Amy, I wear a Dexcom CGM but tried the MM CGM when I was just trying them out. I found the MM CGM to be so uncomfortable/painful that I told my CDE I wasn't interested - then I tried the Dexcom and found it so much better.

Even with the Dexcom, my experience has been that if you hesitate or are tentative at all when you push the plunger to insert, it will be painful and possibly bleed. The smoother and quicker you can do it, the easier and painless.

Like Spock, I turned off my high alerts because I test so often that I can deal with that on my own. My low alert is set at 60 and it's saved me more times than I can count.

Just for reference, I found a comparison that shows that the sensor cannula size for the Dexcom is 13 mm and for the MM is 14 mm, so that could account for the comfort level.

Thank-you all so much for the tips and advice. I will plan on changing my alert settings and flattening my skin when I try inserting the new sensors. I never thought to call MM for them to replace the unused sensors - It’s too late now. But I did call them recently to request a new inserter but I had the same problem so I will try your advice. Much appreciated!!! -Amy

How long have you had the sensertor, insertion device? My sensertor was getting the tip of the needle into my skin. I would then have to manually push it in the rest of the way. This was often my least favorite part of the week. My insurance will cover a new sensertor after 12 months so I got a new one. Now the needle is inserted completely with the new sensertor.

If the alerts are too annoying, then I would increase your limits to a point where you can handle the amount of beeps you have. You have to be able to live with your devices. They aren't supposed to drive you crazy, but we all have a few of those days.

Actually, Amy, I find that MM is good about replacement. When I change a sensor, I put the bag it came in into my medicine closet. It helps to have the Lot#, etc when you call. They actually mail a tube that you place the old sensor in to ship back. They are really good at replacing things--even when I may have been the cause of the malfunction.

Amy- I just saw your discussion about MM sensors not penetrating the skin. I have had the exact same problem. I did return the insertion device to Medtronic, but I am having the same problem with the new one. The only remedy I have found is to insert the sensor in a spot with a little more fat. Medtronic told me I needed to keep it in my abdominal region though.
Did you have any success with a new insertion device?