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May 21, 2005

Insulin Pumps, Other

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Question from Lehighton, Pennsylvania, USA:

My daughter, age 14, is on an insulin pump. She seems to have developed allergies to the tape that holds the infusion set. I have contacted her endocrinologist and her primary care doctors and they recommended a dermatologist. She puts IV 3000 down first, then inserts a Quick-set over top of that, and by the second day she is scratching at her skin so badly, sometimes she tears it open. We tried Tegaderm and polyskin, also.

Her abdomen is now bruised and it is very difficult to find another area for the infusion set. I asked her endocrinologist about another infusion set that used different plastic, as I read another pump company uses “PVC-free” canulas, and they don’t really know what to tell me. We haven’t seen the dermatologist yet, but I was wondering if you have ever seen this?

Answer:

From: DTeam Staff

I am assuming that she is allergic to the Quick-set seal itself and that is why she is using IV 3000 patch.

Try a product called AllKare. It looks like an alcohol swab. When you wipe it on the skin, if you let it dry and then apply the infusion set, it puts a barrier between the set and the skin. The phone number for the product is 1-800-422-8811, or Convatec

Try different infusion sets. If the pump is a MiniMed Paradigm model, there are only three sets to use. The one she is using, the Quick-set, the Silhouette, and the Soft Set. She could try another one. If she is using any other pump, she should try all the sets on the market until she finds one that she can use. We have had good luck with the Disetronic Ultraflex. People don’t seem to be as allergic to that one.

People do tend to be allergic to IV3000, though.

LAD
Additional comments from Dr. Jim Lane:

Yes, this is not uncommon. Previously, this was a common reason for discontinuing pump therapy. We have been able to get around this because there are a number of additional commercial products available to use. It is such an important issue, we have our diabetes educators keep a “tape library” so as to provide choices for additional products when there is evidence of allergies to the current product. Medtronic MiniMed has a publication out called “Tape Tips.” You can also contact a local diabetes supply company for a list of different tapes. Another strategy is to use Benadryl spray over the area before applying the tape. Your daughter may want to use alternate sites or go back to insulin injections to allow those areas over her abdomen to heal.

JTL