FreeStyle Libre alternative sensor sites

The FreeStyle Libre sensor which provides a non-invasive and practical way to detect glucose levels, has transformed glucose monitoring for people with diabetes. The sensor which is frequently placed on the back of the upper arm, continuously provides insights into glucose levels, allowing for improved management of the condition. In this expert guide, we’ll go into the typical FreeStyle Libre sensor’s placement before looking at some alternating places. We’ll also discuss the best procedures because accuracy and dependable readings depend on knowing where the sensor should be placed.

FreeStyle Libre Sensor Placement: Maximizing Accuracy

A continuous glucose monitoring device called the FreeStyle Libre sensor is commonly placed on the back of the upper arm. The possibility of sensor displacement during routine activities is reduced by this placement which provides a level and solid surface. To get reliable readings, consider a location free of moles, scars, or tattoos. To avoid potential interference, it is also recommended to keep your distance from any recent insulin injection site at least 2.5 centimetres (Steineck et al., 2019).

The back of the upper arm is the best place for the FreeStyle Libre sensor placement because it offers the right amount of stability and accessibility, enabling people to accurately and confidently manage their diabetes. This placement is advised for several reasons:

1. Flat Surface for Stable Adherence

The relatively smooth surface of the upper arm ensures reliable sensor attachment during routine daily activities. This reduces the possibility of displacement and encourages reliable readings.

2. Avoidance of Skin Irregularities

Moles, scars and tattoos must be avoided because they might affect the accuracy of the sensor readings. It is crucial to select a spot of skin that is smooth and unrestricted.

3. Distance from Injection Sites

Keep at least 2.5 cm away from the closest injection site to avoid any potential interaction between insulin injections and sensor readings.

4. Rotating Sites for Comfort

People are urged to pick a different location for each sensor placement to avoid discomfort or skin irritation. This rotation makes sure that no one place undergoes excessive stress.

Exploring Alternative Sensor Sites

Although the FreeStyle Libre sensor placement often takes place on the upper arm, people may prefer other sites due to a variety of factors, including comfort, accuracy, or personal taste. Here are several FreeStyle libre alternative sites to take into account:

Lower Back:

Position: At the level of L4/5, halfway between the iliac crest and the vertebrae.
Considerations: During routine activities the lower back offers a flat, largely stable surface. Moles, scars and tattoos must be avoided, though, as these may affect the accuracy of the sensor readings. For those looking for a covert sensor position, this placement may be particularly appealing.

Chest (Third Intercostal Space):

Position: At the third intercostal space along the mid-clavicular line.
Considerations: This site offers a user-friendly, flat surface. For accurate readings, it’s crucial to stay away from skin imperfections in certain locations. This Placement might be more practical for certain people, especially if they prefer something simple to access for scanning.

Upper Thigh (As Suggested by Previous Research):

Considerations: Some study points to the upper thigh as a feasible alternate placement, despite it not being as frequently investigated as other locations. It provides a covert location and can be appropriate for people who desire to keep the sensor hidden.

Abdomen (With Caution):

Considerations: The abdomen might not function as well with the FreeStyle Libre as it does with other continuous glucose monitoring sensors. It is suggested that you use caution.

The study (Hall et al., 2022) evaluates the FreeStyle Libre Flash continuous glucose monitoring system’s (FSL-CGM) accuracy and acceptability when used in alternative sites. Three FreeStyle Libre sensors were placed on the upper arm, lower back and anterior chest of participants with type 1 diabetes (Pickup et al., 2011). In the study, venous glucose levels were compared with glucose readings from the sensors after various situations, such as a typical breakfast, during and after exercise and after skin cooling. Participants had capillary glucose tests for comparison and conscientiously used the sensors for 14 days, regularly scanning them at all sites. The results showed outstanding accuracy rates; when compared to the arm sensor the back sensor and chest sensor had accuracy rates of 97.9% and 98%, respectively (Hall et al., 2022). The arm sensor, however, performed better than the back and chest placements under test conditions. The arm and chest were preferred locations for sensor placement, with sensor failures most frequently occurring on the backside.

With this information, people may decide with confidence where to wear their Libre sensors, resulting in optimal and reliable glucose management. When used properly the FreeStyle Libre continuous glucose monitor performs as a clinically accurate tool whether it is worn on the upper arm, lower back, or anterior chest (Steineck et al., 2019).

How to Apply FreeStyle Libre Sensor

Preparing the Skin
Clean with Soap and Water: Start by rinsing the chosen area in soap and water. After that, thoroughly dry the skin.
Use an Alcohol Swab: Use an alcohol swab to clean the area then let it air dry. This extra procedure makes sure that the skin is clean and prepared for the application of sensors.
Applying the Sensor
Make Sure the Area is Clean-Shaven: The area on the back of the upper arm should be hair-free. A sensor attachment that is secure and accurate will be made possible by shaving the area.
Prepare the Sensor Applicator
Peel the sensor pack open then take the sensor applicator out.
Align the sensor applicator’s dark marks with the sensor pack’s dark marks.
Application
Place the sensor applicator on a hard, flat surface and apply pressure. Press down firmly until it stops entirely. This guarantees that the sensor is firmly fastened.
Removing the Applicator
Carefully Remove the Applicator: Carefully take the sensor applicator away from the arm after firmly applying it.
One-Hour Warm-Up Period
Give the sensor an hour to warm up because it needs time to adjust and sync with your body’s glucose levels. This one-hour equilibration period is pre-programmed to guarantee precise readings right away.

These steps will help you get the most out of your FreeStyle Libre sensor for the best possible glucose monitoring.

Comparison of Accuracy at Different Placement Sites

Researchers recently evaluated the precision and accuracy of FreeStyle Libre (FSL) glucose monitoring sensors when positioned on various anatomical sites among Belgian patients with type 1 diabetes in a study (Charleer et al., 2018). 23 adult individuals used three FSL sensors concurrently for 14 days while they were placed on their upper arm, abdomen and upper thigh. The gathered information was compared to capillary blood glucose readings obtained using an integrated FSL BG meter. The results showed that there were few variations in the upper arm and thigh FSL sensors’ accuracy throughout the 14-day experiment (Charleer et al., 2018). On the other hand, sensors worn on the abdomen showed a noticeable loss in accuracy, especially during the second week of use. Furthermore, precise measurements showed that sensors positioned on the upper arm and thigh performed better than those positioned on the abdomen. According to this study (Charleer et al., 2018), placing FSL sensors on the upper thigh results in accuracy and precision levels that are comparable to those on the upper arm, however doing so on the abdomen may lead to less than ideal performance.

Another study (Hall et al., 2022 – Where you can wear your Libre? Using the Freestyle Libre continuous glucose monitor on alternative sites ) examines alternative freestyle libre placement sites for attaching flash glucose sensors and compares the effectiveness of the chest and lower back locations to the traditional upper arm placement over the placement of 14 days. The effects of experimental settings like eating, exercising and variations in skin temperature were also evaluated. Twenty people with type 1 diabetes participated in the study (Hall et al., 2022) by wearing sensors simultaneously on all three sites. Results showed clinically acceptable accuracy at the chest and lower back sites, with 98% of readings lying within zones A and B of the Clarke error grid and closely matching the upper arm position.

However, compared to the arm the back and chest sites showed marginally lower zone accuracy. Additionally the arm site demonstrated greater accuracy than the back and chest locations under certain experimental settings. Notably, 45% of participants chose the chest as their favourite site, followed by 40% who chose the arm and 15% who chose the back (Bailey et al., 2015). Despite this, sensor adhesion on the back was found to be problematic which increased sensor displacement. In conclusion the chest and lower back are both suitable locations for the placement of flash glucose sensors, with the chest providing somewhat better accuracy and comfort. Users should be aware that results can vary between hyperglycemic and hypoglycemia levels, prompting fingerprick testing for confirmation.

“While exploring freestyle libre sensor alternative placement sites is a game-changer, taking an extra step to safeguard your investment is just as crucial. That’s where NJAP patches come into play. These specially designed patches not only offer an added layer of protection for your FreeStyle Libre sensor but also enhance your overall experience. With features like improved adhesion and water resistance they ensure your sensor stays securely in place, even during activities like swimming or workouts. Plus they come in a variety of designs, allowing you to add a touch of personal flair to your monitoring routine. So, why settle for just a patch when NJAP patches can elevate your experience to a whole new level?”

Best Practices for Optimal Sensor Placement

Rotate Sites: It’s best to pick a different location for each sensor placement to avoid discomfort or skin irritation.
Consult with Healthcare Provider: Always speak with your healthcare professional to get tailored placement advice based on your unique requirements and preferences.
Monitor and Adjust: Pay attention to sensor readings and if you experience any irregularities or discomfort, move the sensors.
Maintain Skin Health: To encourage reliable readings, make sure the chosen location is clean, dry and unintimidating.

One of the most important parts of controlling diabetes is navigating the realm of glucose monitoring. While the FreeStyle Libre sensor’s go-to location is still the upper arm, many other potential placements are just waiting to be discovered. These clinically acceptable choices provide a new perspective on everything from the dependable chest to the strong lower back. In terms of comfort and accuracy the chest in particular leads the pack. Because everyone has different tastes, finding your ideal placement of the freestyle Libre sensor is a unique journey. The release of FreeStyle Libre 2 and FreeStyle Libre 3 gave users even more flexibility over their monitoring experience, so let’s not forget about the fascinating technological advances in that area. Just a polite reminder that it’s critical to get specific guidance on freestyle Libre sensor placement from a healthcare professional and take good care of your skin. So here’s to making wise decisions and incorporating diabetes control into your daily life without any hassles!

References

Bailey, T., Bode, B. W., Christiansen, M. P., Klaff, L. J., & Alva, S. (2015). The performance and usability of a factory-calibrated flash glucose monitoring system. Diabetes technology & therapeutics, 17(11), 787-794.

Pickup, J. C., Freeman, S. C., & Sutton, A. J. (2011). Glycaemic control in type 1 diabetes during real-time continuous glucose monitoring compared with self monitoring of blood glucose: a meta-analysis of randomised controlled trials using individual patient data. Bmj, 343.

Steineck, I. I. K., Mahmoudi, Z., Ranjan, A., Schmidt, S., Jørgensen, J. B., & Nørgaard, K. (2019). Comparison of continuous glucose monitoring accuracy between abdominal and upper arm insertion sites. Diabetes technology & therapeutics, 21(5), 295-302.

Hall, R. M., Dyhrberg, S., McTavish, A., McTavish, L., Corley, B., & Krebs, J. (2022). Where can you wear your Libre? Using the FreeStyle Libre continuous glucose monitor on alternative sites. Diabetes, Obesity and Metabolism, 24(4), 675–683. https://doi.org/10.1111/dom.14630

Charleer, S., Mathieu, C., Nobels, F., & Gillard, P. (2018). Accuracy and precision of flash glucose monitoring sensors inserted into the abdomen and upper thigh compared with the upper arm. Diabetes, Obesity and Metabolism, 20(6), 1503–1507. https://doi.org/10.1111/dom.13239

Today, both Libre 3 and Dexcom G7 are widely used in different parts of the globe. The ease they offer in continuous glucose monitoring and the mobile interface’s real-time update has made it popular among different patient demographics. In a bid to help you better understand these devices better, we have compiled a list of important similarities between both devices…

Tattoos can impact the accuracy of FreeStyle Libre 3 sensors because the extra layer of ink in the skin can interfere with the proper placement and functionality of the CGM electrodes. The electrodes are essential for measuring the glucose concentration in the interstitial fluid, which provides an estimate of the blood glucose concentration. If the electrodes are…