Sunday 11 March 2012

Uncharted territory

Site rotation, or moving the cannula around to a new area which has not been used for a while, is a really important part of diabetic management, particularly on an insulin pump.  Why?  Because every time we insert a cannula into the skin for three days to allow for insulin to enter our bodies, we are literally inserting a foreign body into our skin that our immune system will attempt to get rid of.  And it does that through the means of infection and scar tissue.  So kind of my body's immune system to get rid of foreign bodies, which I only have to put there because that very same immune system destroyed all my insulin producing cells.  Thanks for that, body!

Anyway, an infected site looks a little like this:

This photo was swiped from someone else's blog because unlike this rather svelte waistline, I would rather steal than get my wobbles out. But back to the point, it shows what the body can do in just a few short days.  If it were just for some short-lived discomfort, infected cannula sites really wouldn't be that big of a deal.  The problem is in the short term, infected cannula sites cause blood sugar swings, thanks to the body being insulin resistant when an infection is on board.  In the long term, and this is the more worrying for me, the sites become scarred and eventually all but useless for insulin infusion, causing massive problems with management.

Most pancreatically pants people have rules about how long we will use each site; some people go below the maximum of three days while other observe strict rotations, making sure they don't go back to a site for at least two weeks.

In general I only use my arms and 'love handles' (there is a benefit to NOT having a svelte waistline, you know!) because I find these sites the most reliable, the least painful and I have never had a kinked cannula using those sites.  But site rotation is something that does worry me because I want to be able to reap the benefits of insulin pump therapy for years to come.  Unfortunately though, I have never had much luck using my stomach with 6 millimetre, 90 degree insertion (some cannulas come with 45 degree insertion) and when I have used them 9 times out of 10 the cannula kinks at the very beginning, resulting in no insulin getting in and inevitable high sugars.  But I realised yesterday that I have never tried to use the lower part of my stomach.

Why?  No idea.

Challenge?  Count on it!

Today was cannula change day and in true stubborn form, I decided to go into uncharted waters and have a go.

So far things are good; no kinks, no pain and my other sites are grateful of the site rotation.  It is a strange feeling getting used to a new site; almost like the first time I ever wore a cannula.  But other than being acutely aware of where it is, my body seems to have no objection to it, yet.

I will be sure to keep you informed!


  1. Wishing the best of luck to you!! I cannot use my abdomen at ALL due to serious pain. I use the sides of my butt/hips, love handles and lower back. I too worry about running out of areas to use in several years. I find the variety of spots of the sides of my butt to be the best, just be sure to use something to keep them stuck down, they are easy to rip out there. I use infusion set IV3000 or Opsite Flexfix.

  2. Thanks Megan! The second one unfortunately kinked so will try again to the other side as I feel it could have been too close to the hip. It wasn't actually kinked when I pulled it out although it clearly didn't like being there.

    Thanks for the tip about the other areas, will try those too!