Kinda intresting update to my ongoing sensor issues (salicylic acid)

[Sara Grice]

Ok so to summerise my sensor has been giving me off readings, saying I'm lower that what my my blood is saying (14.8 from my finger and 11.3 20 minutes later to account for lag on my sesnor, its even started to be out when im ment to be steady, as my pre breakfast blood check said iwas at 11.3 ((thanks dawn phenomenon))when the sensor was only saying 9.8)


After asking for advice on reddit aswell someone told me a list from Abbotts website about things that can effect sensor readings, one of them was salicylic acid, found in asprins and some skin care products, I dismissed this as like..I don't take asprin and there's no way my hand cream would even have it in by chance..and even if it did would putting on my hands realt effect anything? My hands get dry and cracked and I found it helps, but I do use alot of it

But sure enough ad I went to put it on and before I did wanted to check and see? And sure enough it says it right where "benzyl salicylate". So I did a bit of googling and I kinda got even more confused

as what I've seen mainly focuses on oral (so..asprin) and says it basically causes the body to produce more Insulin, meaning you get lower levels, but I don't think that would cause the false levels I was reading compared to my blood. This is the exact

"Most people consider aspirin a harmless cure-all. Before you take your next one, remember its active ingredient—salicylic acid—can lower your glucose reading. The mechanism isn’t fully understood, but one 2008 study showed that triflusal, a compound related to salicylic acid, can spur the pancreas to make and secrete more insulin, thereby reducing blood glucose levels. This reduction is usually insignificant, but the error level depends on how much you take.

You’ll also find salicylic acid in the skincare aisle. It’s a popular ingredient in cleansers, lotions, and treatments because it’s a good exfoliator. Though there’s a lack of research on topical salicylic acid and CGM accuracy, it’s possible that these products may affect your readings"

I'll like the article down below

and it states that not much research has been done into skin based application of salicylic acid but it's possible it could have an effect... huh. I mean I kinda understand, it gets absorbed into your skin guess. And I'm type 1 so I shouldn't be producing any insulin, although I'm less than a year in so honeymoon phase is still a possibility. I don't understand how the readings could be considered false..if it is actuly bringing your levels down to due insulin production??

Anyone know anymore and could elaborate? Interesting fact I never knew about and might help others, check the creams you use.

It's honestly astounding what can effect levels that you would never think of

Link:
https://www.levels.com/blog/7-things-that-can-falsely-impact-glucose-readings

 

[helli]

"Most people consider aspirin a harmless cure-all. Before you take your next one, remember its active ingredient—salicylic acid—can lower your glucose reading. The mechanism isn’t fully understood, but one 2008 study showed that triflusal, a compound related to salicylic acid, can spur the pancreas to make and secrete more insulin, thereby reducing blood glucose levels. This reduction is usually insignificant, but the error level depends on how much you take.

I struggle to see how this is relevant for someone with Type 1 diabetes. No matter how much salicylic acid we consume orally or dermatologically, nothing I know of can stimulate my pancreas to create insulin when it has killed off all the insulin producing cells - thanks autoimmunity.
And, as I read this quote, the use of salicylic acid does reduce BG (by a small amount). It does not give a falsely lower reading.

 

[Inka]

I wash my face every day with a wash that contains salicylic acid and it’s in my daily cleanser too. It has zero effect on my CGM readings @Sara Grice The internet is full of cr@p, inaccurate statements and gross generalisations. I know you know this but the problem isn’t your sensor, it’s your anxiety.

 

[Sara Grice]

I wash my face every day with a wash that contains salicylic acid and it’s in my daily cleanser too. It has zero effect on my CGM readings @Sara Grice The internet is full of cr@p, inaccurate statements and gross generalisations. I know you know this but the problem isn’t your sensor, it’s your anxiety.

Huh..Realy? This was even on abbotts own website, is abbott themselves "full of cr@p?"

(from their website about things that can effect readings)

Taking ascorbic acid (vitamin C) while wearing the Sensor may falsely raise Sensor glucose readings. Taking salicylic acid (used in some pain relievers such as aspirin and some skin care products) may slightly lower Sensor glucose readings. The level of inaccuracy depends on the amount of the interfering substance active in the body.

Severe dehydration and excessive water loss may cause inaccurate Sensor glucose readings.

 

[Sara Grice]

I struggle to see how this is relevant for someone with Type 1 diabetes. No matter how much salicylic acid we consume orally or dermatologically, nothing I know of can stimulate my pancreas to create insulin when it has killed off all the insulin producing cells - thanks autoimmunity.
And, as I read this quote, the use of salicylic acid does reduce BG (by a small amount). It does not give a falsely lower reading.

I mean from what I've been told I very much could still be in the honeymoon phase producing some insulin still as I'm less than a year in

 

[Inka]

Huh..Realy? This was even on abbotts own website, is abbott themselves "full of cr@p?"

(from their website about things that can effect readings)

Taking ascorbic acid (vitamin C) while wearing the Sensor may falsely raise Sensor glucose readings. Taking salicylic acid (used in some pain relievers such as aspirin and some skin care products) may slightly lower Sensor glucose readings. The level of inaccuracy depends on the amount of the interfering substance active in the body.

Severe dehydration and excessive water loss may cause inaccurate Sensor glucose readings.

The Vitamin C is well-known. Using salicylic acid in toiletries is not the same as taking aspirin! If it was, we’d never have a headache!

 

[Sara Grice]

The Vitamin C is well-known. Using salicylic acid in toiletries is not the same as taking aspirin! If it was, we’d never have a headache!

I get your point, but i asume using it on healthy skin like once a day is probably fine, my hands are dry and have cracks that open up into small sores and I use it multiple times a day, it it realy that outlandish to think it may be having an effect? Especially if im still in the honeymoon phase,

is it not worth at least trying to see if not using it for a few days makes things more accurate?

 

[Inka]

I’ve just checked my handcreams @Sara Grice I get dry hands because of my job (lots of hand-washing) so use handcreams many times a day too. I promise you I have never seen anything in my sensor readings that suggest it’s interfering with them. I’ve also been on holiday and not taken my handcream and my readings didn’t change or become unpredictable or different.

The readings you’re getting from your Libre are normal. It’s less accurate at either end of the range and most accurate in the middle. If your Libre says 14 but your fingerprick says 12 for example, that all normal and usual. The Libre has still done its job: told you you’re a little above range.

You can do what you want but I wouldn’t stop using your handcream. Why? Because I think such fixations aren’t helpful and the potential stress they’re causing will be having more of an effect on your blood sugar and control. I also think that if the handcream is proved to be OK, that that won’t bring you peace. You’ll move on to something else. That’s not your fault and I know how hard it is to stop thoughts that feed on anxiety, but I don’t think you should do anything that might encourage this cycle, personally.

 

[rebrascora]

its even started to be out when im ment to be steady, as my pre breakfast blood check said iwas at 11.3 ((thanks dawn phenomenon))when the sensor was only saying 9.8)

Firstly your levels are often not steady before breakfast because your liver is pumping out glucose at a faster rate than at any other time of day for most of us. As you say Dawn Phenomenon/Foot on the Floor Syndrome causes that and I imagine that your graph was probably showing a slight rise.

Secondly 9,8 and 11.3 are more or less the same number. ie. about 10-11. You could easily get a discrepancy like that from 2 different BG meters or even two different test strips. When your levels get down more into range, the difference between them will usually become less as I mentioned in my other posts. You don't seem to be grasping this part of what we are saying.
You can't say for sure if the finger prick is closer to your actual BG or the sensor. The useful information you can take from it is that Libre seems to be fairly consistently reading lower than a finger prick which is what I also find and that should give you some comfort because your low alarm will trigger before your Blood Glucose actually gets to whatever that level is you have it set at, so you have slightly more advance warning of a hypo, because the Libre is reading lower.

Some of our members here on the forum have done quite a bit of testing of different fingers and BG meters and found that even in range, there was a difference of more than 1mmol between some of the meters and others and different fingers, so you really have to accept that your Libre reading 9.8 and a finger prick giving you 11.3 is perfectly normal and acceptable, so please stop worrying about it. In many respects it is advantageous for it to be reading lower than blood.

I too get hard cracked skin (keens) on my hands and feet and use a salicylic acid based cream/ointments frequently on both and have no problems with it affecting Libre. Please just accept that these discrepancies you are seeing are totally normal. If it reads 4.5 and your BG is 7.8 that would be meaningful but 9.8 and 11.3 are not significantly different.

 

[Sara Grice]

I’ve just checked my handcreams @Sara Grice I get dry hands because of my job (lots of hand-washing) so use handcreams many times a day too. I promise you I have never seen anything in my sensor readings that suggest it’s interfering with them. I’ve also been on holiday and not taken my handcream and my readings didn’t change or become unpredictable or different.

The readings you’re getting from your Libre are normal. It’s less accurate at either end of the range and most accurate in the middle. If your Libre says 14 but your fingerprick says 12 for example, that all normal and usual. The Libre has still done its job: told you you’re a little above range.

You can do what you want but I wouldn’t stop using your handcream. Why? Because I think such fixations aren’t helpful and the potential stress they’re causing will be having more of an effect on your blood sugar and control. I also think that if the handcream is proved to be OK, that that won’t bring you peace. You’ll move on to something else. That’s not your fault and I know how hard it is to stop thoughts that feed on anxiety, but I don’t think you should do anything that might encourage this cycle, personally.

Ok, I'll bite, to clarify it wasn't a 12-14 split like you said, it was more like a 11-15 difference, with 11.3. Being the reading shown on my sensor 20 minutes after a blood reading of 14.8, close to 15, which is sort of something I need to know that i went up...its kinda importsnt
As I wasn't " alittle above range" it was alot above range...up around 15, and if I had just gone off what the sensor told me..I have thought that I had a good meal that never put went over 12,

How is this in anyway useful information, just to know that my levels have gone up? I could have told you that based on absolutely considering I had eaten something an hour ago, when sensors are this far out it makes actuly manging this sucky disease impossible because I'm trying off readings that just aren't right. Like..as I mentioned in my post it's NOT just an issue around meal times, this morning it was off to..not by as much but still an unhelpful degree. And my last one did this too..so there must be some reason behind it

Everyone keeps telling me it's normal but it certainly dosent feel normal for a device made to help me manage my disease accurately when all it can do is tell me I've gone up or down..but not able to tell me by how much with any reliability, as I said if I hadn't checked with my monitor I wouldn't have known ide gone high

 

[helli]

if I hadn't checked with my monitor I wouldn't have known ide gone high

What was your BG 4 hours after eating?
If it was back in range, you should not be worrying if it was 11.3 or 14.8. A short sojourn into double figures (where both CGMs and finger prick meters are known to be less accurate) is unlikely to cause lasting issues.
It is not necessary to check between meals.

 

[Lauren]

I take a double dose of aspirin daily at the moment and sadly this does not lower my blood sugar. It does lower my blood pressure though!

 

[Sara Grice]

Firstly your levels are often not steady before breakfast because your liver is pumping out glucose at a faster rate than at any other time of day for most of us. As you say Dawn Phenomenon/Foot on the Floor Syndrome causes that and I imagine that your graph was probably showing a slight rise.

Secondly 9,8 and 11.3 are more or less the same number. ie. about 10-11. You could easily get a discrepancy like that from 2 different BG meters or even two different test strips. When your levels get down more into range, the difference between them will usually become less as I mentioned in my other posts. You don't seem to be grasping this part of what we are saying.
You can't say for sure if the finger prick is closer to your actual BG or the sensor. The useful information you can take from it is that Libre seems to be fairly consistently reading lower than a finger prick which is what I also find and that should give you some comfort because your low alarm will trigger before your Blood Glucose actually gets to whatever that level is you have it set at, so you have slightly more advance warning of a hypo, because the Libre is reading lower.

Some of our members here on the forum have done quite a bit of testing of different fingers and BG meters and found that even in range, there was a difference of more than 1mmol between some of the meters and others and different fingers, so you really have to accept that your Libre reading 9.8 and a finger prick giving you 11.3 is perfectly normal and acceptable, so please stop worrying about it. In many respects it is advantageous for it to be reading lower than blood.

I too get hard cracked skin (keens) on my hands and feet and use a salicylic acid based cream/ointments frequently on both and have no problems with it affecting Libre. Please just accept that these discrepancies you are seeing are totally normal. If it reads 4.5 and your BG is 7.8 that would be meaningful but 9.8 and 11.3 are not significantly different.

Firstly your levels are often not steady before breakfast because your liver is pumping out glucose at a faster rate than at any other time of day for most of us. As you say Dawn Phenomenon/Foot on the Floor Syndrome causes that and I imagine that your graph was probably showing a slight rise.

Secondly 9,8 and 11.3 are more or less the same number. ie. about 10-11. You could easily get a discrepancy like that from 2 different BG meters or even two different test strips. When your levels get down more into range, the difference between them will usually become less as I mentioned in my other posts. You don't seem to be grasping this part of what we are saying.
You can't say for sure if the finger prick is closer to your actual BG or the sensor. The useful information you can take from it is that Libre seems to be fairly consistently reading lower than a finger prick which is what I also find and that should give you some comfort because your low alarm will trigger before your Blood Glucose actually gets to whatever that level is you have it set at, so you have slightly more advance warning of a hypo, because the Libre is reading lower.

Some of our members here on the forum have done quite a bit of testing of different fingers and BG meters and found that even in range, there was a difference of more than 1mmol between some of the meters and others and different fingers, so you really have to accept that your Libre reading 9.8 and a finger prick giving you 11.3 is perfectly normal and acceptable, so please stop worrying about it. In many respects it is advantageous for it to be reading lower than blood.

I too get hard cracked skin (keens) on my hands and feet and use a salicylic acid based cream/ointments frequently on both and have no problems with it affecting Libre. Please just accept that these discrepancies you are seeing are totally normal. If it reads 4.5 and your BG is 7.8 that would be meaningful but 9.8 and 11.3 are not significantly different.

Ok, taken a deep breath and did some calming thoughts and will try to take what you say on board, my main sticking point is while I'm sure the discrepancy I the range of accepted difference (although to the far end of it you've gotta at least give me that..11.3 to 14.8..anyway) it just makes everything harder when managing my levels harder if they arnt actuly what they apear to be

As an example I am still nervous about hypos and like to keep myself around 7 or 8 after meals, which often means a bit ot a snack between them to keep me in that range, my diabrties team recomended this as as once I get more confident then I can aim a bit lower, but it's hard to actily build up said confidence if I need to d to math on my libre sensor readings to kinds guess what my actual levels are and then go of that becuase its this off. And like..what if I showed my diabeties team my levels without the notes I added explaining how off my readings where, they could advise me wrong because it looks better than it is without context

Also I want to ask one question, can you elaborate on when you said 4.5 compared to 7.8 is noteworthy but 11.3 to 14.8 isn't?? What's the difference they are both 3 mmol/ml apart and so if my sensor did sbow me at 4.5 then with how off it is right now it would be about 7.8.... why is that worse I don't quite understand because the situation you said was noteworthy is something that with my current sensor could happen...

 

[Sara Grice]

What was your BG 4 hours after eating?
If it was back in range, you should not be worrying if it was 11.3 or 14.8. A short sojourn into double figures (where both CGMs and finger prick meters are known to be less accurate) is unlikely to cause lasting issues.
It is not necessary to check between meals.

My levels always go back down below 10 before my next meal

 

[Leadinglights]

As you are not yet in a position to be adjusting your insulin dose then reducing the amount of testing with whatever device you choose to use to checking before eating and after 4 hours to see if your level has returned to the pre meal amount. Resist the temptation to be using both.
You could use just finger pricks only for a couple of days then use only your Libre for a couple of days just looking at trends not actual numbers.

 

[Leadinglights]

Ok, taken a deep breath and did some calming thoughts and will try to take what you say on board, my main sticking point is while I'm sure the discrepancy I the range of accepted difference (although to the far end of it you've gotta at least give me that..11.3 to 14.8..anyway) it just makes everything harder when managing my levels harder if they arnt actuly what they apear to be

As an example I am still nervous about hypos and like to keep myself around 7 or 8 after meals, which often means a bit ot a snack between them to keep me in that range, my diabrties team recomended this as as once I get more confident then I can aim a bit lower, but it's hard to actily build up said confidence if I need to d to math on my libre sensor readings to kinds guess what my actual levels are and then go of that becuase its this off. And like..what if I showed my diabeties team my levels without the notes I added explaining how off my readings where, they could advise me wrong because it looks better than it is without context

Also I want to ask one question, can you elaborate on when you said 4.5 compared to 7.8 is noteworthy but 11.3 to 14.8 isn't?? What's the difference they are both 3 mmol/ml apart and so if my sensor did sbow me at 4.5 then with how off it is right now it would be about 7.8.... why is that worse I don't quite understand because the situation you said was noteworthy is something that with my current sensor could happen...

You will see from the table posted either this or one of your other treads that as the permitted accuracy of monitors is a % then the higher the readings the bigger the range of permitted accuracy.

 

[Sara Grice]

As you are not yet in a position to be adjusting your insulin dose then reducing the amount of testing with whatever device you choose to use to checking before eating and after 4 hours to see if your level has returned to the pre meal amount. Resist the temptation to be using both.
You could use just finger pricks only for a couple of days then use only your Libre for a couple of days just looking at trends not actual numbers.

Tends aren't even being accurately shown on my sensor, as I mentioned the highs underestimated , unless I'm misunderstanding what trends are. It means how fast you are rising and falling right? I know for sure it isn't depicting how fast I am rising accurately as it never showed I rose up to where I was
If I'm misunderstanding please correct me

 

[Inka]

Ok, I'll bite, to clarify it wasn't a 12-14 split like you said, it was more like a 11-15 difference, with 11.3. Being the reading shown on my sensor 20 minutes after a blood reading of 14.8, close to 15, which is sort of something I need to know that i went up...its kinda importsnt
As I wasn't " alittle above range" it was alot above range...up around 15, and if I had just gone off what the sensor told me..I have thought that I had a good meal that never put went over 12,

How is this in anyway useful information, just to know that my levels have gone up? I could have told you that based on absolutely considering I had eaten something an hour ago, when sensors are this far out it makes actuly manging this sucky disease impossible because I'm trying off readings that just aren't right. Like..as I mentioned in my post it's NOT just an issue around meal times, this morning it was off to..not by as much but still an unhelpful degree. And my last one did this too..so there must be some reason behind it

Everyone keeps telling me it's normal but it certainly dosent feel normal for a device made to help me manage my disease accurately when all it can do is tell me I've gone up or down..but not able to tell me by how much with any reliability, as I said if I hadn't checked with my monitor I wouldn't have known ide gone high

You don’t need to ‘bite’. There was no malice or criticism or taunting in my post. I sympathise with your anxiety and I’m trying to help. My 12 and 14 were an example. 11.3 and 14.8 are similar - above range and not too different. It doesn’t matter. If it stresses you to look at these differences, then don’t look. Limit the amount of times you check your blood sugar. You’re torturing yourself about differences that don’t matter.

 

[Leadinglights]

Having been involved in supporting students with their science experimental work where they may be comparing different treatments and they get odd results, when you go through what they have done it is apparent they have not kept their method consistent, they may have used a different instrument, added reagents in a different order, used a different incubation time or temperature so are introducing variables other than what it is they are comparing. Once they are consistent in their method then they can get meaningful results. If things look odd there is usually an explanation once you rule out sloppy methodology.

 

[Thebearcametoo]

When we talk about trends with sensors it’s a bit like thinking about the weather and the way data points are used to predict the future and if you use weather forecasts often you’ll likely find that one company is more accurate for your area than another is or you may just like the interface of one more.

Sometimes it can be raining at the front of the house but not at the back of the house. If you’re not going out it doesn’t really matter. If you’re about to step out of the house then you want to know which one is going to be accurate in a few minutes so you can prepare and take an umbrella or a coat.

Your sensor (and finger pricks) are really useful if you’re about to step out the door (eat) or you’re about to have a hypo. Otherwise they’re just gathering data and from that data you and your DSN or doctors can see how accurate your basal levels and meal ratios are. The individual readings are of passing interest but don’t really matter that much. You can stand all day at the window looking out to see if it’s raining or not but then you don’t live.

It’s a clumsy metaphor but I hope it helps you to put sensor (and finger prick) readings into context.

Your sensor has had some issues especially with failures etc but micromanaging them just raises anxiety and doesn’t help you manage your diabetes.