Marks where my infusion site was

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EricW2004

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Type 1
Hi everyone. I use a Tandem TSlim with 30 degree soft infusion sets. I have a lot of muscle and not much fat in my stomach. After most infusion set changes, I have a red mark on my stomach where the canula was. Sometimes it bleeds and I get a big bruise. More often than not, it creates a bump that's sore for days. I often feel the infusion site sting. Is this normal? I asked the diabetes nurses at the clinic I attend, they have nothing to offer.

Sorry the photos are not pretty but this is what it looks like after I change a set
 

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Sorry to read of your problems.
i am afraid I don’t have many ideas but I wonder if the stinging is from the infusion set or your insulin. I know quite a few people have commented on Fiasp stinging and a few less commenting they experienc something similar with NovoRapid.
Would you be able to trial a different insulin to discount this?
 
Welcome @EricW2004 🙂 Those look uncomfortable. Do they itch? I’m wondering whether the adhesive is contributing to the redness? Do you use an alcohol wipe prior to inserting the cannula? Also, have you tried inserting by hand? I have a different pump but I insert all my cannulas by hand. I also pinch up as I haven’t got much fat on me.

I do get an occasional bruise, but that’s rare and when I catch a small blood vessel.

@helli ’s suggestion is good, and I think you’re going to have to go through a process of elimination to sort this - eg adhesive, insertion, insulin, catching or pressing the cannula once it’s in, trying a different cannula type, etc etc

@everydayupsanddowns uses the Tandem so might have more specific advice.
 
Ouch! Those look sore @EricW2004

I’ve only ever had a few slightly tender 30-degree cannulas on Novorapid (though when I tried Fiasp that did sting and leave sore sites).

I usually have a small red dot after site change, but I don’t expect it to be tender - unless I’ve knocked the site or it has got a bit sore going in.

Hope it isn’t a reaction to the cannulas (or the lubricant on the teflon etc) - have you considered trying a steel cannula?

I’m not sure there are all that many alternatives. most pumps seem to use a bespoke connector unfortunately.
 
helli said:
Sorry to read of your problems.
i am afraid I don’t have many ideas but I wonder if the stinging is from the infusion set or your insulin. I know quite a few people have commented on Fiasp stinging and a few less commenting they experienc something similar with NovoRapid.
Would you be able to trial a different insulin to discount this?
Click to expand...
Hi thank you very much for the suggestion @helli . I think because the marks vary significantly from one application of the infusion set to the next, whereas the insulin (Novorapid) is constant, I don't think it can be the insulin.
 
everydayupsanddowns said:
Ouch! Those look sore @EricW2004

I’ve only ever had a few slightly tender 30-degree cannulas on Novorapid (though when I tried Fiasp that did sting and leave sore sites).

I usually have a small red dot after site change, but I don’t expect it to be tender - unless I’ve knocked the site or it has got a bit sore going in.

Hope it isn’t a reaction to the cannulas (or the lubricant on the teflon etc) - have you considered trying a steel cannula?

I’m not sure there are all that many alternatives. most pumps seem to use a bespoke connector unfortunately.
Click to expand...
Hi thanks for the kind remarks @everydayupsanddowns . I box (but I don't do sparring anymore, because of the pump!) and also sprinting up the stairs in my flat stairwell to keep fit. I find that the soreness is more common after those exercises. So the fact that you get tenderness when you've knocked the site is consistent. The reaction is worse after I'm doing sports. I've been looking for advice online for how to tie the cabling so it doesn't tug while I'm doing the activity. Do you have any suggestions.
I should have said in my post, it really varies from one infusion application to the next, so I don't think it's a reaction to the cannula. Unfortunately the steel cannulas offered by Tandem are too long for me.
How long do you think your red dots last after you change the infusion site?
 
Inka said:
Welcome @EricW2004 🙂 Those look uncomfortable. Do they itch? I’m wondering whether the adhesive is contributing to the redness? Do you use an alcohol wipe prior to inserting the cannula? Also, have you tried inserting by hand? I have a different pump but I insert all my cannulas by hand. I also pinch up as I haven’t got much fat on me.

I do get an occasional bruise, but that’s rare and when I catch a small blood vessel.

@helli ’s suggestion is good, and I think you’re going to have to go through a process of elimination to sort this - eg adhesive, insertion, insulin, catching or pressing the cannula once it’s in, trying a different cannula type, etc etc

@everydayupsanddowns uses the Tandem so might have more specific advice.
Click to expand...
Thanks @Inka for all those suggestions. They don't itch so probably not the adhesive. I'm not using alcohol. Should I? I've never even considered inserting the canula by hand. What's the advantage of that? The reaction is worse after I'm doing sports. I've been looking for advice online for how to tie the cabling so it doesn't tug while I'm doing the activity. Do you have any suggestions.
 
EricW2004 said:
@Inka yes it could be, I sweat very hard when I exercise. How would I know it was sweat, do you think?
Click to expand...

By process of deduction - keep a diary and jot down site issues along with exercise and anything else that you think might be implicated. Hopefully you’ll see a pattern. With a previous pump, I sometimes had red patches on my tummy under the adhesive and I worked out that sweat was making it worse.

For the tubing, you can use something like Micropore tape to tape it down eg in a ‘protective loop’ on your tummy so any tug doesn’t go straight to the cannula. I don’t bother now because I have nice quality tubing that behaves so I just tuck in into my underclothes if needed. Also, watch the length of tubing you’re using. There is a ‘Goldilocks length’ that will work best for you.
 
Also, for high-contact sports, I tend to remove my pump so that’s another option for no tubing issues.
 
EricW2004 said:
Hi thanks for the kind remarks @everydayupsanddowns . I box (but I don't do sparring anymore, because of the pump!) and also sprinting up the stairs in my flat stairwell to keep fit. I find that the soreness is more common after those exercises. So the fact that you get tenderness when you've knocked the site is consistent. The reaction is worse after I'm doing sports. I've been looking for advice online for how to tie the cabling so it doesn't tug while I'm doing the activity. Do you have any suggestions.
I should have said in my post, it really varies from one infusion application to the next, so I don't think it's a reaction to the cannula. Unfortunately the steel cannulas offered by Tandem are too long for me.
How long do you think your red dots last after you change the infusion site?
Click to expand...

I was thinking about your post earlier, while doing a set change, so managed to grab a pic of my old site next to the new one.

1636053290585.jpeg

I would expect that little dot to heal over the next 2-3 days, and fade to almost nothing within approx a month. You can see slight scar marks from 5 ‘sites’ ago just beneath my current row - which would be 15 days? I tend to run 3 rows of 4-5 sites around my sides and back, then swap sides. By the time I swap sides it’s a month or more since that area was last used, and by then the ‘dots’ are pretty much invisible.
 
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