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Have you ever changed your insulin delivery routine because of insulin absorption issues? Select all that apply, and share what has worked for you in the comments.
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I stopped pumping when I retired/dropped health insurance and went to self pay utilizing insulin pens found the insulin pens seemed to take longer to react, needing 10-15 minutes longer before eating. Thus instead of the20 minutes prebolus before meals, now need 30-35 minutes.
Yes! I have always been MDI (almost ten years since dx’d at 55) and have to bolus 30 minutes as well.
When MDI, my thighs worked fine for shots but now that I am on omnipod, I have horrible absorption in my thighs. I can’t use them anymore for insulin.
How would one know if they have insulin absorption issues?
Hi, you would suspect you have absorption issues if you have unexplained highs and your BG comes down quickly when you change your infusion site. That said, it is sometimes very challenging to pinpoint the culprit, given the many variables that can cause high BG! Adam Brown’s excellent book, “Bright Spots and Landmines” has a great chart that lists lathe variables – there are over 40, I believe!
Changed to metal infusion sets. Greatly improved absorption and decreased scares I had with the plastic cannulas.
Changed brand of insulin pump due to issues w/ absorption using tubed infusion sets. Reacted to all infusion sets w/ Tandem Pump.
I have gone from changing my site every three days to changing it every two days. This has helped. So many pinholes after 33 years!!
I have increased my carb ratio several times. Also made a digram of .y abdomen that doesn’t infuse well.
I used injections for 62 years and pumps for 16 years. There is a lot of scar tissue that interferes with absorption. I have stopped using my upper ab and parts of my lower ab and upper legs.
I had to switch to shallow, angled infusion sets from 90° sets many years ago. I insert infusion sets manually so I can tell when there’s too much resistance, which seems to mean scar tissue that won’t absorb well. I have to avoid the area where I use to put Dexcom sensors before I switched to using my arms for sensors. It seems sensors left behind scar tissue after years of insertions. Even with those precautions, some sets only last for 2, rather than 3 days before insulin stops working properly. Seems like there’s always something to tinker with to make things better.
I get a lot of bleeders when applying a G6 sensor and pain also… only use tummy area …
Changed my infusion site every two days rather than every three days, particularly while pregnant
Sometimes on third day, pump needs more insulin than usual carb ratio calls for. When I notice this happening, I’ll add more to each bolus. (honestly a lot of guesswork and staying on top of what the CGM is telling me and trying to avoid a rage bolus which sometimes sends me spiraling in the opposite direction) BUT my endo just updated my scrip for changing pod every two days. Once I have a comfortable back up in case of emergencies, I’ll happily be moving to doing that instead.
I took a pump vacation for two years so my body could recover from 20 years of infusion sets. I returned to a pump, Tandem with control IQ and use Trusteel instead of canulas.
After 25 years of pumping I had to stop using my abdomen for a year. I can’t wear arm based sensors due too many arm shots with OLD U-40 insulin caused fatty tissue burn.
Yes, back when I used a pump.
Started using inhaled insulin for more consistent absorption.
Reading comments below, I’m disappointed that Endos have not suggested to more patients inhaled insulin option. If you NEED insulin and skin is unreliable, the solutions I’m reading is “moving cannula to undesired location” or “switching cannulas”. It’s all still adding to the problem that will eventually happen again.
Need to get more HCP’s educated on this, they need to look at the data.
I’ve done most all of the things others have said. Finally went off multiple injections to a pump. Had even more issues with that. Inhaled insulin has made all the difference!!
Yes, to all the yesses. I’ve also done basal via pump and MDI for bolus and correction; switched from pump to MDI only for about a year and a half. Continue to have absorption issues but it seems more random. Since I’ve switched to TruSteel I at least get the complete life of the infusion set. I’ve had to change from 6-8mm cannula and am not back on 6.
Had cannula problems with Medtronic placement. Went to omniPod but same problem. Went back to MDI for past two years. Was using the IPort , a device you use for MDI. Only change every three days. But needed to be accessible to inject which for me was abdomen. Had absorption problems after awhile so went back to regular injections. No problem because so many sites to choose from. Use my bum when home. Very rarely abdomen. Scar tissue and stretch marks. Will let it heal.
For the first 25 years (1955 – 1980) I only used my upper thighs for injections. The beef-pork insulin caused tissue damage in addition to scars from overuse. Switched to lower abdomen and upper arms for injection sites when I started using Humalog. After 60 years I gave up MDI for a tubed pump, then added a CGM a year later. At first I was limiting both to my abdomen, but soon needed to add my upper arms for the CGM. I have very limited reach because of arthritis in both shoulders. While switching from one arm to the next for CGM placement works okay, I’m still limiting pump infusion sets to my abdomen and am concerned that I’m running out of viable territory. Changing infusion sets and sites approximately every 4 days still seems to be working.
Hi Janis – I am soooooo with you on this!
Ozempic is an absolute game changer for me. My body essentially won’t absorb insulin without Ozempic.
Only absorption issue is a detached infusion set. This has happened twice with the new Medtronic extended wear infusion set which has fallen off short of the 7-day time without knowing it until my BG spiked huge without basal delivery.
I said no but may have absorption issues. I am slow or sometimes confused about mysterious readings to give a certain label.
My G6 is the mystery maker !!!!
In addition to the top 3 “yes” answers, I tried using a compounded cream on my lipoatrophy sites to try and get them back to normal.
It was an experimental cream that I read about. It was developed in the UK and they had some success as long as they were new problem sites.
I think it didn’t work for me because my lipoatrophies were so old.
After 60 years with diabetes, Ive probably done them all. Who knows at this point!
YES… we have !!!
Decades ago I learned from other T1Ds that abdominal injections produced less by variation than using arms, legs or buttocks. As a devoted gym-rat, this made sense to me. I’ve used abdomen with no problems for MDI changing sites each day. In the past couple of years I also use abdomen for CGM and I change sites every time I replace sensor. So far, no problems. I’ve always had very little fat, so I use syringes with shortest needles, 8 mm, 31 gauge.
I have used 6MM syringes for a long time [walmarts]…. now using 4MM Pen needles with Humalin Quickpen on upper legs.. 70 yrs T1D so back then resharpened giant needles on matchbook strikers, and boiled glass syringes..
The shorter the cannula is usually the best for me as I have very little body fat.
I have poor absorption in my legs and arms, also area where my rib cage is under the skin.
I also found that the soft “Vari Soft” cannula works the best for me. The cannula that goes in at a 90 degree angle did not work because I am too thin, and felt the cannula constantly. I also had poor absorption. I also had to switch from a 17mm cannula to a 13 mm cannula. The 17mm cannula was just too long.
Also, before I was on the pump, I used NPH insulin with Regular. The NPH insulin was a disaster for me. It forced me to have VERY extended low blood glucoses that I could not recover from. I lost MANY whole days of my life between 1977 and 1998 because of all day low blood sugars caused by NPH insulin.
Lawrence S. – My experience is very similar to what you described. NPH nearly killed me dozens of times in college. Have never been able to tolerate the pump infusion sets that insert straight in, which are prone to kinking and failing. I have also had success with the shorter length Vari-Soft (Tandem) and previously the Silhouette infusion sets (Medtronic).
After 27y with T1D, I’m starting to notice scarring and absorption issues. I’m on the thinner side, so overused my lower abdomen. After my pregnancies abd didn’t work so well. So started using upper hip/buttocks for 12+ years. Starting to notice some resistance there too. Now retrying my upper thighs, though I find they get irritated and pull out a more easily. I never mastered my arms.
It’s nice to know that someone is out there in spirit, and has experienced the same issues. Sometimes it feels like I’m out there alone, and no one else understands what I’m going through. Aside from the pregnancy part, I could have written your comment. Hang in there and keep moving forward. I’m with you in spirit.
I forgot to say in my reply that I was responding to Jneticdiabetic. Thank you.
After 55 years, yes, I have Insulin absorption issues. Not many sites left to try. The Legs are out! Still too active to have used my thighs.
Avoid my abdomen as much as possible. I have tried the tru steel needles and they seem to work better in areas of poor absorption. Type 1 for 60 years, running out of areas to stick!
One note that I think is important here – – I don’t avoid placing my cannula say, in my thigh. I just use a different side/area of my thigh to let the affected area heal.
When I first used a pump 23 years ago, I chose a short cannula as the long cannula did not work very well. As I approach 57 years of T1D and previously taking 4-5 shots a day, I have issues with scar tissue. I no longer get the exercise I once did, so I’ve switched sites to other areas to avoid scar tissue. A BIG help is to use a Square/Extended bolus as much as possible to slowly drip in the insulin rather than a large sudden delivery. Medtronic also had a ‘slow bolus’ option that was very, very helpful. Too bad Tandem doesn’t have that option.