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How would you describe the amount of scar tissue you have because of T1D management? Please feel free to share more about your experiences in the comments!
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We have a strict regimen that we follow for pump sites
On our son. Prior to insertion, we use IVPREP wipes. To remove we use Unisolve to dissolve all adhesive residue, then wipe away with a piece of gauze. We apply Aquaphor liberally.
For overtape, we use IV3000 as it allows the skin to breathe. Our son was diagnosed at 18mos old nine years ago, and his skin looks wonderful. I think that the steel insets have helped significantly with keeping scar tissue at a bare minimum.
My fingers are mostly healed dice using Dexcom
Done small issues on abdomen and thighs from injections and pump sites over the last 30 yests
Years
“Mild”, although I considered answering
‘very minimal” under the circumstances considering the horse-nails, about the size of 3d finish nails called needles we used over and over for injecting insulin. Twenty-four (24) gage, 1 1’4 inch long.
Started with 26 Gauge injections in 1964 so scarring from 58 years is minimal
I scar very easily, so the multi-injection regime created considerable amount of scarring beneath the surface of the skin. This created problems with the absorption of the insulin. My A1C was rising to ‘uncontrollable’ levels. I switched to the inhalable Afrezza, had much better control, and my A1C has not been above 6.9. Now I wish I could find a way to take my basal insulin without injecting, which would allow for even better control.
Scars may be emotional, psychological, as well as physical.
I’ve been a T1D for over 50 years. I started using a Minimed pump in 2000. Every 5 to 10 years, I took pump vacations of 6 months to a year after the onset of erratic insulin absorption, which I attribute to internal scarring of my abdomen. Some boluses would simply have no effect while pen injections worked normally. The last pump vacation lasted a year and ended in February 2022. After resuming use of Quick-Set catheters, insulin absorption was still erratic. I abandoned the Minimed pump and have now started using the Omnipod, which allows me to use sites on my arms, legs, buttocks and back. I avoid my “scarred” abdomen and insulin absorption has improved.
I used injections for 62 years and now I have used a pump for 15 years. While using injections I favored my upper abdomen. The flesh eventually became very tough and scar tissue caused poor absorption of the insulin. That part of my body is still that way now. My lower ab and my legs are much better, but I occasionally have poor absorption and I have to change sites.
Really hard to tell unless a pump site takes more insulin than I expect….this, after 72 years with diabetes.
Already answered this
I donāt feel I have any scar tissue and I check a lot, only use fingers.
I have small lumps on my abdomen (4, 2 on left, 2 on right). I have lumps on my sides, and on my legs. There is some scar mild scar tissue on my fingers. Luckily, I used 33 guage lancets on my fingers. I don’t see any scars on my upper buttocks. My scars are not highly noticeable, just denser lumps. I try to avoid those spots when I’m inserting canulas and sensors. Sometimes it’s difficult finding spots to insert my devices.
I have scar tissue on my stomach and lower back from my pump and CGM. Iām thin so I tend so only a few areas have much fat but those areas are less painful to use. Cushioned. Those area are building some scar tissue.
I have moderate scar tissue on my abdomen and legs, I also have significant atrophy on my arms and legs from old U40 insulin. I can still find usable areas and am much more careful about site rotation. All of this, the result of 66 years of T1D.
Picasso’s Guernica š¤¢
I track and rotate cgm (12 sites) and pump infusion (38 sites) on abs and quads and side, and I note when sites seem to not work, yet still have some concerns about scarring interfering with cgm accuracy and insulin absorption.
I also sometimes have issues with the sites reacting to exercise/dislodging at cgm and infusion sites that twist a bit during some workouts (e.g., an twists or quads flex).
Frustrating, but try to roll with it and make changes/waste infusion or cgm (kinda expensive) quickly when I notice a problem.
T1d keeps you on your toes. Maybe ask a ? about how our toes are holding out…you know from always needing to be on our toes : (
I ranked my scar tissue as “moderate.” I’ve had T1D for 27y. My abdomen hasn’t worked well since my two pregnancies. For the past 12+ years I’ve used the upper buttocks for pump and CGM sites. Starting to to note a few resistant spots there now too.
I use the Silhouette (Medtronic) or Vari-Soft (Tandem) infusion sets that go in at an angle. The sets that go straight in almost always kink and fail on me.
Anyone ever hit a spot and have the needle not go in and instead the plastic tubing bunches around the needle (like your scrunching down a long sock)?
My fingertips are good since the cgm days began. After my first few years with insulin (1962) I developed hollowed out regions on my thighs, and lumps on other parts f my thighs. These have mostly disappeared, but at this point in my life, I am no longer embarrassed by such things.
Significant. 66+ years of T1. 18 years inserting cannulas for pumps. 9 years inserting CGMs. Before that many years of 5 injections per day. In early days was taking Pork insulin. Caused significant pitting in arms & buttocks. Can’t even calculate injections taken with stainless steel needles which were sterilized between uses. I was in college when I began using disposable needles then whole hyperdermics.
I salute your diligence Henry. I also have longtime T1D, 53 years. Many challenges but we are survivors!!
I liked the first reply that used the word Survivors. That is a good description of our long term with this condition!
I remember those old metal needles having to sterilize them before school with the glass syringes oh my gosh itās come along way thank goodness itās catching up
#inhaledInsulin for the win! No scar tissueš
I have dense scar tissue on both thighs and some areas of my lower abdomen from over a half century of MDI. Several fingers on both hands are also scarred from multiple daily bg testing. I try to avoid using the scarred lower abdomen areas for pump insertion sites, but it’s definitely becoming more difficult as arthritis in my shoulders, neck and lower spine now limits my ability to twist and reach. I’ve kept my upper arms for CGM sites and fortunately, that’s not as issue.
How do you know for sure how much scaring you have? I have sites that don’t seem to work as well as before. But to know specifically would be very interesting as I have been a T1D for over 40 years. Now using short needles. Does it help? My A1C is pretty historically level. Interesting question. Look forward to reading comments.
Most abdominal areas due to pregnancy stretch marks occasionally interfere with CGM sensors or pump infusion sets.
I chose “Moderate”, but it’s really between moderate and signficant. T1D 56 years, MDI for 30+ years. Scar tissue may have been worse under the beef and pork insulins, but early adulthood and increasing (5) shots/day caused scarring on hips and stomach. Scar tissue does not seem to be considered in insulin pump infusion site design. I have to tape down the tubing so it stays at 90 degree angle from the set when near a scarred site.
I’m only 6 years in as T1D, and pumping for 5. I rotate religiously. But my sites need to be changed every 1-2 days, so I figure I may scar easily.
For finger sticks to calibrate my CGM, I use the distal portion of my fingers, just below the nail. Heals quickly, no calluses.
After 45 years of MDI & pumping I definitely have some degree of scar tissue. As a pharmacist-CDE I often saw patients with scar tissue. I believe this is the seldom spoken of bogeyman of T1D. At the best of times insulin absorption is erratic.
As a T1d fir over 53 years I have significant scaring. Many years on animal insulin, MDI, then pump therapy, then added CGM has had its toll on my tissues. Even with careful rotation of sites there is only so much territory to be had. Have had some surgically repaired in the abdomen. Diabetes poses daily challenges.
Ditto for me 61 years
T1 for 40 yrs. Early on, Dr showed me pix of hypertrophy, which by 1983 they’d learned was a problem, so I always rotated sites religiously right from the start.
But pumping makes that more of a problem. Canulas are thicker than needles, it’s easy to get a bad one, and with a tubed pump there just aren’t as many locations as there are for injections. So I put “moderate” because I definitely have spots where I hit a gusher and got subcutaneous swelling and scarring. Steel insets are an alternative, but I’ve tried them and they have their problems too. I’m not in dire straights yet but after 12 yrs pumping it’s a growing problem.
My finger tips have recovered nicely since going CGM
My stomach fat layer doesnāt appear to develop scars, so far anyway. Been injecting since 1965
I have lipoatrophy all over… so, instead of “bumping”, I dent… and the dents are large.
Pumping has been a significant contributor to my skin issues.
Iām not sure – I have lipe hypertrophy over frequently used sites on upper arms and thighs. I try to use those for CGM, and save abdomen for insulin infusion. I canāt really tell anymore (55 years in).
i have lipodystrophy rom years ago takin different insulins like NPH and regular prior to pumps and CGMs. not sure if any has occurred since then but I do have peas that absorb better on my abdomen and I am aware and use them most if possible Use a sacral belt for back pain sometimes and that limits where i can’t a site on my abdomen also. but overall I am okay finding spots I note that needle infusion sites are better but I bleed easy so I prefer infusion sites that are cannula.
I choose moderate but it leans towards significant. I have to find and use atypical sites often to get absorption. Majority of my stomach I canāt use at all because I run high. Legs are also off limits due to muscle movement causes red and irritated sites.
The ONLY part of my body I’m aware of having any scar tissue are almost all my fingertips, including the tips of my thumbs.
I donāt know how to answer this question; I chose Other. Iām not sure how to tell where the scar tissue is because Iām not sure I know what it looks like. I am only ever guessing where it is when I change sites. I have been T1D for 55 years so I know I have it. Iām just not totally sure where it is. I wish there was some special light to shine on my skin so I would know more certainly.
I do have some places where the fat was eaten away but I don’t know if I have any scar tissue build-up
@AnitaS, same here. My daughter has a very visible indent on her thight from her Omnipod and she hasn’t used her thighs for almost a year š
Lots of areas with iffy absorption. Is it an absorption issue or scar tissue issue? Lost the use of the majority of my upper abdomen with a central incision for a nephrectomy.
I have minimal scar tissue in at least two sites from only two decades of T1D: the useable side of my abdomen and my right upper thigh.
I donāt count my fingers as they seldom come into play anymore.
Iāve had help with the doctor finding spots for insertion of CGM and pumps and they are on a clockwise rotation.
Iāve also been trying for some time to gain weight.
I said Other because after 35 years the only spot I have had problems with was my abdomen from lipodystrophy. Once I started pumping and not using my abdomen it took about 7 years but the tissue now seems and feels normal, works okay for my pump site but doesn’t work at all for my Dexcom CGM site. I use only my upper arms for my CGM after trying many others without any luck or accuracy!
My daughter has lipodystrophy from her pump on her thighs (especially one of them, which has a very vissible indent). One is starting to form on her upper arm now š
Not too sure if I have any scar tissue in my abdomen where my CGM and MDI’s go – I hope not. After 55 yrs of NPH, I did have dents on my thighs, but they are gone now. Good question regarding effect of insulin absorption.
@Maurine Bowser, I am relieved to know that your dents have disappered. My daughter has a very visible indent on her thight from her Omnipod and she hasn’t used her thighs for almost a year š