Dexcom G6 accuracy when inserted in upper thigh

I upgraded from Dexcom G5 to the G6 with Basal IQ a few weeks ago and am loving it. As with the G5 I’ve worn it on my stomach and upper arm, and accuracy has been great. I decided to experiment with my upper thigh this time and am wondering about peoples experience with accuracy that area? I tried the G5 there but found it pulled off easily as I was getting undressed, and it’s been so long I can’t remember! I now have a shield and patches I’m hoping will help with that.
I know insertion in a muscular area can make it more sensitive to drops during exercise (that’s not the wording in looking for but I can’t think of it at the moment) but I’m wondering about accuracy overall. I have plenty of fat in the area so that’s not a concern.

Hey there @wadawabbit! Personally, the upper thigh is my favorite site for my Dexcom. I’ve never really had a problem with accuracy there and I find that it stays on much better than when I wear it on my stomach (especially in summer when I can wear shorts!). I do occasionally have problems with compression lows overnight (if I’m laying on the sensor it’ll sometimes give a false low reading) but that’s honestly only happened a handful of times. One piece of advice: I recommend you pinch the skin when you’re getting ready to insert it because that’ll ensure that you don’t hit muscle.

Thanks! I sleep on my back or side - sleeping on my stomach hurts my back so that won’t be a problem. My only problem is sometimes I roll over on my pump in my sleep, or wake to find I’ve tucked it under my pillow without realizing it😳! Hopefully I’ll be good. Thank you much for your advice!

1 Like

@wadawabbit, just one to fact check… on another D forum there was discussion DexCom and most insurances would not cover “off label” placement misadventures like lost sensor wires. You may want check this out so there are no surprises if there is a problem. Keep us posted.

Thank you. I do remember that. As “luck” would have it I got a transmitter error on one I had only been using fit about 3 weeks. They sent me a new sensor along with the transmitter so I’m ahead of the game at least for now.

I’ve only used my thigh with the G6. The little filament of the sensor part really isn’t long enough to go into muscle. I don’t pinch and it stays in place very well in the thigh location. I was swimming with it in recently and just used a bit of extra tape to double secure the edges.
I find it accurate and very comfortable . You can only wear so much hardware on your abdomen without developing scar tissue. I am also on the Omni Pod so it is easier for me to rotate sites for both pump and sensor.

I know, right? After a while your abdomen becomes a pincushion - especially with two devices! I’m all for expanding my real estate, and while it’s only been a few days, like you I find it’s working well. Thanks for the feedback!

I use a Medtronic 670g and associated CGM, and have had no accuracy problems. I don’t have enough fat elsewhere, so I now use only thighs for both sensor and infusion. I have gradually adopted pinching and preparation of the sensor site by rubbing an ice cube over it for 30 seconds before insertion, but both of those were because I kept drawing blood. That’s been very rare with these to changes. I also hold the pinch until I remove the needle from the cannula.

On the insurance question, Medtronic has on a few occasions asked me if my endocrinologist has approved my use of this alternate site. Once I said “yes” (truthfully), no further questions were asked.

Have you thought about upgrading to Control IQ. It is free if your pump is in warranty. It automatically corrects for highs and lows. My 7 year old daughter is using it and it has allowed me to sleep more at night.
Thanks for reminding me about upper thigh placement for her dexcom. I’m always trying to find a new place that hasn’t been used recently.

Yes. I’m approved gut CIQ and am waiting did a thumbs up from my doctor. Her DNA told me to start with Basal then step up, which I’m hoping to do in the next several days. Don’t ask me why - I understood some people start with CIQ right away, but there didn’t seem to be any harm in eating in gradually :grin:. Thank you!

In some ways, Dorie @wadawabbit, it is a shame that the DNA insisted that you first experience BIQ before beginning Control IQ. It is quite obvious that your educator is thinking that BIQ is a step to CIQ that should not be avoided. Yes, my opinion [I only used BIQ for 5 weeks] having used both tools.

Both BIQ and CIQ are different, and one is not a stepping-stone. When you begin CIQ, the first “head change” you will need to make is to forget BIQ.

I’m guessing their office has mostly patients on Minimed pumps. When I first discussed CIQ with my physician she said I was the first patient she thought of when she learned about it. And I had to remind the DNE that I use Dexcom - I guess her thoughts go to Minimed first as well. No complaints about the office overall though. I’ve been with them a few years now and they’re excellent. I’m looking forward to CIQ and having the success on the higher side that I’m having with the low, if that makes sense. Thanks as always for the advice!

1 Like

I was feeling a little funny so I took a look at my pump and my reading was 55! Of even greater concern though, is the fact that while my Basal IQ is running, it’s not active - the diamond is grey rather than red.
There have been times when I’ve dropped into the 50s even while BIQ stopped delivery, and I was wearing my sensor in my abdomen. The only explanation I could think of was that my basal rate was too high for the correction to work as it should. I did a basal test, have tweaked it a bit, and it’s gotten better, until now.
So, before I call tech support, with my head tucked between my legs as it were, to find out why BIQ didn’t activate - I’m wondering if it might be the placement on my thigh? Receiver and pump are well within range and I’m getting regular readings. Just concerned why BIQ did not respond as it’s supposed to. Thanks!!

Dorie @wadawabbit, when your CGM was giving you a reading of 55 mg/dl, what did your finger-stick say? The CGM reading most probably was correct, and when I’m in the situation where you found yourself, I most probably would have chomped a glucose tablet or drank fruit juice.

Keep in mind, especially when depending on BIQ, tat once insulin is infused, it can not be withdrawn. BIQ continues delivering the basal rate set in your Profile until the G6 AI anticipates that your BGL will go below your set threshold - at which time it will suspend basal.

What you encountered is a major flaw of BIQ which was corrected with CIQ. For me today, while bike riding with “activity” mode selected, my basal was delivered at reduced rates once my BGL ventured below 140 mg/dl. I usually begin my biking and hiking soon after a n intense carb meal to assure that my BG will be either close to, or higher than 140.

Thank you Dennis. When I saw that number I went into response mode, which unfortunately due not include a fingerstick. Judging by the number and how I was feeling a headed for the fridge and downed some juice. When I did check a little later my Dexcom was around 70⬆️, fingerstick close to 90. Any idea why Basal doesn’t always slow or stop the drop? Is there too much IOB - basal and bolus - for it to handle if, say I miscalculated my carbs and took to much for lunch? I recall seeing a disclaimer reminding us to keep an eye on things but still…
Anyway, it’s good to know CIQ should help with that. Thanks as always for your words of wisdom.

Dori, you did what I do very often. Yes, I stop at the frige on my way to the place where my meter sits. Better safe getting carbs working immediately rather than waiting until hands are washed, dried and meter is located.
CIQ may help in a situation like you experienced. But of course, if you over-counted carbs significantly, or if your insulin"carb ration was too high, the reduction or suspension offered by CIQ would not be sufficient. At least for me, CIQ doesn’t always work for me when I make a significant over-bolus; my total daily basal is less than 7 units.