#t1dsummer – Diabetes Amigo

T1D Make Dexcom Stick for 10 Days

June 29, 2023July 2, 2023 Diabetes Amigo

Tips

The Dexcom Continuous Glucose Monitor (CGM) has an adhesive patch that adheres to the body and is expected to last 10 full days. Daily life (baths, swimming, heat, etc.) and your personal skin can cause the CGM’s adhesive patch to fail. Add extra adhesive or utilize accessories to help keep the Dexcom sensor adhesive patch, sensor wire and transmitter securely in place for 10 days.

Extra Adhesive / Accessories / Sunscreen

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Extra Adhesive

Clear Film Dressing Tape – cover entire Dexcom in a transparent adhesive bandages that makes a watertight seal over the CGM. Precut in circle and square shapes to cover the Dexcom on various site locations. If you like to make your covers, the clear film can be purchased in a roll.

Overpatches – add an extra adhesive patch over Dexcom’s initial adhesive patch. Overpatches are typically precut to fit over the transmitter (and available in various colors and designs). Dexcom supplies free overpatches via an online ordering form.

Shield – Add a shield before applying an overpatch to your Dexcom CGM to allow for easy removal of the overpatch. The shield protects the CGM’s initial adhesive patch when applying/removing an overpatch. When the overpatch starts to peel at the edges, simply remove the extra overpatch without disturbing the CGM’s initial adhesive patch.

Liquid Adhesive – Adding an adhesive barrier with liquid adhesive before applying a Dexcom sensor provides skin protection and extra adhesive to the sensor’s initial adhesive patch. A second layer of liquid adhesive on top of the sensor’s patch provides even more sticking power. Further, apply liquid adhesive to the edges of an adhesive patch that starts to peel-up from daily wear-and-tear. Purchase in economical bottle or in travel wipe size.

Accessories

Arm Bands – Arm bands can worn over a Dexcom sensor’s initial patch and transmitter or be used in addition to overpatches. Adding an arm band over a sensor’s initial adhesive patch can help during water activities (be sure to keep the arm band on until the adhesive patch dries to help keep the adhesive patch and sensor wire in place).

Compression Band – wear a compression band over a Dexcom sensor and transmitter to protect the CGM from being ripped off your body and during water activities (wear in water and then wear the compression band until the band dries to help keep the adhesive and sensor wire in place).

Adhesive Bandage Wrap (a.k.a. Vet Wrap) – comes in various colors and sizes to wrap over the Dexcom CGM sensor and transmitter. Vet wrap works like a compression band but is much easier to remove and dries faster. Also, allows for custom sizing of the wrap to cover Dexcom on arms, legs and stomach. Tip – vet wrap can shrink when going from dry-wet-dry again. It is important to check the tightness of the wrap throughout the day on young kids.

Sunscreen

When applying sunscreen stay clear of the Dexcom sensor’s adhesive patch (sunscreen can make the adhesive malleable and device will just slide off). Consider using a sunscreen stick or solar buddy to apply sunscreen safely around adhesive patches.

T1D Making CGMs and Pumps Stick in Water

June 13, 2023June 16, 2023 Diabetes Amigo

Tips

Water and Type 1 Diabetics (T1D) medical devices (Continuous Glucose Monitors [CGMs], insulin pumps and infusion sites) require special considerations for T1Ds. When adhesives patches get wet for long periods of time, the adhesive can become mailable causing the adhesive patch to more around and/or fall off. Have a relaxing and manageable day in the water (swimming, pool, lake, beach, ocean, etc.) with the right preparations for managing Type 1 Diabetes adhesives.

Overpatch / Arm Bands / Shield / Liquid Adhesive / Vet Wrap / Sunscreen

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Overpatches Extra Adhesive for CGMs and Pumps

Overpatches add an extra adhesive patch over the T1D medical device’s initial patch. Overpatches are typically precut to fit the T1D device (Dexcom, Libre, Infusion site or OmniPod) but you can also make you own patches.

Dexcom Overpatch Options

Skin Grip
Rayon that is latex/ zinc oxide free and hypoallergenic

Expression Med
Exclusive non-woven material in many designs

Libre Overpatch Options

OmniPod Overpatch Options

Shields

Add a shield before applying an overpatch to a T1D medical device to allow for easy removal of the overpatch. The shield protects the initial medical device’s adhesive patch when applying an overpatch. When the overpatch (applied over the shield) starts to peel at the edges, simply remove the extra overpatch without disturbing the initial adhesive patch.

Arm Bands

Arm bands can worn over T1D medical device’s initial patch or be used in addition to overpatches. Adding an arm band over a T1D medical device while in water and then wearing it until the adhesive patch dries, helps keep the adhesive in place. Use a device specific arm band (Dexcom, Libre or Omnipod) or general compression band over all devices.

Liquid Adhesive

Adding an adhesive barrier before applying a T1D medical device (Dexcom, Libre, Infusion Site, OmniPod) provides extra adhesive to the initial adhesive. A second layer of liquid adhesive on top of the adhesive patch provides even more sticking power. Further, apply liquid bandage to edges of an adhesive patch that starts to peel-up from daily wear-and-tear from being in water.

Adhesive Bandage Wrap

Adhesive Bandage Wrap (a.k.a. vet wrap) comes in various colors and sizes to wrap over T1D medical devices. Vet wrap works like a compression band but is much easier to remove and dries faster. Vet wrap can shrink when going from dry-wet-dry again. It is important to check the tightness of the wrap throughout the day on young kids.

Sunscreen

Keep your skin protected even at indoor pools. Sunburns can cause high blood glucose levels and ruin your fun. When applying sunscreen stay clear of the medical device’s adhesive patches (sunscreen can make the adhesive malleable and device will just slide off) and OmniPod insulin pumps (sunscreen causes pods to crack/leak). Consider using a sunscreen stick or solar buddy to apply sunscreen safely around adhesive patches.

Swimming and T1D Type 1 Diabetes

May 31, 2023June 10, 2023 Diabetes Amigo

Day-to-Day T1D

Pool days and swimming require special considerations for Type 1 Diabetics. Have a relaxing and manageable day swimming at the pool with the right preparations for managing Type 1 Diabetes (medical devices [pumps and CGMs] and blood sugars).

Supplies / Insulin / BGs / Hot Tubs / Swimwear / Sunscreen

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Supplies

We have a compact daily supply bag that holds all our Type 1 Diabetes (T1D) supplies. The supply bag is compact and convenient when accessing supplies. For pool days, consider additionally bringing the following supplies:

Extra CGM (Dexcom or Libre) sensor and transmitter – just in case the entire device is lost in the water, a back up might be needed.
Waterproof Cases – consider keeping receivers, phones, pump controllers, and pumps (disconnected or connected) in waterproof cases.

Waterproof Pump Belt that Allows for Tubing

Extra Protection for the CGM and Pump – options include overpatches, CGM shield, armbands and/or vet wrap. Giving the medical devices extra help to stay on during hours of being submerged in water helps.

Travel BG Checking Supplies – CGMs do not send blood glucose data to receivers or phones while swimming underwater. Getting the CGM and phone to reconnect can take up to 15 minutes once out of the water. In the absence of CGM data, we manually test blood sugars every 30 minutes. Consider keeping a small bag that only holds lancer, lancets, blood glucose test strips, the meter and low supplies for easy access. This helps to keep all other supplies dry and manual BG supplies easily accessible.

Insulin

Consider keeping the daily supply bag containing insulin pens or vials out of direct sun exposure. Simply keep the supply bag under your pool seat for shade to keep insulin from getting too hot. If you are concerned about insulin in the shade, here a few tips for keeping insulin at the right temperature:

Lockers – public pools typically have lockers that can get hot (typically a metal box that heats up in both indoor and outdoor pools). Keep supplies cool with ice packs or look for lockers in the shade.
Frio Wallet – a Frio Wallet will help keep insulin vials and pens cool and does not require a fridge/freezer to activate.
Insulated Bottle – add ice to an insulated bottle, wrap your insulin pen/vial in a paper towel or Frio bag (adds insulation so the insulin is not directly in freezing water, if the ice melts), place the wrapped insulin pen/vial in sandwich bag and secure with the bottle’s lid. A coffee travel mug works well because of the wide mouth design (any insulted water bottle works though).

Insulated Tumbler with LED Temperature Display

Blood Sugars

Every Type 1 Diabetic’s blood glucose levels respond differently while swimming at the pool. Variables that can effect blood sugar include water, water temperature, swimming, exercise, heat, excitement, adrenaline, etc. Be prepared for hypoglycemic (low), hyperglycemic (high) or blood sugars that stay in-range. Make adjustments to basal or I:C ratios based on the individual’s body and how it responds to exercise/water/heat.

Favorite supplies for managing low blood sugars while swimming at the pool:

Favorite protein bars that travel well in a swim/pool bag (helps to maintain blood sugars in range):

Hot Tubs

Being in hot water can cause insulin to be absorbed faster. For insulin pumps users other than OmniPod you will have to disconnect and store your pump. This can cause blood glucose levels to rise faster than expected due to not receiving basal insulin while in the hot tub.

Swimwear

The right swimwear can help with keeping Type 1 Diabetes medical devices stuck to the skin while swimming. Consider swimwear that covers the devices for extra protection; cannon balls, diving and jumping into the pool all add extra force onto CGM’s and pump site’s adhesive.

Swimwear options:
- Swim Jammers – adding swim jammers under swim trunks can protect a CGM or pump site that is placed on the legs.
- Rash Guard – a swim shirt or rash guard is helpful for avoiding sunburns and for protecting CGM or pump site that is placed on the stomach or arms.
- Wetsuit – a lightweight wetsuit (2mm) is comfortable to wear all day long, protects most CGM or pump sites all at one time and helps avoid sunburns.

Sunscreen

Keep your skin protected even at indoor pools. Sunburns can cause high blood glucose levels and ruin your fun. When applying sunscreen stay clear of medical device’s adhesive patches (sunscreen can make the adhesive malleable and device will just slide off) and OmniPod insulin pumps (sunscreen causes pods to crack/leak).