Finding New Sites

Using an insulin pump has many, many, many advantages. It also has it’s disadvantages. One of which being potential scar tissue if the sites are not properly rotated as they should be.

When I started on an insulin pump almost 13 years ago, the infusion set I was given was the Accu-Chek Tender. It’s the one that’s similar to the Minimed Silhouette or Animas’ Inset 30, except it’s manually inserted. And for some strange reason, they started me off on the longest length. I mean, I know I was chubby, but come on! Anyway, I hated changing them out, so I would use them to the max, which by my definition meant either until they were falling off or until the area around them started to turn red… easily 6-7 days, mostly when my insulin cartridge ran out.  And I always wore them on my stomach because I simply couldn’t muster what I needed to put the site anywhere else.

Fast forward til now. Those areas are pretty well done. If I use them, I can only wear a site for about two days and I no longer get good absorption, if any at all. If you take a two-inch-wide band and run it around my stomach where my belly-button is, that’s the area I used. Nothing higher, nothing lower (mostly because I’m short-waisted). I had been using the top/side of my butt or the top/side of my thighs for sites, but I notice that my absorption isn’t great there either, but certainly not as bad. It’s just not what it used to be. So, to try to give them a rest, I decided to try other areas.

Site Rotation Areas

From Tandem’s User Guide

The chart above is pretty universal between insulin pump manufacturers. So, to rule out a few areas, just visualize a belt round the middle of the waist the width of that circle that’s around the belly button, as well as marking off the thigh/butt areas too. What’s left is the upper/lower abdomen and my arms. While I could use my arms, I don’t like to use them during the summer because I get all of the “OMG – WHAT IS THAT?” or “What did you DO to yourself?!?” or “What medical tests are you having done??” questions. So what does that leave me? Yep, the top and bottom areas of the abdomen.

I am used to using the longer 9mm canulas for my infusion sets. They always seemed to work better for me. But this last shipment that came was all 6mm. Rather than call the company, pay for return shipping, and all that other mess, I decided to use what I could of them for the “new” areas. Granted, I don’t really have a “lower” abdomen as shown there (I mean, seriously… is that normal to have that much space between your belly button and whooha?), but I do have about that amount of space above the belly button, but I’ve been too chicken to try it with the Insets. The memory of sweaty, shaking hands and passing out on my floor from trying one that high when I was younger just doesn’t make placing one there enticing. But I tried it with these short sets and whatdoyaknow? I actually liked it there. Now, it’s one of my go-to areas.

So, I have use for those 6mm sets now. I need to find other good areas to place them too so that I get good absorption and not overuse the upper abdomen. Any ideas? Do you use any “off-label” places for insertion?

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4 Comments

Filed under dblog, Diabetes

4 responses to “Finding New Sites

  1. laosita

    I don’t have the pumping experience that you do (or not even close- about a year), and I can’t imagine giving my shots in the some of the places I place my infusion set now.
    Thanks to CsLifewithD, I tried side-boob. Zero pain insertion and I love the site! It stays out the way and I almost forget about it (granted, I’m single). This week I’m trying upper calf – kind of to the outside of the bottom of the knee. So far it seems to be working! I wouldn’t do that in summer though. (Your Diabetes May Vary- always follow FDA guidelines…uh). Good luck!

  2. Denise Bricher

    Pain, swelling and redness around an infusion site indicate indicate that there is an infection going on. It’s always a good reason to change the site immediately. I’ve been pumping since 1982 and have had 2 serious site infections, one of which landed me in a hospital connected to an antibiotic drip (Well, OK, my A1C at the time was 13-something!). Rotating sites is a good way to let the tissue recover from the foreign substance (insulin) that invaded it (was injected). Back in the ’60s, I used my legs almost exclusively. Granted, this was in the days of the old beef-extract, zinc-filled insulin and syringes were glass with metal needles that developed hooks as Mom and I used the same ones over and over again. I still hesitate to put anything into my thighs… hurts too much, even after 40+ years.

  3. I cannot go above the belly button – it hurts too much for me! My favorite sites are on my thighs. My arms get good absorption but I also don’t like all the questions and weird looks I get from those. I want to try pinching up a small bit of fat on my lower back and doing a site there but I can’t figure out the angle to do it alone and my hubby is a little squeamish about putting a needle in me unless its for an emergency.

    • sarahkaye

      Try sort of leaning back when you insert a lower-back site. If you have any fat there, it causes it to roll together and form a better “cushion” for the site. Otherwise the skin may be too tight and it may hurt a bit. 🙂

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