Hello, all. I've derived much comfort here over the past year since I've been diagnosed (T1 can be lonely in a small town) but have never had reason to pipe up. All my questions have been answered in advance! Now I have a dilemma.
I'm on MDI with Levimir and Humalog. A couple of weeks ago, I found a lump on my abdomen where I inject on the left side. A large lump, about 5 inches long. A doctor looked at it (a generalist in an emergency-care place; I was on the road) and told me it was benign. I now realize it had something to do with insulin. Two days ago, I got a red, egg-shape lump, also in my abdomen where I inject (I've purposely avoided the bigger abdomen lump, so this was new). I tried injecting on my thigh -- just Levimir, so I could start separating out all the variables. Next a.m., another lump. It's either the pen needle or the Levimir that I'm reacting to; I know that because I didn't use Humalog there. I read that pen needles have a higher nickel content than syringes (I have always been allergic to nickel), so I switched to a syringe, thinking maybe this would help. Last night I tried the syringe/Levimir combo. on my left side. No lump. Hooray! Problem solved. This morning, I injected both Levimir and Humalog on my abdomen with syringes. No reactions! I'mm in the clear! But wait: this afternoon, I notice I HAVE devloped a smaller welt, but nevertheless a welt, on my left thigh, after all. (Levimir/syringe combo.) I should add that two days ago I started Claritin, so maybe that's why the lumps are subdued. I hesitate to switch to Lantus, it made me feel really weird when I tried it before. But I may have to. What would you do? I'm scheduled to see my endo. in a couple of weeks (he's 5 hours away). Your thoughts? I sure would appreciate it.
are they small hematomas, collection of blood underneath the skin? i get them often? Is it a lump like a welt - hive, itchy or lump like hard, bruised, bleeding, does it hurt to touch and raised?
Yes, I have considered a pump. I hesitate because I already have a CGM attached to me, and one unit's enough right now. Also, I can't figure out where I'd comfortably put a pump for everyday wear. I'm female, and would rather not have it showing. Finally, the thought of pump problems -- infections, kinks, etc. steers me away. I'm the type of person all would happen to, and more, trust me. Look at the odd tangle I seem to have gotten myself into with MDI. If I switched to a pump, you'd soon be seeing a thread titled Pump Weirdness. And it really would be!
It is hard, it is large, ranging from initial lump (about 4"!) to smaller welts, about 2" in diameter. No collection of blood underneath that I can tell. It does not hurt. Just raised and red, most recently, and before that, large and odd. I'm thinking I'm going to end up in an allergist's office before this is all over.
I used to wear a pump, and while it did have it's weird moments, overall I loved it. I had a medtronic (with tubing) and wore it with a spibelt, which was not visible. At any rate, good luck!
Lumps and bumps from insulin are called lipohypertrophy. This is a medical word for a lump under the skin from an accumulation of fat at the site of many insulin injections. Scar tissue may also develop at the sites. This happens due to the action of insulin on the fat cells. Insulin can actually cause fat cells to increase in size. lipohypertrophy was much more prevalent with the older insulin's like NPH and regular.
Yes, thank you, good point. I'm thinking at least the last couple of lumps may not be that, though. For starters, I've never injected on my thighs before, I just did so as a test, and I got a big red welt one night, and a smaller, pink welt on the other leg the next. So I'm guessing at least some of this is an allergic reaction, you know? I shouldn't have big bumps the next morning after I inject on an entirely new site, right? So, my thinking is, I've either built up a sensitivity to the nickel in the needles, or the Levimir, or both, which is a truly funky thought. I'm just trying to sort this all out. So much of this disease seems to involve figuring it out on your own! Glad I'm here.
it does kind of sound like an allergy but you'd think it would be itchy - hive like, ya know. cause i think that's how they might test you (as they do with other stuff) knick the skin and put the insulin on it, like a allergy test, if you develop a hive you're allergic..but, i'm not sure. good to have checked out though. it is pretty rare to have allergies to insulin. good luck!
Yes, but lipohypertrophy occurs over time, not after a single injection. And these days, it usually only occurs when you repeatedly inject at the same place.
An allergic reaction will usually result in itching, hives or redness around the injection site. If it is just a lump that suddenly appear, it is likely more of an issue with some sort of trauma.
What I would suggest to help isolate what is happening is to start a record. Rotate your sites generously and mark each injection with a little permanent marker (just a little dot) and then observe whether lumps appear and how long they last. Record your injection, dosage, kind and exactly how you did the injection. Did you pinch, did you use a short or long needle, did the plunger have resistance, was there a spot of blood?
ps. My experience is that at times, I don't pinch right and don't properly hit the subcutaneous fat layer and it hits other tissue and can cause some sort of bruise, a deep bruise that kinda gets hard and swells, but goes away.
I had some problems with basal insulin's and making a switch helped but my best solution was to start using a pump as others have suggested. Injections can be unpredictable causing limps, bumps, bruising, scaring, and sometimes bleeding.
Ask your doctor to run a insulin antibody test this may shine some light on your problem, also some people take a antihistamine for a few days and if the problem resolves changing brands maybe a permanent solution...JMHO
I also did not have good results with the disposable pins, less than perfect (clunky) operation caused a lot of damage and I found a solution in using the pediatric pins which where very smooth operating.
Starting a record is an excellent idea, and probably the only scientific way to go about this. What I'm referring to is a raised, firm, pink welt around the injection site, and last night I found another, on the spot where I'd injected Levimir about 8 hours earlier. So (I believe, at this point, having not kept a detailed record yet) that the problem is at least the Levimir. The 3 sites I've injected Levimir in the past 3 days and have watched closely have all reacted with these welts. 3 strikes and you're out: I switched to Lantus this a.m. The trouble is, I hate Lantus, or did a year ago. It made me feel really lousy. So, even though I'm probably allergic to the ingredient in the Levimir, I'll probably call Novo Nordisk (manufr.) and ask if there's anything they suggest I do. I really don't want to swtich back to Lantus, and they have a financial interest in keeping me on this drug. I'll continue to watch for weird marks from needles. I called Becton Dickson (needle manufr.) yesterday to report the welt problem, thinking that it might be the nickel allergy The spokesman was less than helpful. When I explained the problem, she sighed as if she'd heard it all before. Yes, she said, "We do use a trace amount of nickel in our syringes. ALL manufacturers do. We also coat all of our needles, pen or syringe. So over time, you may find you have the same problem with our syringes." Gee, thanks. I'll keep posting on how this plays out. I think of it as a sort of a diabetes-at-the-margins experiment, and it makes me feel tons better to know this can be worked through, and that people out there can relate and (even) care. It's very unsettling to feel you're becoming allergic to something (or somethings) that keeps you alive, and you don't which one (or both) is culprit. It's not like worry x 2, but more, worry squared.
1) take the syringe, nothing filled in it - no insulin, inject (empty)into skin and remove...so if you get the 'welt'.
2) take something (clean, sterile), knick the top - just surface of your skin and add a drop of levemir to you skin, wipe off levemir and see if you get a welt, like they do for allergy testing.
I used to use Novolog, Novo-Nordisk's rapid acting insulin analog. I injected it via an insulin pump. Over time I started to notice a round red raised bump, larger than a quarter, but less than a coin dollar, after site changes. I concluded that I was having an allergic reaction to Novolog insulin. When I changed insulins, I had no more "pump bumps." If these welts no longer occur with your recent change to Lantus, you might conclude that you were having allergic reactions to Levemir.
I'd be curious if there are any common ingredients if these two insulin formualtions.
I checked the package inserts for Levemir and Lantus. Levemir does contain some inactive ingredients that Lantus does not, three, in fact.
It's interesting that Levemir has a pH of 7.4 while Lantus has a pH of approximately 4. Not sure if any of this is germane. Good luck sorting it out. I'll be curious to see what you discover.
Novo Nordisk (among other manufrs) apparently used to make allergy tests that were quite good at pinpointing exactly which ingredient in this chemical soup is the problem. I read last night that they no longer make/distribute these tests. I don't know if that's true, but I found it interesting.
Thanks for your good wishes. Metacresol (sp?) is a common preservative that all these insulin analogs use, and has been implicated by some as being a problem. It's fairly scary to imagine (which I briefly did) that one might be allergic to that, which means ALL the "good" insulins could be off-limits to me, and what would my life be like then? Luckily (?!) this happened to some young girl in New Zealand, and her docs published a paper last year on the successful workaround/desensitization scheme they came up with. I can provide the link if you'd like. But for me, I think the problem's just Levimir, since I'm not reacting to Humalog badly, which is a relief. It's been sort of a mind trip, but I remind myself that people are bravely troubleshooting in these forums all the time. One good thing I can say about diabetes, it makes you more resilient.
If Lantus doesn't do the job for you, perhaps trying a pump might help. I know you're skeptical about that option but many here have had good luck with pumps.
Yes, diabetes does have some positive aspects. If you accept it, it hones learning, discipline, and resilience. Stick with it; you'll figure out something that will work.
