What happens to insulin in scar tissue

Hello All,

I’ve been using the OmniPod for about 1 year now and have had overall good success with it. My common places for Pods are inner calf and inner thigh. I do my best to rotate location and areas but I think I’m getting some scar tissue in my calf areas. I noticed( more than once) when I changed a pod from my upper leg my calf, my sugar seemed to climb and seems to require alot more insulin and a greater time to drop to normal when eating.

Now that I’m fairly convinced it’s scar tissue: What happens to the insulin I inject/pump into scar tissue? Does it eventually “kick-in” albeit later? Normally for me, any bolus has done all it’s work within about 3 hours time. I often give a regular injection, if the pump bolus doens’t seem to be getting the job done…could this scar tissue insulin blob hit me later and cause an unexpected low?

Thanks,
Ted

It usually will hit later and cause a potential low for me. If you think about the scar tissue is not necessarily making the insulin less potent- it is simply making the absorption different than when it is infused in to fat that has no scar tissue. The other issue is that when you deliver the bolus, if absorption is not happening there is the possibility of the insulin pooling right around the cannula and this leading to the insulin actually leaking out around the cannula. The other danger of putting the Pod on areas with scar tissue would be a greater risk for a kinked cannula. The scar tissue is much more dense and “hard” than normal muscle or fat so kinking could be a problem in those areas.

Your best bet if you think the Pod is in an area with scar tissue is to change to a new Pod. The rate at which the insulin will hit the blood stream is simply too unpredictable and in my experience will lead to a whole lot of highs and lows.

For my son it does exactly that… like a dam breaking open once it breaks though the scar tissue.

I came to TuDiabetes over 3 years ago trying to figure out my 'scar tissue issue" - here is a discussion I posted then with some very informative replies

https://forum.tudiabetes.org/topics/583967:Topic:167026

I now keep a log of where I put my infusion sets, and I’m very strict with rotation. it hasn’t solved things 100%, but it’s greatly cut down.

That is really good to hear that strict rotation helped. Normally, a wound heals with a formation of “quick” fibrous protein (collagen), which is over time replaced with an organized protein matrix. If you repeatedly injure the same place (or have a massive injury), you can impair the full healing and end up with a scar (which is this quick fibrous formation). It is for this reason that it is important to rotate injection and pumping sites, leaving (hopefully) several weeks or longer before the reuse of a site.

So pay heed to Marie, she speaks wisdom. Rotate your sites diligently and you shall be rewarded.