I use an insulin pump and have only ever used my abdomen area for infusion sets. I know there are other candidates for insertion sites like the back of arm, thighs, bottocks but these all give me irritation and cause redness so I always have to fall back to the tummy area.
I’ve been a diabetic for 20 years and have been pumping for half of that time. While I rotate my insertion sites, I worry about overuse and scarring underneath the skin over time making injections less effective. How long does it take before scarring happens and can it heal?
I’ve been getting constant insulin flow block errors and worry this is the reason for it.
I’ve pumped since 1996. When I started I had a lot of scarring from using the older insulins via a needle, followed by using Sof Sets and then Quicksets–both of which are cannula type sets. After having lots of blockages due to kinked cannulas, I switched to Sure-T’s. After a couple of years, the toughened, leathery skin eventually resolved. Now it has been smooth sailing and I only use my abdomen. If you have scarring it will take a LONG time for it to resolve, so be patient, and above all else, CHANGE WHAT YOU ARE DOING, or the issue will continue for sure.
Not sure if you are living by yourself or if you have a family member who can help. But the key to insulin is rotation, rotation, rotation! That was drilled into myself and my parents back in 1970. We used all available sites. Once I took over my own care, I have continued with rotation.
I have been pumping since 1990 and I use every spot I can. I use my arms even the underside, I use my buttocks as far back as I can reach. Hips are a great spot with all that extra padding. I use thighs both inner and outer sides. I have seen people use their calves which I haven’t yet but might have to try it. Problem with that is the tube is short but I have seen a few pods down there.
If you have someone who can help, that opens up a lot more sites. Hope you can branch out and try other areas!
I always rotate my site on the tummy. However I am unable to inject anywhere else because of irritation. Is there anything I can do to minimise irritation on the site. It goes itchy and red after 24 hours. If I suck it up and let it stay for the full 3 days, after removing it from the site, it’s very red and a bit raw and you can see the hole from the insertion
@tedos For the rashes…
Have you tried some of the barriers? Skin Tac helps too, but there are some other things people use, I’m sure they will come along and tell you.
Also Flonase antihistamine spray used before you apply adhesives. Someone recently talked about how well that worked for them, there was a recent post of people talking about all this but it must have been under another heading and buried now. But there is this one
That sounds a lot like an allergic reaction, whether it’s to they insulin itself or the adhesive on the infusion set. I’m confounded why you wouldn’t react on your abdomen, though, unless it’s just because you’ve got too much scar tissue for the for effect to be noticeable.
I’d try putting a layer of tegaderm down and setting the infusion set right through it. If you don’t get irritation at the sites after that, you’ll know it’s a reaction to the adhesive. You may also need to talk to your doctor about switching you to a different manufacturer of insulin, because they all use different preservatives. Novolog vs humalog, et al… Even if your insurance prefers one over the other, there will be a workaround allowing exceptions for allergies.
I think I have the most issues with adhesives of anyone. I have a complicated procedure I have to do for CGM and pump sites and it definitely included them being inserted on top of the dressing. I use 2 different uncommon dressing that irritate my skin the least (Polyskin II and Suprasorb F) and also put down Benedryl gel, then a couple layers of Cavilon barrier. I STILL get irritation though. I tried Grifgrips again for a few sites, and while they didn’t feel like they were irritating my skin while on, I have 3 patch shaped red areas that itch pretty bad and the first one still hasn’t healed after a week.
I have yet to find anything that doesn’t irritate my skin that actually will work. I tried a few different oddball tapes, Hy-tape that has a zinc oxide based adhesive, and another weird brand that had a silicone based adhesive. Both had a fairly stiff material to them, so while they stuck well, they didn’t stay adhered well when I was sweating/wet and moving around and flexing. The crappy thing is neither one of them irritated me.
After 30 years pumping I’m starting to run out of infusion sites. I wasn’t the best at rotation in my early years for sake of building up a supply of extra infusing sets. I left them in well beyond manufacturer recommendation. A mistake in hindsight. The abdomen is really my only practical spot for infusion sites. My arms and legs are relatively muscular/thin and there’s not sufficient subcutaneous tissue. Aside from that, it’s painful!
I’m toying with the idea of delivering all my boluses as a 15min extended bolus. My thought is absorption might be better with slower fluid infusion into the denser scare tissue. Has anyone tried this? I notice that my less effective sites generally present themselves as poor bolus response. Basal delivery, while somewhat impaired, is generally OK.
Ironically, this was the “original” Grifgrips fomula and material, but I tried the “Extreme” version again and it gave me very little irritation… Go figure. I am still going to try it a few more times to be sure and then I might start using that from now on. I do cut a little hole in the center of it for the cannula to go through as I found that the thicker material tends to cause bent cannulas when inserting through it. The t:90 sets stick to the “extreme” version material very well, but another issue I had with the original material was that the sites didn’t stick to it. The needle end of the TruSteel sets doesn’t stick to either at all, but the disconnect patch does. Unfortunately that is not the end that is most important lol. I have been having decent luck with the t:90s currently though, so not going back to the Trusteel for now.
I have recently gone off Pump for of lack of absorb[tion from scar tissue and limited sites because I am thin. I am loving the freedom of the insulin pens. Never been on them as I went on pump as soon as they arrived. T1 for 50 ears. Wondering if others have taken pump p vacation and gone back after some time?
Does scar tissue resolve?
Eventually, but I had scar tissue from MDI and some from using soft cannula sets. After more than 15 years using steel sets there is no more toughed skin or tissue on my abdomen. YMMV.
Why is that steel sets don’t leave scarring or cause skin to harden?
I have another question, this week I tried revisiting another site (buttocks and thighs)that’s not in my abs but this time I use the wipes like skin tac recommended earlier by @Marie20. I need to use up all my mios before I start on steel sets.
The area is a bit sore but not unbearable and seems to have good sensitivity to insulin and no blockages yet. But it’s really painful when I need to take off my pants and it catches on the side of the infusion set. How to prevent this, I can’t actually stick a tape on it because once it’s on, I won’t be able to disconnect it for showering. There’s no way of avoiding it unless I make a mental note which isn’t reliable either since I most probably forget haha.
I can only guess at the reason(s): The following is simply a WAG.
A steel set’s diameter is FAR smaller than a soft cannula. IIRC, the outer diameter of a steel set is .016" and a cannula is .026". Don’t quote me on that as I’m thinking back more than 10 years when I had researched the sizes. Whatever the actual sizes are, the steel set is much smaller in diameter.
The second thing I can think of is movement and kinking. Imagine a little worm crawling around in your tissues.
Both of those comments I made are conjecture. The FACT that I have less tissue damage (I should say no discernible damage) when using steel sets makes me not question too much the reasons why–it just is the way it is.
