Written By: ADCES Staff. Supported by an
educational grant from BD
Just as we rotate and change the tires on a car to prevent uneven tread wear, flats and dangerous blowouts, we must rotate pump infusion sites to prevent skin problems and uneven insulin absorption.
Infusing insulin into the same spots repeatedly can cause lipodystrophy—a breakdown or inflammation of the fat tissue below the skin. When this happens, the skin can either dimple or become unusually hard and insensitive. These spots tend to have reduced blood flow, and insulin does not absorb properly—if at all. In some cases, they can also be unpleasing to the eye. Rotating sites evenly over large areas of skin will help prevent the development of lipodystrophy and allows for consistent insulin absorption and action. Given that it may take years for lipodystrophic tissue to heal (if it heals at all), it is well-worth taking the steps necessary to prevent the problem in the first place.
First, know the best locations on the body.
Choose these areas:
Avoid these areas:
Second, Rotate Sites Among Recommended Body Parts
Rotating sites in an organized fashion is the best way to prevent site overuse. Simply going from right side to left side repeatedly may result in overuse of sites before they have a chance to fully heal. Instead, stay on one side of your body for several site changes, moving just a couple of inches each time – 2” minimum for angled infusion sets, 1” for 90-degree infusion sets. Keeping the old infusion set on the body can serve as a good reference point for placing the new infusion set. For example, when placing infusion sets on a large body part such as the abdomen of a heavy adult, a 4 x 4 pattern can be used:
Once all sites on both sides of a body part have been used, the individual may repeat the process on the same body part or move to a different body part.
To avoid using infusion sets longer than their intended duration, consider the following:
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This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your diabetes care and education specialist or healthcare provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. To find a diabetes care and education specialist near you, visit diabeteseducator.org.
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