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October 13, 1999

Insulin Pumps

Question from Germany:

I am a 29 year old woman with Type 1 diabetes for 13 years. I have always been very brittle even after using in excess of 130 units of insulin per day. My internist felt that the insulin pump would be ideal for me and so I began using one. My control improved; however, I began developing severe abscesses at the infusion site requiring incision and drainage. I have had four such infections thus far. The most serious was a very severe submuscular infection resulting in DKA. Each has left a very large disfiguring scar. At my physician's advice I have discontinued its use for now. I was changing the infusion needle (first Soft-set, then bent needle) daily and disinfecting my skin with Hibiclens and alcohol. Will I ever be able to use the pump safely? What do you recommend?

Answer:

I would not use the alcohol at all. Only use something like Betadine or Hibiclens. Always change your site after showering. You must ask about topical antibiotics or steroids at the site. I would change the site every 48 hours and do it with your diabetes educator or pump rep several times to be sure you’re doing it correctly. Also start fresh with completely new supplies and insulin. Perhaps you got a bad batch of either.

Definitely try the pump again and take extreme precaution when changing the site. Perhaps even use sterile gloves.

SS