Do You Know What It Means to “Sensor Soak” Your CGM?

This post was originally published on Hugging the Cactus on September 27, 2019. I’m sharing it again today because I still find the concept of “sensor soaking” to be fascinating, though I haven’t been brave enough to try it yet. Not sure what sensor soaking is? Read on to find out…

I saw an Instagram story a few weeks back that intrigued me.

In it, a friend of mine was talking about how she “soaks” her CGM sensors. Instantly, I was confused: What the heck did she mean by that? Soaks them in what, hot water or some other liquid?

Contrary to the connotation of the word “soaking”, this does not mean you’ll be submerging your CGM in any sort of liquid.

Within seconds, her definition of “soaking” became much clearer. “Soaking” a CGM sensor means inserting a fresh sensor hours before you intend to activate it. Rather than giving your sensor just two hours to warm-up, you’re giving it 4-6 hours so it can supposedly provide much more accurate readings immediately after the warm-up period has ended.

I was interested in this practice because I’ve definitely experienced sensors that were off for several hours post-insertion/warm-up. Sometimes, it even takes a full day for a sensor to start reporting accurate numbers, and I wouldn’t exactly call that efficient.

While I haven’t had the guts to actually try sensor soaking yet – I’d like to sometime in the near future – I’ve been doing some research on it so I’m fully prepared to try it whenever I’d like. Here are some questions I had about the process, and the answers I’ve found to them:

Q: Doesn’t this mean that you’re wearing two sensors at once?
A: Yes. But it’s only for a short window of time, until the old sensor expires and it’s time to activate the new one; in other words, for the full soaking period.

Q: How long should I let a new sensor soak?
A: According to what I’ve found online, it seems that 4 to 6 hours is the sweet spot for soaking. It’s basically doubling or tripling the built-in warm-up period that all sensors must go through, so I can see how this might contribute to improving immediate accuracy.

Q: How do I protect the new sensor if it doesn’t have a transmitter snapped in it for several hours?
A: The reason why I haven’t tried soaking yet is because I was worried about wearing a sensor that didn’t have a transmitter snapped in it. But I found some photos online of people who wore transmitter-less sensors with stretchy, self-adhesive wrap tape to protect the nook in which transmitters rest for the soaking period. It’s smart to protect that space, because in theory, it could be vulnerable to catching on clothing or other surfaces. Plus, tape like that is really easy to remove without damaging the sensor in the process.

Q: What changes about the sensor activation process when it’s finally time to start the new soaked sensor?
A: My research leads me to believe that nothing really changes at the end of the soaking period/when it’s time to activate the soaked sensor. All that will be needed is the sensor code so it can be properly activated within the receiver/Dexcom app. So the most important thing you can do at the very start of the soaking period is hold onto your sensor code/store it somewhere safe so you’ll be able to enter it at the end.

Q: So…why would anyone bother trying this again?
A: My understanding is that it all relates back to making sure a fresh sensor is as accurate as possible once it’s activated. I can’t tell you how many times I’ve put on a new sensor, only to discover a few hours after it has warmed up that it’s off by 40 or 50 points – and that just doesn’t cut it. So I don’t think there’s any harm in me giving sensor soaking a shot one of these days. I just have to remember to do it, and have the patience to wear three devices at once (my pod, the soon-to-expire sensor, and the new soaking sensor).

Have you tried soaking? If so, please drop a comment and let me know your thoughts on it – and be sure to tell me if I missed any key steps in my research!

How to Make Medical Adhesive for CGMs and Pumps Last Longer

Something that all people with diabetes that I know – myself included – struggle with from time to time is the adhesive that keeps our diabetes devices stuck to our bodies.

Real talk? Both the adhesives for my pods and my Dexcom sensors can be lackluster. About half the time, the adhesives that secure them to my body begin to peel around the edges when I’m only partway through the wear time of both devices. And another (much smaller, though far more infuriating) part of the time, the adhesives lose their stickiness entirely, causing the device to fall off my body.

When the adhesive is the reason why a sensor or a pod doesn’t last the full 10 and 7 days, respectively, it’s practically like experiencing a slap in the face because at least a technology error or failure feels more out of my control…the adhesive, though, feels like something that should never be a real issue, and I can’t help but blame myself for not making a pod or sensor more secure when the glue completely fades.

On the bright side, my experience with less-than-sticky pods and sensors forced me to think of ways to get them to last their full lifecycles on my body. Here’s how I make them last as long as possible:

Protective barrier wipes: I use these wipes each time I do a pod change. When my new pod is priming, I wipe whichever site I’m about to place it on with a protective barrier wipe. (I use an alcohol wipe earlier on in my pod change process.) These seem to help with adhesion without adding a ton of stickiness like regular SkinTac wipes tend to do. They literally do what they say they’ll do, which is make a protective barrier for a piece of medical equipment to stick to easily.

Dry my skin: This seems incredibly obvious, but I make sure that new pod and sensor sites are as dry as possible before I apply a device. This is much more of a problem for me in the summertime when weather causes me to sweat more, but I’ve been able to navigate that by wiping my skin with a clean towel and making sure air is circulating well in the room in which I’m applying the pod or sensor so any excess moisture evaporates off my skin.

I may or may not have tried using Scotch tape in the past to get my devices to stick better…(Spoiler alert: It did not work and I do not recommend.)

Specially designed stickers: Both Dexcom and OmniPod produce stickers that customers can request for free. I get them mailed straight to me and I find that they are most useful when a pod or a sensor is hanging precariously off my body. The stickers are shaped exactly to fit around both, so I never have to worry about missing a spot, and they’ve definitely helped me save more than one pod and sensor in the past. I don’t like wearing them unless I have to, though, because sometimes the extra adhesive seems to make the underlying adhesive weaker (not sure how that’s possible, but I’ve always had more luck waiting to add a sticker on top of a loose pod/sensor that’s in its last couple days of wear than adding the sticker on top in the beginning).

The “circle and press” technique: Most people probably already do this, but I actively have to remind myself that when I apply a new pod or sensor, I need to take my finger and circle it around the adhesive firmly three times in order to make sure it’s pressing up against my skin as securely as possible. This method also sort of irons out any wrinkles that might have appeared when the pod or sensor was initially stuck on, so it’s a simple yet effective thing to do…which is absolutely something we could all use more of when it comes to handling diabetes.

5 Reasons Why I Took a Break from Continuous Glucose Monitoring

I’ve decided to take a break from continuous glucose monitoring. This means that for an undefined period of time – maybe 3-4 days, a week, or a few weeks – I’m not going to wear my Dexcom G6 CGM.

Initially, I wanted to give myself a break because I was just burnt out from wearing it all the time and feeling so dependent on it. But as I started thinking about more, I realized that there were some other really great reasons for me to take a break from my CGM:

1 – I wanted to wear one less device. It can be tough to wear two medical devices 24/7. Sometimes I get super self-conscious of them. Other times they just aren’t comfortable to wear, such as when I roll over one the wrong way when I’m sleeping at night. So it’s nice to feel a little more free with one less device stuck to my body at all times.

2 – I was sick of the constant data feed. All those alarms going off whenever I cross my high or low threshold are straight up annoying!!! I know I could just turn them off on my CGM receivers, but the point of them (for me) is to try to maintain as tight of a control on my numbers as possible. But now that I’m intentionally not wearing my CGM, I’m realizing how much I appreciate the reprieve from all that buzzing and beeping.

Pink Minimalist Kindness Quote Instagram Post
There’s lots of reasons to take a break from continuous glucose monitoring, but sometimes one is enough.

3 – I have some new blood glucose meters to try. The only way that I can really put my new meters to the *test* (lol) is to use them – and goodness knows that I have very little desire to do manual finger stick checks when I’m wearing my CGM.

4 – I’d like to hold myself more accountable. I rely on my Dexcom heavily at all times. I look to it before I start exercising, before I eat something, before I do anything, really. I bolus using the data it provides and trust it implicitly. But I’ve recognized that by developing this habit, I’ve become lazy. I don’t measure out food as much because I figure that if I bolus too much or too little for it, I can just watch what my Dexcom tells me and treat from there. It’s kinda sloppy, in my humble opinion, so I’m trying to put more of the trust back in myself for my diabetes monitoring.

5 – I’m trying to reacquaint myself with my body’s cues. Before CGM technology, I was really good at recognizing high and low blood sugar symptoms…but then I started using a CGM and found myself reacting to highs and lows (e.g., treating them prematurely), even if I didn’t feel those high/low symptoms. So I want to retrain myself so I can make sure I never lose that ability, because I think it’s important to know exactly how my body alerts me to various blood sugars, rather than depending solely on a piece of technology to do it for me.

 

Four Signs of Diabetes in the Summertime

Sun’s out, guns pumps out, amirite guys?

The summertime season is in full swing, and now that it’s here I’m thinking of the various ways my diabetes is more pronounced in the warmer weather. It’s much more visible, leading to many more questions, but what are the cues that give it away to others? I thought of four…

Visible sites. Shorts-and-t-shirts weather makes it much harder to place pods or CGM sensors in discrete locations. And if I’m going to the beach? There’s no way that I can even attempt to hide my devices. That’s probably why I make them even more obvious with…

…Pump and sensor art. I’ve written about Pump Peelz and GrifGrips in the past – they make adhesives and skins that are specially designed to fit pods, PDMs, pumps, meters, and more. The products they make are truly little works of art for diabetes devices, and I like to make sure all of mine are decked out in the summer months so I can show off tech that’s not only functional, but also stylish.

Four Signs of Diabetes in the Summertime
I’m looking forward to donning my best beach-y Pump Peelz on what I hope will be many trips to the beach this summer.

Gadget tan lines. Or if you’re like me, it’s more like sunburn lines. That’s because each summer, without fail, I somehow manage to neglect the space around my pod or my sensor, so when it’s time to remove it, there’s a huge red circle around the perimeter of where the device was situated. Maybe this year I’ll actually learn my lesson and take the time to apply sunscreen properly so I can avoid the very not-cute sunburn circles.

Travel coolers. This is probably the least obvious sign of diabetes in the summertime, but to those in the know, coolers meant to protect insulin are pretty recognizable compared to regular coolers. Whether it’s a Frio cooling pouch or another brand of insulin cooler, people with diabetes tend to carry these throughout the summer months in order to prevent insulin from spoiling due to heat exposure.

 

WTF is CGM Sensor Soaking?

I saw an Instagram story a few weeks back that intrigued me.

In it, a friend of mine was talking about how she “soaks” her CGM sensors. Instantly, I was confused: What the heck did she mean by that? Soaks them in what, hot water or some other liquid?

HUGGING THE CACTUS - A T1D BLOG
Contrary to the connotation of the word “soaking”, this does not mean you’ll be submerging your CGM in any sort of liquid.

Within seconds, her definition of “soaking” became much clearer. “Soaking” a CGM sensor means inserting a fresh sensor hours before you intend to activate it. Rather than giving your sensor just two hours to warm-up, you’re giving it 4-6 hours so it can supposedly provide much more accurate readings immediately after the warm-up period has ended.

I was interested in this practice because I’ve definitely experienced sensors that were off for several hours post-insertion/warm-up. Sometimes, it even takes a full day for a sensor to start reporting accurate numbers, and I wouldn’t exactly call that efficient.

While I haven’t had the guts to actually try sensor soaking yet – I’d like to sometime in the near future – I’ve been doing some research on it so I’m fully prepared to try it whenever I’d like. Here are some questions I had about the process, and the answers I’ve found to them:

Q: Doesn’t this mean that you’re wearing two sensors at once?
A: Yes. But it’s only for a short window of time, until the old sensor expires and it’s time to activate the new one; in other words, for the full soaking period.

Q: How long should I let a new sensor soak?
A: According to what I’ve found online, it seems that 4 to 6 hours is the sweet spot for soaking. It’s basically doubling or tripling the built-in warm-up period that all sensors must go through, so I can see how this might contribute to improving immediate accuracy.

Q: How do I protect the new sensor if it doesn’t have a transmitter snapped in it for several hours?
A: The reason why I haven’t tried soaking yet is because I was worried about wearing a sensor that didn’t have a transmitter snapped in it. But I found some photos online of people who wore transmitter-less sensors with stretchy, self-adhesive wrap tape to protect the nook in which transmitters rest for the soaking period. It’s smart to protect that space, because in theory, it could be vulnerable to catching on clothing or other surfaces. Plus, tape like that is really easy to remove without damaging the sensor in the process.

Q: What changes about the sensor activation process when it’s finally time to start the new soaked sensor?
A: My research leads me to believe that nothing really changes at the end of the soaking period/when it’s time to activate the soaked sensor. All that will be needed is the sensor code so it can be properly activated within the receiver/Dexcom app. So the most important thing you can do at the very start of the soaking period is hold onto your sensor code/store it somewhere safe so you’ll be able to enter it at the end.

Q: So…why would anyone bother trying this again?
A: My understanding is that it all relates back to making sure a fresh sensor is as accurate as possible once it’s activated. I can’t tell you how many times I’ve put on a new sensor, only to discover a few hours after it has warmed up that it’s off by 40 or 50 points – and that just doesn’t cut it. So I don’t think there’s any harm in me giving sensor soaking a shot one of these days. I just have to remember to do it, and have the patience to wear three devices at once (my pod, the soon-to-expire sensor, and the new soaking sensor).

Have you tried soaking? If so, please drop a comment and let me know your thoughts on it – and be sure to tell me if I missed any key steps in my research!

The Low I Didn’t Feel

Do you ever feel so engrossed in a task that something (like the time) sneaks up on you, and totally disarms you and puts you in panic mode?

That’s sort of what happens when you don’t feel the symptoms of a low blood sugar. Usually, I’m lucky enough to say that I feel my low blood sugar symptoms – shakiness, sweating, dizziness – but unexpectedly, I didn’t feel them during a recent low blood sugar episode. And it nearly knocked me off my feet.

I’d been traveling all day long. I’d taken an Uber from my apartment to the airport, where I waited a couple hours to catch my flight, which was so turbulent that I nearly yakked on the tarmac. When I finally arrived to the airport and lugged my bags up to the hotel room that I was staying at, I was struck by how queasy my stomach still felt and chalked it up to after effects of the turbulence.

I figured my body was just mad at me for skipping dinner. It was already 9 at night and I didn’t really want to go back down to the crowded terminal just to get a mediocre fast-food dinner. That’s when I decided to check my blood sugar: That would determine how necessary food was for me at that point in time.

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The low I didn’t feel.

Just as I was taking my kit out of my bag, my CGM alarmed. According to it, I was low – low enough that I’d be below 55 within the next 20 minutes. “Impossible”, I thought. I feel my low symptoms coming on when I’m 80 mg/dL sometimes, so I was convinced there was something wrong with my CGM. I proceeded with the fingerstick check. The result popped up on my screen: 65. What? How? I could’ve chalked it up to a long travel day, but at that moment in time, I didn’t care about the cause. I only cared about the fact that I didn’t feel it whatsoever.

It was scary and an unpleasant surprise. As I sat down on the hotel bed and crammed M&Ms in my mouth, I felt a little confused about how I got so low (especially since I’d been eyeing my slightly-elevated blood sugar all day). But mostly I felt gratitude for my CGM. Times like these make me feel incredibly privileged to have one. I find its alarms annoying and I don’t love wearing an extra thing on my body, but its functionality makes it totally worth it.

Testing for Accuracy, in Addition to Blood Glucose

This post originally appeared on Hugging the Cactus on March 21, 2018. I’m republishing it now because of a recent experience I had with my meter reporting inaccurate and inconsistent blood sugar levels. Has this ever happened to you? Drop a comment and let me know.

Blood glucose meters serve the sole purpose of checking current levels of glucose in the blood. Pretty self-explanatory, right? And it’s equally obvious that it’s crucial for all meters to generate accurate results so PWD can make the right treatment decisions based on those numbers.

Unfortunately, though, accuracy isn’t always what I get.

The other day, I was running low before bedtime. I corrected with an organic rice crispy treat (honestly, it was a million times better than the brand name kind). I waited nearly an hour for my blood sugar to come up. When my CGM wasn’t showing any progress, I tested: I was 47. It’s rare for me to be that low, so I tested again. 52. I believed it, especially since I was experiencing several hypoglycemic symptoms.

B. J. Palmer

I chugged a glass of orange juice and plopped down on the couch to wait for signs of improvement. Before long, I was freezing cold – a sure sign I was coming up, because I had been sweating 20 minutes prior. But I didn’t feel comfortable going to bed yet. I wanted to see if my CGM would show an up arrow. When it finally did, I made my way upstairs to brush my teeth and wash my face. In the middle of my routine, though, I decided to glance at my CGM again – and saw the dreaded ??? screen.

I decided then that the Dexcom should be out of commission, a.k.a. not trusted at all, for the remainder of the evening.

I ripped it out and inserted a fresh one, not really caring that it would wake me up in two hours to be calibrated. I would need to set at least two alarms for the middle of the night, anyways, if I decided to go to bed disconnected from my Dex. So it just made sense.

Once that was done, I tested again. I was pretty tired at this point and really didn’t want to have to eat something else, so I did it as quickly as I could. In my haste, I jostled my meter just so – enough that I saw the test strip, already marked with my blood, move slightly as it brushed against my PDM and was placed next to it.

113 mg/dL flashed upon the screen. Normally, I’d be thrilled! But I furrowed my brow. Something just felt…off about that reading. So I tested again.

206.

What?!

I tested a third time – 203. Okay, something was definitely wrong. Either that 113 was wrong (likely) or my meter had just produced two wildly inaccurate blood sugars in a row (less likely).

This is one of the many times that it’s convenient to live with another PWD. I asked my mom if I could borrow her test kit and see what result it generated. Seconds later…a twin 203 popped up on the screen, reassuring me that the 113 was a fluke on my meter.

Relief with the reality and irritation with the technology washed over me simultaneously as I went to correct the high with a bolus. I was glad I wasn’t heading down again, but irked that my meter had failed me. True, it was a bit of human error there, but aren’t we at a point in technological advancements where this sort of thing just shouldn’t happen? I put my life into the “hands” of my meter, Dexcom, and OmniPod. They should produce results that are undoubtedly accurate.

I guess we aren’t quite there yet.

The Red Wedding

If you’re reading this post and knew immediately what the title was referring to…rest assured that what you’re about to read is not nearly as dramatically violent as The Rains of Castamere episode of Game of Thrones. I just chose the title because it semi-accurately described what I encountered with my CGM at a weekend wedding I recently attended. And because the final season is here in a mere FOUR DAYS and I’m struggling to hold in my excitement/terror/anticipation.

Anyways, the day of said wedding began normally, if not a bit early. I put on makeup and a nice dress, tried (and somewhat failed) to curl my hair, and ate a light breakfast. Somewhere between slipping on my jewelry and singeing my hair with the curling iron, I heard my CGM’s alarm blaring, notifying me that my blood sugar was going up. That wasn’t surprising, since I’d just eaten food. But I was caught off-guard when it stopped alarming after two alerts went off…I hadn’t dismissed the previous two, so why was it no longer making any noise?

I checked the app on my phone and saw “sensor error” on the screen…and said out loud, “NOT today, diabetes,” as I promptly stopped my sensor and ripped it off my body. I didn’t even hesitate to do it because I knew that the sensor was due to be changed that evening, anyway, so I saw no harm in doing it a bit early.

“What?” My partner yelled from behind the bathroom door.

“Nothing, nothing,” I said dismissively, which reflected my determination to just brush this inconvenience away and stick a fresh sensor on my body.

Oh, if only it were that simple…

It should’ve been an easy, routine sensor change; alas, upon pressing the button on the insertion device, I let out a little pained squeak. Sensors don’t normally hurt, but every now and then, I get myself in a sensitive spot. And I definitely did this time around. Before popping the transmitter into the sensor, I noticed a bit of blood pooling underneath the sensor’s adhesive.

Save the date

Pools of blood as I make my way to a wedding…do you get the red wedding connection now?

Fortunately, this tale has a happier ending than it did for much of the *spoiler alert* Stark family. Sure, my sensor kinda freaked out when it warmed up two hours later and measured blood instead of interstitial fluid, and it took like 12 hours for it to get its act together and display my readings accurately, but…it all worked out in the end. And thankfully, not a single person had any clue that there was a patch of blood on my belly throughout the wedding…it didn’t even stain through my dress.

A Device-Free Shower

For the first time in *literally* years, I took a device-free shower the other day.

AND IT WAS AMAZING.

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Ta-ta for now, little friends.

Let me clarify that by device-free, I mean that I wasn’t wearing a pump or a CGM on my body. Both were due to be changed that evening, so with what can only be described as unadulterated glee, I peeled my Dexcom followed by my pod off my body before practically leaping into the shower.

It probably sounds funny, and perhaps a little dramatic or flat-out fucking weird, but those 15 minutes without a single medical device stuck to me were glorious. I wasn’t worried about accidentally knocking something off. I was free to scrub off the adhesive that had kept the devices stuck to my skin, and I felt oddly empowered – carefree, even – that I could enjoy one of the most mundane daily routines without needing to worry about my diabetes. Sure, for the duration of my shower, I wasn’t receiving my basal rate of insulin, but I really didn’t care because 1) I took a small bolus to compensate for it before I removed my pod and 2) I was more focused on doing this one little thing for myself to reclaim my body from diabetes devices, even if it was for a short window of time.

So you might argue that I had my first truly nekkid shower for the first time in forever. And it made me happy. A brief reprieve from diabetes is always welcome, and I’ll take it in whatever silly form I can get it in.

Is a Bleeder a Reader? My Take on a Bloody Dexcom G6 Insertion

This blog post probably shouldn’t be read by anyone who gets squeamish when discussing blood or when viewing photos that show any amount of it…my apologies in advance for a bloody gross blog post, but I thought this was a good topic for discussion. 

I placed the new Dexcom G6 sensor on my abdomen, hovering my index finger above the large orange insertion button. I pressed it, exhaling as I felt the minute needle pierce my skin’s surface. I looked down, and started to rub the adhesive in circles to make sure it was stuck, when I saw blood. Not just a drop, but a decent-sized pool forming beneath the sensor. Before long, just about the entire surface of the white adhesive was soaked in red.

Yeah, this was going to be a no-go.

It’s pretty rare for me to experience blood at the site of a Dexcom sensor. If I had to put a number on it, I would say less than 10% of my insertions draw blood. An even smaller amount – like, 2% – have caused me to bleed as much I did in the scenario described above. But I know I’m not alone in my bloody sensor experiences – it’s something that many other T1Ds who use a Dexcom have gone through.

There’s a bit of debate, though, that I’ve noticed in the past on Twitter threads and Instagram posts. What to do with a bleeder? Keep it and assume that it’ll read blood sugars normally? Or change it immediately and call Dexcom for a replacement?

Are bleeders readers? Or does it depend?

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Do you think that bleeders are readers?

I’m going to go with…it depends.

Obviously, in that situation I described in the opening of this post, I decided that it wasn’t a good idea to keep the sensor on my body. There was too much blood and I didn’t trust that it would adhere well to my body. I didn’t know how long it would take for the blood to stop (only a few minutes, but still), and I couldn’t be sure that it wouldn’t mess up my readings. On top of that, I wasn’t trying to stain my clothing, if I could help it.

So in that circumstance, I did change my sensor right away, and was glad that the second try resulted in a much cleaner, blood-free insertion. I called Dexcom, explained what happened to the customer support representative, and got a replacement sensor mailed to me.

However, just about any other time I bleed upon a sensor insertion, it tends to be a minuscule amount of blood. I usually don’t even notice until it’s time to replace the sensor, and there’s a bit of dried blood left on the site. Other times, I’ll see small beads of blood forming underneath the spot where the transmitter snaps in. And there’s been a couple of occasions that I’ve bled a fair amount and been totally unaware of it until I caught my reflection in the mirror and noticed the blood staining the white adhesive. And in all of those cases, I’ve kept the sensor on for the full ten days, without noticing any discrepancies in my readings.

All that considered, in my inexpert opinion, I think that bleeders usually are readers and that they’re safe to continue wearing. Of course, there will be exceptions, like when there’s just too much blood to salvage the sensor. But every time I’ve kept using a bloody sensor, I’ve had the same amount of success with its functionality…so yes, I think that for me, bleeders are indeed readers.