How Can Diabetes Pump or CGM Users Avoid Skin Issues?
With summer coming to a close, I’m trying to get in as many trips to the lake as possible before the leaves start to change color and the cold sets in. I live in Utah, around 15 hours from the nearest ocean, so the lake is the best I can get.
My last trip to the lake earned me some nice tan lines; one where my Omnipod was placed on my arm, and the other for my Dexcom on the other arm. While these made me laugh, and warranted some odd looks and questions, these “ghost sites” made me think of how important keeping my skin healthy really is. Short term, problems such as poor absorption, infection and irritation can cause problems with high BGs, insulin pockets and pain, and in addition long term, not having many good areas to use.
As I meet with clients, I notice that most have a favorite and comfortable spot/s to inject their insulin. Does this make you think of your favorite spot? Where is it? On your thigh right above that freckle? If someone were to look at your skin and easily point out where you usually inject your insulin, it might be time to be looking for some new real estate. Of course, some have very limited real estate given age and BMI, but in most cases there are areas that people haven’t thought of or haven’t tried much. It’s also important to note how frequently you’re changing infusion sets, which products you’re using, and ensuring healing.
The article focused primarily on the use of Continuous Glucose Monitors (CGMs) and insulin pumps, but the information is relevant to those doing Multiple Daily Injections (MDIs). Included are several charts with recommendations for areas of the body to use, products, adhesives and more.
The article states that most people with diabetes report at least some kind of skin problem related to their pump or CGM use, whether it be scarring, infection, irritation, or something else.
But most skin problems can be fixed easily or avoided all together by following simple guidelines.
How to avoid skin issues if you use a diabetes insulin pump or CGM
Make sure to use as many areas of the body as possible.
Rotate your infusion sites in an organized fashion.
Stick to one area for a few infusion set changes before moving to a new area.
Here is an example:
Left side arm
Right side arm
1 2 3
12 11 10
4 5 6
15 14 13
7 8 9
18 17 16
For this example, you’d place your pump site in the number 1 spot. After 2-3 days, move it over a couple inches to the number 2 spot, and so on. You’d then move on to the other arm, then a thigh, for example, then the other thigh, then the right upper buttock, left upper buttock, and finally back to the right arm. By the time you get back to the arm it’s been several months and all areas are completely healed
Other healthy skin tips
Use a skin barrier wipe, such as Skin Prep before placing the infusion set.
Don’t go more than 3 days on an infusion set.
If signs of infection start to appear, change the set asap.
As you finish out your summer, challenge yourself to be brave and try a new area if you feel you aren’t using as many areas as you could be. Remember that your skin is the only skin you’ll get, so preserving it is important now and throughout your life.
Annette Valle is a registered nurse and certified diabetes educator who also serves as an English/Spanish medical language interpreter. She has lived with T1D since age 13. Annette has personal experience and is certified to train on all models of insulin pumps, CGMs and hybrid closed loop systems.