I’ve been using the Abbott Freestyle Navigator continuous glucometer for about 10 months now, and in concept, I love it — it lets me see my blood sugar levels in near real time (okay, it lets me see my interstitial glucose levels with a 15-minute lag, but still). It has trend arrows, it has high and low alerts. Granted, its incessant buzzing sometimes wakes me up at four in the morning to do a recalibration (you have to wait 10 hours, which is ridiculous) — but still. I’m very glad I have it.
And yet, I am not happy that I have to wear the sensor on my body. As CGM aficionados know, the Freestyle is the largest sensor of the main three (Abbott, Minimed, and DexCom). Roughly the size of a box of matches, it’s a big pain in the ass. (Sometimes literally; see below.)
I bring this up because I am on a quest to find the least obtrusive site to wear this thing. The company recommends the back of the arm or the stomach, but there are problems with both: the back of your arm is often quite visible, turning your CGM (and its lint-covered, peeling adhesive) into an inevitable conversation starter. It also gets smushed if you sleep with your arm under the pillow.
But the stomach has its own problems. (N.b. that is not a picture of my stomach.) You have to put the sensor high enough to not get caught by the waistband of your pants. You have to position it carefully so that it’s not visible under your clothes. And, more importantly for me, if you exercise, it’s really hard to keep it on. Before I started wearing the Navigator, I was not fully aware of the amount of sweat my stomach is able to produce. I also hadn’t recognized how many creases there are whenI do sit-ups. Adding to the difficulty, my husband and I have started spending a lot of time at the climbing gym, and the harness hits right above the normal waistline of my pants, ruling out yet another piece of prime real estate. (Not to mention taking potential sites away for my pump, which has left me with so much scar tissue on my hips and stomach that it’s hard to find a good insertion site.) Lastly, the skin on your stomach — or my stomach, at least — is more sensitive than that of my arm, and if I leave a swath of wet adhesive on it for five days, the results are not pretty. (Itchy, yes. Pretty, no.)
So for a while I was wearing the sensors on my hips — a little less conspicuous, as far as clothing is concerned. But that, too, has its own problems. Like, for example, if it’s on your right hip (by which I guess I mean haunch), it will catch on your car seat every time you sit down to drive. Also, this position — just above your waistband, on your outer back hip — happens to be precisely the area that’s rubbed if you’re wearing a backpack.
My endocrinologist suggested I try it on a bold spot: my butt. So I did that for two rounds. Again, I appreciated the fact that it was inconspicuous. But you need to be careful to place it in a way that doesn’t get smushed when you sit or lie down. You need to be very careful when you take off your pants so that you don’t rip it off. And, lastly, my butt turns out to be even more sensitive than my stomach — by the time I pulled it off the site was red, inflamed, wet and itchy. Not exactly adjectives most people would like to use to describe their bottoms.
And so I am now trying yet another spot: my thigh. So far it’s been okay — I haven’t exercised enough to sweat, so it’s not yet totally gross. I’ve been careful when removing my pants, so it hasn’t fallen off. And I don’t usually sleep on the front of my thigh, so it’s been relatively comfortable. Granted, the rubbing of my pants seems to dislodge the sensor pretty frequently, and the bulk of the sensor is clearly visible through my (not too tight) jeans. But so far, at least, it’s an improvement — and it’s inspiring me to look at my body more creatively, at least where potential sensor sites are concerned.
The bottom line: I’d love my CGM even more if I could get the results without actually having to wear it. But since I have to, I want to ask other people: where do you wear yours? Is there some piece of prime bodily real estate that I have not yet explored?
Lastly, can they please do something about the adhesive? In all of the examples listed above, I had to reinforce the Navigator’s pathetic backing with four separate strips of IV prep adhesive, lest it fall off after a day. (I’m serious: without that stuff — even sometimes with it — the sensor rarely lasts more than 24 hours.) Minimed has figured out a great, porous, fabric adhesive to use with their pump. Why can’t Abbott do something similar?