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Review: Medtronic Enlite Glucose Sensor

We notice a couple of people in the community had started to wear the Medtronic Enlite Glucose Sensor (newly available in Canada) and were curious about their experience with the new system. So, we asked them! Here’s some thoughts about the new sensor from Shaun, Chloe, Amy, and Jen…

SHAUNA

How does the new sensor insterter compare to the Soft Sensor?
I absolutely detested inserting the Soft Sensor, as there was nothing soft about it. It was a little intimidating to insert the new Enlite sensor just because it was different and the cost associated with getting it wrong made me nervous. So, I had a T1D friend insert it for me who had done it a few times before. Of course, the first attempt failed and the sensor didn’t disconnect from the inserter. She tried again, double clicking it this time, and it disconnected and the needle stayed in my arm. I felt that there was no way it would be an accurate sensor, since the needle went in and then out (and then stayed in)- but I got a good solid 6 days out of it.

I found it much more accurate than the Soft Sensor in general, especially as days ticked by. In the past, with the Soft Sensor, I always felt the first 1-4 days were the most accurate and then the accuracy seemed to diminish for me.

I also bled profusely every time I used the old system and I don’t know if it was a fluke or not, but no blood was shed with the new Enlite system. It also seemed to go in much smoother with less pain – overall a way better experience.

How does using a sensor compare to testing regularly?
I test the same amount (maybe slightly less) when wearing a sensor. Sensors are great for trends and for making adjustments, but I would never bolus or treat (low or high) without verifying the information by blood glucose monitor. Or drive or adjust for activity, etc., etc.

Sensor data helps reassure me that I am coming down from a high or coming up from a low without testing every 10-15 minutes, but I would rarely solely rely on the data to make care decision. Or only test to calibrate the sensor.

It’s a fantastic tool to help me make big picture decisions and adjustment to my diabetes management (basal rates, monitoring reaction to activity, sick days, etc.) but it hasn’t changed the way I manage my day to day routine… but, perhaps I am just old school.

Have you used your sensor while being active? How does it fair? Pros? Cons?
I first tried an Enlite sensor during Ottawa Race Weekend. I was outside and active all weekend – I was nervous about how little tape was being used to hold it in place and was worried about it falling off or getting pulled out with all the activity, as that’s been my biggest challenge with sensors in the past. However, I was pleasantly surprised at how accurate it stayed and how little adhesive was holding it in place – it was definitely a different feel that I will have to get used to. When I eventually removed it, the adhesive was still firmly holding it in place, which increased my confidence for next time.

I find sensors provide me the best data when I am out of my routine or being extremely active as it provides you “live” (although slightly delayed) info about trends up and down. I wish it didn’t have that delay and I hope that the technology offers that at some point down the road. But, overall it’s a helpful tool, especially to understand your blood glucose reactions to training, or how various basal adjustments are working, or carbs calculations work to prepare for a race day or to get you used to an increased activity level.

Anything unique you’ve noticed about it or want to comment on?
I was just really impressed with the accuracy, as well as the tape system on the new Enlite sensor.

If you were to design the next generation sensor, what would be different?
I mentioned it early, but I would love that the next generation could measure blood glucose levels and not interstitial fluid so that you can have real time live data. I would also love an app that could download sensor data immediately rather than having to have the stick and a computer. I would be open to a permanent device inserted under the skin – that would really be ideal so that you don’t have to worry about the insertion process.

Some of my healthcare providers don’t seem to know what to do with the data that I do download, which is frustrating as I find it such a useful tool – I don’t know how much education Medtronic provides to healthcare providers to work with their patients to get the most out of wearing a sensor. I think that is a gap moving forward with the active young generation of T1Ds.

CHLOE

How does it compare to the Soft Sensor?
Much different insertion process, new device, new system, new parts and pieces – along with a 90 degree insertion and much finer needle. Doesn’t look like a horse injection anymore. I had to re-train my brain. The hardest part? Remembering that I no longer have to clench my entire body and ‘brace for impact’!

I haven’t noticed a huge difference in accuracy, but I have had a number of very close meter/sensor readings. I’m not sure that my personal results with improved accuracy would be statistically significant quite yet.

Staying power seems to be quite good – I got 10 days out of one! (shhhhhhh!)

How does using a sensor compare to testing regularly?
I still test roughly the same amount while wearing the sensor (maybe a few less per day?!). It is just great to have all of that additional information to fill in the gaps between tests.

Have you used your sensor while being active? How does it fair? Pros? Cons?
The new taping system with the Enlite allows for much better airflow. Contrary to what most people think – more tape is not always better – especially when you’re sweating from activity. Sweating them off has been my biggest activity challenge. That and rubbing them off with backpack straps while hiking and skiing – solved by not putting sensors under or around backpack straps!

Pros….taking a quick glance at your pump and getting a sense of where your BG’s are at (and where they are going) while ‘in motion’.

Cons….Obsession with data. Easy to get caught up in a cycle of over-correcting and reactionary behavior. While active or not….

Anything unique you’ve noticed about it/want to comment on?
Had some trouble with sensors itself not sticking – but that seems to have been an isolated occurrence. The new taping system is great.

Over all, I like it.

If you were to design the next generation sensor, what would be different?
Let’s make the transmitter smaller. Let’s imbed a small permanent chip sensor in true blood (not interstitial fluid) which would be scanned, or similar to now, have data transmitted from it to a device.

Have alerts that tell me I am ‘awesome’, that I am ‘doing great’ or ‘way to go diabetes champion’ when my blood sugars are in a GOOD range. Why are all the alerts negative?!

AMY

How does it compare to the Soft Sensor?
I think it’s superior in so many ways! First and foremost the size of the needle and sensor itself: so much smaller! I also love that it goes in at a 90 degree angle; with the Soft Sensor, if you bled when inserting or even after the Tegaderm tape that was put on it tended to make it look like a war-wound!

How does using a sensor compare to testing regularly?
Freedom! I still test about 4 times a day while on the sensor, but being able to know your blood glucose at any minute of any day without having to test is awesome.

Have you used your sensor while being active? How does it fair? Pros? Cons?
I’m a pretty active person, I find that it holds out pretty well, but if I sweat a lot it does need a piece of Tegaderm on it to hold it in place. The only con I’d say is that sometimes the small piece of tape that goes over-top of the transmitter digs into my skin- it’s almost as if it has a plastic coating on it that lifts a bit and irritates my skin…

Anything unique you’ve noticed about it/want to comment on?
I love, love, LOVE how the needle retracts itself and, also, the inserter is a lot less intimidating.

If you were to design the next generation sensor, what would be different?
I’d love to be able to have a sensor that told you your sugars as accurately as testing does, regardless if your sugars are rapidly changing or not. Also, a smaller transmitter would be fabulous!

JEN

How does it compare to the Soft Sensor?
I LOVE the new Enlite Serter. Although the old ‘harpoon’ inserter (the Soft inserter… what a name…) was scary and loud and exposed the needle, I don’t think I realized how much of a mental impact that was having on me until I got to use the new Enlite inserter. Previously, I’d have to psych myself up for each sensor insertion. I’d have to convince myself that even if it hurt (which, to be honest, it rarely did,) it wouldn’t hurt as bad as [fill in one of many injuries I’ve had in the past…] The new Serter doesn’t allow you to see the needle – ever. It is quiet and has been virtually painless for me. I don’t get stressed out at the thought of changing my sensor. Although just a small and, to a non-Type 1, probably silly thing to be excited about, I honestly think that taking away that little stress/anxiety will have a massive cumulative impact in the long run.

The sensor itself is tiny – I never notice any marks and haven’t gotten scar tissue.

The lack of tape is incredible. Although I was nervous at first about it ‘staying put’, I have never had any problems. There is no longer a build up of sweat around the transmitter, allowing less irritation and for it to stay in place longer/better.

I don’t get hung up on the ‘accuracy’ of sensors in general because when we look at most of our comparison points – our meters… well… accuracy? Really? The current Enlite sensor is within 2% as accurate as most meters… which are only 15% accurate. One thing I WOULD like to see change would be an improvement over time in the actual sensing technology. It would be fabulous to see a progression forward from Medtronic (the accuracy of the Medtronic sensor has stayed relatively the same over its lifespan…) On that note, though, I commend Medtronic for taking the time to make the user experience better. We have seen improvement in strips, ‘better’ sites (in terms of deliver), but rarely does a pharma company say ‘hey – how can we make the life and experience of the Type 1 the priority… Let’s ask..”

Overall. Approved. For now.