I’ve had diabetes for almost 20 years. Of those twenty years, I have had my insulin pump almost as long, getting it in 1997 or 16 years. For sixteen years, I have been putting my infusion set into my stomach and rotating sides. I usually stuck pretty close to the center of my tummy, obviously avoiding the area closest to my belly button. I did this for fifteen years. It wasn’t until I got my continuous glucose monitor (CGM) that I had to start thinking outside the box. Although for me, I didn’t go too far outside the box, I went a little farther out on my stomach. I have read lots of blogs where people have been putting their infusion sets and CGMs in the arms or legs or bottom, but I haven’t built up enough courage to give that a try, so my stomach keeps taking the brunt of it all.
For sixteen years, I never thought that I had any scar tissue built up from my many set changes. Doing math, I realized that I’ve done close to 2,000 site changes, changing it every 3 days (don’t laugh at my lie-this # is purely for calculation reasons) for 16 years. I’ve heard other people talk about their tissue build up and how it affected their insulin absorption but I never thought it applied to me. UNTIL this past weekend.
As I said above, I normally insert my infusion set on the outer area of my belly and I save my inner belly area for my CGM. Well this past Friday, I was do for a new CGM and infusion set change and they were to be on opposite sides of my stomach. Because they were going to be on opposite sides and I didn’t need to save room on my infusion set side for a CGM change (because I change my CGM every 6 days but my infusion set every 3-if that makes any sense), I decided to put my infusion set closer to my belly button than I normally would.
Well, Friday night my blood sugars stayed in the 200’s. Normally, I wake up high around 2AM (something I need to talk to my doctor about) and I bolus for a high and I end up dropping down to about 80 by the time I wake up around 7AM. On Friday night, I did my normal correction bolus but I didn’t drop down very low. I think I went down to about 150 so I ate breakfast, bolused for both the correction and for the meal. I was heading up to DC on Saturday and because my infusion set site wasn’t working too well, I stayed high during the drive which was not fun when the alert went off. I was going up for a baby shower and when I got there, I tested my blood sugar and I was still high, so again I bolused for the high then went to the shower. At the shower, I ate all sorts of goodies, including a delicious cupcake. I thought I bolused good for all the carbs but my blood sugar climbed up to 300.
I began to do even more correcting boluses and the lowest I got was around 160, before going back up high again after eating dinner. I was so frustrated and thought that maybe it was because of my infusion set but I wasn’t ready to throw in the towel. I did eat pretty crappy on Saturday so I was thinking that could have been the cause of my highs. I also didn’t work out on Saturday like I’ve been doing most days, so that too could be another cause. The insulin could have also gone bad since it’s been hot out. With diabetes there are always so many options as to what could go wrong!
I was able to come down from the 300’s overnight, but I still hovered in the 200’s and when I woke up at 6AM Sunday morning to prepare for my 12 mile bike ride and 3 mile run, I was upset to see the 250 #. So I decided it was time to stop being stubborn and change the infusion set. I did a correction bolus for the high blood sugar and by 8AM when I was beginning my bike ride, I had already dropped down to 170, before ultimately going to 100.
Seeing as how 2 hours after I changed my infusion, my blood sugars were finally coming down to normal, I can admit the high blood sugars were probably due to a bad infusion set site. The troubling part is that when I took the infusion set out, it looked fine. It didn’t have any kinks or holes. My skin didn’t look irritated from a bad insertion. Everything looked and felt fine. Which is why the only thing I can surmise from this situation is that my inner stomach area has finally got some scar tissue that makes insulin absorption difficult (luckily I can still use the inner tummy for my CGM). I’m not sure if it took 16 years for that to happen, or it was happening before but I didn’t notice because I didn’t have as tight control over my blood sugars as I do now (thanks CGM!). I have a feeling that in the next few years, I’ll be forced to become adventurous with my site locations, but I’m not quite there yet!