- advertisement -

MDI, Pumps, CGMs and scarring ... ?

Discussion in 'Parents of Children with Type 1' started by DavidN, Oct 15, 2012.

  1. DavidN

    DavidN Approved members

    Joined:
    Sep 7, 2012
    Messages:
    744
    Of course my top priorities are my son's near-term safety and doing our best with his BG management for his long-term health. While not nearly as important, there's other stuff I think about too. One of these is scarring. I've read that MDI causes the most scarring, then I turn around and read the exact opposite. I just have no idea. Maybe the answer is, "it just varies so much from child to child". But I guess I'm just wondering what your experiences have been with MDI, pumps and CGMs as it relates to scarring, both aesthetically and regarding site effectiveness. Is it just another one of those unavoidable byproducts of T1D? Or maybe not. Is one insulin delivery technique less scarring prone than the other? Are advances in technology (smaller needles) making a difference? Thanks for sharing.
     
  2. Beach bum

    Beach bum Approved members

    Joined:
    Nov 17, 2005
    Messages:
    11,315
    We've been pumping for 6.5 years and we have had issues with "puffiness" in areas. This is the beginning stages of scarring. What we need to do when this starts to occur is to give the area a rest and be more mindful of rotating sites.
    I think diligent site rotation is key to avoiding it, more so than route of delivery or CGM. In addition, not letting sets stay in for too long (but this varies from person to person) can also help in avoiding buildup.
     
  3. sugarmonkey

    sugarmonkey Approved members

    Joined:
    Feb 16, 2008
    Messages:
    1,713
    We've been pumping for 5 years and have had a few lumpy areas. We just make sure we avoid the area for a while. This can happen with injections too, so not just a pump issue. Phillip hasn't had any sign of scars from pump sites. Consistent rotation really helps.
     
  4. katerinas

    katerinas Approved members

    Joined:
    Apr 20, 2010
    Messages:
    394
    What do you mean by scarring? We've been MDIing for almost 5 years and appart from a few bruises I haven't seen anything else. We rotate hands legs and bum. I think the needles today are tiny to cause scarring. We use BD 33G 4mm
     
  5. wilf

    wilf Approved members

    Joined:
    Aug 27, 2007
    Messages:
    9,652
    Please provide a quote or link to where you've read MDI causes scarring. The claim seems bizarre.

    My daughter has been on MDI only for 6 years - no scars and in fact no sign whatsoever if you look at her skin that she has Type 1 D.
     
  6. Sandy's mom

    Sandy's mom Approved members

    Joined:
    Jan 12, 2008
    Messages:
    495
    My husband has only been pumping for 10 years but prior to that he did shots for 20 years, no scars!
    My little girl has been pumping for 4 years and has no trouble either. Just gets a little lumpy sometimes if she does not rotate enough.
    Like others said, rotation is key. Don't use the same area all the time.
    The only scarring are her fingertips from testing. They are not pretty. So many spots and she tends to hide them and tries every lotion to try to help. Maybe boys don't mind as much, my dh doesn't seem to care about that.
     
  7. emm142

    emm142 Approved members

    Joined:
    Sep 7, 2008
    Messages:
    6,883
    I injected for a year and didn't have visible scarring. After pumping for 4 years and CGMing for 3 I have little white dots all over my tummy and legs, but no problems with hypertrophy or anything.
     
  8. Kaylee's Mom

    Kaylee's Mom Approved members

    Joined:
    Dec 4, 2007
    Messages:
    789
    That is what Kaylee has .. little white dots all over her belly. We use Bio Oil on her stomach ... and I hope eventually it will help fade the spots ... But we would not trade her pump for anything!

    Crystal
     
  9. DavidN

    DavidN Approved members

    Joined:
    Sep 7, 2012
    Messages:
    744
  10. danielsmom

    danielsmom Approved members

    Joined:
    Jul 18, 2011
    Messages:
    798
    Daniel is prone to underskin lumping...we've had to give tummy 3 month break, arms 3 month break...now we've been using his sides and I can see it is time to give them a break. His arms felt so bruise for a long time...I think he is just extra sensitive...we are on MDI
     
  11. Michelle'sMom

    Michelle'sMom Approved members

    Joined:
    Aug 21, 2009
    Messages:
    1,432
    "One evening, after taking an injection in my arm and watching most of the insulin come coursing back out thanks to a scar tissue pocket,"

    I think what Kerri is referring to is not true scarring (visible marks on the outside of the skin) but the buildup of fat tissue under the skin (lipohypertrophy) caused by not rotating injection &/or pump sites. It causes leakback & also absorption problems.

    My dd had a bad habit of injecting in the same area in her tummy. By the time she started pumping 7 months in, we couldn't use the right side of her tummy for pump sites at all. She's very careful to rotate now.

    My dd has an olive complexion & scars easily. She does have tiny reddish pink scars from pump sites, even though she rotates faithfully & changes sites usually every 2 days. The angled Inset 30s leave bigger & darker scars.

    2 yrs of wearing the Dexcom sensors 24/7 & she has no visible scars on her arms, which is the only site we use. She typically wears a sensor for 10-14 days.
     
  12. Mimi

    Mimi Approved members

    Joined:
    Dec 19, 2008
    Messages:
    1,906
    This is what I was also thinking when I read this. My dd had similar issues on one side of her tummy because it was the easiest place for her to inject. After not using the area for 3-4 months, all is well.

    I've seen no visible scarring now that we've been pumping for a year. Red dots that take some time to heal but no permanent scars.

    And no marks or anything from the CGM sensor.
     
  13. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

    Joined:
    Sep 23, 2007
    Messages:
    12,521
    And don't forget that when Kerri was dx'd, which was 20 something years ago (?), she was most certainly using longer and thicker needles than our kids use today.
     
  14. Connie(BC)Type 1

    Connie(BC)Type 1 Approved members

    Joined:
    Nov 11, 2005
    Messages:
    3,388
    Not rotating often can cause scarring, I use all 8 areas and still get some scarring. Did on MDI and do using a pump as well! It heals with rotation!
     
  15. Christopher

    Christopher Approved members

    Joined:
    Nov 20, 2007
    Messages:
    6,771
    I believe the OP is talking about lipohypertrophy and not scarring on the outside of the skin.
     
  16. Beach bum

    Beach bum Approved members

    Joined:
    Nov 17, 2005
    Messages:
    11,315
    I think this is one of those terms that is used interchangeably. I've heard it referred to as both.
     
  17. mamamccoy87

    mamamccoy87 Approved members

    Joined:
    Nov 22, 2008
    Messages:
    529
    We have some little white lumps from insertion site - a little scarring but she mostly uses her bum.

    As far as the fingers go - I wouls try finger rotation along with the lotion - Monday one finger, Tuesday the next or per poke. It does help, but oh their poor little fingers:(
     
  18. SarahKelly

    SarahKelly Approved members

    Joined:
    Nov 14, 2009
    Messages:
    1,147
    I think this may be a person to person deal, at least in our family it is - my husband has little scarring from MDI which he has been doing for over twenty years. He sometimes forgets to give his left side of his belly a break and will get a little soreness, but no scar or lumpy tissue. However, Isaac still has fewer areas where we can rotate and his skin is sensitive, he has more marks from pumping, but only time will tell if it is actually scar tissue or just inflamed. We have to change sites every two days or less and rotate frequently as his skin gets irritated and sometimes a bit hard. So...not sure if it's an MDI/pumping difference or a person to person difference.
     
  19. TheFormerLantusFiend

    TheFormerLantusFiend Approved members

    Joined:
    Sep 10, 2006
    Messages:
    4,925
    I have never seen a study comparing scarring or lipodystrophy in pumpers vs MDI. I would love to see such a study.
    I have seen studies on both scarring and lipodystrophy in MDIers (with very high rates of lipodystrophy), but none that were done in the past 20 years on a type 1 population.

    Personally, I have a few scars (white areas with a diameter of about 2mm each) on my arms from the sof-sensors I had reactions to, I have a lot of purple marks that have been there for a long time (not sure if they change or are the same ones) on my butt where I do Lantus, and I had to stop injecting my thighs for about a year because I was getting hard knotty areas in my thighs after injections. They did not fit the profile for lipodystrophy and my endo said he wasn't sure what they were. My thighs might have some scarring but it's hard to see the skin under my hair on my thighs so I don't know.
    A number of long term type 1 diabetics I've met have told me that they have scars and that the scars are inevitable if you're at it for 10 years+. I assume they mean like freckle sized scars.
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice