July 26, 2004
Daily Care, Insulin Pumps
Question from Russellville, Akansas, USA:
I have been a diabetic for 41 years. I am 5’8″ tall, with a weight of 145 pounds. I have been on an insulin pump for the last four years, the best thing I ever did for diabetic control. My A1c has run about 5.6 to a high of 6.2. The problem that I have is, when I replace my infusion set, my skin is so tough I can not push the needle through. It is not uncommon for the cannula to roll up the needle while trying to push the needle in. It appears that the resistance starts just under the epidermis layer of the skin. I have tried several different types of infusion sets. The silhouette from MiniMed gives me the least amount of trouble. Could you give me some insight as to why this is happening and what I could do to help eliminate this problem?
Answer:
It sounds like you are trying to stick the insertion needle into an altered area of skin. Perhaps this has been altered by lipohypertrophy. This occurs when insulin is continuously injected or infused in the same site. When the fat tissues gets enlarged, it leaves bumps or hard areas that are discernable from the rest of the tissue. It is self-selected because the lipohypertrophy sites hurt less when the needle is stuck in that particular area. The downside is that the insulin does not get absorbed normally from those sites. You may have to look at areas of infusion that are distant from those you are using now and see how the skin heals up after avoiding them for months.
JTL
