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April 30, 2005

Aches and Pains, Insulin Pumps

Question from Old Saybrook, Connecticut, USA:

My 16 yr old son has been on the pump for over a year and a half. He is experiencing quite a lot of pain each time he changes his site. He changes sides every three days, but it still hurts. He wants to give up already. What can we do to help ease the pain?

Answer:

I think the issue hinges on when the pain occurs. If the site gets sore and irritated and painful, then it might be the insulin. Is he using Humalog in the pump? Many find that NovoLog is less irritating.

If the issue is pain with catheter insertion, then options include the use of a topical anesthetic (most use EMLA cream or ElaMax; this latter does not require a prescription and does not require an occlusive dressing for 45 minutes before effective); but I like to prescribe ethyl chloride spray. This material briefly “freezes” the skin to numb it up. (You’ve probably seen sports trainers use this on the sidelines in football and basketball games.) A quick spritz is all it takes.

Talk with your own diabetes team to see what the hurdles and complaints REALLY are.

DS