Scar Tissue? ... and other questions about wearing a sensor past the 7 days

Diabetes Technology Glucose Monitoring
1

I have not had my dexcom very long and the sensor tape comes off or gets really itchy (so far in my 2 sensor experience)… but I have a couple questions since the sensors are insanely expensive for me and I would like to wear one as long as possible.

  1. What “symptoms” does the sensor start to have when it is dying?
  2. How do I get the stupid thing to stay stuck if I am still getting use out of it but the adhesive is getting itchy and non-sticky?
  3. Do any of you long-term dexcom users notice scar tissue built up like with the pump sites?
2

I go with no adhesive until it starts peeking off (4-5 days), then put some tegaderm , then when it itches( 1-2 days later) I rip it off and put tea tree oil or lavender oil on the red itchy part. Feels great and heals. Then put the tegaderm back on in a day or so. Ususally get 12 days out of all this chaos.

Scar tissue is major issue. Must change sites as often as possible and use other areas of body. Its individual which work for each person. I get massages for the scar tissue and can do on myself too.

3

I was under the impression that the dexcom did not build scar tissue like the pump does. As far as the adhesive coming off that’s pretty normal. Some stay on better than others haven’t figured out why yet though. I use opsite flexifix tape when it starts getting loose. This tape is great and works very well. As far as the itching goes I guess it’s just part of it. Try using barrier wipes? And you can usually tell in the second week of use when it starts to get less accurate and you see ??? often. I get 10-14 days out of most sensors.

4

I’ll second what has already been said: itching is just a part of the deal, but usually i find that it only lasts for two or three days and then stops, so the longer i can wear a sensor for, the less it itches.

As for tape, i’ve had pretty good luck with both tegaderm hp and hypafix (but i’ve heard good things about opsite flexifix, too). Hypafix is the cheapest of the three, if that makes a difference. I also use smith and nephew skin prep wipes before placing the sensor initially and also every time i put a new piece of tape on and this seems to help a lot. Like lisa c, I don’t put any extra tape on until the original tape starts peeling, since the added tape will also peel after 5 or 6 days and the goal is to apply extra tape as few times as possible.

I use sensors for as long as they will last, usually about 16 days. You’ll find that regardless of the money issue (which is a major consideration, i agree), the sensors tend to get more accurate as they go (up to a point), so you’ll want to keep restarting the same sensor for that reason alone. How to know when a sensor is done? In my experience if the ??? shows up for more than three hours at a time, or if the sensor reads consistently more than 30 mg/dL off of the fingerstick reading, it’s time to toss it. Others on this forum have also mentioned that if you see the readings jumping up and down every 5 minutes, which results in the 12 hour graph looking sort of fuzzy), this is also a sign that it’s time to toss the sensor.

Regarding scar tissue, it was also my understanding that the Dex doesn’t create scar tissue in the same way a pump does. Granted, keeping any foreign body under your skin for many days in a row does create some scar tissue, and you should always place your new site at least a few inches away from the last one, but the real culprit with the creation of scar tissue is the infusion of relatively large quantities of medicine (i.e. insulin) in one place under the skin. This is why I have had a great experience with the Dex but I had to stop using the OmniPod after less than a year, even though I’m using a lot of the same sites for the cgm as I did for the pump.

I hope this helps!

5

FIRST, A HINT: There are many, many discussions on these topics, so “SEARCH” is definitely your friend. (The tool at the top right corner of each TD page.)

Now I’ll save some time and answer directly:

(1) A dying Sensor will usually begin to show a “fuzzy, jumpy” line of bG results first. The bG line, especially in the 6-hour graph, should be solid and smooth. If it shows a lot of “up, then down, then up again, then down again” on ADJACENT READINGS, it’s wrong – bG doesn’t change that way, you can’t trust the readings anymore.

(1A) If you continue to push it past the point of #1, you will begin to see a higher frequency of “???” and lost data points in the graph. (Those empty spots in the graph are a history of “???” occurrences.) “???” can happen a lot on days 1 and 2, or after a bit of wetness/sweat gets under the Transmitter. But if the frequency starts to increase, the transmitter contacts are dry, AND you’re past day 2, the Sensor is Done.

(2) Use Smith&Nephew “Skin-Prep” underneath the entire Sensor area. This reduces itch, AND helps the tape last much, much longer. Skin-Prep is NOT!!! the same thing as “IV Prep”, don’t confuse the two products. You might have to go online to find it.

(3) Dexcom isn’t injecting insulin, so the immune response is orders of magnitude less strong than a pump site left in for too long. And the wire is a titanium alloy, you won’t react to it as strongly as other materials. BUT! You ARE doing a very violent injection, causing a lot of tissue damage. And you’re leaving the wire in your body for days (or weeks). There IS an immune response - both to the damage of the shoot-in, and the chemical traces of the wire surface and reactants inside.

With that said, my opinion is that fewer damaging punch-ins, left in longer, is “less awful” than more punch-ins, taken out quicker. But in your case, with a strong reaction to the tape, you need to get THAT solved first – or use Sensors for shorter numbers of days, so that the skin surface IR isn’t so severe.

With all that said, here’s my situation: Without Skin-Prep, I grow blisters by day 2, and they’re Pussing by day 4. With Skin-Prep, there’s no IR at my skin surface for 20 days. For scarring, I wait a few hours after Removal to let the hole seal up – then I massage with “Udder Cream”, and I also use it to massage ALL visible previous sites. After a few weeks, they become completely invisible.

Scar Gel would probably work, but costs a lot. Udder Cream is cheap, but smells really BAD. Take your pick!

6

I am a new Dexcom user as well and I am wondering how users are able to use their sensor past the 7 day time-frame. My Dexcom tells me “sensor expired” and stops working. Am I missing something? Thanks for any input.

7

Once the Dexcom sensor expires, just start it again as if it were a new sensor.