Our first Thigh Site

[EmmasMom]

I decided that Emma's back needed a break from all that tape, so I'm trying the sensor in her thigh this time. So far, so good.
I've read on other boards that it's a great location for adults, so we'll see how it goes. Have any of you tried the thigh area for your kid's sensors?

[sammysmom]

exactly where did you put it on her thigh?? We use the tender minis for sam so I think it would be the same kind of insertion you do for the sensor. Did she cry?? I am trying to get sam to do a thigh site and he is not happy with that suggestion...I am not sure where to put it on his thigh..were you worried about being enough fat there??? I think I will tell sam that Emma did a thigh site, maybe he will be more keen to the idea.

thanks

shannon

[EmmasMom]

I put it on the front of her upper thigh. If you drew a line from the diaper's tab it would be straight down. She didn't even feel it, but if you read my post about the numbing cream... she had Elma on for about 3 hours.:rolleyes:
It doesn't seem to be bothering her at all so far, and the sensor is giving great readings.

For her quick-sets I often use the very top of her outer thigh, and I'd imagine that would work for the minis as well, of course Emma has a bit of chub on her thighs! (I'd be nervous to put an angled set on a lean thigh.) I see a big difference in her numbers when she's running around if the site's in her leg, that big muscle will definitely absorb insulin quickly!!

Good Luck!

[sammysmom]

Thanks Amy, we also use the quick sets (luer lock) but the only place we can use them is his rear end!! The mini's are intimidating, but I must say, we get some really good numbers with them...maybe I will try the quick sets on his thigh..we really need some more spots...thanks for the advice..

shannon

[sammysmom]

Oh WOW Amy, we did it...he needed an emergency site change at school today...so I went in and changed him out. He thought it was going to be a butt site, he did not agree to a thigh site..but at the last minute I popped it in the thigh!! and guess what?? he said "mom that didnt even hurt!!!"......I guess I just have to force him to try new things sometimes!! We called his dad at work and sammy also told his aid at school...everyone made such a big deal about it and he is on cloud nine right now!!...He said that we can start using his thigh for sites now....i used the quick set and so far no problems!!

thanks a bunch

shannon

[payam7777777]

I decided that Emma's back needed a break from all that tape, so I'm trying the sensor in her thigh this time. So far, so good.
I've read on other boards that it's a great location for adults, so we'll see how it goes. Have any of you tried the thigh area for your kid's sensors?
why do you do that? i've read A LOT about where to put the sensor in kids and upper but cheek is *the* choice.

[EmmasMom]

Wonderful Shannon! I hope it works great for him!!:)



why do you do that? i've read A LOT about where to put the sensor in kids and upper but cheek is *the* choice.

Only because her back has been "abused" from all the tape and needed a break. We have always put her infusion sites in her upper butt cheek too, so the area gets a lot of use. I want to try all possible options since she's so tiny, the more rotation we can get the better!!
There just aren't that many 2 year-olds using this thing, so as usual, the general advice doesn't always work best for us.

[EmmasMom]

Well, our results weren't great. She got a little red lump, (possibly a minor infection), and started telling me it hurt after about 24 hours. I think our readings would've been good, but we were having trouble with the transmitter, so it's hard to say.

Maybe I'll try again another time. For now I'll just to use her thighs for her pump sites and save her bottom for the sensors. It seems to work pretty well that way!

[payam7777777]

Amy,

Why do you not use abdomen for infusion set placement?

[EmmasMom]

Amy,

Why do you not use abdomen for infusion set placement?


Her tummy is very lean, you can actually see her abdominal muscles. I have tried to place a 6mm quick-set there with bad results, including bleeding, bruising and a pocket of insulin under the skin. Her tummy is also the only place we have tried that ended up kinking the cannula, so I'm certain that it's not a good option.
I could probably try a "thin-set" angled infusion set, but I never know how still she's going to be, so it would be very difficult to get good placement in that tiny layer of fat.
We actually have great results with her infusion sets in her upper thighs.

[payam7777777]

With the conmon, what is *your* tyipical/usual postmeal peaks for bkfast, lunch and dinner?

[EmmasMom]

She usually hits 250 after breakfast and around 200 after lunch and dinner before her insulin peaks and brings her back in range about 1 1/2 hours later.
We rarely pre-bolus at this point because she's a very erratic eater. I try to bolus as she eats, so she may get 3-4 boluses during the meal to help with the spike.

[payam7777777]

We rarely pre-bolus at this point because she's a very erratic eater.

that explains the high spikes. frankly i didnt expect her to spike so high taking into considateation the fact that you have a con mon.

[jacone]

Just because you have a conmon does not mean that you won't get spikes. With an ever changing carb ratio, hormones you can't control, and food that behaves differently, even with predosing by 20-30 minutes, we have spikes to 250-300 after breakfast and 200-250 after dinner depending on all those variables above.

I am a scientist by trade, and believe me, the spikes drive me crazy. But, as long as they are spikes and not leveling off, sometimes you can't help it. Giving more insulin isn't the key either because just as you have a fast spike you can have an equally fast crash. :confused:

[payam7777777]

even with predosing by 20-30 minutes, we have spikes to 250-300 after breakfast and 200-250 after dinner

then something is wrong. maybe the basals.


edit: predosing by 20+ minutes is DANGEROUS. you can see this by testing 25 after bolusing.

[payam7777777]

Amy,

you do insert the sensor with a shallower angle, dont you. like 30 degree instead of 45 degree.

[EmmasMom]

that explains the high spikes. frankly i didnt expect her to spike so high taking into considateation the fact that you have a con mon.

I think that anyone who has use of a con mon for any length of time would be shocked at the reality of what blood sugars do, especially in small children. Not just immediately after eating, but also when the insulin peaks, and immediately after falling asleep and before waking in the morning, during exercise, etc.
I was testing 10-12 times a day prior to her sensor and was still shocked by what I saw. Even with a 15-20 minute pre-bolus Emma will hit 200 within 20 minutes of eating, and she stays there for about 30-45 minutes before the insulin starts to bring her down. She has a rapid drop at 1.5 hours after her bolus that brings her back in range.
Dosing her earlier makes only a slight difference in the spike, and giving her more insulin causes a low later. I've just come to the conclusion that it's not possible to safely prevent the spike at this time. Maybe when she's older...

Amy,

you do insert the sensor with a shallower angle, dont you. like 30 degree instead of 45 degree.

I insert at a 45 degree angle, and if she has enough fat I try to go at 50-60. My rep insists that it works better and is more comfortable when it's NOT shallow. (Her 6 year-old daughter wears one too.)
The few times we had trouble with false lows it was on a sensor that was placed at about 30 degrees. I think it's best to go at least 45.

[EmmasMom]

edit: predosing by 20+ minutes is DANGEROUS. you can see this by testing 25 after bolusing.

I think that depends on the kid and the situation. If they are high they may need insulin 30-60 minutes before eating to get back in range. Some people take insulin 30 minutes before eating and never have a pre-meal low.

Of course, most people probably don't re-test after they pre-bolus.

[payam7777777]

I insert at a 45 degree angle, and if she has enough fat I try to go at 50-60. My rep insists that it works better and is more comfortable when it's NOT shallow. (Her 6 year-old daughter wears one too.)
The few times we had trouble with false lows it was on a sensor that was placed at about 30 degrees. I think it's best to go at least 45.

hmm... interestingly different than what i'd read. so yo do not recommend 30 degree at all.

[EmmasMom]

I think it depends on where you put it, obviously you don't want to hit muscle.
It works better for us when it's not shallow.

[payam7777777]

we've decided to put it in the upper but cheeck area.

[rickst29]

even with predosing by 20-30 minutes, we have spikes to 250-300 after breakfast and 200-250 after dinner depending on all those variables above.
then something is wrong. maybe the basals. edit: predosing by 20+ minutes is DANGEROUS. you can see this by testing 25 after bolusing.

"something is wrong, maybe the basals" was a really DUMB guess. (I would have thought you know better.)

And your following declaration is bad: For lots of people, pre-dosing is absolutely necessary, and depending on what they eat, even dosing 20 minutes might not create hardly ANY bG drop before the food comes on. And if they're starting from >150, then they can afford some drop....

Different people get different Mileage. YMMV!

[wendy]

Dear Emmasmom, I'm a little off topic but.... I'm an adult using the MM CGM and was told by a MM rep that the thigh was a good place for the sensor. I'm very nervous about it though and would like to hear about other peoples expereinces. You mentioned in your post that you had read on other boards that it was a good spot for adults. Can you tell me where you saw that information? Thx for your help.

[EmmasMom]

Hi Wendy,

If you join the diabetescgms group at Yahoo you will find many, many people that use various cgms'.

Here is a link to a search about thigh sites from that group. You may have to set up an account to view it, I'm not sure, but it's worthwhile! Lot's of great info! :)

http://health.groups.yahoo.com/group/diabetescgms/msearch?query=thigh&submit=Search&charset=windows-1252

Emma's thigh site didn't last nearly as long as her hip sites normally do, and it was pretty irritated and red when I took it out. I'm not sure if it was a fluke, but we're sticking to hips for now!