My dd has been on the pump for ~18 months. The first 17 months have been great -- her control has been great, and she has loved the flexibility. Starting around a month ago, her control has gone haywire. She will have good control for the first 48 hours of a set, but increasingly the last 24 hours of a set are really difficult BS-wise. At her doctor's suggestion, she is using "real estate" that she is less fond of using to try to give the areas she normally uses a break. But even this doesn't seem to be working -- after 48 hours her numbers just go wacky. She is seriously thinking of giving up on the pump and going back to shots. Has anyone else had this happen? I would guess that she has just run out of fresh sites, though she has been good about rotating so I am surprised this is an issue. Her appointment is coming up and I am hoping that I can get some kind of feel for whether running out of fresh sites is a common issue and whether people do occasionally find that over time the pump no longer works for them. (She is 15 and 5'9", so even though she is thin, running out of sites would not be a problem I would expect.)
We found after a while that sites were only lasting 2 days. We switched from Humalog to Novalog, and that helped quite a bit with that.
We had this problem from the get-go and just bit the bullet and changed out the set every 2 days like clock-work. Since then, no problema.
The life of a site can depend on what insulin you're using and what type of set you're using. I found, when I first switched from straight sets to angled sets, I could go for three days. After a while, that shrunk down to two days. I've always been on Humalog, so I can't comment on the differences between different fast acting insulins, but many people have found that there's a difference in site life based on whether Humalog or Novolog or Apidra is used.
My DS has been on the pump for four months (MM Revel) and we've had to change the sites every two days since day one. I was actually going to talk to the endo on our next visit to see if we should switch to the angled sets. My son only wears the site on his bottom, as he's very lean (not enough fat on his abdominal area) - since he's 9 ( and very active!) and we seem to have kinked cannulas when we remove the site. I'm finding that if we faithfully change the site every two nights, we avoid a lot of problems (no fun changing a site at 2 am!). I would ask your endo about perhaps using another type of pump set or even insulin (I have also heard about Novalog being more effective than Humalog with the pump). Stephanie, Mom of Jacob, age 9 Dx since 2005, pumping since 12-10
Maybe it's time to try a new infusion set? Perhaps she has developed an allergy to what she's been using and it's effecting the delivery. Good luck, it must be frustrating
We had this happen at about 18 months as well. I agree that a change of infusion set or insulin can help. But in our case everything we tried after a few weeks went back to sites lasting 2.5 days. So aftertrying everything else, we went back to the set she likes and change every 2 days faithfully. I never saw better results totally switching up the areas she uses and we have always been really good about rotating. In our case I don't believe it's in any way related to overuse or scar tissue. I suspect her body is better at attacking the foreign invader and the sets get occluded quicker. ETA: My DD would never give up her pump, even with site changes every other day. But we were both really frustrated with crazy numbers until we just broke down and realized it is what it is, and we just have to change every two days to make it work.
