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Thread: CGM insertion

  1. #1

    Default CGM insertion

    We have made the decision to get a CGM for DS and have ordered the CGM and the Guardian. When I asked about numbing the site before insertion the CDE told me we can't use anything on the site besides alcohol. She said if you used emla or anything like that it could affect the readings. So my question for all of you is: do you use anything to numb the site?

    My DS is 9 and while he is open to the CGM he is a bit apprehensive about the needle. We currently use Mios which he tolerates just fine but when we tried the silhouette he said it hurt and he didn't like it. I am sure I have read on here that some of you numb the site, do you find that it alters the readings? For those that don't numb it, does your child tolerate the insertion ok?

    We are using the Medtronic CGM since he is already using the revel pump.

    Thanks!
    Mom to DS, 11
    Diagnosed 3/2011 with Type 1
    Pump: MM Revel 12/2011, Omnipod 3/2013
    MM CGM 3/2012, Dexcom G4 3/2013

  2. #2

    Default numbing cream on cgm

    Yep, we have always used numbing cream on each and every cgm insertion.

    I don't think he would do it without. Readings getting messed up usually has more to do with site selection, laying on it, or old sensor.
    Tammy

    Johnny (15 years old - dx 2009, OMNIPOD, DEXCOM G4 CGM)

    Heather (13 years old)

  3. #3

    Default

    We have never used Emla & DS has always tolerated the insertions w/o much fuss. Started using 24/7 in 2006 at age 7 so have done lots of sensors over the years. I know many others do use it and will disagree, but for us I am all about getting all D tasks done w/ as minimal time & distraction from life as possible, and did not want to have to be tied to the extra hour waiting for the numbing cream to take effect every time a new sensor was needed.

    When he was smaller I used to do the inserts as he was engrossed in TV or even in his sleep, but now he really doesn't care, insists it is pretty much pain free. Every once in a while he will flinch on insert and say it hurts for a moment but nothing monumental. If you do chose to use Emla, just have to be sure to thoroughly wipe off skin so it doesn't interact w/ the sensor. Another alternative is to try holding an ice cube on the area before insertion.

    Mom to DS (12), dx'd Jul 2004, pumping MM since Oct 04, CGMS since Oct 06
    Also Mom to non-D son (14) and non-D daughter (6)

  4. #4

    Default

    We just started using a CGM and we use numbing cream. We just make sure to clean the area really well with lots of alcohol swabs. We have not had any problems with our readings so far. Generally they are +/- 10 points of the meter. For my son, the 1 hour wait is worth the time.
    Andi

    Mom to :
    William, 5 YO, DXD at 13 months
    Samantha 8 YO - nonD
    Pumping with Blue Animas Ping since 9/30/2010
    Also using Dexcom G4

  5. #5
    Join Date
    May 2008
    Location
    Philadelphia
    Posts
    4,246

    Default

    We've used EMLA for 1-hr every time for the past 5 years. No problem at all for accuracy, the site, or anything else. Clean the site well with alcohol of course before inserting.

    I recommend tilting the senserter up around 10 degrees (in other words, more straight up) from the built in 45-degree angle. This virtually eliminates bleeding.

    To tape the sensor, purchase Tegaderm 1624W. Cut two pieces in half (make the cut through the shorter dimension). After the insertion, put one half-piece over the clear part of the sensor, the other half-piece over the adhesive (slide it as close to the clear part as you can). When you're done, the tegaderm should look from above like you've "put it back together" just with a slight gap where the two pieces meet.

    Then wait 2+ hours to install the transmitter (I wait 6 hours), and after it blinks, use another half-piece to tape down the edge of the transmitter (this piece will partly overlay the existing tegaderm).
    Dad to Leah and Anna, married to Pam
    Leah is 15, dx 1/1/2007 at age 8, Type 1 and Celiac, Omnipod since 2007, Guardian CGM 2007-2013, Now using Dexcom G4 CGM, loves to sing

    CGMS Calibration - DCCT: The Study That Forever Changed Treatment of Type 1 Diabetes - Improved Glycemic Control in T1 children Using Real-Time CGMS

  6. #6

    Default

    We always numb the site. As long as you clean it off well there is no problem.
    K, 9.5yrs, dx 1/06 @35months
    Pumping MM 723 w/ Mio sets and Apidra
    Celiac dx 5/08
    Cgms-ing 11/07
    Podding for 'tubing' breaks 4/11

  7. #7

    Default

    Quote Originally Posted by Darryl View Post
    We've used EMLA for 1-hr every time for the past 5 years. No problem at all for accuracy, the site, or anything else. Clean the site well with alcohol of course before inserting.

    I recommend tilting the senserter up around 10 degrees (in other words, more straight up) from the built in 45-degree angle. This virtually eliminates bleeding.

    To tape the sensor, purchase Tegaderm 1624W. Cut two pieces in half (make the cut through the shorter dimension). After the insertion, put one half-piece over the clear part of the sensor, the other half-piece over the adhesive (slide it as close to the clear part as you can). When you're done, the tegaderm should look from above like you've "put it back together" just with a slight gap where the two pieces meet.

    Then wait 2+ hours to install the transmitter (I wait 6 hours), and after it blinks, use another half-piece to tape down the edge of the transmitter (this piece will partly overlay the existing tegaderm).
    Thanks, Darryl, for the taping instructions...I'll have to try that when we start. We are supposed to have our training next Friday so I am excited (as excited as I can be about D). Our trainer is pretty adamant about not using anything on the site. Does anyone know if you can get EMLA over the counter or is it just by prescription? We will be using nothing next week so we will see how it goes. I really hope this works out for my son, as I think the information it can provide for us is invaluable. He is willing to try it for me, but not too thrilled that it might hurt going in.

    Thanks to everyone else too. It is helpful to hear how others are managing it!
    Mom to DS, 11
    Diagnosed 3/2011 with Type 1
    Pump: MM Revel 12/2011, Omnipod 3/2013
    MM CGM 3/2012, Dexcom G4 3/2013

  8. #8
    Join Date
    Dec 2011
    Location
    Germantown, Ohio
    Posts
    85

    Default

    We get our Guardian CGM training on Wednesday Our rep had Endo office call in numbing creme so we would have it for training! She asked that we put it on (and cover with plastic wrap) at least 1/2 hourt before she arrives.
    Daryl, thanks for the taping hints!
    Roseann, mom to:
    Alison Jane 2.9.02 DX 11.23.11 MDI Novolog/Lantus CGM (Medtronics) 3.7.12
    Dexcom 3.24.13
    OmniPod 2/20/13
    Sara RoseMarie 9.16.85 Non DX

  9. #9

    Default

    Your trainer is wrong. We've used numbing creme for four years with no issues.

    EMLA is RX only, but LMX4 is similar and over the counter. You'll have to ask for it at the pharmacy counter, but you won't need a prescription.
    Mom to J., age 10
    Dx 2007 @ age 3
    Medtronic pump and CGM (4/2008-6/2013)
    Tandem t:slim and Dexcom G4 CGM (current)

  10. #10

    Default

    Quote Originally Posted by hawkeyegirl View Post
    EMLA is RX only, but LMX4 is similar and over the counter. You'll have to ask for it at the pharmacy counter, but you won't need a prescription.
    Thank you for this. I will look into getting it at the pharmacy if need be.
    Mom to DS, 11
    Diagnosed 3/2011 with Type 1
    Pump: MM Revel 12/2011, Omnipod 3/2013
    MM CGM 3/2012, Dexcom G4 3/2013

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