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Re: [IP] "Site degradation

<1.  What is the specific cause for the elevated BG involved with site
<corruption?  Could the site be leaking?  Could it be an immune system
<response?  Does site corruption always accompany redness or local puffiness?

	When a site gets "inflamed", there are lots of enzymes let loose
that break down proteins.  The insulin is easily degreded.  And with the
swelling there and occasional "tunneling", the insulin takes longer to
reach the blood, so more time for the enzymes to work on it.

<2.  Is a particular insulin/combination of insulin more apt to produce site
<corruption?  What is the mechanism?  Is allergic reaction involved?

	Maybe, but there is no published or systematic evidence to say that
one insulin is better or worse than another.  There are many factors, local
tissue composition, physical movement, wound healing (think of the catheter
as a smooth splinter), depth, etc.   Site degradation is not related to
allergic reactions.  People with allergies know it, and have worse problems
than just site degradation.  But only 1% or less of diabetics have true
insulin allergies.

<3.  Are there any measures that will reduce or eliminate site corruption
<(cleanliness, a particular cleanser, a particular dressing, a particular
<infusion set?)

	Site degradation is unrelated to cleanliness of the skin, or the
type of dressing or glue.  It is all internal.

<4.  Is it possible that site corruption will have an effect on INSULIN
	No.  Insulin resistance is a totally different phenomenon, related
to insulin receptors.

<Bob Blakely


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