How to identify a site problem?

Oh I think it's a great thread that is definitely helpful for us all....I just couldn't resist the comment!

I try to change every three days but if the site begins to hurt I yank it.

1 Like

Though this is a topic that has been around for years now (can’t believe I started it in mid-June 2007!!) it’s painful (pun intended) that we still live with the realities of bad infusion sites… For me, these days, almost unequivocally pain while infusing is a sure indicator of a site gone bad.

1 Like

I dunno @askmanny… This week I had a series of site problems. One site simply went bad - It was not uncomfortable in any way, but my BG was rising rapidly, and without any food involved, approached 300. (Of course, this happened when I was sitting in a restaurant after I’d ordered food… Good thing I had a pen needle with me!) The next site itched terribly enough that I accidentally scratched it off. Third site HURT immediately on insertion, but by that point, I didn’t want to go do yet another one, so I left it alone. Ironically, it settled down and worked just fine. Final site for the week (gee, that’s a lot this week!) works great so far, except for the stinging I get with each infusion…

Is the week over yet!!?? :dizzy_face:

1 Like

I agree with @Thas. I’ve also found that pain is not always a reliable indicator of a bad site. For me, the smoking gun is the steady march of rising BGs, even in the face of corrections, sometimes many. The CGM is good at showing this signature steady up-trending line over time when you would expect to see a more typical for you post-meal or post-correction line. I’ve gotten better over the years and I pull sites more quickly, especially if I’m late in the second or into the third day.

@Thas, that is one bad run of luck! It’s almost as if there’s some evil intelligence plotting against you. As a rule, I’d much rather risk pulling a good site early rather than stick with a bad site for too long.

Well, if the week is not over, at least the year is! :wink:

Back to the bad site topic, I agree a rising BG trend as if you are not getting insulin, is the surest indicator.

My sites aren’t always painful when they go bad. And sometimes when I get pain on insertion, I can be pretty sure the site won’t work. I hate to change if it is not necessary so I usually wait to see if it will work. When BG’s keep rising for no reason and a couple corrections don’t work, I make the change.
A couple weeks ago I had a day when my BG’s really shot up. I was on day two. I made a change and things settled down but a couple days later I had the biggest bruise I ever had at an insertion site. It was probably the size of a kiwi.

I rarely get pain with bad sites and sometimes get pain with good sites. I have been known to do a temp basal increase to accommodate a site with bad absorption to see if that works (sometimes it does). Other times I just pull the site out and move it a few inches (I use contact detach). I rarely have problems in my abdomen. I get most of my problems with my thighs, but when my thighs work, they work amazing. I have one in my leg now that I had to move. To test, I usually do a syringe correction to get my BG down, then see if it rises when that insulin is used up.

I recently had an itchy one, but it was the anchor that was itching me. I got home from work and saw that I had, in fact, scratched it half off. I slept the night with only the site and no anchor attached to me, kind of terrifying, but I was alright.

I sleep every night with only the site and no anchor – I have too much sensitivity to tape that I try and minimize extra. I do use Opsite Flexgix with me Dexcom sensors to hold them on better/longer, but when I’ve tried that as anchor tape it didn’t work well and ended up creating more irritation if the tubing got pulled against it. Paper tape was worse, so I just decided not to use any anchor. It has worked out OK for me, so far - though I have occasionally scratched off a site, it hasn’t been too often or gone unnoticed (except once, when my jeans held the site in place enough hat it felt OK, even though it was not).

I’ve used this method also Miss Margie, a slight increase in basil rate to start with and I have had stubborn (suspected bad site) start to work properly.