diabetestalk.net

Insulin Pump Injection Site

Preventing And Treating Insulin Pump Site Infections

Preventing And Treating Insulin Pump Site Infections

People who use insulin pumps purposefully break their skin, the body’s main defense against bacteria, to receive continuous doses of life-saving insulin. For many, the decision to use an insulin pump is a wise one, though it necessitates careful care of pump insertion sites to prevent infection. Preventing Pump Site Infections It is important to always follow the instructions given for safe insertion of an infusion set. You and the equipment must be cleaned with the prescribed disinfectant or kept free from contamination, including hands, the injection site, top of the insulin bottle, needle, cannula, and infusion set connections. Having the set adhered snuggly to the skin also reduces risk of infection. Since cleaning the infusion site with soap can leave an adhesive-weakening residue, the use of alcohol, or IV prep wipes is recommended. Spraying the site with an antiperspirant and letting the area dry thoroughly before insertion helps keep the cannula’s adhesive patch dry and secure. Some individuals place a bacteria-barrier such as a Tegaderm dressing over the needle or cannula to help secure it, and prevent the entry of Staphylococcus aureus or other infectious bacteria. Still, no matter how careful you are with cannula insertion, an infection may occur at the site. Signs of Infection Pump users must change infusion sites regularly and be attentive to the current site’s condition. Redness, pain, swelling (a “pump bump”), and an unexplained elevated blood sugar reading are signs of possible infection and should addressed immediately to prevent more serious symptoms. Either an abscess or cellulitis indicates a more serious infection. An abscess is a pocket of pus that develops around the insertion site. It may become swollen, red, and be warm to your touch. Continue reading >>

What Is Insulin Pump Therapy?

What Is Insulin Pump Therapy?

How Does an Insulin Pump Work? An insulin pump is a small electronic device, about the size of a smartphone, that can be easily carried on a belt, inside a pocket, or attached to a bra and so virtually invisible to others. The device is attached to your body via a thin tube called an Infusion Set. This makes insulin pump therapy very discreet. An insulin pump replaces the need for frequent injections by delivering rapid acting insulin continuously 24 hours a day. Basal Rate: This is the small amount of insulin that your insulin pump continuously gives you. Your pre-programmed rate is determined by your own body's needs and programmed by your healthcare professional. Because the quantity can be more precise and the rates can be customised e.g. can very each hour if need be, an insulin pump can mimic a healthy pancreas more closely. Bolus Dose: Additional insulin can be delivered “on demand” to match the food you are going to eat or to correct a high blood sugar. Insulin pumps have bolus calculators that help you calculate your bolus amount based on settings that are pre-determined by your healthcare professional and again based on your individual needs. How does insulin get from the pump to your body? The insulin pump has a compartment that holds a reservoir that is filled with insulin. From the pump's reservoir insulin travels along a thin tube and "infused" into your body through an infusion set which is inserted into your skin. The infusion set contains a small cannula which is sits just under the skin. The pump and tubing can easily disconnect and reconnect to your body whenever you want to. This can be helpful, for example when you want to shower or play sports. A small durable electronic device that has: - Buttons to program your insulin and navigate through th Continue reading >>

Insulin Pump Overview

Insulin Pump Overview

As people with diabetes know, keeping blood sugar levels in a safe range is extremely important. Good blood sugar control not only makes you feel well, but also helps prevent long-term diabetes complications, such as blindness, kidney failure and heart disease. People with type 1 diabetes don’t produce insulin, a hormone that helps the body use sugar (glucose), a key source of energy that comes from carbohydrates. If you have type 1 diabetes you must make up for the lack of insulin with insulin therapy. Meanwhile, people with type 2 diabetes produce insulin, but their bodies don’t use insulin properly, or they don’t produce enough insulin. Diet, exercise and medication can often work to control glucose levels. However, in certain cases, these measures aren’t enough, and insulin therapy is needed to better control blood sugar levels. While insulin can be given by self-injection, people who take multiple daily injections of insulinmay also consider using an insulin pump. An insulin pump provides continuous delivery of short acting insulin all day long. The insulin pump substitutes the need for long acting insulin. A pump also replaces the need for multiple daily injections with a continuous insulin infusion, and also helps to improve your blood sugar levels. How Do Insulin Pumps Work? Insulin pumps are small, computerized devices that mimic the way the human pancreas works by delivering small doses of short acting insulin continuously (basal rate). The device also is used to deliver variable amounts of insulin when a meal is eaten (bolus). The basal insulin rates are usually set up in your pump with your doctor, and you can have one or multiple basal settings programmed in your pump, based on your needs. You program the amount of insulin for your mealtime bolus di Continue reading >>

Insulin Pumps

Insulin Pumps

Insulin pumps Insulin​ pumps continuously deliver insulin. Their formal name is continuous subcutaneous insulin infusion pump. The pump is ​about the size of a phone pager, and is worn on the belt or kept in a pocket. An insulin pump allows your child to get as much insulin as needed without having to get a new needle each time. How insulin pumps work An insulin pump system is made of four main parts: a small cartridge of insulin called a reservoir a thin plastic tube (the cannula) that sits under the skin flexible plastic tubing that connects the cannula to the reservoir a pump which allows you to set and change the amount of insulin delivered. The cannula within the infusion set is placed in the fat under your child’s skin with an infusion set insertion device. The insertion device pricks a needle through the skin. The needle brings with it the cannula. The infusion set insertion device is then removed along with the needle while the cannula stays in place within the infusion set. The infusion set must be replaced every two or three days. How an insulin pump works The insulin is delivered from the reservoir to your child’s body through flexible tubing to the cannula. You must change the reservoir before it runs out. The OmniPod System is another type of insulin pump with two distinct parts: The Pod device is placed on the skin. It contains the needle to insert the cannula, the cannula, and the refillable insulin reservoir. The pump controller is separated from the pod and can be carried elsewhere (in a pocket for example). In this case, no visible tubing is needed because the cannula is directly connected to the insulin reservoir. The buttons on the pump allow you to control the timing and dosage of insulin boluses. The device sounds an alarm if the tube is cl Continue reading >>

Infusion Sites | Diabetesnet.com

Infusion Sites | Diabetesnet.com

Tue, 11/23/2010 - 16:21 -- Richard Morris For sites, most pumpers prefer the abdomen, but anywhere that has padding will do. The abdomen usually gives the fastest and most consistent absorption.You should stay at least 2 finger widths away from the navel for good absorption, and above or below the belt line.The upper buttocks, thighs and back of the upper arms also can be used. The buttock area often works best for young children because it is a large skin area that is out of sight. An area you can easily see is best when first starting on a pump or if you are having site issues. A patch pump can be placed in many of the same locations but stay away from skin folds where the pump may get detached if you bend over or twist sideways. Change the infusion set and site every 2 to 4 days, at least 4 hours before bed, and at least 24 hours before your glucose typically rises if you have set problems. You want to prevent infection, damage to the skin, scarring below the skin, and fat buildup from excessive use of one area, called lipohypertrophy.Rotate areas, such as right upper quandrant of the adbomen to right lower to left lower to left upper. Sites may also be rotated in small steps, such as moving each new site about 2 inches from the last one. To remember to change your infusion site, put just enough insulin in the reservior to last until the next site change. Most pumps have reminders that you can set to alert when it is time to change, as well. Insulin injections very rarely cause infections, but pump infusion set sites or patch pumps are more prone to infection because they stay in place for 3 days or so. Bacteria can be present on the hands, breath, skin, counter tops, clothing, and everything you touch. If you have had even a small skin infection in the past or a hi Continue reading >>

“help! There’s A Lump Where I Inject Insulin”

“help! There’s A Lump Where I Inject Insulin”

It might be a sign of lipohypertrophy, a condition that affects insulin absorption. Integrated Diabetes Services (IDS) provides detailed advice and coaching on diabetes management from certified diabetes educators and dieticians. Insulin Nation hosts a regular Q&A column from IDS that answers questions submitted from the Type 1 diabetes community. Q – Every time I think I know what I’m talking about when it comes to diabetes, I come across a new thing to worry about. I saw something about lipohypertrophy. What is it and should I worry about it? A – Lipohypertrophy is when fatty lumps appear on the surface, or just under the surface, of the skin. This is a fairly common side effect from insulin injections or insulin pump sites. It is more likely to occur if injections are administered to roughly the same part of the skin over a period of time, or if the same patch of body real estate is used for pump infusion sets over and over again. When the skin becomes lumpy, the insulin injected or pumped into this area won’t be absorbed as consistently as it once was, which can mean it will take longer to be absorbed or it will be inadequately absorbed. This can lead to higher than usual blood glucose levels. The signs of lipohypertrophy are a raised area of the skin at the injection or infusion site. The raised area may cover a wide area – up to an inch in diameter. The skin affected will feel more firm than the skin elsewhere on your body. The best treatment for lipohypertrophy is to avoid injecting or applying infusion sets in the affected area of skin until it has fully healed. Prevention is easier than dealing with lipohypertrophy after the fact. Make sure you pick a different area of skin for each injection and rotate your injection and infusion sites. Ideally, you Continue reading >>

Photos Of Infusion Sites

Photos Of Infusion Sites

This is a work in progress. Many thanks to the list members that shared these photos of infusion set placement. Please contribute additional photos by email to [email protected] or by snail mail to: Insulin Pumpers 558 Valley Way Milpitas, CA 95035 All photos are anonymous and will be cropped and/or retouched as necessary to make sure they are "decent" These photos do not constitute a recommendation for a particular method of inserting infusion sets, they are merely examples of how some members of the Insulin Pumpers mail list do their set insertions. Abdominal Sites: Sil/Tender/Comfort set on lower abdomen with a little extra adhesive... SofSet - mid abdomen with lots of tape, must be a swimmer?? Sil/Tender/Comfort set on upper abdomen Detail of neat tape trick to help hold down Tender/Sil/Comfort sets QuickSet on upper abdomen Inset on lower back, pump in bra Using your breasts for infusion set placement. If you have questions you wish to ask the donor of these photos, send them to [email protected] Can you pinch an inch? There is not any difference using the skin around you breasts than any other part of your body. You are just inserting the cannula into fat. Just be careful that you really only insert at a 20-30 degree angle maximum or you will be in for a lot of pain and a black and blue boob. If you have enough "padding", you can put the site right under your breasts as well, not on the bottom side, but just beneath. The sites heal well, although this user no longer wears bikinis, but does wear regular swim suit tops with the set "in place". When doing the insertion, I make sure and stay at least two inches from the nipple area. What about sex?? It is just like wearing the set in any other place. The other partner must be careful, that's all. Bre Continue reading >>

Everything You Need To Know About Insulin Pumps

Everything You Need To Know About Insulin Pumps

Everyone needs insulin to live. Insulin is a hormone that helps our bodies use and store the food we eat. People with Type 1 Diabetes no longer make insulin and have to give insulin in order to sustain life. People with Type 2 Diabetes don’t use their own insulin well, and over time can have trouble making enough. So, all people with Type 1 diabetes and some people with Type 2 diabetes need insulin. When people give insulin injections, they may take 1-2 injections of a long acting insulin every day and 3+ injections of rapid acting insulin for meals and snacks. The typical person with Type 1 Diabetes could take anywhere from 4-7+ injections a day. Many people currently give insulin through an insulin pen or a syringe. But, there is another option, an insulin pump. An insulin pump delivers rapid acting insulin in two ways. First, the pump is programmed to give you insulin every hour throughout the hour referred to basal insulin. Basal, think “base,” is the insulin your body needs even in the absence of food, it is also referred to as background insulin. This basal rate replaces the long acting injection that you take. Second, is bolus, this is the insulin you take for food or to correct a high blood sugar. If you get basal and bolus confused, think “bowl”, as in you eat out of a bowl, to help you remember bolus is for food. Once you are on a pump, all insulin is delivered through the pump and shots are no longer necessary. Components There are a few things necessary to make a pump work. When a pump is shipped to someone: they will also need to send infusion sets, reservoirs, and possibly batteries, depending on your pump. Let’s talk about each component. Infusion Sets An infusion set is the part that is actually inserted into the body and has tubing that conn Continue reading >>

4 Tips For Infusion Set And Sensor Site Rotations

4 Tips For Infusion Set And Sensor Site Rotations

When I started the MiniMed 530G with Enlite, I committed to wearing the Enlite sensor all the time. When I wore the Sof-sensor, I took occasional sensor breaks, but now with Enlite, I didn’t want to continue that same habit. I quickly found it was important to use my “real estate” wisely when it came to wearing two sites 24/7. Here are some tips I have learned along the way that might help you with infusion set and sensor site rotations. I call it the “S.P.O.T. method”. (S) Site Location The stomach is a very common place to wear an infusion set and one of the main areas that I have used for years. I initially started wearing my sensor and my infusion set in my stomach (making sure they were an inch away from another), but I found it to be too much space taken up on my skin with not a lot of flexibility to rotate. So after talking with my doctor, we decided to dedicate my stomach to sensors only (at least for now). For my infusion sites, I rotate between my thighs, arms, and back/love handles. Saving my stomach for my sensor allows ample time for my sites to heal and skin to remain healthy during the six day sensor wear. Before I insert a sensor or infusion set, I think about all the locations I can insert them, often choosing a site based on the answer to these questions: 1. Where did I insert last? (Choose a different spot) 2. What types of activities am I planning on for the next 3 days? (Activities like working out might change placement) 3. What kinds of clothes will I be wearing for those activities? (Beach day or formal events mean different outfits so I choose a different spot) 4. Are any of the following true for the selected spot: a skin fold, scar tissue or overused site, too close to the belt line? (Don’t use those areas for sensor or infusion se Continue reading >>

Choosing And Using An Insulin Pump Infusion Set

Choosing And Using An Insulin Pump Infusion Set

When a person uses an insulin pump to control his diabetes, one of the decisions he has to make is what model of infusion set to use. Pumps are often an excellent choice for people who use insulin and seek tight control of their diabetes but need some flexibility in their diabetes regimen. Most insulin pumps require the use of an infusion set to deliver insulin from the pump to the user. An infusion set consists of a length of thin plastic tubing, a very thin stainless steel or Teflon cannula that is inserted just under the skin, and a plastic connector that joins tubing and cannula together. The connector is generally mounted on an adhesive patch that is stuck to the skin at the insertion site to help keep the cannula in place. The connector allows a person to disconnect from his pump temporarily (for swimming, intimate situations, etc.) without removing the infusion set. Insulin infusion sets come in a variety of styles to suit individuals’ unique needs and preferences. In addition to having either a Teflon or steel cannula, infusion sets may be designed to have the cannula inserted straight into the subcutaneous tissue or at an angle. Some cannulas can only be inserted manually, while others can be inserted either manually or with an insertion device. All infusion sets offer a variety of tubing lengths. Teflon versus steel cannula A “soft” cannula is a thin, flexible needle made of the synthetic substance Teflon that is inserted into the subcutaneous tissue via a steel introducer needle. The introducer needle is then removed and only the soft cannula is left in place. Soft cannula sets are popular because they are comfortable to wear and they can remain inserted for up to 72 hours. One disadvantage of the soft cannula, however, is that its flexibility can poten Continue reading >>

Big Bleed From Infusion Site

Big Bleed From Infusion Site

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Sorry for the dramatic headline. I know everyone gets those little bleeds into their infusion set cannula when they hit a capillary. But the problem I'm having is quite different. Twice now, when a new cannula has been extremely painful to insert - and stayed painful; the cannula is completely clear and looks normal- I've then removed it and like a dam bursting a flow of blood has emerged. Enough blood to run down my legs. It stops with pressure applied to the site - like an injury. But it leaves a painful blue lump of a bruise. This second time it has stayed very painful for a long time - my pharmacist gave me lidocaine cream for it. I'm not on any blood thinners and never had any bleeding issues previously. I've only been on the pump 5 months and this has happened twice in the last 6 weeks. Upon contacting my pump clinic they don't know what it is. The AccuChek Aviva rep says it can happen when capillaries are more open from a shower - I didn't change the cannula at a showering time. The pharmacist said it may be a little tissue has been caught by the cannula which then stops the flow of blood, building pressure which translates as pain. This is then released when the cannula is removed. DSN says it might be, but they don't know. I see on this forum discussions of the cannula bleed being solved by using the angled infusion sets. The Accuchek rep did advise me to change to their angled infusion set Tenderlink - but it doesn't have an insertion device. I saw the mention of the Tandem Cleo which does have an insertion device, but I'm guessing it's not on the NHS - yet to find out. Has anyone had anything similar happen to them? Feeling weird that pump Continue reading >>

My Pump Almost Killed Me… Twice

My Pump Almost Killed Me… Twice

One of the greatest technological advancements in diabetes care has been the insulin pump. For one, it gives you the illusion of being “normal” because you no longer have to inject insulin throughout the day. Instead, you “bolus” by pushing a button on the pump itself or using a remote control. It allows better glucose management because you can adjust your basal rate (the “background” insulin dose) by increments of one thousandth of a unit every hour. Especially when you’re moving from the peaks and valleys of NPH or the restraints and hazards of Lantus, the freedom of living with an insulin pump is incredible. But pumps do not come without their kinks. Most people in the diabetes community know what a pump is, but for those who don’t, I’ll give a quick overview. A Medtronic MiniMed insulin pump, for example, carries about 200 units of fast-acting insulin in a machine about the size of an early pager. The insulin moves from the pump via a tube that is connected to your skin through a cannula. The cannula is inserted into your subcutaneous layer via a two-inch needle. After insertion, the needle is removed and the plastic tube remains under the skin, held in place with sterile medical tape. The pump pushes insulin through the tube into your body in increments as small as .05 units per hour. Pumps like the OmniPod don’t even have a tube; they’re connected directly to your skin after being pre-programmed with your insulin requirements. When you’re using a pump, you no longer require insulin injections via syringe and you no longer use basal insulin (NPH, Lantus, or Levemir). I have learned many lessons while on the insulin pump. For example, I learned how my body reacts to the Dawn Phenomenon, that early morning rise in glucose levels that occurs w Continue reading >>

Lipohypertrophy... Say What?

Lipohypertrophy... Say What?

From the "crap no one ever tells you about with diabetes" file, comes: Dissect the word with me for a moment: Lipo -- OK, that sounds like weight loss surgery. Hyper -- Yes, we often are. How else could we juggle work, kids, exercise, myriad lab tests and doctor's appointments, non-stop carb-counting and dosing adjustments, etc., etc. and still do our taxes? Trophy -- Do I get one, for putting up with all this diabetes crap? Just because Wikipedia brushes this off as "common" and "minor," doesn't mean that at some point, it won't be the biggest thorn in your side (pun intended!) with diabetes. I personally have had ongoing skin issues with the adhesives for diabetes devices, and now that I'm regularly wearing both the OmniPod and new Dexcom sensor again, I am feeling like Public Pin Cushion No. 1! I'm not sure which is less sexy: these two chunks of plastic hanging off my body, or the black-and-blue-and-yellow track marks I now sport all over from where said chunks were formerly stuck: It's really hard to find good information on lipohypertrophy, even from the vendors whose products clearly cause it regularly. And how come it seems like so few patients are ever warned about skin issues at all, but just have to learn the hard way (pun again!) when scar tissue "rears its ugly head"? Then suddenly, it seems like we've got no good sites left... everything's lumpy and bruised, and our insulin absorption goes all to hell. My recent frustration, via twitter: To be fair, Roche has been the most proactive vendor on this topic. A few years ago, they even kicked off a "National Infusion Site Awareness Week" initiative to raise awareness about the importance of choosing your sites carefully. They shipped out a box of stuff to a bunch of bloggers that I still have sitting on my self Continue reading >>

Trying A New Infusion Set Site Location

Trying A New Infusion Set Site Location

I look forward to my endocrinologist appointments because it’s an opportunity for me to get the most out of my diabetes management. Take my last appointment, for example, where we discussed trying an infusion set in a new place for the very first time. While discussing this, my doctor recommended testing my blood glucose more frequently to make sure that I know whether or not the insulin absorption is the same for my new infusion set site location compared to my previous site locations. For some background, in almost 11 years on a MiniMed insulin pump, I’ve used four different infusion sets with a variation of tubing lengths. I’ve always practiced the habit of rotating and alternating infusion sets. Today I might wear my site on the right side of my belly, but in two days I’d plan to move it to the left side or down to my thigh. But the one approved location that I’ve never worn used is the back of my arm. How would it feel? What do you do with the tubing? It never seemed to make sense to me. So when my doctor and I discussed using the back of my arm for the first time it made me a little nervous. But after all of these years my site rotations are that much more important and it’s time to find new areas of skin, so I went home to try it with my Mio infusion set. I stood in front of the mirror, twisted around, and placed the serter on my skin. I then took a deep breath and whispered a word of encouragement to myself before I inserted it. “Phew, that wasn’t so bad.” (Note: this is one of the site locations where it actually might be a good idea to get help from a loved one depending on your flexibility and dexterity.) Although this transition hasn’t been perfect, now I’ve worn it in my arm eight times and each time it’s gotten easier as I continue Continue reading >>

Insulin Infusion Set: The Achilles Heel Of Continuous Subcutaneous Insulin Infusion

Insulin Infusion Set: The Achilles Heel Of Continuous Subcutaneous Insulin Infusion

Go to: Introduction Insulin therapy by means of continuous subcutaneous insulin infusion (CSII) is a well-established therapeutic option.1–6 Since the 1980s, insulin pumps have developed into highly sophisticated infusion devices that provide infusion of different types of insulin boli.7 The most recent versions of these pumps have also integrated information management and advice functions. The traditional insulin pump is connected to the patient via thin, soft, and flexible plastic tubing. One end of this tubing is attached to a needle that goes through the skin into the subcutaneous (SC) adipose tissue. The needle is either a steel needle or a soft Teflon catheter, which is inserted at various angles through the skin. The other end of the tubing is connected to the pump’s insulin cartridge via a Luer-lock or proprietary connector. Once the set is attached to the skin, insulin is pumped through the infusion set into the SC area to induce a metabolic effect according to the wearer’s current needs. Lower infusion rates cover the basal insulin requirements, while higher rates (boli) are given to cover prandial insulin requirements and hyperglycemia. Insulin infusion sets (IISs) are available in a variety of different lengths, diameters, connectors, materials, and designs to meet the individual patient requirements. Another type of insulin pump that has been introduced into the marketplace is the so-called patch pump. The main difference between patch pumps and traditional insulin pumps is that these new pumps—with one exception—have no visible IIS. Typically, these patch pumps have a very short IIS, but it is completely inside the pump housing or within the base part of the modular designed pump.8 The adhesive that fastens the IIS to the skin is located on the Continue reading >>

More in insulin