No More Good Infusion Sites Left

I've had Diabetes for over 18 years now and I've been on the pump for over 10 years.  Just recently,I started getting irregularly high blood sugars for no aparent reason.  Once I changed sites, I was fine for a few hours but after that, I would go right back to bing high.  Most times, my levels rise gradually and spike after I bolus and eat a meal.  I assume that my butt (my favorite place for my infusion sites) has a buch of scar tissue so I tried to move to my stomach area or my love handles.  From day 1, I get the same results!  I stopped using my stomach about a year ago becasue I thought it had scar tissue too - I assume that it is still there becasue I can do a manual injection in the back of my arm and my blood sugar will come right down.

I think that I am going to try to switch to using my thighs or hips now becasue I have no other places to use and it doesn't seem like my body is losing the scar tissue which makes me very nervous.  I've read a lot of posts in this forum and I thinkt hat you guys have got me over the paranoia of using my legs - thank you!

I'm 39 and in pretty good shape - I'm not too fat and I have a lot of muscle which makes my choices limited.  I am just deathly afraid that once I start scarring my new sites, I will have no where else to go.  My bloood sugars have consistantly run high for a few months now and my A1C is completely out of whack (last time I checked it was 10!) when it used to be in the 7's...  I know that my basal rates are good too becasue when the infusion site is good, my blood sugars are constant and manageable throughout the day - my problem now is that once I use an area that is scarred and I move, it bends the cannula which, in turn, causes me more high blood sugars!

I'm not sure what else I can do but I'm extremely discouraged right now and feel like I can't control my Diabetes anymore - especially after 10+ years of good control!

Does anyone have any ideas to try?

I doubt it's scar tissue, but it's probably just that the skin is overused and needs a break.  After 9 years on the pump I've had to branch out into using my upper thighs and arms.  Sometimes get kinked canulas in these spots and the insulin absorption isn't as good in my legs, but overall it's been a positive change.  

Now some of my old favorites seem to work again because the skin isn't used much and has a chance to really heal.  Call the pump manufacturer and request different infusion sets to try.  Some of them are pretty good in more muscular areas that I couldn't use with a soft canula.

This is a tough issue and I can't imagine how it will be as I get older (I'm in late 30's now).  I have no idea how parents of babies and young kids on pumps deal with this, but gues their skin probably heals more quickly since they are young

I hear ya. I was on a Minmed 508 starting in 2001 then a Paradigm in 2007 until July 2011. I had the same problems as you, ie: scarring, bent canula's, high A1C's etc after intial great results. I finally just got sick of the pump and starting injecting again. I use Novo-Nordisk Levamir "injected' in place of my old basal and Novolog "injected" as my new bolus. Minimed makes great products yes, but i could no longer deal with the scarring, cost etc. Maybe talk to your endo about maybe injecting again for a while until your scar tissues go away. I still have my Paradigm Pump and i can alway's go back to it if i change my mind.

I wonder if you tried using a different site. I've kinda had the same thing where the bloodsugars go nuts and I think when we found a different kind of site altogether, it helped. Also, if it comes in a different needle length, maybe consider trying that. That was the problem when I kept having bent canulas. I've had a pump for 10 years and I've done it mostly in my but, stomach and some in my legs. But the rotation is very important. I get about 5-6 sites in one "cheek" before I move on the the next and I go in a circle around my body. I actually have a little bit of a "dimple" on one side of my stomach because I did too many sites there. I usually avoid that spot now which means on that side I'll get like 3-4 sites in stead of 5-6. Also, at least for me, you can see the scar tissue (like a little white dot) and so I'll get pretty close to it but always try to never put one right on top of another. If I do, they usually go bad.

Hope you figure it out and God bless.

I get scar tissue from my pump, i scar pretty easy, they have been yelling at me about rotating sites to prevent "mounding" since I was little. I would only let my parents give me shots in my arms, then it was only my legs, pretty much until I went on a pump, so that would be for like 6 years just in my legs. . . major scar tissue. Most of it went away when I went on the pump and used my stomach for a good percent of the time, but now that I can't use my stomach any more, and just because it's been almost 19 years of shots/infusion sets my legs are full of scar tissue and bumps. I'm working on it. I just started using my arms, and it's working ok, but I think i'm going to need longer tubing if I use them as sites a lot. I also found out they hurt less in my arms as long as I remember it's there and don't bang it on something. . . I'm a huge klutz. You could try using an inset that leaves the needle in. That way it wouldn't kink off. Also, I just switched from minimed to animas, and my pump trainer said that sometimes the shorter straight infusion sets (like the 6mm quick set)  will kink off easier than longer ones. I didn't really get why that would be, I guess it has something to do with the movement of the skin, idk, just thought I'd pass it on. Good Luck I hope it gets better, I know the feeling I just want to have like liposuction for the scar tissue in my legs. . . or something along those lines, lol.

i have scar tissue like no other on my arms, abdomen and hips. i cant use my butt because my sites will go bad there. my left arm wont take sites either. my stomach will once in a blue moon. basically after 12 years of being a pin cushion, i have ran out of areas to poke myself.

Sites for my infusion sets are my biggest problem. I agree with all the other comments. I use my sensors in my legs so I use the stomach and upper body for infusion sets. Some ares work only one day. I use silhouettes now and the are the best for me but not perfect.

Hi, I just joined and saw your posting about infusion sets. I have been diabetic for 18 years now and on the insulin pump for 12 years. Before I was using the pump I did injections in my arms and legs. Once I went on the pump I started using my stomach for my sites. I have been told that you can use arms, and legs but I am a bit nervous to use those sites. What on earth do you do with that tubing? I am wary of putting a site somewhere that I can't see easily. I have always used the soft set infusion sets and rotated between the 9mm and 6mm canula to try to help vary the depth to try to not get scar tissue in the same spot all the time. I do go through phases where over and over I get bad sites that ethier are painful when inserted or end up with blood in the tubing that I have to change. I also have to look very carefully at my stomach to make sure I don't insert the site into an obvious vein or old site. Sometimes I have to change my site because the site hurts when I get a bolus of insulin. Its as if I can "feel" the insulin going in. Even using the insulin pump my A1C's are not the best cause of the varing absorption problems. I am wondering how you can use your butt as a site for infusion sets...I would think it would be uncomortable to sit down...not sure where in your butt you can use them...My doctors have showed me the other sites that I can use but I think I need to meet someone else that uses different sites and see and talk to them to see where they put them.

I was afraid to branch out from my stomach too, but have been so glad I did.  Just have the mindset that you'll try a new site for a day and it you don't like it, you redo it.

For the tops of my thighs I've had to use different infusion sets because I was hitting muscle with the quick sets.  The absorptions isn't as great as stomach, so I've also increased boluses.  You'll laugh, but the biggest inconvenicence with thighs is that I have to remember it's there so I don't  pull the infusion set when I change clothes or use the bathroom.

Best place on your butt is the very top, where you don't sit.  Some people also use their love handles on the back but I'm not coordinated enough to do it.  

I only do arms if I wear shirts with sleeves and usually tuck the pump in my bra.  It's not my favorite, but I do it sometimes.  If you have longer tubing you should be able to clip pump on your waistband.

By adding a few spots it made the places on my stomach that were tender or had bad absoption completely heal.  My stomach isn't all bruised and red looking either.  Stomach sites are my favorite and it's been good to have more of them to choose from again.

I have been on an insulin pump for over 30 years. Keeping the site viable has been a battle. I knew if I wanted to stay healthy, I had to find a way to make it work. I have had to explore a number of methods to help the sites along. I can really identify with what you are going through. I could feel those problems really coming on about 15 years ago. Now almost all of those sites are still working better now than 15 years ago.

Here are some of the things that are making the difference. Some are free, some are not. I really hope this helps someone as much as it is helping me!

  1. Systematically rotate sites and order the sites based on the largest distance from the current site to the next site.
  2. Treat every used site like a wound. Use a good multi-antibiotic cream on the previous site and work it in especially well where u find any lump.
  3. If a site bleeds when u remove the previous catheter, work the site until the bleeding stops and any remaining pooled blood leaks out as best u can.
  4. Use a good IV prep on the new infusion site. Besides the adhesion help, it helps fight infection so the site does not become as inflamed. I think that Medtronics does not push this. To me, it is important though.
  5. Use some good skin cream and for a few days rub the old site with some intensity to work out the swelling, soreness, and irritation out maybe as part of dressing or bathing.
  6. This is probably the hardest part but it really helps. Before getting out of the shower turn the temperature as warm/hot as u can stand it and move the sites u use back and forth in the hot water til the skin is hot and pretty red. Then turn the water to as cold as u can stand it and let that go over the same areas until the skin is cold. Both take maybe on 10 to 15 seconds each. The hot/cold is a lot less disturbing if u only get mostly the infusion sites under it. That keeps it from feeling like u r taking a cold shower, etc. What is this nonsense for u ask? It strongly stimulates blood flow to these site tissues and promotes healing.
  7. Get some help. I have found that going to a massage therapist with fairly strong hands to work over the tissue of the infusion sites every couple of weeks makes a huge difference. U can accomplish some of this yourself, but I find that working in some massage therapy help makes a lot of difference.