I’m participating in a research study on barriers to CGM use. I’ve lived with T1D for over 30 years, yet have not used this technology for ongoing management. I’m curious how it might help me. I’ve hesitated to adopt the CGM technology for these reasons:
Low body mass (I already experience difficulty with pump infusion sets for this reason)
Information overload (continuous data from the CGM concerns me)
Inconvenience (wearing yet another thing)
The possibility of painful sensors (this was my experience when I tried CGM tools in the past for short-term use).
However. I’m also open to the possibility that I might love this management tool. I selected the FreeStyle Libre for the research study. I’m hoping you might share your experiences related to this sensor:
Where do you like to wear the FreeStyle Libre sensor?
What advice might you share for someone with a lower body mass?
I wear my Freestyle Libre sensor on the back of my arm. I love how it checks every minute of the day and keeps a graph of your daily BG and how it runs normally. Helps you what you need to work on and what you do great already. I do find it challenging to keep the adhesive on but i then order these special sticky swabs which help last longer.
Hi @lmacuff I hate CGM. I had a few gen 1 devices and the thing that kept me away was the inaccuracies. Now that G6 is available. It changed the game for me. I think libre is fairly comparable. . Not perfect, but so much better than any previous iterations for me. Good luck
@lmacuffHi Lisa and welcome to the JDRF TypeOneNation Forum!
I do not use the Abbott Libre FreeStyle, but I have had very positive experience with the Dexcom G5 and G6 which I began using only 4+ years ago so Libre specific questions will be skipped. Other information: I’ve used insulin infusion pumps since January 2005 and injected insulin for the previous 47 years; I did try other CGM years ago that were useless for me.
I am, and have always been, low body mass - BMI that is now getting up to 20. Currently I use my abdomen for both the Dexcom and my insulin infusion; I use a 13 mm insulin cannula inserted at a 30 degree angle. During the 1970s when developing MDI I created an 8 region “map” of my belly and rotate both devices according to pattern. Very rarely do I feel discomfort other than occasional “itch” when insulin infuses.
Information overload struck me for a while, bot I have come to really like the awesome experience for effectively, and intelligently managing my diabetes. And history is only a few finger taps away.
Compared to a pump, the CGM is almost totally invisible to my awareness - does that make sense the way I said that? My Tandem t-Slim x2 pimp is my principal CGM Receiver; I also have phone apps the provide pump and glucose information.
I have experience sensor discomfort when using my upper arms and thighs.
Overall. in my opinion, a good CGM is the most useful diabetes management tool that has become available since 1922.
Hi Lisa @lmacuff! I have only been a diabetic for about a year and a half, but I really like my Freestyle Libre 14 day. Unlike the Freestyle Libre 2, the 14 day doesn’t have alarms. It reads your blood sugar once a minute, but you have to scan your sensor with your phone or Freestyle device in order to get a reading. I wear it on the back/outside of my arm. I did have issues with the sensor coming off. I discovered if I take a shower first with non moisturizing soap, then use both alcohol pads (letting the skin dry in between each) my sensor stays on just fine (even in the pool)! The applicator is spring loaded and I never feel anything - and I am terrified of needles. I love love my Libre!! I hope this helps!
Hello Courtney,
I’m so grateful for what you shared with me. Thank you for describing the challenge with the sensor coming off, as well as your solutions. I’m so glad to know you don’t feel anything when you use the spring loaded applicator; I experience fear of needles too!! (even after 30+ years living with T1D).
Hi Dennis!
Thank you for sharing your experiences with the Dexcom that you began using nearly 5 years ago. I appreciate knowing that you began using the technology in 2005; I began using insulin infusion pumps in 1999. Everything you shared was helpful to me.
BMI is an ongoing challenge for me, which I do my best to manage and improve. Alongside T1D, I experience a chronic GI condition that makes this especially difficult at times. Thanks for sharing your insertion tips. I am hoping to use the back of my upper arms because the symptoms I experience around my abdomen often complicates insertion (of insulin pump sets) in this area. I’m curious about the discomfort you felt when using your upper arms.
I am a health information profession (specifically, a Education and Research Librarian at a health sciences campus), so information overload is familiar to me. Thanks for describing how that is (and was) for you … and the specific benefits. Accessing my history is inconvenient with my current pump, so that especially appeals to me.
Lisa @lmacuff , the discomfort of the Dexcom in my upper arms may have been my fault because of where I implanted them. Instead of placing the sensors on the “outer back” of my arms, I placed them more to the inside because I always sleep on the outer part of both arms.
I had decided to place the sensors where I did because of “loss of signal” issues when I had them in the more proper location. In retrospect, the signal loss may have been because of faulty Transmitters; I had two defective transmitters that completely failed early - both replaced and returned to Dexcom for study. I intend, probably after the first of the year, to give my are another try.
I found the freestyle to help me understand what my diet was doing to me. I found it easy to have the read out always available. It makes it so that I can see how certain food affect my glucose readings. I learn from experience what works for me and what does not.
Hi @lmacuff . I use Dexcom G6 but keep Freestyle Libre2 as a backup. In some ways I prefer the Freestyle - a quick swipe of the reader (I don’t use my phone as receiver) over the sensor can be quicker than digging my pump out of my pocket or fishing for it wherever it may be😊. But since I use Dexcom and others have contributed about it, I’ll join in.
Let’s just say I don’t have an issue with leanness so sensor locations are not problematic. When I use my upper arm, if I’m standing with my arm straight down and my palm touching my body it’s on the side or front. I usually use my abdomen but with 35 years of injections followed by nearly another 30 of pump use and 25 or so of CGM I use arms and upper thighs to avoid scar tissue. Some people use the upper buttock but I imagine you would need help with insertion. Those sites may not apply to the Freestyle but I do like having the options.
Info overload can be hard to avoid. You look at trending arrows and want to take action immediately, especially when you first start. It takes some work but people train themselves not to over-react to every little rise and fall, but to wait out trends unless the numbers are extreme or they’re having symptoms - in those cases confirm with a fingerstick and take action as necessary.
The Libre2 has alerts - I’ve only used them with the receiver, but the phone. You can customize them to hopefully suit your needs. Dexcom has customizable alerts as well although there are some fixed ones that cannot be changed. Hopefully those are rarely needed.
Overall use of a CGM has been a game changer for me. I had been in insulin for about 20 years before home glucose tests even came out. When they dud I was on fingersticks up to 4 times a day (more of needed) for about 15 before I got my first one. The technology has gotten better and more accurate, and I love the convenience. I like the Freestyle, but since I use Dexcom Control IQ with Mr insulin pump I think of the Freestyle as more of a “starter device,” which in all honesty probably undervalues what it does do. If there’s an issue getting my Dexcom supplies or if my Dexcom stops working, I choose the Freestyle over fingersticks in a heartbeat.
If you’re out of range of your Freestyle receiver your sensor will store the most recent 8 hours of readings but no more. It will catch up when it’s reunited with your sensor. Any gaps over 8 hours old may not make a difference by the time it catches up, and you may have done fingersticks in the meantime.
There are over patches you can but on Amazon if you have concerns about your sensor coming off. I find the adhesive for Freestyle and Dexcom to be very good, but it’s nice to have a little extra protection did your investment, perhaps especially if you swim or play contact sports. That said, another nice thing about the Freestyle is it’s a fraction of the cost of Dexcom so it’s less painful if you pay out of pocket. With just price in mind it may be a better choice for people on injections or pumpers who want to “pump manually” without the advanced features of pairing their pump with their CGM.
You’re more than welcome. I hope you find it to be an invaluable tool. As you’re getting whiplash looking at your numbers every few minutes😊 in the beginning, just try to remember your body isn’t doing anything it wasn’t before - now you can just see what that is. And from there you’ll learn where you need to make some adjustments. Keep us posted on how things go!
Hello!!
Thank you for your kind words and generous sharing.
You, and all the others, are helping me “re-frame” my ideas about CGM that often center around fear (will it hurt?) and inconvenience (how can I wear yet another thing? how can I manage even more data?). Now … I am able to make more space for possibilities, and all the wonderful benefits this tool might allow.
Thanks to the many replies, I have ideas for sensor sites that might work for a person with low BMI. And your description of the tendency to quickly “react” to unexpected or undesired numbers helps me so much. It’s helpful to remember that these fluctuations are not new; now I can see them, whereas before they might have gone unnoticed. My diabetes educator also pointed out that a person who doesn’t live with T1D experiences similar fluctuations (all the way up to 200, in some cases), they just aren’t aware. We have so much more awareness. That can be wonderful, yet it also introduces particular challenges (information overload, anxiety, fear … what might happen to me as a result of this illness/BG number?). I think that some of the hardest work is learning how to accept the illness in my body, and to still live. To engage with life in all it’s beauty. To do the things that bring me meaning. To balance meaningful work, leisure, and self-care. And to see myself with compassion.
Thanks for helping me, Dorie!
Lisa @lmacuff your positive outlook is encouraging and is something we all desire. As fatr as data overload and seeing “numbers”, keep in mind that numbers are just bits of data and by themselves don’t provide much other than to act as guideposts. I try to refrain from action when viewing my number data immediately - other than to take action when I get a low reading with arrow(s) pointing down. With other numbers and arrows, I take time to look at what I’ve been doing, including if I ate and properly calculated insulin. I try looking at the BIG picture and not just a single moment in time, living a full, active, productive and enjoyable life.
Your diabetes educator is very correct in telling you that people not pancreas challenged also have body and blood glucose levels that increase after eating and fall during exercise or just getting toward the time for next meal. You may have seen me writing here about that, often to the parent of a child / teen who is concerned because “… the kid’s BG shot up after lunch”; I tell that parentv to eat the same meal as the child, and prick his/her on finger after the meral at 60, 90, 120 minutes following eating and compare results with the child’s readings. Eyes and mind are opened.
Enjoy life, and work at letting diabetes fit your lifestyle.
Hello Dennis!
I appreciate your specific encouragement. Thank you for sharing your experiences and lessons with me. It helps me to see how others approach data and numbers. The data, at times, is worrisome and frightening to me. I appreciate the reminder/reorientation toward the BIG picture. As well as the focus on living a full, enjoyable, productive life. This helps me so much.
Thank you for your kind and generous sharing with both me, and all the others on this forum!!
Where do you like to wear the FreeStyle Libre sensor?
Back of upper arm. I’ve never tried anywhere else.
What advice might you share for someone with a lower body mass?
At 5’5 and 130 pounds I think I qualify to answer. There’s not much flesh in my arms, so rotating spots is more of a challenge than it may be for someone with some more meat on them. However, rotating is important. I also find that being thin it’s harder to sleep on the side with the sensor.
What do you love about the FreeStyle?
I actual love seeing how my body reacts to different foods. I perhaps overuse it, but it doesn’t matter. No pain and the more I use it the more I learn. Love the alarms, especially for lows.
What do you find challenging?
As above, sleeping on my right side, which I prefer, when I have the sensor on my right arm is a challenge. Other than that, I can’t say I struggle with anything.
