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redness around canula site

johnpol

Well-Known Member
Messages
919
Location
Consett
Type of diabetes
Type 1
Treatment type
Pump
I have been on the pump for nearly three years now and it is brilliant, it has changed my control immensely, but the last few weeks I have been developing redness around the canula site after just a day. I do a full set change every two days because of the amount of insulin I have to use (240-280 units a day), I'm just wondering out loud if the amount of insulin is irritating the site, which has never happened before. And before anyone mentions it yes I know that it is a vast amount of insulin, but I am massively resistant to insulin, even when I retired from strength sports and lost a lot of weight I was still in the 200iu club ( must be just me). I was wondering if I should try daily canula changes? but this would increase my infusion set needs. The sites don't hurt as such they just feel hard underneath. It is a bit of a quandary. I see my Consultant in a couple of weeks and I will be bringing it up with them.

The only other possible solution is go back to daily injections to rest the sites???? Sorry for going on.

Take care everyone.
 
Sorry to read about your problems.
I have a few thoughts

- you say you have redness "around the cannula site". I think someone else experienced something similar and worked out it was caused by the alcohol wipes they were using: nothing to do with the cannula. Are you using any wipes to clean the area before inserting the cannula.
- Do you rotate your sites? You say the sites feel hard which suggests you may be returning to the same site and building up scar tissue. Have you tried inserting your cannula somewhere else such as on your back or upper thigh?
- If you try daily cannula changes, do you need to change your cartridge? It is certainly possible for my pump (Animas Vibe ... no longer available) to just change the cartridge or just the cannula (although I change them in parallel).
- How do you remove your cannula? When I was younger, the way to remove plasters was always a quick yank. But nowadays, that does not seem to be the way to do it - a slow gentle tug with lots of water (e.g. in the shower) seems to reduce the chances of welts appearing from the stickiness.

Or it may be a problem with the amount of insulin as you suggest.
Or is may be something else - I wait with baited breath to learn from the pump gurus.
 
If you can get reassurance that the redness isn't causing any damage or discomfort then it might not be a big issue.....

where are you using currently....

I know that I almost always have a mark when its time to rip the old one out.......

I would think going back to injections is extreme, especially if its not effecting the insulin delivery.......does the pump not help out with something the injections cant achieve?
 
Sorry @johnpol I know nothing about such high TDI (my total is around 21units). I also change my set every 2 days, due to high BGs on the 3rd day. I remember things weren't going so well months after starting the pump and I asked my DSN if I should change my cannula every day. She said I would be as well going back to injections, rather than have daily set changes. I don't know if this would be due to cost or due to other problems.

I persevered with changing sets every 2 days and things settled down nicely.

Have you tried varying your sites more? By this, I don't mean necessarily e.g. changing from tummy to legs. You could try that too but what about using e.g. parts of tummy you don't normally use (the edges of usual sites rather than the parts that may be easier to reach).

I take it you haven't changed your insulin relatively recently.

I don't like the sound of hardness under the cannula. Maybe it is something to do with your TDI but it could possibly have something to do with using the same sights too much. Why not ask your DSN? If she's anything like mine she'll get back to you before you see your consultant.
 
Thanks for the input, I do change my sites every time, right side abdomen, left thigh, left abdo, right thigh avoiding any residual marks from previous use. I have never had the redness before, and the hardness underneath the skin could be scar formation, but when I spoke to my DSNat the beginning of Feb, she suggested it could also be volume going through the canula, never make things easy for myself!!! on removing the canula I find a good yank works every time. I am due for my review soon so will be looking for their advice. The pump seems to be working, Medtronic 640G 3ml one, just can't seem to understand why the redness around the sites.
 
Maybe some barrier cream might help.....

My site preference is upper thighs and there's marks all over them.....

but not noticeable hardness.....think I have been quitter lucky in that respect....

what size of needle is being used....maybe reduction may also help...

you could give you buttocks a go too by the way......can present challenges during lavatory visits but you can adjust to it..lol
 
Might give the old buttocks a go, and see if it sorts out what is going on. I still think that the hardness is just down to the volume of insulin, again I'm open to other possibilities as to what could be causing it. I can't remember off hand what size the canula is, I will have to check when I get home, The wife says it resembles a harpoon!! Unless she's implying I look like a whale!!!!
 
Also could try LiftPlus to ease the removal of the cannula, I sometimes find if they have stuck really well that I get a red patch on removal. LiftPlus wipes are available on prescription (Ref 5502).
 
Chas C said:
Also could try LiftPlus to ease the removal of the cannula, I sometimes find if they have stuck really well that I get a red patch on removal. LiftPlus wipes are available on prescription (Ref 5502).
Click to expand...
Thanks I will look into them, much appreciated
 
Hi @johnpol get hold of some Calvon spray, it forms a barrier on the skin, works great at preventing redness in the skin.
 

Hi. I am a pumper of 7 years (on my 2nd Roche Insight) but do not have these problems. I am posting this article by Dr Bernstein who is somewhat anti pump in the hope that it might give you some ideas. I very much hope that these can be overcome as you are finding your control is so much better with it. Just being nosy, why are you so insulin resistant at this stage?
http://www.ladalife.com/2010/12/dr-bernstein-anti-insulin-pump/
 
Hi @johnpol forgot to ask what sets are you using ?

I ask as I was using mio sets and getting lumps, soreness and red marks which would last days, the Cavlon worked but it was still irritating me due to the plastic, so changed to sure t's and change sets every 2 days, I still get soreness from time to time but much better than the mios.
 
I have been insulin resistant about 2yrs after diagnosis, so for about 19yrs, as my weight fluctuates and my training varies so does my insulin resistance but have always had a heavy need for insulin
 
I am using the silhouette canula since I started on the pump, but this is the first time that I have ever had the redness around the site. Thanks for the info regarding the Cavlon spray, it is much appreciated.
 
johnpol said:
I am using the silhouette canula since I started on the pump, but this is the first time that I have ever had the redness around the site. Thanks for the info regarding the Cavlon spray, it is much appreciated.
Click to expand...

Contact Medtronic and get a supply of Sure-T cannula sets, they are steel and you manually insert, they are very easy to insert but reduces the lumps/redness so using these with Cavlon will reduce the site issues greatly, I use Sure-T's and they are much better.
 
I have tried the sure - t but I didn't like them, especially for my work and training, the flexible type suited me, but I might try them again as I have a box of them in the cupboard (and still in date) thanks for the advice
 
When I asked Medtronic if they could let me try the 6mm Mio, as the 9mm had started hurting on a couple of sites, I was told I would have to get permission from my DSN first.
 

How much insulin is going in when you bolus.....?

The way the pump delivers the insulin allows for much better and efficient absorption, so it shouldn't, under normal circumstances, be gathering at the cannula site....
 
novorapidboi26 said:
How much insulin is going in when you bolus.....?

The way the pump delivers the insulin allows for much better and efficient absorption, so it shouldn't, under normal circumstances, be gathering at the cannula site....
Click to expand...
It depends but it averages out at 30ius a bolus, regardless of what is being eaten at the time, I did manage to get it down to under 15ius but it was the case of not eating at all!! it seems that if I even look at food I need insulin, but I have been like it for years. On average my carbs range from 25gms to 60 gms a day I love salads and bacon and eggs, would love a bacon sandwich, but I need around 60ius for the bread alone. So I'm a bit complicated, ha ha. If I am eating just protein and fats I need to bolus for them too, that can be 19ius up to 30ius. when I was doing all the work with the dietician it was flagged up that I required a bolus for protiens and fats, its turned everything in to a bit of a nightmare, but after discovering this my control has improved ten fold
 

you need what you need I suppose.....

does the pump not have a maximum bolus...? I think some settings need tweaked to get a 30 unit bolus...

what's your largest basal rate out of curiosity...?
 
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