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Mobile Infusion Set Site Change

Eric Lagergren

February 18, 2010

A person with diabetes who’s tasked with writing an entry each week about his life with Type 1 diabetes might, at certain times, have those days when finding something to write about seems extremely difficult. Diabetes writer’s block, maybe? Or a creative roadblock in which the vast well of material that diabetes offers seems to have dried up.

Rarely is this the case with me. However, yesterday evening as I drove home from work contemplating what it was I’d write about, I peered into that diabetes well, dropped a few pebbles, some stones — anything that might elicit a splash — and got bupkis.

That is, until a few hours later when Kathryn and I were setting out to walk to the Corner Brewery for some microbrews and Wednesday evening conversation with good friends.

Typically when I have a series of high blood glucose readings, one of the usual suspects is the bad infusion site. An infusion site, for those of you who aren’t insulin pump informed, is the place on my body through which the insulin is delivered at a continuous basal rate throughout the day, as well as where the bolus amount of insulin I need prior to meals is infused. Here’s a picture of someone’s infusion site so that you have a visual. (Please note again that this isn’t my site. That’s not me. I believe this person is female. I am not).

Once I explore other variables and possible reasons for a high blood glucose and determine that all things diabetes-related are (for the most part) constant, I proceed to the supposition that my numbers might possibly be caused by a malfunctioning medical device. I assume, or hope, it’s something as simple as a bent cannula, a clogged cannula, or maybe just somewhere that the insulin, once entering my body, isn’t taking. In short, the insulin can’t work because it can’t get in. Thus the higher blood glucose.

Earlier yesterday, while at work, I changed my infusion site due to a series of high glucose numbers over the previous day. This new site placement was higher on my abdomen than usual, about an inch north of my belly button and to the right about three inches. There is less fatty tissue there, and I hoped that particular site remedied the high numbers.

By evening, by the time we were headed out the door to walk the three blocks to the brewery, the discomfort at the new site had become pretty pronounced. Halfway down the block I complained to Kathryn that it hurt, and that maybe I’d just infuse a small bolus of insulin in anticipation of a snack I’d have at the brewery and then rip off the irritating site and go it pumpless for the next couple of hours.

Kathryn was curious about just how much pain I was in. I wasn’t doubled over, but it hurt, and that hurt was constant — it was as if a wasp or bee had gotten into my shirt and kept stinging, constantly, in the same place. (For you smart alecks, yes, I do know that a bee can only sting once!)

Kathryn said she had an extra infusion site in her purse. I had forgotten she often carried one of the Cleo sites with her, so I said that yes please, I’d like that. I immediately ripped off the old site as we were walking. We were about a block from home, of a winter evening, during twilight.

I took the new set from Kathryn. The device looks like this with the cap off; you can see the needle behind the purple plastic, and it’s that needle, sheathed in the cannula, that plunges into the skin, deposits the cannula subcutaneously, then retracts quickly leaving only cannula and the circular adhesive base on my belly. To this little nub that protrudes above my skin is where I attach the insulin pump reservoir surgical tubing.

I slid the device under my shirt, found a suitable location lower on my abdomen on the other side, and plunged it in, all the while maintaining my pace on the sidewalk. After ten or fifteen seconds, after allowing the adhesive to adequately stick, I eased the application device from beneath my shirt, leaving behind a new site. Then I reattached the tubing from my insulin pump, and we continued on to the brewery, all without breaking stride.

And I was pain-free!



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