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!

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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.

 

Third Time’s the Charm: Here’s How I Restarted My Dexcom G6

You GUYS! I finally did it! I managed to restart my Dexcom G6. Sometimes, a little bit of trial and error pays off.

I restarted it by following the exact same steps that I linked to in my post from a few weeks ago. It involved five simple things:

  1. Allowing my sensor to expire and remain on my body
  2. Starting a new sensor session and choosing “no code” when prompted
  3. Running the 2-hour warm-up session for only 15 minutes, then stopping it
  4. Starting a new sensor session again, without a code (if you still have the code, though, that you used when you first inserted the sensor, then enter that into your receiver/app. But don’t make up a code or enter one from another sensor – just say “no code” if you don’t have it)
  5. Allowing the 2-hour warm-up session to take place and receiving readings once it’s complete

The only thing that was different between this time and last time was the steps leading up to the restart. What do I mean by that? Well, for starters, I made sure I was attempting to restart a sensor that was giving steady, reliable readings – it seems as though it’s impossible to restart a sensor if it’s experienced any sort of error in the 10 days it’s been worn. So this means that when the sensor expired, I’d been receiving readings consistently up until the moment it expired.

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That gap represents the sensor’s second round of two-hour warm-up.

That was the main difference. The location of the sensor I restarted was the back of my arm, which may or may not have affected the restart. I also restarted without using the sensor code, which I had set aside to use but somehow misplaced prior to the attempt. I have no idea if having or not having the code makes the restart more or less successful, but I do know for sure that I got three more full days of use out of my sensor. Cumulatively, that means that I was able to wear the same sensor for almost two full weeks! It might not seem like a lot to the marathoners who are able to make older G5 sensors last 3-4 weeks (I’ve even heard of people keeping the same one on and working for 6 weeks), but it’s exciting to me to have confirmation that it IS at least possible to restart a G6 sensor.

In terms of the sensor accuracy, dare I say that it was even MORE accurate on the second go?! I don’t have proof to really back that up, but honestly, it seemed that it was right on point with all my blood sugar readings (within 5-10 mg/dL). I don’t know how to explain that, but no complaints about it here.

The only other difference that was noticeable during the sensor extension was that I was prompted to calibrate at least every 12 hours. No big deal, since I had to do that when I was on the G5. But it caught me off-guard a bit at first, because on both my receiver and within the Dexcom app, a small blood drop icon was always visible onscreen (when actively checking the app or the receiver). Initally, it wasn’t too alarming because it was merely a reminder to calibrate twice daily. But then it became an absolute nuisance when weird “calibrate after __ A.M./P.M.” messages occurred multiple times per day. I would check my blood sugar at the appropriate time and enter the result into my app/receiver, only for it to be rejected and trigger another specific time-calibration message.

To me, that indicated that my sensor’s second go-around ought to come to anend sooner rather than later. It was getting obnoxious to have to wait and check my blood sugar manually in order to appease the Dexcom messages that kept popping up. Plus, it came down to my comfort levels with wearing a sensor for a certain length of time – I just don’t love the idea of keeping the same one on for ages.

But this was my first taste of success with restarting a sensor, so naturally, I want more of the same! I’ll definitely continue to try to extend the life of future sensors, but remember, follow the steps above at your own risk. When in doubt, simply follow protocols as outlined by Dexcom. If I experience an even more successful sensor extension, you can bet that I’ll have all the details to share with you all here.

 

 

My CGM Sensor Ripoff

Oh, the Dexcom G6. You have no idea how much I simultaneously love and hate you. I love you for your painless insertion, increased accuracy, acetaminophen-blocking capabilities, and your sleeker profile. But I effing loathe you for having communication issues with the sensor on days 9 and 10 of wear…that is, if you even last that long on my body. You have serious sticking issues, old pal. Your adhesive tends to be a bit of a ripoff – both literal and figurative.

You see, I was just trying to roll over into a more comfortable position in the middle of the night when you decided right then would be the ideal time to just fall off my arm, prompting me to go from blissfully snoozing to wide awake and angry in less than 10 seconds. Way to go! It pissed me off because it happened with very little effort. I would’ve understood if I had scratched or touched it in any way, but all I had done was flip from sleeping on my left side to my right. Not fair and definitely not the ideal way to wake up.

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The ripoff sensor in question.

I wish I could say it was a one-time occurrence, but no, it happened a couple months ago. Again, it was the middle of the night and again, it was ripped off prematurely. I think that in both cases, I still had at least another three or four days of use before it was due to be changed. And even before these two middle-of-the-night ordeals, I had trouble with a freshly inserted sensor that was peeling all around the edges. What the heck is going on with Dexcom G6 adhesiveness?

Maybe this is a sign that I need to start using something in addition to an alcohol swab each time I change a sensor. Perhaps Skin-Tac or more regular usage of Pump Peelz/Grif Grips will prevent future sensor ripoffs. But still can’t help feeling ripped off, because this never really happened when I was using my G5 sensors.

The small mercy in this situation is Dexcom customer service. Kudos to their team for being understanding and willing to replace my not-so-sticky sensors…but I wish I could say that I had more faith in a G6 sensor’s ability to stay on my body for the full 10 days that it was intended to.

Restarting the Dexcom G6: Attempt #2

“If there’s a will, there’s a way.” This statement totally describes the Diabetes Online Community (DOC) and its collective determination to find workarounds when it comes to extending the life of certain diabetes devices.

In November, I briefly wrote about my first stab at restarting my Dexcom G6, which was completely unsuccessful. So why bother going through with a second attempt at it? Two reasons: 1) I know that other T1Ds have been able to triumphantly restart the G6, and 2) I know that there are multiple methods out there that people have used in order to do so.

I wasn’t necessarily on the hunt for a method I hadn’t tried yet, but I stumbled across one when I was scrolling through my Instagram feed a few weeks ago. Shout-out to Leah (Instagram handle: @the.insulin.type) for sharing her technique, which you can view for yourself by clicking this link.

You’re probably wondering whether it worked for me, so let me cut to the chase and give you a super annoying answer: yes and no. I restarted the G6 according to Leah’s process, but received the “Sensor Error: Temporary issue. Wait up to 3 hours.” message, which resulted in graphs with sporadic gaps created by a lack of readings. That message popped up at least three or four times over the next 48 hours, before the “sensor failed” message notified me that I had to put a brand new sensor on and finally get rid of the restarted one.

This means that attempt #2 went better than my first try at restarting a sensor, but it was far from the flawless restarts that I know other people have experienced.

I haven’t given up hope, though. I do think that I’ll achieve success, eventually, after some more trial-and-error. I do have my theories that might explain why this didn’t go as well as I wanted it to, and it has to do with the following factors:

  • I restarted my sensor on day eight of wear
  • The sensor error message was on my receiver when I began the restart process

Next time I try this method, I want to see if it makes any difference to let the sensor expire naturally on the tenth day of wear. And if that doesn’t work, I want to at least give it another shot when the sensor and receiver are communicating properly and there are no error messages causing interference.

All in all, the experiment wasn’t a total failure. I did manage to extend the sensor’s life by about six hours – it was due to expire at 2 o’clock in the afternoon on the tenth day of wear, but the sensor didn’t fail completely until about eight o’clock that night. So TECHNICALLY speaking, I got a bit more usage out of it…but then again, those six hours (and probably slightly more than that) got wiped out by those stretches of time that I was dealing with sensor errors.

As I work through more restart attempts, rest assured that I’ll post about them so hopefully someone else will learn a method that works for them, too. But remember…restart your Dexcom G6 at your own risk. It’s not guaranteed to restart or, even if it does, to be accurate.