Inserting an Enlite thru a skin barrier? Hey, what could go wrong? ☻

Continuing the discussion from Dexcom G4 sensors are driving me crazy! Help!:

[quote=“Dave26, post:19, topic:46226”]

Go for it! I’ve been punching through Skintac for nearly 2 years now, and have never, ever, had any problem.[/quote]

I don’t think I was clear enough in explaining that I am not using a Dexcom as you are. Oh, well.

I do use the Medtronic CGM and their Enlite glucose sensor. So I’m really not sure what might happen if I tried to insert the sensor through an area I’ve prepped with either Skin Tac or Mastisol. I have my doubts about whether the sensor probe sheath is completely encased by the introducer needle and thus more likely to be protected from possible contamination.

I have never tried to visually inspect the Enlite introducer needle simply because my eyesight is not all that good. Still I might try doing that tomorrow afternoon when it will be time to swap out my current sensor.

The only other thing I have to go on is the bit of “needle porn” in the pic below. It shows a slide from the 2014 Medtronic Diabetes Advocate Forum conference which compares the size of the Enlite introducer needle to the previous Sof-sensor (aka “Harpoon”) which Enlite replaced.

In the slide it appears from the needle cross sections that even though the sensor probe is technically inside the introducer needle, a portion of it may still be exposed. Assuming some portion of the probe sheath is “exposed” then I am also not sure how much damage would follow if any of the exposed probe sheath were contaminated from contact with a skin barrier. :confounded:

MM has been uniformly ADAMANT that we not insert Enlites through any skin barrier. I haven’t tried, as I have enough trouble with sensors as it is.

Amen to that! :fearful:

I still haven’t decided whether to try this out or not. Part of the reason I created this thread was to think publically about it a bit more before actually doing anything … well, that and the fact that it made no sense to try to talk about this in a context where folks could continue to mistakenly assume I was using the Dexcom CGM.

However, I think I will at least try to visually examine the introducer needle before my next insertion. I’ve never really bothered to look at it up to this point. :blush:

My gut feeling is that Medtronic tends to be officially obstinate about a great many things. Reflecting on this a tad further @phoenixbound, do you feel they have been any more insistent about the whole “skin prep with alcohol only” thing than they have been with all the other rules we’re supposed to follow with their CGM?

I’ve examined the needle in the Enlite sensors and they do expose the probe sheath. The picture above shows pretty much what I saw, except that the groove seemed to have a bigger opening than is implied by the drawing. I didn’t notice the edges wrapping around the probe, it was more of a groove than is shown.
My endo encouraged me to use an IV prep with the sensors to prevent skin irritation, she must not agree with or be aware of Medtronic’s policy. I tried it once (can’t remember the brand, it was a free sample) but it didn’t seem to affect the accuracy, such as it is. In fact this and the uncomfortable nature of these things, is why I don’t wear one all the time anymore. I’ve had several sensors that were so bad I had to turn off all the alarms and auto-suspend because it kept waking me up in the middle of the night. The sensor would show I was at 40 but my meter showed I was closer to 130 so I started ignoring all the feedback from that CGM sensor.
The IV prep I tried didn’t help with adherence of the tape and I don’t have problems with skin irritation so I didn’t use it again.

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wheelman , if you ever decide to try a CGM again, try using Skin Prep (NOT IV prep) and after about 10-15 seconds, when the SKin Prep is still SLIGHTLY TACKY, slap down your tapes. For me that works better than the vaunted Mastisol, and it doesn’t stink like Mastisol. IV prep has way too much alcohol to be any good as a “stickum”. Dunno why your endo encouraged you to use such a wimpy product for adherence enhancement.

###Sooooo … here is my update

Earlier I had decided not to try inserting an Enlite through a skin barrier product. The cautions I received about it (above) when I first created this topic influenced me.

Unlike the Dexcom, the Enlite probe sheath does appear to be at least partially exposed. I had decided that if there was any non-trivial chance that the probe sheath might be compromised by contact with glue residue on my skin … well, why risk trashing an otherwise pretty often good enough sensor? :fearful:

Oh, well. :blush:

Tonight I tried it anyway. I applied a coat of Mastisol to the insertion site and then let it dry for 10 or 15 minutes while I waited for the MiniLink to finish charging. Then I inserted pretty much as usual. (I had to be a little more careful removing the inserter since the Mastisol was still tacky and caused the inserter to stick to my skin.)

That was about 4 hours ago. No problems that I am aware of so far. My speculation is that if there were going to be problems, they would have manifested immediately after insertion during sensor initialization. But only time will tell, of course.

If this does continue to work, what would it mean? Well, essentially nothing, of course. All it would demonstrate is that inserting an Enlite through a skin barrier is not absolutely, positively guaranteed to always result in instant sensor death. :smirk:

Still so far everything seems to be copasetic. I just completed the second calibration. For a meter BG of 124 the ISIG is ~38 and the calibration factor the pump calculated was 3.393. That is about as good as it ever gets for me.

For the moment at least, this sensor is performing better than the previous two or three. Wonder how it will hold up as the days pass? Oh, the suspense! :anguished: :wink: