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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 
by itself?

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?

regards, Andy 
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