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A handful of questions...
by Pat M., Oct 05, 2004 12:00AM
Hey.
I've have diabetes for about 4 years now. I just had a few questions about some things. (Im on the Pump)
1. I have these white dots around where my site is located. Are these normal?
2. Do you always wake up when you are low while sleeping? I find this is the case for me.
3. I use Novalog, which is supposed to be better for the skin. (It's basically the same as Humalog...eh, I'm sure all of you know) I usually go about five days between site changes. I see no infection, and my blood sugars are fine. Is this okay? I mean I know you are supposed to leave it in for a maximum of 3 days, but I see effect on me when I leave it in longer.
That's all I can think of now, but maybe I'll think of more as I get responses.
Thanks everyone. :)
I've have diabetes for about 4 years now. I just had a few questions about some things. (Im on the Pump)
1. I have these white dots around where my site is located. Are these normal?
2. Do you always wake up when you are low while sleeping? I find this is the case for me.
3. I use Novalog, which is supposed to be better for the skin. (It's basically the same as Humalog...eh, I'm sure all of you know) I usually go about five days between site changes. I see no infection, and my blood sugars are fine. Is this okay? I mean I know you are supposed to leave it in for a maximum of 3 days, but I see effect on me when I leave it in longer.
That's all I can think of now, but maybe I'll think of more as I get responses.
Thanks everyone. :)
Doctor's Answer
by JDRF-Team-SS, Oct 05, 2004 12:00AM
Hi Pat M.
First I want to tell you that I am not a medical professional, so my advice/input is soley based on personal experience and knowledge and is not in place of medical advice.
My son, now 9-1/2 was diagnosed at the age of 3. He is on the pump, as well, however, he has only been on it for a little under 2 months. My sister was diagnosed 8 yrs. ago at the age of 24.
I just took a look at his leg where his infusion set is and I do not see any white bumps and honestly, have not noticed any thus far.
While searching in regards to the bumps, this is what I found: (this info. can be found on page 3 at this url http://www.minimed.com/patientfam/pdf/tapetips_07.15.03.pdf)
"Proper infusion site selection and rotation promotes predictable insulin absorption and protects infusion sites from undesirable tissue changes such as hardening and bumps." Now, it did not say white bumps, so I am unsure if this is related to your situation. You might want to go to this page yourself and read all of the info. Also, on page 4 at this same address it states "sites should be changed at least every 48-72 hours, or upon advice of your healthcare provider."
I change my son's set every 3rd day. We changed his on Sat afternoon, so this afternoon is when we will change it again.
As far as waking up when Low during sleep, I do know that my sister, like you, will have lows during the night that wake her, however, there have been times when my son was asleep and for some reason I decided to test him....maybe his forehead was sweaty when I checked on him or I had a gut feeling and he was low and asleep and I gently woke him and squirted frosting in his cheek and had him sip on a juicebox, so possibly everyone is different.
I am looking forward to the day when this new device is on the market where you can set it to have an alarm go off at certain readings, such as 80 and 250. I do know that if I can get one of those for my son it will help alleviate night anxiety and school anxiety for me.
As far as waiting and changing infusion sets on the 5th day, again we were told every 3 days. Someone else who posts here may have more info. for you, as we are new to the pump, but are very happy with it.
Please keep checking back, as you will receive comments in regards to your questions. Sorry if I could not fully answer your questions.
Keep taking care of yourself:)
First I want to tell you that I am not a medical professional, so my advice/input is soley based on personal experience and knowledge and is not in place of medical advice.
My son, now 9-1/2 was diagnosed at the age of 3. He is on the pump, as well, however, he has only been on it for a little under 2 months. My sister was diagnosed 8 yrs. ago at the age of 24.
I just took a look at his leg where his infusion set is and I do not see any white bumps and honestly, have not noticed any thus far.
While searching in regards to the bumps, this is what I found: (this info. can be found on page 3 at this url http://www.minimed.com/patientfam/pdf/tapetips_07.15.03.pdf)
"Proper infusion site selection and rotation promotes predictable insulin absorption and protects infusion sites from undesirable tissue changes such as hardening and bumps." Now, it did not say white bumps, so I am unsure if this is related to your situation. You might want to go to this page yourself and read all of the info. Also, on page 4 at this same address it states "sites should be changed at least every 48-72 hours, or upon advice of your healthcare provider."
I change my son's set every 3rd day. We changed his on Sat afternoon, so this afternoon is when we will change it again.
As far as waking up when Low during sleep, I do know that my sister, like you, will have lows during the night that wake her, however, there have been times when my son was asleep and for some reason I decided to test him....maybe his forehead was sweaty when I checked on him or I had a gut feeling and he was low and asleep and I gently woke him and squirted frosting in his cheek and had him sip on a juicebox, so possibly everyone is different.
I am looking forward to the day when this new device is on the market where you can set it to have an alarm go off at certain readings, such as 80 and 250. I do know that if I can get one of those for my son it will help alleviate night anxiety and school anxiety for me.
As far as waiting and changing infusion sets on the 5th day, again we were told every 3 days. Someone else who posts here may have more info. for you, as we are new to the pump, but are very happy with it.
Please keep checking back, as you will receive comments in regards to your questions. Sorry if I could not fully answer your questions.
Keep taking care of yourself:)
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I am not a physician, just a young type 1 DMer for 10 years and pumper for 2 years now. Due to financial reasons, I change my infusion site only when my bgs start going high, or I have pain at the site. I am by no means advocating this practice, as I am sure that it is probably not the safest method. I am lucky and have the advantage of online classes for school and I also work at home, so I am near my tester most of the time and can monitor my bgs closely. By only changing the sites when its high or painful, sometimes I only go 1-2 days, sometimes I go up to a week. Once again, I am not advocating this in any way! Just letting you know, that I myself, also use the infusion set for longer than the recommended length of time.
Regarding your comment about waking up with low bgs. I almost always wake up when my bg goes below 50 at night (usually in a pool of sweat :P ), but there are times when I don't. You can refer to my previous post "Low Blood Sugar Seizure" as a kind of 'be careful' note, to not always depend on waking up when it begins to/does go low. As a precautionary measure, I won't go to bed unless my bg is above 100, you may want to discuss this with your endo.
Lastly, about your 'bumps.' I have never heard of these before and I would definitly talk to your endo about them. This could be a possible minor allergic reaction to the adhesive or insulin (did you recently change to Novolog?), or it could be nothing at all! You can never know for sure without discussing this with your endo.
Hope I've helped you in one way or another. My biggest advice to you, is to always discuss all your concerns with your endo, who has gone through extensive training, and should be able to answer all of your questions, or refer you to someone else who can.
~vprrchk
I completely agree with vprrchk about not going to bed unless you are above 100. You" meaning anyone living with diabetes:)
I like to see my son around 125 or a bit higher at bedtime. Before he started on the pump, I actually liked seeing his BG at about 180 before he went to bed since he was on NPH and I worried about it peaking during the night and causing him to go low, but now on the pump. for the most part if he is over 100 when he goes to bed, he is in good shape. On the other hand, if he had extra physical activity even in the late afternoon, I do worry about that kicking in later and causing a low, so on a day like that I might make sure he is 150-ish before going to bed.
This may sound lame, however, how would someone living with diabetes know if every low woke them, unless they were monitored for several nights??? There could be times at night that my son dips a little low and then that particular hormone (not sure of the name:) kicks in and brings him up. Sometimes in that case he might wake up high...
Take care and if you do find ut the culprit that is causing those little white bumps, pleasse post so we can all be enlightened. Thank you!!
2. Yes, I ALWAYS wake up with a feeling of dread when I'm low.
So I just keep a 12 fl. oz. bottle of Gatorade next to the bed.
3. I use Humalog by pen.
Nick
I am a long time DMer, and I don't use a pump(yet) so I can't comment on when to change sites. What I do have experience with, however, is adhesives and their effect on the skin. I can't wear bandages, or even hypoallergenic adhesives (EKG pads) on my skin for very long without experiencing irritation, itching and eventually bumps. These are often fluid filled and similar to what you might find with r first degree sunburn. You may wish to investigate whether you have or are developing a sensitivity or allergic reaction to the adhesive used with your infusion set. If this is the case, there may be alternatives that you are less sensitive to. If your physician cannot explain the cause and any possible complications, I would think you may wish to visit s dermatologist for evaluation of the cause. It is always best to know all you can about what is happening to your body, for as a diabetic you are your own primary caregiver. If you don't address it, no one else may.
Good luck
Long story, but I'll cut out all the long boring stuff. I started having, what my endo thought was hypersensitivity to insulin (which was pretty scary to me), and so she sent me to a dermatologist. There is actually a test that can be done, where they inject a little bit of the insulin (or maybe an ineffective version of the insulin, I'm not sure), on your forearm every 15 minutes, I think it was. Kind of like your other general allergy tests. I'm sure they could do this for you for anything you think could be causing the bumps (adhesive, insulin, prep, or other), to find out what it is.
~vprrchk
A though just occured to me and I apologize if someone already mentioned this and I overlooked it.
Could you possibly be allergic or be sensitive to the tape???
Just a thought.....
Take care:)
I am a type 1 since 1969 (I have just turned 40), and have been pumping since May 1978 (one of the original ten worldwide, apparently).
I have had the white spots... they have always just appeared as scar tissue to me, not raised, itchy, or sore. Is that the case for you?