Problems with Infusion Sites

15984 Views 6 Replies 5 Participants Last post by naynay, Dec 20, 2013

orangeorphan

Discussion Starter · Dec 7, 2013

I have been using a minimed paradigm pump for years. About ten years I would say, and before that I had an older model. So I have plenty of experience with the pump.

I used to have trouble finding enough infusion sites because I'm quite skinny and I found that I couldn't inject into most places on my body because there was no fat and injecting into muscle hurt/didn't absorb insulin well. So a couple years ago I switched to the Silouhette infusion sets because they inject at an angle and therefore don't hit muscle. I have had more success with these but I still have unexplained cases of "site failure".

Sometimes a site will work for a little while, then suddenly without any observable cause, will stop absorbing insulin.(I think that is the problem) I will bolus and bolus and see very little or no decrease in blood sugar. So I will change out the site and the catheter isn't bent and there is no kink in the tubing. So what is the cause of the site failure?? It's very frustrating and expensive to keep changing sites.

Normally the sites on my lower back work the best and give me almost no trouble. The sites on my butt are so-so. And the sites on my upper leg are the worst (probably %50 fail).

A couple things I notice usually coincide with the site failures are blood and pain. Sometimes there will be blood coming into the catheter or when I take the catheter out blood will come out of the site. (usually just a little, but there have been instances where a lot comes out and it takes a while to stop the bleeding.) And sometimes the site will be sensitive to touch and bolusing.

Any help or feedback is much appreciated!

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Tamagno

· #2 · Dec 7, 2013

I use Omnipod, so I'm not familiar with Minimed, however, I have the same skinny problem.

The cannula on mine injects at an angle and is somewhat flexible. I'd imagine they're similar in length and diameter, etc.

My preferred site is the back of my arms over the tricep area. On insertion, I pinch the skin up to avoid muscle.

I save my abdomen for my CGM sensor. Thighs are impossible as there's little extra skin or fat. Same on my lower back.

I still get occlusions from blood in the cannula at times, but less. I move the site around every three days when I change pods. I guess there's risk of developing scar tissue/callousing, but I haven't seen it yet.

Of course, with the Minimed, you'd have more of a tubing problem on your arms, so that may not be viable.

The pinching thing might help. It was the best advice available from Omnipod, at least.

Good luck! Let us know if you come up with more solutions - got to be plenty of skinny pampers out there...

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orangeorphan

Discussion Starter · #3 · Dec 7, 2013

I've actually never heard of the Omnipod until now. I went to their website just now and it sounds cool! I don't really have anywhere on my arms that I can inject because they're all muscle and because I have tubing to worry about.

How big is the pump site with the Omnipod? I imagine it's much larger than the Minimed because the insulin is stored at the site rather than in the pump.

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Tamagno

· #4 · Dec 8, 2013

Its smaller than you might think. I often have to check to see where I've put it.

They'll send you a model to wear a few days if you want to try it. I can't think of anything common that's roughly its size - maybe about a quarter to a third the size of an Apple mouse. Very light, it holds enough insulin to last most of us a full three days.

No tubing and water proof are really great features. The associated software is very good, but only runs on Windows, however.

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Strawberry

· #5 · Dec 20, 2013

orangeorphan said:
I have been using a minimed paradigm pump for years. About ten years I would say, and before that I had an older model. So I have plenty of experience with the pump.

I used to have trouble finding enough infusion sites because I'm quite skinny and I found that I couldn't inject into most places on my body because there was no fat and injecting into muscle hurt/didn't absorb insulin well. So a couple years ago I switched to the Silouhette infusion sets because they inject at an angle and therefore don't hit muscle. I have had more success with these but I still have unexplained cases of "site failure".

Sometimes a site will work for a little while, then suddenly without any observable cause, will stop absorbing insulin.(I think that is the problem) I will bolus and bolus and see very little or no decrease in blood sugar. So I will change out the site and the catheter isn't bent and there is no kink in the tubing. So what is the cause of the site failure?? It's very frustrating and expensive to keep changing sites.

Normally the sites on my lower back work the best and give me almost no trouble. The sites on my butt are so-so. And the sites on my upper leg are the worst (probably %50 fail).

A couple things I notice usually coincide with the site failures are blood and pain. Sometimes there will be blood coming into the catheter or when I take the catheter out blood will come out of the site. (usually just a little, but there have been instances where a lot comes out and it takes a while to stop the bleeding.) And sometimes the site will be sensitive to touch and bolusing.

Any help or feedback is much appreciated!

How often do you change your sites? In the beginning of my life with Medtronic pumps I was changing as recommended, which is every 3 days. However, I began to have trouble similar, not the same but similar, to what you're describing. My Endo suggested I change every 2 days which has helped a great deal.

Also if you are using Silhouette sets, what length cannula are you using? Because you have a slim body, you might want to consider the 13mm length cannula. There is also a webpage on the Medtronic website, Comparing Infusion Sets | Medtronic Diabetes - that compare the different infusion sets they offer. Good Luck to you.

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mmckie

· #6 · Dec 20, 2013

It had been a while since I've come on here but I will reply to this. I am very thin as well. I use the quick set infusion because my pump trainer said I was way too thin for anything larger than a 6mm cannula length. At times it was even tough to find places to inject with that tiny cannula, but since being diagnosed I have gained a couple pounds which helps to add a tiny more fat to my areas. I have the best luck on my upper thigh or my abdomen. I too notice when it hurts that my blood sugars tend to fluctuate more as well. I would try getting a smaller cannula set and try that.

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naynay

· #7 · Dec 20, 2013

I for sure do not have problems because of being skinny and not enough "fatty" areas to inject. With that said, though, I still have times when I will experience higher numbers for no reason and can bolus and bolus without my numbers not being affected very well. Sometimes you might be using an area to often and you are building scar tissue. This can cause malabsorption. Also, some spots just don't absorb well for me no matter what. I tend to use my abdomen, back, and close to the buttocks. I tried my thigh once but that didn't work too well for me. I've never done the upper arm, but that might be an option in the future.

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