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[IP] Cannula tolerance -- the fat hypothesis
I've been a Type 1 diabetic for almost 30 years and have been pumping for
about 15 months. I use a Minimed 507C, Sof-set Ultimate QR 42" infusion
sets and Humalog U-100 insulin. When I started pumping, I had problems with
infusion site irritation and infection. The infections were mild, never
affecting the insulin requirement and, therefore, never requiring
antibiotics, but they provoked swelling, sores, and pus.
No more. All gone.
The change was imperceptible. After first trying to match the average 3-day
cannula change frequency, I settled for a 2-2-3-day change frequency, which
was convenient, since I always changed on the same days of the week. After
a couple of months, I noticed that the 3-day period was well-tolerated, so
I extended to a 3-4 frequency. Recently, I switched to 4-5-5. At this
point, I'm no longer experiencing site infections. When I remove a cannula,
I have to squint to see where it was inserted. I even need to make a
conscious effort to remember the side of the body that was last used so I
can insert the new one on the other side. Yet, I haven't changed my site
preparation technique *at all*. I wash with soap and water, use the
Sof-serter and affix the supplied Smith+Nephew OpSite adhesive over the
cannula hub. In terms of what I do, NOTHING has changed, but the results
have changed _dramatically_.
Then, I noticed one difference that may indeed be important. I've developed
fatty deposits on my abdomen that I never had before. Though I'd been
injecting into thighs, abdomen, arms and buttocks for several decades, the
protracted use of the abdomen promoted the development of supplemental fat
at the infusion site locations. I believe that the fat deposits may have
lessened my sensitivity to the cannulas and allowed me to tolerate their
insertion for more extended periods. This may make sense physiologically,
since the body presumably builds a layer that can take the abuse.
Is such a physiological explanation medically recognized?
Has anyone else noticed this kind of adaptation response? If so, how long
did it take to develop? A couple of months? 6 months? A year? Longer? How
has it extended your cannula change frequency?
Have others noticed that they've "gotten used to" cannulas? If so, what
other non-technique-related explanations can be offered? Please, no
lotions, cremes or potions here. What's your body appear to have done all
If you've experienced an adaptation response, were you advised to expect it
when you first received your pump? Has any medical professional ever talked
to you about it since that time?
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