Infusion Site Issues

[sleepyheadzzz]

I've mentioned this a couple of times on here, but I've been having some really frustrating infusion site issues for the past couple of months (23 weeks currently). I've been a pumper for 15 years, primarily using my stomach, but at the beginning of my pregnancy I started to use more sites around my back, higher on my stomach, etc with no issues. Around week 14 I started taking aspirin and I think (but am not certain) that's around the time the issues started to get worse but most stuff I read indicates such a small amount of aspirin shouldn't make a difference.

I use the 6mm quickset infusion set and for every time I change the site I have to use 2-3 sets before I find a spot that works. Usually I can tell when I've hit a bad spot because it's quite painful and when I pull out the bad site there's blood. Now pretty much every site I pull out has at least a little blood, which has never happened before. Sometimes the site feels totally fine, like earlier this evening, but an hour later my sugar is up to 16-17 and I have to change it again and hope the new site works. The only sites that seem to reliably work are my upper stomach to my sides, but it's hard to move them around with so little space. My legs, back, upper bum, and lower stomach seem like they're no goes despite working fine at first.

I see my OBGYN Thurs so I'm going to ask if I should try stopping the aspirin (I was talking it as a preventative measure for possible preeclampsia) and I see my endo again next week and I'll be asking her if she has any ideas. I really don't want to try switching back to needles after 15 years but I'm getting increasingly frustrated.

So have others had these issues? Any ideas? Different infusion sets? I'm just trying to test like crazy when I change the site but it's hard to catch the spike sometimes. This is definitely something that started after I got pregnant and I doubt it's just a coincidence.

 

[himtoo]

Hi there
as I have read loads on this and other forums ( am a bloke so not experienced it ) one of the things that gets mentioned a lot is that insulin needs can go through the roof at around the 14-18 week period and not come back down to normal for ages
could this be a cause rather than bad sites ??

it is definitely worth speaking with your midwife and endo team ASAP though

keep us posted on how you are doing

 

[azure]

I took aspirin and I don't think it made my blood sugars high. I did have highs but assumed it was just hormones.

The fact so many possible sites don't work is worrying. Have you tried a different set? I had to go onto Rapid Ds for my bum after Tenderlinks stopped working. If I was you,mid experiment with different sets and cannula lengths. Remember your body fat will change during pregnancy so that might be contributing.

But the insulin resistance caused by pregnancy does come on very suddenly and that might explain the lack of working sites. Are you adjusting your basals regularly? By the end of pregnancy, mine had almost tripled! My boluses increased hugely too. Some of these changes happened in a few days.

But I'd investigate different sets first, if it was me because it appears some places do work ok.

 

[sleepyheadzzz]

Hi there
as I have read loads on this and other forums ( am a bloke so not experienced it ) one of the things that gets mentioned a lot is that insulin needs can go through the roof at around the 14-18 week period and not come back down to normal for ages
could this be a cause rather than bad sites ??

Unfortunately it's definitely site issues - my needs have increased, but I can tell this is insulin not getting absorbed - which I used to get occasionally but never like this.

I took aspirin and I don't think it made my blood sugars high. I did have highs but assumed it was just hormones.

The fact so many possible sites don't work is worrying. Have you tried a different set? I had to go onto Rapid Ds for my bum after Tenderlinks stopped working. If I was you,mid experiment with different sets and cannula lengths. Remember your body fat will change during pregnancy so that might be contributing.

But the insulin resistance caused by pregnancy does come on very suddenly and that might explain the lack of working sites. Are you adjusting your basals regularly? By the end of pregnancy, mine had almost tripled! My boluses increased hugely too. Some of these changes happened in a few days.

But I'd investigate different sets first, if it was me because it appears some places do work ok.

It's not that I think the aspirin is making me go higher, but I'm wondering if it's making me have increased bleeding contributing to the bad sites - but from what I've read that doesn't sound very likely anyway because it's such a low dose.

I was hoping someone on here might have a recommendation for a different set but I may just have to experiment on my own. I'm using a 6mm set right now but it almost seems like even that short length is going too deep, which also seems counter-intuitive with the extra pregnancy weight.

While I have been increasing my rates, I can tell this is a site issue because I go sky high 1-2 hours after a new insertion and that's the only time - once I change out the site and find a spot that works the issue is 100% resolved and my sugars go back to normal. I'm at the point where having to change my site is becoming really stressful once I've found one that works well - of all the pregnancy diabetes issues to deal with, this is not one I was expecting.

I've tried googling this issue a lot but it doesn't seem like a problem a lot of people have run into - I was hoping someone else might've run into the same thing.

I'll have a chat with my dr's over the next week and see what we can come up with.

 

[himtoo]

don't give up hope of help on the forum yet -- sometimes topics can take a day or 2 to gain the needed momentum for the right people to see them
i will tag a couple of pumpers that may know or may know even other pumpers that might be able to help

@donnellysdogs ( brilliant lady !! ) @CarbsRok ( and another ! )

 

[CarbsRok]

Can only suggest you use different types of cannulas for different spots, there are Teflon or steel cannulas plus angled sets to try so ask your pump company for a collection of them to try.

 

[azure]

I used different sets for different sites, and I have slightly different basal rates too.

I know how frustrating site problems can be, and they're a thousand times worse when you're pregnant. I encourage you to try different sets. Stainless steel straight in ones solved my absorption problem.

Also, do you rotate site areas? Could some of your sites be getting 'used up'?

 

[sleepyheadzzz]

I used different sets for different sites, and I have slightly different basal rates too.

I know how frustrating site problems can be, and they're a thousand times worse when you're pregnant. I encourage you to try different sets. Stainless steel straight in ones solved my absorption problem.

Also, do you rotate site areas? Could some of your sites be getting 'used up'?

I'm going to call minimed today and see if they can send me a sample of the different infusion sets - I hadn't thought of that.

I do rotate area's, but oddly, the sites that are working the best are the ones I've used the most over the past 15 years. The ones I just started using around the time I got pregnant, which worked great at first, are now the ones that I can't seem to use at all. So bizarre.

Did you find you could feel the stainless steel ones more? I've always been a bit put off by the idea of them, but did you find them just as comfortable?

 

[azure]

I never fancied the steel ones either - in fact that was the first thing I said when I got my pump! But they're absolutely fine. I can't feel them (got them in my bum). The only thing that's different is you have to remove them more carefully than the Teflon cannulas.
They're easy to put in and there's no big insertion needle.

They've been a godsend for me. My absorption issues were stressing me SO much.

 

[tigger]

I've got lots of threads running on the pump forum about infusion sets as I only got a pump when I was 10 wks pregnant. I also started aspirin around the same time.

I had a lot of problems with the quicksets and am now using silhouettes and sure-ts (the steel ones). I like both although still have some issues. My major issue with the steel ones is not how they feel but the lack of stick. I've hopefully solved that now with a new technique for insertion. According to the pumping insulin book your basal rates can change every 7-10 days in pregnancy which is an awful lot of basal testing

Good luck!