Will my child get scars on his skin later in his life due to repeated insertions? I have heard this in discussions of forums of long duration diabetics. Any suggestions to prevent that? Minimal distance which is required to be kept when inserting cannula in site closer to previous one? Abdomen is supposed to be best, but we are left with few sites if we use only abdomen, we find thighs to be equally good so far.In how much time healing occurs? Which cannula is preferred for a 5 year old kid...6/8 mm, angled/straight...steel/teflon?
My son is 3 and he uses the Omniopod system. He has historically removed his own pod and then scratched his skin off. He gets ugly looking scabs, but I am amazed at his ability to heal them. I do think that there can be scarring from repeated insertions but I also think that as they grow, we will have more spots. We have had a few pods we had to remove due to alarms which Insulet said may be due to scarring (it can cause occlusion). Jonah will only let us put his pod on his tush (which was fun during potty training) and the side of his thigh. He is too small to put them on the back of his arm. I also think that technology is getting better and better with each update of model. Regardless, I think the pump system is better than injections!
It's not so much scarring ON the skin as it is scar tissue UNDER the skin that's the problem. If you rotate sites every time and take care to avoid prior sites while they're still healing, you can avoid the overt scars and the lumps, but there will still be some scar tissue below the surface. The problem with scar tissue is that insulin doesn't diffuse very well through/around it. So if you put a site or a syringe into a mass of scar tissue, you will not get quite as good a response from the insulin as you would otherwise. Scar tissue can also mean a crimped site if you put a new site in too close to an old scar. I had hoped that switching to Mio insertion sets would solve this problem, as they go in straight (unlike the Silhouettes) and therefore create less scar tissue per surface area, but they simply didn't work for us; Eric lost the sites at an amazing rate. So we went back to the Silhouettes and I just deal with having crimped sites every so often.
Like Jonah in the reply before mine, Eric was diagnosed very young (18 mos.) and the only possible location for his insertion sets was his butt. He simply didn't/doesn't have enough flesh anywhere else! We now use the thigh as well, and we've tried using the abdomen, but he says it stings when it's there (other adult T1s have told me the same thing about abdominal sites so I'm not trying to push it with him at this time.)
I would not go for a steel cannula — those are really for people who are allergic to the plastic ones, or who are so active that they lose a plastic cannula very easily. Butt, abdomen, thigh are generally the preferred sites for thin/small people, although you can use the fleshy part of the arm too if the person is big enough — I can't use that spot on Eric because he's a string bean with very little body fat. Try to go to a site on the opposite side of the body from the one you're removing each time, and use the old site's red mark as a sign post for what to avoid — stay a good half inch away from any mark that is still red or pink is a good rule of thumb.
My older daughter has had diabetes for 13 years and my younger one for 2 years. Scarring from pump sites is kind of unavoidable. It's no big deal. We always rotate locations of sites and keep a good 3 inches away from the recently used sites. For my 5 year old, we really like the Sure T's in the arm with the steel tip but my older daughter likes the quick sets. Don't get too hung up on the scarring thing - it's just a part of this. Do your best to rotate and don't keep the sites in longer than you are supposed to. Over time, you will see dimpling of the skin if they overuse the same area too much and then it will harden and be unable to absorb insulin in that area. That's the bigger worry in my opinion. Several of my daughter's friends have that situation.
Well, we are taking care of the rotation of sites. When we remove the cannula, a small pin point red nodule forms at the insertion site. Is it normal? It heals but there is still a mark at that insertion site, it becomes brown after around 15-20 days.Is it what should happen or is it hypersenstivity to cannula? There is no pain/swelling/lump around it.
Visible scarring on the skin is an individual thing. My daughter has an olive complexion & scars easily, so it takes longer for the sites to disappear...but they eventually do. The red spot you describe after removing the set is common. As long as there is no pain or swelling, it should be fine.
I was told by one of the person in diabetes care team to pinch the skin site after removal of the cannula, this removes the remaining insulin and extracellular fluid and helps in faster healing. Does anybody follow this and if yes what are your experiences regarding this?
I’ve never heard of doing that. We have problems with highs after site changes, so I would think it would make things worse. We just clean the skin well after removal. Inset 30s (angled sets for Animas) tend to leave marks that take longer to heal, so we use tea tree oil starting the day after removal & apply for 3 or 4 days.
Thanks all for their support and advise