CGM insertion sites a burden?

Hi everyone. I am a T1, Animas pump user and I haven’t tried CGM yet, but I would like to one day. My main concern though is about the insertion sites. Are they basically exactly like pump sites? I have a fairly lean build and I tend to have trouble finding free “real estate” to stick my pump infusion sites in without overusing certain areas. Do any of you feel it’s difficult to find room for the pump and the CGM site?

Yes and no. I’m playing with a kit now, and my midriff is OK. I can use my Pump in the arms and upper legs, upper boo-tocks. so I can use my midriff and abs for the sensors.

I DO NOT use the sen-serter, it doesn’t go in well with the 'serter. I basically stick the sensor into me manually. Always have done my pump sites the same way.

I can control the degree and depth is more reliable.

I do not like using the CGM on my abdomen as it is a bit larger than the pump site and I also felt it caused more scar tissue than my pump site, so I am saving my abdomen for my pump. I tried it on my back above my waistline, but it got bumped too much and it was uncomfortable for me. The best place that worked for me was on the side of my thigh right below my pantie line. I have heard others use their arms.

Just an FYI, I am not using my CGM right now even though I did a 6 month insurance fight to obtain it.

Thanks for both of your responses… That’s interesting… Do you mean your insurance company eventually covered the CGM? I didn’t know any did… and if so, why aren’t you using?

Yes they did pay for my CGM.

I had some good days and some bad days with the CGM. When it was working well, I found it to be helpful, as it did show where I needed some tweaking with my basal setup and the fact I was going high after waking up in the a.m., so now I know to cover that with added bolus in the a.m.

The days that the CGM did not function well, I felt like I was testing with my meter to see how far off the CGM was. I was testing to see if the CGM was accurate, if that makes sense.

I need real time readings I guess and the delay bothered me at times and I felt so focoused on my numbers, but it did improve my A1C from a 6.8 to a 6.3, so I am sure I will wear it again.

I feel there is room for improvement so I am hoping for that before I am a true convert.

I know fellow users that love it and cannot imagine not having it on. I think I was expecting more from it accuracy wise.

Hi Felix…I originally had a problem with Blue Cross covering it but when I did the first appeal, they agreed to it and stated that they had some policy changes due to legislation and do cover it (never found the legislation they spoke about). I have the Minimed CGM. As far as sites - I have the same issue with finding “real estate” because I am fairly thin and muscular. I insert the CGM on my abdomen - just right or left (2"-3") of belly button where there is a somewhat natural “indent”. Minimed’s CGM has quite a large needle to insert & you have to use the inserter in order for the wire (which is very thin) to be in straight otherwise it causes an issue with readings. I have not used it as often as I would like because it is a bit of a process to get it going properly. Hopefully it will get better as I continue. Definitely helped with the night lows and tweaking my basal. Good luck fellow NY’er and Esq.

I am using the MiniMed CGM and love it. Have been useing it 24/7 since last Nov. I do not have the issue of being to thin generually insert it in the side of my hip under my underware. Saved me this week driving and BG was 45 and I got a low alarm and was not feeling it.

I have found that the more I wear the CGM, the more reliable it has become. At first it seemed to be off by quite a bit some days but not others. I know what you mean by testing more to make sure the CGM is working. But now my values are usually within 2-15 mg/dl of each other even with lag time. My control has improved tremendously according to my downloads after making several very helpful adjustments. There really is a learning curve though and it does take time.

There are now several choices of sensors out there and some have larger needles to insert them than others. I use the Minimed CGM with my pump and I love it but it has the largest needle. I am also very thin and that was definitly a problem for me. You must place the sensor in enough fatty tissue that there is free flowing interstitual fluid for it to get readings from. If that can’t happen, then you will not have accurate results. I also like to designate sensor sites that are always different from my insulin sites so that there is no extra scarrinig or problems. The Dexcom has a smaller needle for insertion but I believe it is the one that must be placed on the arm or the abdomen. I could have that confused with the new Navigator though. Each website should have some good pictures and info for you though for more accurate info than I could give you.
More and more insurance companies are covering the CGMs and others are going by a case by case basis so it may be worth the extra effort to pursue the coverage.

Since you use an Animas, why not try the Dexcom? Animas will communicate with the Dexcom shortly. My niece has the Minilink and needle quite large and thick. Dexcom’s introducer needle has a much smaller gauge. More comfortable, so you may wear it more often.

Thanks for the info everyone… I think I am going to wait for future developments for now since it sounds like the insertions might be an issue with some of the models anyway, but hopefully the technology will evolve quickly…

Yes, yes and yes. Niece has taken a hiatus from using the cgms. Mom had been using the arm with good results first three insertions; after that, having pain after insertion (she uses EMLA so would feel it after EMLA wore off). She had a serious infection last time she used it. She uses MM and it’s a great system, but they need to reduce the size of the introducer needle for children. We need to use cgms and are hoping MM will come out with the smaller introducer needle in December. Her Mom is trying to work up the nerve to try again. I have gleaned that Dexcom is much more comfortable to insert and wear. Since you have the Animas pump and Animas will communicate with Dexcom in the future, I would go with the Dexcom. MM has better software; Dexom is more comfortable to wear. MM has low alarms, can’t hear the alarms if you are under the covers at night (have to wear a Radio Shack wireless mike in addition to pump to hear alarms). Dexcom, not sure if you can turn the alarm to “vibrate” so you don’t announce lows or highs to the world at large. Navigator by far most accurate but I would never use it because of the ten hour calibration requirement.