Long time T1D here, I have had issues with severe site reactions over the years using both short and long acting insulins. I was put on the T-Slim to keep my reactions in check using Humalog. The thought by my endo was that it would only be 1 type of insulin in use, and delivered in small incremental doses, may desensitize my reactions over time. I’ve managed the ongoing reactions with Humalog using a T-Slim, but still get the occasional angry red lump at the site.
I’ve decided to take a pump break, and yesterday took my 1st dose of Tresiba, which so far I’ve not had any sign of a site reactions, I know its only my 1st dose, so fingers crossed… I am however having bigger reactions to the Humalog when taking bigger doses for boluses.
Do any T1D using fast acting insulin who also get site reactions notice a difference, lets say using Humalog vs Novolog, or any other fast acting insulins? I believe my sensitivity is to an insulin preservative issue (maybe metacresol?) which I believe is in all insulins, but maybe the various insulins have different amounts of preservative, causing more of a site reaction? Anyone who has these type of issues, and has any input on both which long and short acting insulin gave less site reaction would be appreciated.
I have been using a pump for 40 years and have had reactions like what you describe. I think what I have/had are infections at the site of the cannula. Seem to happen for a while then a long period with no symptoms. When I first started on the pump there were abscesses that dad to be lanced.
Thanks for your response. I believe the issue may be with the insulin additives/stabilizers. I’ve been off my pump and using both pen tips and syringes to inject insulin while taking a pump break. The skin reactions is happening with short acting insulin. The long acting basal insulin Tresiba injections are not causing the same reactions, so far..
I assume you change your insertion site every time you put in a new one? Another possibility is to try Fiasp insulin – it is a bit faster acting than Humalog but is a somewhat different formulation.
I did not ever have problems with the short-actings, but one of the older long-actings stung like a … super stingy thing… and switching brands helped. I don’t see how trying a different one could hurt (metaphorically, it might hurt physically!) just to see if you get a different or lesser reaction though. For me Huma and Novo act the same, so I can switch back and forth easily without adjusting rates/ratios.
Do you also take a regular daily allergy med (Zyrtec, etc)? I have been for years for other reasons and recently stopped for a month only be rudely reminded that I get adhesive rash and can eat maybe 1/4 tomato before my mouth gets itchy. I hadn’t realized (or at least Id forgotten) the allergy meds were keeping other irritations at bay, but the generics are so cheap and available now (365 day supply of generic claritin at Costco for $11)….
I have something called Polyglandular Autoimmune Disease, as well have dealt with allergies for much of my life . I am extremely careful about clean sites, whether inserting a pump site or using syringes/insulin pens, and believe infection is not a contributing factor to my reactivity issue. I worked in a hospital laboratory for many years, and know about aseptic techniques etc. I saw a dermatologist recently, and she biopsied one of these reaction sites, said she has some thoughts, but will discuss things once the results are in. I’m thinking I might have to go on an antihistamine.? I do think it’s something that is in the insulin, but it’s hard to make sense of it.
As though “easy diabetes” even existed… yeah, adding on some ‘poor physical reaction to the treatment’ just seems an extra layer of unfair!
I dealt with several years of non-specific pump site failure, it wasn’t a bad site, it wasn’t a kinked cannula, it wasn’t entirely an adhesive reaction, it was an angry (but never infected) often poorly absorbing site, after site, after site… sometimes they’d be good for a day or two but never three. Ugh! I had a really hard time convincing any medical professional that it wasn’t me being dramatic, and I finally decided for lack of better worse that I had a “cannula allergy”. The week I switched back to MDI I got to cut my doses by almost 30% which just confirmed I wasn’t tolerating the infusion sites for some reason, but that it also wasn’t the insulin (which I had considered but couldn’t figure out what that could mean).
All that to say you have my sympathies, and Im impressed you’ve got a medical professional taking you seriously! I now treat myself as the biggest guinea pig on the planet and aim always trying something else to see if it solves a problem, so I wouldn’t think twice about adding antihistamines and switching insulins for a few weeks/months to see if it helps, but Im a lot more comfortable managing my own trial and error approach than maybe I should be!
