Infusion site "fade": only two days?

Hi All! 'Been pumping since last November with Animas Ping. I use both the Inset30 (angled) and Inset (straight-in.) Those have Teflon flexible cannulas (not steel needle.) I use the shortest available cannula length.

I run Apidra in the pump, and my basal rates could be considered low: about 14 U/day total and max rate is .75 U/hr throughout the morning.

I noticed my BG starts running high when I'm in my 3rd day on a set, and I'm guessing that's because the basal is not absorbing properly anymore. When I bolus for food or to correct it still works just as I expected.

When I change the set, I get good BG performance again.

I get the same pattern regardless if I have been very active exercising or just being a "slacker" so I have ruled out low activity as a cause.

Site exhibits red tenderness and slight swelling at cannula "dive" too, in the days following insertion.

On a couple of the straight-in sets, I had a lot of accumulated blood under the skin at the site (like a hematoma or blood blister) that bled profusely when I pulled the set out.

When I described all this to my witch blood doctor, he suggested I could try an anti-histamine to suppress my body’s reaction to the inset. I haven’t taken him up on that suggestion yet ....

OK so here's the Q's: does anyone else have similar experience (BG control is better when you change site every 2 days)? And does anyone have any tips or secrets for making the site last longer? I'd love to be able to stretch it out to 3 or 4 days for convenience...

Regards, Tom

I use humalog, quicksets 6mm. I notice the tendency for increased sugars in heat (summer) vs cold (winter) after 3 days. I have gone more than 5 days on same reservoir/site location, and up to 7 days on same site with new insulin and reservoir.

You might try using the old site with new insulin in your reservoir after day 2 - if your sugars remain stable an additional 2 days, it's probably the insulin not the site. If your sugars are unstable after using new insulin in the reservoir, then the site itself may be a problem. Then I would suggest talking with Animas to see if they have a suggestion if you are having an allergic reaction to the Inset.

It’s the apidra. I had the same problem til I switched back to humalog. Now I have no problem making it to 3 or even 4 days. Talk to your doctor about switching insulins.

Set fade "absorption issues" are typical. The wound channel starts healing as soon as the damage is done. We must maintain a certain insulin saturation level and this is going to change over the life of the infusion set. Sub-Q infusion therapy is somewhat unpredictable. Most CGM users see some inconsistency every day but we make small corrections which makes this problem easier to live with.

I can get 3 days out of my infusion sets...yes they fade and I just do small corrections to keep my BG on target...My infusion sets can be very good, good, not so good, and I can't live with this one.

When my body starts rejecting a infusion set it increases blood flow to the area around the cannula and the accumulated blood can escape out of the hole when removing the set...

I would never consider taking a anti-histamine..."Here take this it's just one more pill".

Thanks for the info, John - it helps to put my experience in perspective. I'm skeptical of the doc's advise re: antihistamine, too. Anyway, even though I couldn't rule out "heat damaged Apidra" as noted above I am confused by why my bolus still works even if my site's basal absorption apparently is "fading" ... and I attributed that to the low rate of basal delivery (much less than 0.75U/hr for most of my day.)

Maybe I will try bumping my basal rate up +10% to experiment in my 3rd day next time ...