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What are the potential dangers of extended use of an infusion set?

Discussion in 'Insulin Pumps' started by GChick, Feb 20, 2014.

  1. iliisa

    iliisa Approved members

    Joined:
    Sep 29, 2015
    Messages:
    10
    I have been pumping for 13 years, T1 for 43 years. Even though I take very little insulin (5.2 basal units daily), I change my infusion set every 2 days. I used to change every 3, but had many occurrences of insulin pooling and high sugars as a result. Infections can also be a risk of not changing every 3 days. As someone else has mentioned, your doc can contact insurance and give medical necessity for you to change your infusion set more frequently.
    ...Liisa
    T1 43 years
    Medtronic 530g and Enlite sensor user
     
  2. sszyszkiewicz

    sszyszkiewicz Approved members

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    Dec 24, 2013
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    Wow 43 years! What advice would you give my son (he is 13 diagnosed 2 years ago this month). I feel so handicapped when it comes to T1D with no real life experience as nobody ever had it on either side of our family. So i am always looking for advice on the "big picture" from folks who have walked the walk and understand.
     
  3. sarahspins

    sarahspins Approved members

    Joined:
    May 5, 2009
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    I've pumped for a majority of my 15 years with T1 and I've had exactly one infected site, and that infection actually developed a couple of days after I had removed the site, so I'm not convinced that it was really 'from" the site, it was likely more of an opportunistic thing. Off the top of my head I don't think I had left that site in very long, I remember it being in an annoying spot, so it probably got pulled earlier than most, and it was about when I pulled the following site that the prior one got infected. In my case I developed cellulitis (with a fever, and required antibiotics), so it wasn't an acute thing like an abscess at the site.

    Even still, I'm happy to leave a site in place if it's working well - I just recently had one on my thigh for 6 days, and it honestly looked like I had just put it on when I finally pulled it off... no irritation, no bruising, just a tiny hole in my skin, which was all but invisible the next morning. On the flip side I've had sites "fail" after less than 24 hours (fail = insulin leaking out along cannula, usually combined with inflammation/irritation), so I don't think there is always a magic formula for success.

    BTW, speaking of scarring, I have had very little from using 90˚ sets - either steel or teflon, but I have TONS of scars from using comfort shorts and silhouettes... for some reason the cannula being "exposed" where it goes into the skin always resulted in some low level irritation/infection aka "pump bumps" and I found no good way to avoid that, and those sites would often take a week or more to get "better" while 90 sites would look normal after about 24 hours unless they had bruised (in which case the hole left behind would heal up faster than the bruise). I stopped using angled sets for that reason.
     
  4. Ali

    Ali Approved members

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    Aug 1, 2006
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    2,223
    This is a great post. Everyoe reacts differently too sets and insulin. I had horrible issues with teflon sets. I use steel and do much better but still have issue after 2 1/2 days to 3 days. My body is either reacting to the set or to the insulin being in one place for too long. This is really YDMV issue. But if insurance will cover I would suggest swapping out at 3 days max and watch to see if you are one that needs to switch out sets under that 3 day range.
     
  5. iliisa

    iliisa Approved members

    Joined:
    Sep 29, 2015
    Messages:
    10
    I change my set every 2 or 3 days based on whether my sugars are running high (indicated by both CGM and blood readings). They would be high if:
    1. Insulin no longer being absorbed. I can get 3 days when infusion set is in my abdomen, but most of the time when inserted in my thigh, I only get 2 days.
    2. Infection - redness at site.
    3. Kink in cannula (although this typically happens on the day of insertion)
    4. Accidentally get tubing caught on a door handle :)
    I have a script written for every 2 days which makes it a no brainer for me to change one out if needed!
    ...Liisa
    T1 43 years
    Medtronic 530G and Enlites
     

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