Infusion Sites Keep Failing

My daughter’s infusion sites frequently fail. She changes them every 2 days, but often they only work effectively for a day and half or so. So for example if she changes her site on Monday morning, it’ll often fail in the early hours of Wednesday morning.

What I mean by failing is:

  • Her BSs will start climbing up over a 3-4 hour period
  • she’ll develop small ketones
  • there will be a small, red bump where the cannula was which can be sore.

She uses Autosoft XC’s with 6mm cannula which go straight in.

Things we’ve tried:

  • various others insertion sites including steel ones
  • bolusing with a pen whenever possible to reduce the insulin going through the site

Any other ideas? Sites to try? Techniques?

Thanks so much,

Paul

You’ve exhausted all options with no success. Changing sites, hasn’t been fruitful, experimenting with various cannula types, lengths, angles and material yielded the same poor results. Sounds like a insulin pump is not a viable option for her.

Have you tried alternate insulins?

This is the symptom I had when using Novolog insulin in a pump. It didn’t happen right away as I used Novolog for a few years before I started seeing “pump bumps” at my infusion site. Turns out I am allergic to Novolog. Apidra works well for me without any raised red infusion welts that accompany impaired absorption.

I’ve dealt with very similar issues over the years. It’s difficult when the reaction is happening around the cannula rather than just the tape (which is what most people have issues with).

Some of the things I’ve tried:

  • Using steel sets (in general, these cause less irritation for me)
  • Changing sites every 24 hours, or earlier if there’s irritation
  • Using barrier creams such as Cavilon

It’s worth trying different insulin types as @Terry4 suggested. I find the reactions happen with all types of insulin, but that’s a simple solution if it works. I would also continue to experiment with different types of sets. Even two steel sets can be quite different. Although, unfortunately these days you’re often tied to the infusion sets that go with your pump…not like 10 years ago when most were interchangeable across brands. :frowning:

Good luck in problem-solving this!

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Thank you, all, some really helpful input here. Had not thought at all about trying different insulin, so will be running this by my daughter’s health team.