December 21, 2008
Daily Care, Insulin Pumps
Question from Glen Burnie, Maryland, USA:
My 12-year-old granddaughter has been on an Animas 2020 since April, 2008 and she loves it! The problem we are having is the sites on her tummy; they do not hold. After one day, she has to put a band aid over the infusion site in order for it to stay for another day. Can the sites be placed anywhere else besides the tummy? We tried the thigh and it worked well for a couple of weeks, then she had high readings. When we changed the site, the canula was bent, so no insulin was being delivered. She did get sick one day with high ketones. Needless to say, we stopped using the thigh. Is there any other area of the body she can use for sites? We were told that the thigh has too much muscle and that caused the canula to bend. Could the thigh be used if we went to an angled set instead of a straight set? She is currently using a straight set. We are applying I.V. prep, which leaves a sticky film when applied. As soon as it is sticky, we insert the infusion set.
Answer:
You really have two issues:
First, the sites should be staying for more than a day. The biggest reason we see for sites not staying is the soap that is used in baths or showers. Soaps containing moisturizers, such as Dove, are often the culprit as they cause the adhesive to stop working. Changing soaps works most of the time in keeping sites in for 48 to 72 hours.
Second, other places you can consider are the upper buttocks, arms and thigh. If she is using the 90 degree inset, she can insert it in the upper buttocks with one hand. Your diabetes educator or endocrinologist can show you exactly where at your next visit. Other teen and preteen girls will insert them in the buttocks on the bathing suit line for easy connect/disconnect for gymnastics/pool time/gym at school.
The angled sets are another option for the thigh or even arm, but the absorption can vary. Again, you will need some guidance from your provider as an assessment of what are the best options can only be done “live.”
NB
[Editor’s comment: See also a previous question about getting infusion sets to adhere better.
BH]
