Continuous Glucose Monitor Placement Sites Beyond the Arm
Yes, continuous glucose monitors (CGMs) can be placed on the abdomen as an alternative to the arm, with comparable accuracy and effectiveness. 1
Approved CGM Placement Sites
- CGM sensors are primarily designed to be implanted in the subcutaneous tissue of either the abdomen or arm 1
- The abdomen is specifically mentioned in guidelines as an approved alternative placement site to the arm 1
- Both sites measure glucose concentration in subcutaneous interstitial fluid through a glucose sensor 1
Accuracy Comparison Between Sites
- Research shows no significant difference in accuracy between CGM sensors placed on the upper arm versus the abdomen in adults with diabetes 2
- In a comparative study using the Dexcom G4 Platinum, the Mean Absolute Relative Difference (MARD) was 12.0% for arm placement and 12.3% for abdominal placement, with no statistically significant difference 2
- Some newer CGM models may actually have slightly better accuracy with arm placement compared to abdomen, though differences are minimal 3
Special Considerations for Site Selection
- For patients with arteriovenous fistulas (AVFs) or arteriovenous grafts (AVGs), CGM placement should avoid the ipsilateral (same) arm to prevent complications 1
- Patients with advanced chronic kidney disease should be particularly cautious about sensor placement due to higher risks of bleeding and coagulopathy 1
- Skin reactions, either due to irritation or allergy, may influence site selection and should be assessed when choosing placement locations 1
Technical Specifications by Device Type
- Most modern CGM systems (including those from Abbott, Dexcom, and Medtronic) are designed to function effectively in either the arm or abdomen 1, 4
- The Dexcom G7 CGM has been specifically tested and validated for both arm and abdomen placement with single-digit MARD values (8.2% for arm and 9.1% for abdomen) 4
- Newer CGM models are increasingly being designed with flexibility in placement sites to accommodate patient preferences 3
Practical Considerations
- When selecting a placement site, consider factors such as comfort, visibility, clothing interference, and physical activity patterns 1
- Proper insertion technique is crucial regardless of placement site to ensure accurate readings 1
- Patients should follow manufacturer-specific guidelines for their particular CGM model, as recommendations may vary slightly between devices 1
Remember that while both arm and abdomen are approved placement sites with comparable accuracy, individual factors such as comfort, lifestyle, and specific medical conditions should guide the final decision on CGM placement.