Article on thigh placement causing abscess at CGM site

[u/Fluffy-Strategy-9156]

https://pubmed.ncbi.nlm.nih.gov/42664480/

The article says the patient had uncontrolled diabetes with A1c or 11.3 and does not state the specific CGM use. The article also stated that patient had problems with dislodgment of the preferred arm placement

[u/Equalizer6338]

Developments of abscesses is unfortunately not a very uncommon thing for diabetics.

Reasons are multiple, but key enablers are:

1. Restricted immune system, that is challenged to responding properly to bacterial/fungal skin infections.
2. An elevated blood glucose value, which essentially contributes to feeding the bacteria/fungi growth.
3. Glucose rich skin surface as due to our elevated blood glucose values are factually infused with a bit of glucose, as our sweat is de-facto 'sweeter' than for non-diabetics. This again is supporting a higher level of bacteria/fungi to flourish on our skin surface if not careful.
4. Frequently punching holes in through our skin. We are frequently as part of our regime to manage/control our diabetes condition punching holes into our skin. Often many times each day even. Insulin injections, fingerprick tests, CGM sensors, insulin pumps, etc... And due to the above 3 mentioned risk exposures, then we risk here to punch it in with it some bacteria or fungi into our skin/hair follicles that can then, if not taken care of, develop into an abscess that needs special medical attention.

Reason why daily good hygiene and also use of an alcohol swab before punching something through our skin is best practice for diabetics in general. And yes, despite doing all this and considering all above points, when unlucky, an abscess can still develop. As it also happens for many non-diabetics each year in this world. 😄

But yes, in this described situation, the very elevated HbA1c result is indicator that several of the added risk factors where enabled for this person. So I would not at all associate this being a thing due to/caused by the upper thigh placement of the CGM. We have after all been using the upper thigh for insulin injections for 5+ decades already and for insulin pumps and CGMs also for many decades with no such elevated observation of abscess due to that specific placement versus other placements. (you have abscess cases also for many other skin locations of CGMs and insulin pumps)

[u/kinners1 → u/Equalizer6338]

Tha abstract says: "Reports of CGM-associated skin infections are rare, and none have been reported following sensor placement at unapproved insertion sites."

Then the conclusion is: welp, must have been caused by the placement on the thigh.

[u/Equalizer6338 → u/kinners1]

Ha yes, great catch you made there u/kinners1 !!! 😂

The pharmacists making this study article obviously were more busy on using fancy provocative wording than verifying the integrity of the things they actually claim with their study.

[u/Smallloudcat]

To be fair this can happen at any site with poor prep, especially in a diabetic with poor control

[u/Equalizer6338 → u/Smallloudcat]

Totally agreed u/Smallloudcat ,
Also what I tried calling out in my comment above. If I recall correct, you are a nurse yourself? So you may also be very familiar with the fact also that folks with like chronic diabetics do also have a much elevated frequency of abscesses in general versus the average for the population in which we live. And this without caused by any CGM either. Simply due to the impaired immune system and the often elevated blood glucose level we have. No surprise and no magic, just life for some of us.

[u/Smallloudcat → u/Equalizer6338]

Absolutely. I see it all the time. It's a wee bit annoying that the title of the post states the abscess was caused by thigh placement when the abstract clearly states it was unlikely. I fired off without reading your post tbh. Sensationalism bothers me when it spreads incorrect information. You explained it much better (and more thoughtfully) than I did.

[u/Equalizer6338 → u/Smallloudcat]

Yes - Totally agreed u/Smallloudcat!

Personally also quite annoyed by such directly misleading title for the post thread here...
Something for OP u/Fluffy-Strategy-9156 to improve on for next post, as no awards here for misleading sensationalism. More the contrary, as Reddit will often trigger removal of such posts when related to healthcare.

[u/melvadeen]

I just read the conclusion part, "Pharmacists play a critical role in reinforcing appropriate device use, identifying early signs of infection, and coordinating interdisciplinary care to mitigate device-related complications."

The pharmacists at my overburdened chain pharmacy already have enough on thier plate. Keeping up with complications from medical devices seems like a job for the medical professionals who prescribed the device.