Samantha Walsh has lived with type 1 diabetes for over five years since 2017. After her T1D diagnosis, she was eager to give back to the diabetes community. She is the Community and Partner Manager for T1D Exchange and helps to manage the Online Community and recruit for the T1D Exchange Registry. Prior to T1D Exchange, Samantha fundraised at Joslin Diabetes Center. She graduated from the University of Massachusetts with a Bachelors degree in sociology and early childhood education.
I said, “rarely.” I’ve always rotated my sites. But, it seems that years ago, I often experienced bad sites. But, in more recent years, it has been rare. The only thing I can think of that changed was that I went from a 17mm length cannula to a 13mm length cannula. Otherwise, I don’t know why. Oh, also, I stopped putting cannulas in my legs and arms, where I had many “bad sites.”
After pumping into my abdomen for 21 years, it’s hard to find a good site. I still have a few. I feel around for bumps to avoid. Subcontainous injections is suboptimal.
The longer I’ve been pumping, the more often it happens. Getting to be a problem. I use abdomen and thighs. I’ve tried moving to other places but with a tubed pump there are only so many places that don’t get hung up on your clothing or get yanked out or irritated by your movements, sitting/sleeping position, etc. Not keen to go back to MDI though. Fewer failure points but a lot of problems in terms of not having any control of your basal insulin, can’t program a higher rate to deal with dawn phenomenon, exercise etc. After 40 years with T1, pumping is still the best regimen for me. Even when it sucks.
I’ve stopped using the front of my abdomen and now am exclusively on the sides of the abdomen above the belt line. There is more fatty tissue which is less scarred. This has eliminated the bent cannula issues I was having.
Some times .. as once in awhile. Early last year I was experiencing repeated episodes of poor delivery and occlusions at insertion sites in my lower abdomen (below the belt line) where I had been injecting MDI and then inserting pump sites for years and years and years. Endo took me off pump and had me do MDI for 3-4 months to give sites a rest … BG control was not as smooth as with CIQ but it did give my tissues a break and a chance to heal. Went back on pump in late September and have been using upper outer thighs, and posterior of hip bones in fleshy buttocks area as pump insertion sites. So far, so good. A1C dropped by 1.5 points!
After 8 years of pump use I’m starting to have site problems. Arthritis in both shoulders has severely limited my mobility and site selection. I use my front mid-abdominal area above my waist. If I leave the site in for more than three days it gets very irritated and from many years of MDI using my abdomen there’s lots of scar tissue. Considering the 68 total years of insulin injections , I’m grateful there are still some available sites left.
I had used the left abdomen for my pump site for four years straight until I started having problems. I now use above my waistband and have not had any more problems.
T1 60 yrs Pump 25 yrs Varisoft 17 mm, only when I’m sleepy and it’s dark do I get bad insertions about 4 times a year, A1c Low 6’s was 5.4 Feb 2023 – WHY do so many answer “Dont Use Pump” Read People
I only had infusion site issues (bent cannulas) with the soft cannulas. Since switching to the steel cannulas, I have never had that problem. I believe only once have I ever had to switch my infusion site to another area because the absorption wasn’t as effective as it should have been.
Sometimes would be my one word answer. But, my right side absorbs better than my left side. Send as though if I have one bad site chances are I’ll have a free more. I use TruSteel for this reason. Able to move the insertion site without having to do a full change.
Sometimes….. I have lots of scar tissue after 57 years of T1D. If site is initially ‘bad’ or ‘stubborn’, a hot shower or exercise will make it ‘settle in’. Walking or stationary bike will work nicely if the site is in my hip. Stretching and housework are better if site is in my belly.
I said rarely because I am pretty careful to rotate sites, and change every 3 days. I use 6 areas sequentially and move within those areas as well. I think a good rule of thumb is ‘2 inches, 2 weeks’- don’t be within 2 inches of prior site within 2 weeks. Using 6 areas accomplishes this well. That will also vary with the person- some people are much more prone to develop local site inflammation, which over time leads to scar tissue, than are others. Most of the local inflammation likely represents immune reaction to the insulin solution infused in a pump. The fact that the Medtronic extended infusion sets really do work better is at least partially due to a filter that removes insulin microaggregates, which don’t cause occlusion, but they do trigger local immune/inflammatory response.
I use 17mm Varisoft and Trusteel 8mm infusion sets. I find that I don’t often have a “bad site” following insertion, but that from time to time it takes the Varisoft infusion set a few hours to begin absorbing insulin. After 27 years of placing infusion sets I find I am looking beyond the lower and upper abdomen for eligible territory. I’m a bit confused by “putting on a new pump”, but perhaps this refers to a new pod or a pump system I’m not yet familiar with.
I used to have frequent problems, so I switched to a needle and I have never had a problem since.
For the pump that is, not MDI.
This is precisely why I do not use a pump.
I said, “rarely.” I’ve always rotated my sites. But, it seems that years ago, I often experienced bad sites. But, in more recent years, it has been rare. The only thing I can think of that changed was that I went from a 17mm length cannula to a 13mm length cannula. Otherwise, I don’t know why. Oh, also, I stopped putting cannulas in my legs and arms, where I had many “bad sites.”
I do not use an insulin pump.
Once I switched to the verisoft steel infusion set no mor kinked cannulas. Now on OmniPod 5 and have not had a bad site yet.
There wasn’t a response for ‘I don’t use an insulin pump.’ That would be my answer.
Don’t use a pump
Bad sites, when they do happen, are 99% skin absorption issues and 1% set issues.
I do not use an insulin pump
Most often it is a site location that effects the performance of the infusion set as opposed to a bent cannula.
Agree! I use pods and have more problems on my thighs than other places on my body.
Yep. I had very frequent bent cannulas until I switched to Tru-steel after 3 months of starting the pump.
After pumping into my abdomen for 21 years, it’s hard to find a good site. I still have a few. I feel around for bumps to avoid. Subcontainous injections is suboptimal.
I am a brittle T1d. MDI did not work for me. I did MDI for 10 years. I ended up in the hospital 3 times with extreme lows. Come on stem cell research!
The longer I’ve been pumping, the more often it happens. Getting to be a problem. I use abdomen and thighs. I’ve tried moving to other places but with a tubed pump there are only so many places that don’t get hung up on your clothing or get yanked out or irritated by your movements, sitting/sleeping position, etc. Not keen to go back to MDI though. Fewer failure points but a lot of problems in terms of not having any control of your basal insulin, can’t program a higher rate to deal with dawn phenomenon, exercise etc. After 40 years with T1, pumping is still the best regimen for me. Even when it sucks.
I’ve stopped using the front of my abdomen and now am exclusively on the sides of the abdomen above the belt line. There is more fatty tissue which is less scarred. This has eliminated the bent cannula issues I was having.
It is frustrating. Especially if I hit a bleeder or a nerve. Nerve is worst as every time you bolus it hurts.
Some times .. as once in awhile. Early last year I was experiencing repeated episodes of poor delivery and occlusions at insertion sites in my lower abdomen (below the belt line) where I had been injecting MDI and then inserting pump sites for years and years and years. Endo took me off pump and had me do MDI for 3-4 months to give sites a rest … BG control was not as smooth as with CIQ but it did give my tissues a break and a chance to heal. Went back on pump in late September and have been using upper outer thighs, and posterior of hip bones in fleshy buttocks area as pump insertion sites. So far, so good. A1C dropped by 1.5 points!
After 8 years of pump use I’m starting to have site problems. Arthritis in both shoulders has severely limited my mobility and site selection. I use my front mid-abdominal area above my waist. If I leave the site in for more than three days it gets very irritated and from many years of MDI using my abdomen there’s lots of scar tissue. Considering the 68 total years of insulin injections , I’m grateful there are still some available sites left.
I might have said never, but I got a bad site this week. Just really slow to absorb the insulin. BG was stuck between 180-200 regardless of the bolus.
By “Rarely” I mean super rarely. Maybe two or three times in over 35 years.
Sometimes. I have found the steel cannulas to have much fewer issues.
Used to be more common for me but once I gained a little weight, it’s much less so LOL 🙂
no insulin pump for me
I had used the left abdomen for my pump site for four years straight until I started having problems. I now use above my waistband and have not had any more problems.
T1 60 yrs Pump 25 yrs Varisoft 17 mm, only when I’m sleepy and it’s dark do I get bad insertions about 4 times a year, A1c Low 6’s was 5.4 Feb 2023 – WHY do so many answer “Dont Use Pump” Read People
I do not use an insulin pump!
I only had infusion site issues (bent cannulas) with the soft cannulas. Since switching to the steel cannulas, I have never had that problem. I believe only once have I ever had to switch my infusion site to another area because the absorption wasn’t as effective as it should have been.
Sometimes would be my one word answer. But, my right side absorbs better than my left side. Send as though if I have one bad site chances are I’ll have a free more. I use TruSteel for this reason. Able to move the insertion site without having to do a full change.
Sometimes….. I have lots of scar tissue after 57 years of T1D. If site is initially ‘bad’ or ‘stubborn’, a hot shower or exercise will make it ‘settle in’. Walking or stationary bike will work nicely if the site is in my hip. Stretching and housework are better if site is in my belly.
I said rarely because I am pretty careful to rotate sites, and change every 3 days. I use 6 areas sequentially and move within those areas as well. I think a good rule of thumb is ‘2 inches, 2 weeks’- don’t be within 2 inches of prior site within 2 weeks. Using 6 areas accomplishes this well. That will also vary with the person- some people are much more prone to develop local site inflammation, which over time leads to scar tissue, than are others. Most of the local inflammation likely represents immune reaction to the insulin solution infused in a pump. The fact that the Medtronic extended infusion sets really do work better is at least partially due to a filter that removes insulin microaggregates, which don’t cause occlusion, but they do trigger local immune/inflammatory response.
I don’t really feel like I’ve got “good sites” to use. It kinda feels like my body rejects all the poking that it has to deal with. :/
I use 17mm Varisoft and Trusteel 8mm infusion sets. I find that I don’t often have a “bad site” following insertion, but that from time to time it takes the Varisoft infusion set a few hours to begin absorbing insulin. After 27 years of placing infusion sets I find I am looking beyond the lower and upper abdomen for eligible territory. I’m a bit confused by “putting on a new pump”, but perhaps this refers to a new pod or a pump system I’m not yet familiar with.