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Keeping diabetes devices, like CGMs, adhered to the skin throughout the sensor session is an ongoing concern for people with diabetes. This is especially significant for individuals with diabetes who have skin sensitivity, sweat excessively, play recreational or water-based sports and small children who lack adequate body surface area. This blog post will guide you through the common adhesive issues you may encounter while wearing your CGM and steps that you can take to keep your diabetes device in place the entire session.
How long can CGMs stay on for?
CGMs can stay on for different amounts of time depending on the manufacturer. Most CGM sessions last between 7-14 days. Here are the common session lengths for CGMs:
- Dexcom G6: 10 Days
- Dexcom G7: 10 Days with 12 hour grace period
- Freestyle Libre 14 Day: 14 Days
- Freestyle Libre 2: 14 Days
- Freestyle Libre 3: 14 Days
- Medtronic Guardian 3: 7 Days
Common Adhesive Issues with CGMs
A challenge while wearing a CGM is having problems that impact the CGM adhesive. Once a CGM adhesive is compromised, it can be accidently pulled off or end up falling off before the session is over, which can be extremely frustrating for users. Common adhesive issues with CGMs include:
Skin Irritation with CGMs
Skin irritations are a common side effect for people with diabetes using a CGM. The adhesive that holds the sensor in place can cause redness, itching, or rashes. The most common skin reactions that CGMs users experience include: allergic reactions, contact dermatitis, scarring, and lipodystrophy (uneven distribution of fat). If left untreated, skin irritation can become severe and users may need to discontinue using the device. In addition to the physical discomfort from skin irritation, it can also influence the accuracy of CGM readings. If the sensor is not securely in place from rubbing or itching the site, it may not be able to provide accurate readings.
The adhesive that holds the sensor in place may become less effective in the presence of sweat. Excessive sweating can lead to many problems for CGM users as it can cause the sensor to become loose or dislodged, leading to inaccurate readings or loss of data altogether. This can make it difficult for individuals with diabetes to manage their blood glucose levels effectively.
Recreational Sports and Water-Based Activities
Keeping CGMs adhered to skin during physical activity can pose a few different challenges that depend greatly on the type of activity. For people with diabetes who actively participate in recreational sports, CGMs may come in direct contact with other players and/or equipment that can loosen or knock off the sensors. While swimming and other water-based activities can weaken the CGM tape due to water exposure. These activities can cause the sensor to fall off or move out of position which can lead to a loss of glucose readings that can make managing blood glucose levels during sports difficult for individuals with diabetes.
Lack of Surface Area
CGM adhesive issues for small children are common due to limited body surface area. CGM sensors and transmitters need an adequate amount of skin so that they can lay flat. With young children where there is limited surface area, the sensor may not be able to be inserted correctly and cause discomfort or pain from the adhesive pulling and/or lifting off the skin. In addition to the physical challenges, a lack of surface area can also impact the emotional well-being of the child with diabetes and their caregivers. It can be frustrating and stressful trying to find a suitable area for the sensor insertion and constantly monitor to see if the sensor has stayed in place.
How to Make Your CGM Stay on Longer
No matter what CGM device you use (Dexcom, Libre, or Medtronic), there are extra measures that you can take before, during and after insertion to ensure your sensor stays on for the entire session.
Choose a time to insert your new sensor when your skin can stay dry for a few hours. For some users, it can take awhile for the adhesive to fully dry and stick to the skin so it is best to avoid exposing the sensor to water or humidity, like showering or bathing, soon after a sensor change.
CGM Site Location
Choose a location where there are no skin folds when you bend or near waistbands. When a sensor is inserted into an area of the skin that is frequently folded, it can cause the adhesive to weaken and peel off the skin. Additionally, trying to avoid placing sensors near waistbands can be helpful so they do not accidentally get snagged on the sensor and pulled off. It is important to select an appropriate sensor insertion site so that the sensor can be secured in place with the adhesive.
Prepping the skin for CGM insertion is an essential part of ensuring the sensor is inserted appropriately and stays on throughout the entire session time. The skin preparation step is essential to ensure that the skin is properly cleaned from any residues and oils and completely dry so that it does not interfere with the sensor adhesive. Here are skin preparation tips from Dexcom:
- Sensor site should be flat, clean and completely dry before insertion. Consider using adhesive removers to remove any residue from previous sensor tapes.
- The sensor site should be cleaned and dried with soap and water followed by an alcohol wipe, if needed.
- Extra adhesives such as liquid SkinTac or Underlayers should be dried completely before insertion. It is also encouraged to avoid adding adhesive glue to the area where the needle will be directly inserted.
Press and Hold
When inserting the sensor, it may help make the patch stick better by pressing and holding the CGM applicator firmly against the skin – for about 30-60 seconds, before pushing the button to insert the sensor.
After inserting the sensor, gently rubbing over the CGM patch to smooth out any wrinkles and apply additional pressure can ensure that the adhesive has been stuck on correctly.
Allow Drying Time
Everyone has different skin types which may affect how long it takes for CGM patches to fully dry and adhere to the skin, but it is generally recommended to keep the site dry for a few hours while the adhesive dries.
Apply Medical Tape and Overpatches
Overpatches and medical tape, like Skin Grip, can help keep the patch on your skin. Some CGM users prefer to apply patches immediately after their insertion while others prefer to wait until the edges begin to peel off the skin. Overpatches are an extra layer to ensure that your sensor won’t go anywhere. Skin Grip adhesives are available for CGM and other diabetes devices such as Dexcom G6, Dexcom G7, Freestyle Libre, Freestyle Libre 3, Medtronic Guardian, and more! Skin Grip recently released Dexcom G6 patches for kids that is the same adhesive you know and love in a smaller size for your little one!