Running Out of Infusion Real Estate

I’ve had Type 1 for over 45 years and have used a Tandem TSLIM X2 with the Dexcom G6 for the last 6 or 7 years. My A1C is usually around 5.9 to 6 and has been as low as 5.3. I usually put the infusion set on my abdomen from far around the side to the middle and alternate sides with the G6. It happens occasionally to every one of us to get an infusion site that doesn’t work and you have to reposition the infusion site. I use the true steel sets so moving them is fairly easy. I know as soon as my bG goes over 300 (which it never does under any circumstances) that I must change the site. My last A1C was 6.8 and I sure it’s higher right now. I cannot find a place that works, even way over to the side and low near the belt line. My endo said it’s not really “scar” tissue as everybody refers to it but insulinic hypertrophy where the constant presence of insulin causes the cells to swell separating the insulin receptors until it’s similar to Type 2 insulin resistance. Perhaps I’ve gotten a bad batch of insulin? Anyway, my pump is reporting HIGH so it’s over 500, so I have to go find a place on my chest or arm to try it. Any thoughts or ideas of what I should do? Thanks.

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I do the same but my rotation also includes the front of my upper thighs. Have you tried that area? One of my favorite spots back when I was on MDI, couldn’t feel a thing there, so I’ve always favored it after moving to a pump.

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Thanks, I’ll try there. I also used thighs and buttocks (more flexible then) when injections were the only game in town.

The one issue with that location is that it’s a bit more vulnerable to being yanked out by clothing removal, so I’ve learned to be conscious of where it is when taking my pants off. A strip of medical tape across it also helps; you just have to position it so it only covers the clip receiver not the clip itself.

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Yes. Big problem; my sympathy.

One fix: the G7. Since the placement for this is on the upper arm it moves it away from the pump sites. This is possibly helpful because close placement of pump and CGM apparently causes bad things to happen; they say “six inches” (15cm) but who knows?

I’m on my last G6. In a few days I’ll put on my first G7. I moved my infusion set up near my pectoral muscle (BG went down to 110-120) and did yard work for 5 or 6 hours (BG went down to 80.) Thanks for the suggestions from you and DRBB.

Like Dr. B, I tape over the infusion sets on my upper thighs. I also use my butt up to my scapula on both sides. I’m a side sleeper, so some spots just don’t work because the pressure is painful. I use the Medtronic Paradigm sets with the flexible cannula. I used to use the steel sets, but prefer that I can insert these on an angle.

Thanks. I switched to my thigh and it seems to have improved. It’s also possible that my BG to insulin ratio and my carb to insulin ratio have changed. I’m going to upload my pump data and message my endo and see if a change is warranted. My BG wouldn’t come down until I started doubling the the suggested correction.