Wanting to ditch finger pricking for a CGM

[Spudz]

Hi, I'm getting fed up with finger pricking, (fingers starting to get a bit sore), and am looking into a CGM but have a few questions I hope can be answered by you knowledgable lot I know there is a cost involved 😳 but feel the need to do a bit of research first before taking the leap.
1, are some better than others and any that should be avoided? And are some companies better to deal with than others?
2, are they more accurate than finger pricking?
3, is it better to have a reader or use an app on the phone (iPhone in my case)?
4, are the sensors easy to fit and do they stay on?

I think they are my main questions but if anyone has advice regarding other things it would be very much appreciated.

TIA

 

[nonethewiser]

Only speaking from own experience.

1, Libre is good but have to say Dexcom is more accurate even at low & higher levels than Libre.

2, No nothing currently is available is more accurate than bg finger orick test.

3, Personally prefer app on phone as carry.phone around with me everywhere.

4, They are really easy to fit, with both Libre & Dexcom found adhesive used to be extremely good, only ever had 2 dislodge so far.

 

[Eternal422]

I agree with all that @nonethewiser says.

I use Libre 2 ( about to be phased out next year and replaced with Libre 2+ ) and find it really easy to apply and love the real time readings (well, every minute) on my phone. I too prefer the app (I use iPhone) as I always have this with me and having to lug around another device like a reader would be a pain for me.

I am confident enough to use the Libre readings for insulin dosing decisions, accepting that the actual readings are not as accurate as finger pricking. Doing some spot checks every so often I find for me that the Libre is usually fairly close or at most 1 mmol/L lower than finger pricking tests (you need to allow for the lag between the CGM which tests interstitial fluid and finger pricking which is blood).

People’s results do vary and some find that the Dexcom One+ is better for them. Size and function wise there isn’t much to chose between them.

Be aware that some sensors will fail or get knocked off your arm. Abbott for Libre are pretty good at sending replacements free of charge, I would imagine Dexcom are as well but do not have any experience of them. Over the 71 Libre 2 sensors I have used, 11 failed, so that’s a 15% failure rate. All failed ones have been replaced without any problems.

There’s a really useful write up of CGM limitations here :

CGM limitations and precautions

Moderator Note: This helpful reply was copied from another thread as it details some of the commonly experienced limitations of continuous glucose sensors. My blood sugar has been in perfect range for days now, but although I haven't changed anything, I'm starting to get very short periods of...

forum.diabetes.org.uk

Whatever you chose I’m sure you will find it extremely useful!

 

[Lucyr]

Hi, I'm getting fed up with finger pricking, (fingers starting to get a bit sore)

Your fingers shouldn’t be getting sore. Have you made sure the lancer is on the lowest setting that gets enough blood? Also fingerprick on side of finger not pad and look into accu chek fast clix lancer if not using it already.

CGMs are an addition to fingerpricking not a total replacement. They aren’t worth the expense if not on insulin, as the only things you can change are diet and exercise and you can learn what changes happen there through systematic fingerpricking

How often are you fingerpricking? Once you know a food works for you then you shouldn’t still be needing to test it.

 

[Leadinglights]

If you have been doing so much finger pricking to make your fingers sore which incidentally it shouldn't, you must have collected enough data about what meals suit you and have enabled you to make some dietary changes for a CGM to be rather overkill for what you need.
Sort out your technique and it should be too onerous and much cheaper.
You could request free trials of a Libre and Dexcom as long as you have a compatible phone.

 

[goodybags]

Hi @Spudz when you commented you were fed up with finger pricking, and fingers were sore,
I thought to myself maybe you need to look at your technique
and your finger pricking device

are you still using the one that came with your BGM or have you invested in something some of us find more finger friendly (like the AcuCheck Fastclix) which I now use myself

I also use CGM which for me has been a very useful tool, have you dipped you toe in the waters by requesting the “free trials”
yet from Dexcom & Abbott

 

[Spudz]

Thanks for the interesting and informative replies. It would appear, from what you've said, that the best, more reliable and cost effective, method is finger pricking.
I have been taking readings 4 times a day for at least the last month and am using the AcuCheck Fastclix system with the lancer set on 4 ½ out of 5 ½. I'll try taking it down a notch or two and see if it allows me to draw enough blood to take a reading; I'll also try and man up a bit and stop being a wimp

 

[Leadinglights]

Thanks for the interesting and informative replies. It would appear, from what you've said, that the best, more reliable and cost effective, method is finger pricking.
I have been taking readings 4 times a day for at least the last month and am using the AcuCheck Fastclix system with the lancer set on 4 ½ out of 5 ½. I'll try taking it down a notch or two and see if it allows me to draw enough blood to take a reading; I'll also try and man up a bit and stop being a wimp

You only need a tiny drop of blood the size of a pin head for most monitors so you may well not need the setting so deep. I find pricking just to the side of the pad, making sure you hands are warm, if you massage the finger towards the tip before pricking that helps and just gentle pressure is usually all that is needed.
You could assess whether your finger pricks are telling you useful information on which you are making changes rather than just random.
You could reduce it a bit by checking your fasting/ morning and then before and 2 hours after breakfast for a few days to establish a good meal, then move on and do the same for lunch, and then for dinner. You may then only need to check if you are having something substantially different. Of course if you feel unwell it is a good idea to check.

 

[rebrascora]

4x a day!! Many of us were finger pricking 8+ times a day for years plus injecting insulin at least 5x a day. I went through a spell of finger pricking 16 times a day for a month or two to get my prebolus timing sorted out before I self funded Libre and then eventually got it on prescription. If you fancy playing with the technology, admit it but it has quirks and limitations that you need to be aware of and double check with finger pricks and the info it gives can be quite fascinating and addictive but if finger pricking 4 x a day for a month is making your fingers sore, you need to work on your technique. Maybe you are squeezing too hard and that is making them sore but the finger pricking shouldn't. Libre is really convenient and fascinating, but you will likely lose some in the early days due not perfecting your application process/skin prep or catching it on door frames, clothing etc and you may get low alarms through the night from lying on the arm with the sensor etc.
As others have mentioned you can apply for a free trial and I am sure Abbott do this partly because they know it is addictive. I think we would probably only recommend Libre or Dexcom as they are the most widely used and well respected but sometime people will find one more reliable than the other, which may partly come down to body chemistry and algorithms used for each system rather than the system itself being more reliable.

In your situation I wonder if you have perhaps not been finger pricking enough to get useful data and a 14 day free trial of Libre might give you more intensive information about your responses to food to help you modify your diet and then go back to finger pricking just for new/different foods that you haven't tested and found give an acceptable response. Keeping a food diary alongside your readings is important.

 

[Lucyr]

I have been taking readings 4 times a day for at least the last month

What are you using the results for? After a month of testing 4 times a day I’d have expected you may have covered many of your regular meals and not need to test them all any more. Do you have a strategy for when you test and what you’re doing with the results?

 

[Wendal]

Hi, I'm getting fed up with finger pricking, (fingers starting to get a bit sore), and am looking into a CGM but have a few questions I hope can be answered by you knowledgable lot I know there is a cost involved 😳 but feel the need to do a bit of research first before taking the leap.
1, are some better than others and any that should be avoided? And are some companies better to deal with than others?
2, are they more accurate than finger pricking?
3, is it better to have a reader or use an app on the phone (iPhone in my case)?
4, are the sensors easy to fit and do they stay on?

I think they are my main questions but if anyone has advice regarding other things it would be very much appreciated.

TIA

Hi Spudz,
Hope you have had a good festive break.Must admit apart from when I need to confirm my BG levels with finger pricking as whole blood is the gold standard in any diagnostic setting then I use by Libre for all my insulin decisions and find that works fine for me.
I used to prefer the App on my phone I Phone) but found it did not always accept my regular updates so just use the reader now.
Find the sensors very easy to fit and all mine stay on for the full 2 weeks.
Hope this helps and to me it is all about making life as easy as possible rather than trying to be perfect.

 

[Spudz]

What are you using the results for? After a month of testing 4 times a day I’d have expected you may have covered many of your regular meals and not need to test them all any more. Do you have a strategy for when you test and what you’re doing with the results?

I use them mainly to get an idea of what foods affect the readings (up or down). Getting to know things better as I go along. By the replies I've had it looks like I'll be persevering with the finger pricking with some adjustments to how I do it.

 

[Lucyr]

I use them mainly to get an idea of what foods affect the readings (up or down).

If you’ve been fingerpricking meals for a month though, have you not got an idea by now of what meals work or don’t work for you already? Or are you still eating new foods twice a day every day (guessing the 4 readings must be before and 2hrs after 2 meals if you’re using the test results to see impact of meals)

 

[goodybags]

@Spudz good that you've already got a AcuCheck FastClix, for me it was so much better than the finger stabber & lancets that came with the BGM device
If your using the FastClix on the setting of 5, I was thinking could you turn it down maybe ? ok obviously it is there as some people will need it, but maybe you can try a more gentle setting if you wash hands in hot water that can then help to only require a smaller puncture to get the drop of blood your looking for

 

[Spudz]

@Spudz good that you've already got a AcuCheck FastClix, for me it was so much better than the finger stabber & lancets that came with the BGM device
If your using the FastClix on the setting of 5, I was thinking could you turn it down maybe ? ok obviously it is there as some people will need it, but maybe you can try a more gentle setting if you wash hands in hot water that can then help to only require a smaller puncture to get the drop of blood your looking for

I'll give that a try, thanks goodybags

 

[helli]

As well as turning down the depth gauge on your pricker, I also recommend making sure your fingers are warm before pricking.
I tend to "cuddle a cuppa" before I need a reading. This bring blood to the surface so you do not need to prick as deep.
The other thing to consider is what part of your finger you prick. If you are pricking the centre of your finger pad, this can be more sore (, because you use it) than the side of the pad.
And remember to use all fingers - there are eight fingers which you can rotate. Some people also prick their thumbs although I use mine as backup if I injure a finger.

 

[Ph1l]

Just wondering why everyone is questioning how much Spudz is finger pricking without any reference to him being on Gliclazide and my understanding of the DVLA rules is that anyone on Gliclazide has to check before driving and then every 2 hours while driving? I know on some days, especially if I’m doing multiple short journeys or even a long one, I stab my finger more than Spudz :-D

 

[Leadinglights]

Just wondering why everyone is questioning how much Spudz is finger pricking without any reference to him being on Gliclazide and my understanding of the DVLA rules is that anyone on Gliclazide has to check before driving and then every 2 hours while driving? I know on some days, especially if I’m doing multiple short journeys or even a long one, I stab my finger more than Spudz :-D

I think what people are mentioning is that testing should be for a purpose be that to check the effect of meals, a check day to day or to full fill the requirements of the DVLA if the OP drives.
Finger pricking should be a painless procedure meaning people should test enough to meet their needs.

 

[Lucyr]

Just wondering why everyone is questioning how much Spudz is finger pricking without any reference to him being on Gliclazide and my understanding of the DVLA rules is that anyone on Gliclazide has to check before driving and then every 2 hours while driving?

That’s not in the DVLA rules, you don’t have to inform the dvla about diabetes unless you take insulin or have certain complications. Though of course you should carry kit so you can test if feeling low.

Also, as Spudz says they’re testing 4 times a day to learn how food affects them, then it doesn’t sound like they’re testing around driving anyway.

 

[harbottle]

DVLA advice is to check blood glucose when driving if on medication that can cause hypoglycaemia such as sulphonylureas and glinides. If you’ve had more than one hypo on these medications in the last 12 months then you have to inform the DVLA.