Constant skin infections

M

Mole

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Relationship to Diabetes
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My son (15) is having constant skin infections from the Omnipod 5. It's just started happening in the last 4 months (has been on O5 for a year now). He has had 5 lots of antibiotics in the last 4 months - 2 lots in the last 3 weeks, which is obviously not sustainable. His team have pushed for a dermatology review but the waiting list is 4 months, he tried a pump break (but hated it so went back on O5). He doesn't seem to have problems with the Dexcom (although that's another thing - they never last more than 5 or 6 days - it's like his body rejects them).

Any suggestions gratefully received! Thank you
 
Hi. Sorry to hear your son is having problems. Does it look like a reaction to the adhesive or the cannula itself? What have you tried so far other than a pump break?
If it is the adhesive, have you tried under patches or a barrier adhesive like Skin Tac?
If it is the cannula, then I think you may need to explore other pump options.
Which insulin does your son use? I believe Fiasp has a tendency to cause some people what they refer to as "skanky sites"

I think figuring out what part of the system is causing the problem will be key to finding the solution.

Can you take and post a photo of a typical infected site so that people can perhaps relate to it and suggest appropriate solutions for it.
 
Sorry to hear that @Mole Are the infections on the surface of the skin, so to speak, or is it the cannula sites becoming infected - ie deeper in the skin? Pump users are at significantly higher risk of such infections, potentially leading to abscesses. I sometimes use a special spray after I remove my cannula. It’s called Dettol Wound Wash.
 
Thanks so much for replying. So it's in/on the skin with raised red site all around the cannula insertion point, often with pus from the insertion point and then it develops into cellulitis - so very much an infection rather than a reaction, if that makes sense. We are being incredibly assiduous in hygiene prior to putting them on and he has been treated for staph infection in case that was causing it.

Often times we don't know it's infected until we take the pump off - or it feels infected so we remove it, so it's too late to do anything to prevent it.

His team have mooted a new pump, but would that stop the infections? I don't know - I guess it's a wait for dermatology. I just wondered if anyone else had any experience with this.
 
Yes, I had an abscess @Mole which is why I use the wound wash spray. That was a few years ago and with my previous pump. It was very unpleasant.

Where is he putting the Omnipod? Has he tried changing the pods earlier than 3 days?

I obviously don’t know if a new pump would stop the infections but if he wants to carry on pumping, it’s definitely worth a try. The beauty of a tubed pump is that you can choose different cannulas so can find what suits him best, so I’d suggest that if it were me. If the infections are getting him down (physically and mentally) he could take a pump break and go back to injections for a few weeks or months. That might be an idea too. I’ve done that a few times in my 20+ years of pumping and it can help.
 
Inka said:
Yes, I had an abscess @Mole which is why I use the wound wash spray. That was a few years ago and with my previous pump. It was very unpleasant.

Where is he putting the Omnipod? Has he tried changing the pods earlier than 3 days?

I obviously don’t know if a new pump would stop the infections but if he wants to carry on pumping, it’s definitely worth a try. The beauty of a tubed pump is that you can choose different cannulas so can find what suits him best, so I’d suggest that if it were me. If the infections are getting him down (physically and mentally) he could take a pump break and go back to injections for a few weeks or months. That might be an idea too. I’ve done that a few times in my 20+ years of pumping and it can help.
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Thanks Inka - yes he tried a break and hated going back to infections - he lasted 3 days. Being 15, he eats a lot throughout the day and was fed up with constant injections. We will discuss a new pump with his team and see what they say. It's really annoying timing as he has other things to be thinking about! (GCSEs coming up this year among other things!)
 
As you already prepare site prior to applying pods, has a change of insulin been suggested?

Some pump users, for whatever reason get a reaction to some insulins over 3 day insertion period, by switching it can sometimes eliminate problem.
 
@Tom1982 tbis sounds similar to your little one.

I’ve had a few red side sites and brown r/ red discharge with mine but nothing this extreme.

I had a box which seemed to have a few in which caused me issues but it hasn’t happened recently.

I’ve heard of others who just can’t get CGMs to stick with their skin.

I’ve not really got another solution apart from suggesting another type of pump, there’s another patch up out there but I can’t remember the name. Ask his team what they have on their list, you can request another but they might not have the support set up for you if it’s not on their list already.

I don’t think I would keep battling with the Omnipod if I kept having these issues. I do like it a lot but it’s about balance and it doesn’t sound like it’s right in his case. Tubed might be the way to go.
 
Yeah this sounds very similar to what’s been happening to Jo. I think (and I’m sort of guessing here) her body rejects the cannula material and as a result it doesn’t fully close up around it. So big doses seem to spill back out and cause all the issues that go with that. We’ve had some success breaking bigger doses down into two or three separate doses. Keeping them under 3 units seemed to help. Maybe have a bash at that? Really frustrating isn’t it!
 
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