On the 6th of this month, I wrote a post about how I was doing on the new Medtronic 530G system, and how things were going with the Enlite. I’m not going to lie, at the time of the writing, I was pretty upset that I had already used as many sensors as I had just trying to get one to last.
In that post though, I had one inserted at the time that had lasted successfully for 5 days by then. Well, I actually got a full 10 or 11 days out of it (shh!! don’t tell!) and was ever more excited to do so. The accuracy I had compared to my meter checks was almost spot on, and if not, it was within 10% or so. It wasn’t until the last day that I knew it was conking out on me and I had t pull it because the readings were terribly off and the ISIG value was very very low. Either way, I was able to get that one to last and get back the time I lost in the one sensor that got terribly kinked, so I’m happy with that. I hope to be able to get at least 10 days out of all of them if I can so I can extend them as much as possible. Granted, I knew going in that I probably wouldn’t be able to extend them as long as a Dexcom sensor, so I’m not terribly upset if I can’t. It’s probably healthier for my skin that way anyway.
It seems, though, that a lot of people have trouble with even the Enlite sensors, so I thought I’d offer a few things I’ve learned in hopes that it helps someone else.
1. Try to get your basal and bolus ratios worked out as fine-tuned as possible. If you’re someone who swings a lot (and I mean, like, a LOT), the sensors can’t be calibrated properly enough to give you good information. Granted, they’ve loosened up the calibration requirements (you can now calibrate at any time unless you have two arrows showing. I don’t recommend it, but you can if you have to)
2. Try other insertion spots. Yes, the Enlite is only FDA approved for your abdomen, but if you’re like me, you simply can’t wear them there. I have found my best spot is in my upper thigh area. It doesn’t get pressed on or knocked around at all, and the sensor stays pretty stable there.
3. Try inserting manually. I know, crazy, right? But it’s weird that the last sensor and this current sensor have been working so well, and yet I’ve manually inserted both of them. And really, it doesn’t feel any different than inserting a shot needle because of how thin the sensors are now. There are some videos on YouTube that show you how, so if you want to know how to do one, go watch those. I might do one later with the next insertion, I’m not sure yet.
4. This has got to be the most important thing. Develop a routine for calibrating within your schedule. The calibrations you give is what it goes on to calculate your sensor glucose overtime in relation to the electrical current the ISIG signal is reading. So, for me, I found the most stable parts of my day, which happen to be as soon as I wake up, before breakfast (there’s usually a 1-2hr gap there), afternoon around 4-5pm, and then at bedtime. If I stick to this routine, I have better results. If it gets off during that time, I can still calibrate again in 20 minute intervals (usually takes about 3 to get it back in line at the most). Yes, this goes over the recommended 4 times max per day, but hey, if it works, go with it.
5. Never calibrate right when you test your BG and the pump asks you if you want to use it to calibrate your CGM. Always say “no” and then go look at your graph. See how you’re trending. That way you can make sure you’re not showing double arrows that could throw things off.
6. Take some time to research what the ISIG is, beyond what the manual tells you. For me, it was learning how it relates to your trend over time. If your CGM is reading far off from what your fingerstick is telling you, you can do a simple math (yeah, I know, more math!) equation to see if it’s okay to calibrate or if your sensor is just being wonky at the time. (Of course, always wash your hands though if you get a wonky reading, since sugars and stuff from food can throw it off too.) If after washing your hands and retesting, the sensor is still off, take your BG and divide it by your ISIG value. If the value is between 1.5 and 20, then you should be okay to calibrate, though having a result that is closer to the middle of that range – between 8 and 13 – is probably even better. That means that more than likely the value you calibrate it by won’t be seen as erroneous and won’t throw a Cal Error at you. If it’s out of this range, try a few things like drinking some water, moving around or massaging the area (not directly ON the sensor, just around it – the fluid may not be moving around the sensor enough) for a minute or two and see if the ISIG changes in about 10 minutes. Also, if your ISIG is getting low, like around 4-7, it may be time to change the sensor out as no amount of calibrating will probably work.
7. Tape that sucker down. I know they’ve vastly improved the sensor taping this time around, and yes, you could go without using an over-tape, but I still use one piece over it just for security sake. It helps the sensor not to move or get jostled by accident.
8. I insert my sensor at night after the transmitter has charged (which I let it charge about 2 hours – no matter if the little light has stopped flashing), connect the two, tape everything down, and leave it alone until morning. When I wake up the next day, I tell my pump I have a new sensor in, and it usually asks for a calibration within a few minutes instead of two hours. This way, the sensor has soaked over-night and has settled in and has allowed any site trauma or irritation from a newly-made hole to calm down before giving it information. Also, this lets your first calibration come when you’re usually most stable, so you know you’re giving it a pretty good starting reference point.
9. Lastly, if I do choose to restart my sensor (if the ISIG is still “strong”… like, in the 20’s or higher), I carefully take off the tape while holding the sensor “head” still and then disconnect and recharge the sensor. After recharging, reconnect it and retape it. I do this at night so that I can calibrate in the morning just as if it were a new sensor. Then, just start the “new” sensor, calibrate and go. If you choose to restart the sensor, keep a closer eye on the ISIG as usually after a restart is when the sensor will start losing life. Some have made it a whole other 6 days with it, some only get a few more days (like myself). But if readings start going really wonky, check the ISIG (just the one on the pump, not the math equation thing). As I said earlier, if it’s getting low, like, 7-ish or below, you’re probably losing the sensor, so toss it and insert a new one.
I hope these help and not have your mind blown. I will say though, I’ve been very satisfied with their new system. In fact, I’ve not missed my Dexcom at all, and that’s pretty huge for me to say (which I’ll go into that stuff in another post.. this one is already a novel.) If you have any questions, feel free to ask in a comment and let me know.