Pain at pump insertion site

OUCH. On the advice of Tandem, I changed insertion product to TruSteel. There has been question as to whether or not I have been having an allergic reaction to the teflon in the Autosoft sets. The first 24 hours is fine. No pain. But by the end of the second day, the pain sucks. Any movement or touching anywhere near the area causes a sharp pain. Yes, sharp stabbing pain. I have really good pain tolerance… think natural childbirths, numerous surgeries without use of post op narcotics and frequent kidney stones where I don’t take anything stronger than Ibuprofen. I know this can’t be normal. I also have bruising at each site when I remove it that takes about a week to resolve. Any ideas?

It’s most likely an allergic reaction to the adhesive. I have the same issue and it hurts.
It takes a good day for the adhesive to work it’s way down the cannula into the hole in your skin.

I use an iv3000 tape and a dot of neosporin as a barrier to keep it from getting in. And it works pretty well.

I never got the steel sets to work right because they are at 90 degrees and poke into muscle. That causes pain after the fact but it’s more a dull ache.
Not sure if the steel sets use the same adhesive or not

If you’ve given the steel sets a decent trial, you need to listen to your body and experiment with other infusion sets. Or you could experiment with using a barrier between your skin and the infusion set adhesive but if it’s actually the cannula that’s irritating you, that won’t work. If no infusion set gives you relatively painless service, perhaps you need to switch to MDI, multiple daily injections.

So … ??? Best way to rule out the cannula is to try @Timothy barrier suggestion? Possibly, perhaps?

@irrational_John – That makes sense and it’s easy to do.

I don’t react to the adhesive on my Dexcom.

I got away from MDI because I was using 6-8 injection daily.

I already use skin prep otherwise the adhesive doesn’t stick properly to my skin

If it hurts I jerk, period.

I use both the true steel and the autosoft and found that on day 3 with the true steel it can tend to start hurting it also can hurt from day one if its in a sensitive site or when you touch it as the needle tends to hit new tissue. You can cut off the tape around your site and over tape it with a tape that is less sensitive to you. Does your sensor do the same thing? how about the over tape they send you. You should ask your Endo it they have a solution for you.
Good Luck

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Just another possibility - I had really sharp pains both during and after deliveries (similar to what you mention) when I put Lyumjev in my pump. It was very uncomfortable. Might be true for Fiasp, too. I give this just as a possible reason if you’ve changed insulin types recently. If not, ignore.

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I found an occasional problem with the TruSteel infusion set. Every once in a while, a infusion set would be painful from the getgo. I started looking closely at the fine needle that goes into my skin and discovered some of the needles were not square to the adhesive pads. I’ve been checking this out for the past several months and by tweaking the angel of the needle (only when the cover is still over the needle), I haven’t had a painful one since.

YMMV

I can only use steel due to infection/ irritation and dka from kinking plastic ones. I do also sometimes have severe pain that causes me to cry out. If it is super bad I remove it and start again. Sometimes I wait for it to pass and it goes away. It happened with this one. Sometimes it gets worse with bending etc. sometimes if it is painful going in it will be a painful one other times not. It is another of the terrible things I have to live with with this disease. I once had really severe pain with one on my back and had to rip it off right away, someone helped me, that one may have been an opsite reaction combined with the needle causing irritation/ pain as well. I was literally screaming get this thing off me!

I am not sure how you can use a barrier with these since they won’t stick on then if that would be something that might help you. For me it is another issue.

I tried trusteel and had much the same response as you, but it happened after about one day, not two. I ended up with huge hematomas at the insertion sites, which hurt like crazy and while I know a lot of people have had success with the trusteel infusion sets, there are also a number, like me - and it seems you - you have challenges using them. I do know that you are not supposed to leave them in longer than 2 days regardless so perhaps you might have more success changing them out more often - and yes, it is a nuisance. I have found that even with the teflon insets I still have to change sites every 1 1/2 to 2 days - I virtually never get a site to last longer than that before numbers start to escalate and not respond to boluses. I think it is important that those of us trying to find the right approach to diabetes management understand that there is not a one size fits all solution. What works for one person may not work for another. It may be that trusteel is not going to be your solution regardless of how well it works for others. Good luck. It’s a tough place to be when ‘solutions’ just don’t seem to work the way you want them to be.

Now, regarding your possible ‘teflon’ allergy - perhaps revisiting the teflon sets with a view to changing them out more often - down to every 2nd day or so rather than keeping them in longer - might provide a workable solution?

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I have to use tru-steel as the cannula on the autosoft kept slipping out (I am pretty lean with minimal fat). Occasionally i get a sharp pain from the site when I move or bend. I believe it is from the cannula touching muscle as the fat layer is pretty thin. If it is bad or too frequent, I move the needle to a new site. Another problem I do have is that after about 1.5 days, I will take a bolus and yet little happens no matter how long I wait. Problem (I think) is build up of scar tissue (I have had T1 for 33 years, and until 2 years ago did MDI about 6 times/day. I pull the needle out and re-insert in another site, take another bolus, and everything woks well. The insulin from the 1st shot just seems to “evaporate” - it never shows up. My naive interpretation is that it may very slowly make it into my system, at a level that does not really show up on my CGM.

I was very lean and ectomorphic when I was first diagnosed and the cannulas that go in at 90 degrees always bent and came out. The steel would cause major pain.

I switched to the 13 mm Teflon ones that you insert manually on an angle. I put them in almost parallel to my skin so there is no way to hit muscle.

I’m not as lean now and I could probably manage the other sets, but I still use the angled ones. Silhouette at Medtronic or varisoft from tandem.

I never liked the spring loaded inserter anyway, kinda forced into it with dexcom tho.