Lipohypertrophy, Pump Sites, and Your Insulin Absorption
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- čas přidán 10. 02. 2020
- How lipohypertrophy, choosing the right infusion set and body location, exercise, and your insulin dose amount are affecting your insulin absorption.
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Same issues here! I was diagnosed with type 1 diabetes later in life. I was put on the Medtronic minimed insulin pump almost immediately after my diagnosis and still don’t understand much about dosages, bolus, basal rates, etc. I never had an educator who explained the anatomy and physiology of diabetes. I feel I’m a “BAD” diabetic from the lack of knowledge and the educators I’ve had don’t explain. I’d love your guidance not just to get control of my own diabetes but to become a CDE one day so I can help others like us.
Your tips are so helpful! As a type one diabetic for the past 27 years and in pretty tight control, there are still things I have learned from you. Thanks so much!
That is great to hear. We are all in this together and learning from each other. I wish you the best with your management Nora.
I’ve had type 1 diabetes for 38 years and have pumped for 26 years. Looped for 5 years. For the first 18 years pumping, I only used abdomen as this was the only “approved” site. I’ve used every pump manufacturer at some point in my journey.
I’ve have more occlusions in the first month of using tslim than all the other years of pumping combined.
1) t slim pump becomes hotter than all other pumps thus causing the insulin to coagulate in the cartridge easier resulting in more occlusions. Upon occlusion, I’ve literally pried open the cartridge and cut open reservoir bag to witness this. It’s like jello on day 3.
2) collectively, my absolute favorite, most successful, convenient and comfortable spot is the upper thigh. I use this spot for CGMs as well. It’s out of the way, absorption is top notch and never fluctuates. CGM readings are always accurate. Best spots are followed by butt and upper arms. The abdomen is, by far, the worst requiring daily site changes.
3) Quickset is the best infusion set for me. The physics behind the design is what makes it work consistently. It has a solid base with no wobbling and there is no pulling to release the connection (it twists). Unfortunately, t slim doesn’t appear to have an equivalent. I have tried them all.
Thank you, Ariel. This is exactly the advice I needed.
Ah, I wish all diabetes educators dietitians were diabetics, I would change my diabetes educator to you Immediately if I could. So much info in just one video! although some thing I learned from educators, it was "dry" like reading a book. You talking from education AND experience, it makes a BIG difference. Thank you very much. You earned new subscriber :D
Totally, totally, totally agree. I've also always thought a Type 1 endo would be a gift from above. One can wish...
Thank you thank you. Really informative 😊🙏🏼
Multiple doses per meal with the pump is a great suggestion! I hope this helps me 🙏
Thank you
Thanks. Very useful
Thank you for your kind words. I wish the best to you with your management.
I don't know how or why this showed up on my feed, but I'm T1D 45 years now. I did pump therapy for a long time and have decided by choice to be MDI and I love it. I learned something new. Awesome CZcams Channel. Blessings.
I switched to MDI for 9 months and really enjoyed the freedom and there are a lot of great options for different insulin types these days. I wish you the best Ruby. Thank you for your kind words.
@@abovediabetes What means MDA?
Great video. I never had much a problem with absorption until I went on the dexcom. Since the G6 is only approved for the abdominal area for adults it's harder to rotate my sites than it used to be. I've also noticed that I actually have a very tough time trimming fat from my abdomen than I used to. Is there any link between pump usage and decreased ability to loose weight (especially in the abdomen)?
I know the Dexcom is only approved for the abdomen but I’m seeing so many people online put the device on their arms. Have you tried it? I’m tempted to but worry if that will diminish the accuracy of the device.
@@eastonguy62 I haven't, but only because I actually don't have enough fat really to put it on my arm. I had used the G5 for a short period of time and it was very uncomfortable for me on the arm. But I do know a couple people who have tried the arm and haven't seen a difference in accuracy
Great information. Thank you. How could I use the area on the back above the butt if I use an infusion set like the Varisoft or the Silhouette? Would I need to have someone else insert it? I can’t see how one could do that one-handed. Thanks
Thank you again for the info I have the problem you talked about, last night 1 bowl soup (boring) went up to 215 , went down to 180’s all night with correction bolas went to bed at 177. I use sleep iq went down all night to the 130’s never close to112 any ideas. Thanks
I have been looking for a solution to a similar issue. I have had T1 for 59 years, been pumping for 23 years, AND was a DE for 23 years and I need help 😂. I have hypertrophic areas on my legs and upper arms because in the old days we never used the abdomen, and the old insulins were much more irritant. Like you Ariel, most of my problems have been since changing to the Tandem and Autosoft 90. Last change I had to use 6 set insertions to achieve one which didn’t cause bleeding (I mean a LOT, meaning that I knew I would not get proper absorption) I wonder if I should try the Tru-steel, or a longer cannula?
I also have the Tandem T slim pump. Using the auto soft 30 & auto soft XC I do feel like I’ve had issues with absorption. I’m going to try the trusteel infusion set. Do you change it every 48 hours? Any trouble sleeping on the infusion site?
Thank you Ariel. I’ll try splitting up the bolus with CIQ for 1 hour. Also, any reason why Tandem reduced the square bolus from 5 to 2hrs with CIQ?
Hi Dan! With CIQ, because the algorithm is supposed to take over and most of the carbs "should" be absorbed within 2 hours after a meal, is why it has been reduced. However, in my personal opinion, I think time allowed should be able to be extended because carbs and people who have gastroparesis could benefit from a longer extension period and allowing temps would have been very helpful to the majority of users. I wish you the best with your management.
I'm a new type 1 diabetic. Trying to figure out how to count carbs. I haven't been able to find an android app that gives me an easy carb count. Any recommendations?
At 8:50 what is the name of the insulin you said you use? I don’t think I’ve ever heard of it 🤔
FIASP supposed to work faster than Novorapid
The sites i used to use on my arms and legs for 10 years have become hard and started to turn brown/scales. Was told by my doctor start using the stomach. Now its begining to happen there with a stronger insulin type humulin u-500 but now these sites aren't absorbing much with spiking numbers like 350. Any tips to soften tbe tough skin or help the absorption? Oils? Moisturizers? Heavyset male 270lbs and injecting 3 times daily. Is there any way to reverse the lypohypertrophy?
Massaging the areas with lypohypertrophy helps to break down the build up of fat
@@Ikoniic Thanks I'll think I'll give it a try. Do you think applying vaseline might help as well?
@@knightrcer the Vaseline could help heal the skin that’s damaged but not sure about the build up under the skin. Heat and cold pack can help with the build up. Try using heat or cold packs (both at different times would be good) everyday along with massaging throughout the day. This has helped me with my insulin shots. I usually use my PIP joint to massage but I alternate between that and a normal massage, do whatever you’re comfortable with. Be patient and continue with the routine. In severe cases people have gotten liposuction to remove the excess fat but this is expensive and definitely talk to your doctor before considering it. Do some research on insulin injection sites you may haven’t used as much to give damaged areas a break and time to recover. God bless you brother I hope this helps you. I will pray for your healing and strength that we all need to get through this you’re not alone in fighting this. God has helped me tremendously with dealing with type one and has given me peace. I surrendered to God not to long ago and He totally changed my outlook on life it’s amazing! He can give you the same peace and hope even in the middle of any storm you are going through. I pray in Jesus name you have peace and joy like no other from God who loves you more than anyone can imagine and wants you to give all problems to him ❤️
Can lypohypertrophy go away?