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Alert: Product and Recall NoticesLumps And Bumps From Insulin Therapy
One of the most popular blogs of all time here at The LOOP is on lumps and bumps related to insulin infusion, so we wanted to bring it back to you along with some new tips. [Originally published January 17th, 2012—Updated April 21st, 2020.]
Q. What are these lumps and bumps at my injection sites?
A. Lipohypertrophy is a medical word for a lump under the skin from a buildup of fat at the site of insulin injection or infusion. This comes in the form of lumps or bumps under the skin. Scar tissue, or hardened areas, may also develop at the sites.
This can happen to anyone who takes insulin, whether it’s delivered through a syringe or insulin pump. It happens due to the action of insulin on the fat cells because insulin can cause fat cells to increase in size. It’s generally seen when someone uses the same favorite spots over and over again, and usually happens in areas easiest to reach (both sides of the belly button and on the sides of the thighs.)
Q. What happens with these lumps and bumps?
A. Delivering insulin into affected areas can affect your glucose control. Since insulin is not always well-absorbed in these areas, you may find that your glucose control is not what you expect it to be. The more damaged the area is, the more likely it is that glucose control will be affected.1 Sometimes these areas have damaged nerve endings and you don’t feel a needle going in at all. This is a sign that you should stay away from that spot.
Q. If I need to take insulin, how can this be prevented?
A. If you tend to use the same spots repeatedly then you might want to use one of these approaches to make sure you’re spreading out the love:
- Use a visual body map. For example, think about an imaginary clock or the letters “M” or “W” on a body part like your abdomen. Trace your finger along this shape and then the next time you poke your skin, try a different spot along your imaginary shape.
- Create your own simple method. For example, if you insert a glucose sensor on the right side of your body, then do your next injection or insert the next couple of infusion sets there, too. Then the next time you change your sensor and move it to the left side, insert your next couple infusion sets on the same side.
- Use a calendar to keep track. Injections or infusion set insertions on specific days of the week could be done on the front side of your body while others could be on the back. Or maybe you could try to wear infusion sets on the back of your arm when you’re more bundled up during the winter or your buttocks more often during swimsuit season. This will allow for longer periods of time for other tissue, or other sites used to heal, too.
You might also want to talk to your doctor about using a new location that you might not have thought of before. If you move to new areas, you may need to test your glucose more frequently since it’s absorbed differently and may affect your glucose. If you have been using your abdomen (where insulin is generally absorbed the fastest) and start using your buttocks (where insulin is absorbed more slowly), you may see your glucose values change more slowly.
Here’s a guide of some potential areas to give your insulin:
Moving forward, before you inject insulin or insert a new infusion set, take a moment to firmly stroke the areas in a sweeping motion to feel for any lumps. If you find that you have areas on your body that have lumps and bumps, then allow them to heal before using them again. Lengths of time to heal the tissue will vary, but you might want to wait at least a few weeks. We hope these tips help you. Thanks for reading!
1 Famulla S, Hövelmann U, Fischer A, et al. Insulin injection into lipohypertrophic tissue: blunted and more variable insulin absorption and action and impaired postprandial glucose control. Diabetes Care. 2016;39(9):1486-1492. doi:American Diabetes Association
IMPORTANT SAFETY INFORMATION
– Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems.
– Successful operation of the insulin infusion pumps and/or continuous glucose monitoring systems requires adequate vision and hearing to recognize alerts and alarms.
Medtronic Diabetes Insulin Infusion Pumps
– Insulin pump therapy is not recommended for individuals who are unable or unwilling to perform a minimum of four blood glucose tests per day.
– Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately.
For more information, please visit MedtronicDiabetes.com/isi
Tags: diabetes, infusion set, injections, insulin, insulin pump, lipo, lipohypertrophy, MiniMed 530G, MiniMed 630g, minimed 670g, MiniMed 770G, scar tissue, type 1 diabetes, Type 2 diabetes
About Author
Editorial Team
LOOP Blog Editorial TeamAt Medtronic Diabetes our vision is to transform diabetes care together for greater freedom and better health. Each word in that statement is important – including the one “together”. We’re a group of passionate people working hard to make a big positive impact on the lives of those with diabetes. But we can’t do it alone. Collaboration is key. With healthcare providers, academic institutions, non-profits and other companies. And, most importantly, with you – the people who live with diabetes every day.
I’m a widower 79 and have tremor. I have a 670G & a CGM. Pain not a problem but I can’t install anywhere except front stomach area and have absorption issues. What are the chances of my CGM and insulin insertion sites staying on, if I run the tubing down under my belt to my thighs? I question if the transmitter Bluetooth will always read to my pump because it has a problem from my pump in shirt pocket to stomach area.
Hello I am on the minimed insulin pump 670G. I do rotate different injection sites. I was told along time ago since I have been on the pump since 2009 I was told to insert it 2 inches from my navel rotating the position; but I have so many scars on my stomache. Can I use my side (love handles) to insert my infusion set. Please advise or is there another site I can use beside my stomache?
To those who have difficulty w using upper arm…I have difficulty too but I found funny ways to do the insets and sensors or pens or shots…
1. Look in large mirror and take pinky to hold skin (if can) or use a counter top corner or stool to hold skin up…(I had all fingers fixed, wrists, thumb/wrist and elbows done in my 20s after working non stop…esp. w hands/finger)…then insert your device…
2. Just inject site wo holding skin…only if possible…
3. To remove the needle from your arm is hard…so I put my index and middle finger around as best as can, on top of the round part of inset, so it doesn’t come out and then with rest of side hand and other and pull up and you may have to turn it a slight bit but that is why you must hold down the round part…
4. Tell us if you have a way…it could help us all…
I know I’m not a diabetic doctor or coach but I try different ways to help others I know who have same problem…even if you don’t have great fingers or hands…if unable to do this…I have lived on my own 6 yrs after I was diagnosed at 16 yo…so I learned quickly how to do this on my own…my ex husband faints at site of a needle miles away…so he couldn’t help much…well I guess not at all…but possibly find a friend or even neighbor whom you can trust to help out…
I apologize ahead of time for giving this unsolicited advice but I love helping anyone with anything…if I can…so I hope this can help…
Thank you for this helpful article…I’ve been giving insulin in my tummy for over 35 years now…and since I hit my 40s I’ve gained weight and hate seeing those lumps…I only have the fat in my stomach…rest of my body is so small…I do change to the arms or legs but then I have more lows than usual…I do move them around even lower chest area…and love handles and backish area…I try to move it around a lot…I noticed that the lump areas are hardest to keep regular, as much as I can, blood sugars…so I try to stay away from them…it’s hard when you got a tire for a tummy…can’t see well in certain spots…I asked my endo doc and said keep to stomach area for me…I was born w a bad deformed club foot…I have diabetic neuropathy in all limbs and my club foot has had over 20 surgeries since 8 months old…and use crutches and have hard time w walking…but I don’t like to sit…so usually very active and if use arms or legs it makes the insulin to react faster and bring on those lows and I can’t tell since I was about 16 yo when have lows…now in my mid 40s I almost pass out at 40s or less (mg/dl)…just got approved for sensors…YAY!!! Medicare isn’t easy to get supplies…so hopefully this will help me wake up during these lows…my cats wake me up most of the time or bug me…I’d like a diabetic alert dog but they cost up to $55,000 and I’m poor…Question: does anyone know if there is a way to get a Rx for a diabetic alert dog? Again…thank you for this article…it is gonna be so helpful especially since I’ll get my sensors tomorrow!!! Been waiting about 4 years to get them again…Keep coming out w these helpful articles…for all who are diabetic…young and older young (lol) ones…and the family and friends who have lived and help us…as they go thru it and truly understand how hard it is for us…they are there at our worst and best…I thank them and take care and keep living for you…diabetics out there…Keep up the fight!!! You’re worth it!!! It may be hard and make us angry sometimes but I’m grateful it was due to a trauma that I was diagnosed at 10…cause my family…esp my niece and nephews…don’t have to deal with the anguish…and pain…I call myself the “blessed one”…I wish I could take everyone’s from them…but I can’t…so keep moving ahead and hope yall can continue to be brave and courageous!!!
I feel like I’ve come to the party way late and after most of the people have left!
I’ve been doing insulin shots for about 5 or 6 years always using my stomach about 3 inches on either side of my navel as the accompanying inset suggests. I have a hernia mesh that extends about the navel; Will that interfer with absorption?
This would be a great conversation to have with your healthcare team. Our infusion sets can also be inserted in your upper arm, thigh, and lower back.
Been on XXXXXXX for 5 years–keep rotating injection of 60 units/day around upper thigh areas of both legs, never into stomach nor arms. Last week I errored in not lifting my shorts high enough, injecting about only halfway up my left leg. While injecting, I felt a twinge in my leg like I hit something? I immediately felt discomfort & now have a 3″ diameter bruise in place, hardened to touch.
On Antibiotics & Medical Staff observation–no one can tell me what is nor has happened. One week has past & I am overcome with pain, swelling & no lessening of the hardened area, causing sleep impairment. I continue to put warm packs on the lump per medical staff advice-but to no improvement? THX, Oren
Hi there, Oren. We’re sorry to hear this. This is considered medical advice and we’d need to refer you back to your healthcare team for more information.
I too have had type 1 a long time – 44 years. I have stretch mark scars below the navel and surgery scars, so it is very difficult to find a site there. I thought the middle of the abdomen above the navel was not advised
But map shown here does not indicate that
I also take blood thinner so I am trying not to hit even a small blood vessel
I am handicapped so limited in positions. Can’t twist at waist.
You say to talk to our health care provider. Throughout my life I have talked to so many different health care providers, Doctors, LPN’s, and many more. Most are only familiar with people who have been diabetics for short periods of time, 20 or less years. I am 67 now, have been a diabetic since I was 13. So I guess it is mainly a guess for yourself , I just wish there was some way to get rid of the scar tissue . May even be better off the pump, but my control is not as good.
I have used an insulin pump for 20 years. Recently I developed a large (size of a baseball ) hard lump. Is this an infection?
Hi there, Mary. This is a good conversation to have with your healthcare team. They can provide the best answers based on your individual needs.
I am having issues with the site turning really red, raised in the center were the set goes in and it itches, no matter what site I use. I have tried a Barrier wipe and that doesn’t seem to help either.
I’m sorry to hear this, Teresa. This sounds like a good conversation to have with our technical support team. You can reach them at 800.646.4633, option 1.
So what then when all the areas are filled with bumps, I can’t afford to not use them to let them heal, cause I’m out of places to inject the insulin.
I would like to use the back of my arm but how do I do it by myself? I need 2 hands to put the CGM on my arm?
Ok, Now, my wife and I have been taking Insulin since the early 60’s , so you can imagine the difficulties we see. It is difficult to keep the pump infusion set on my body as I work during the summer as also the G6 patch, and I have used everything except stapling it to my body. I am seeing that the sites have become so hard that it takes several hour before it begins to influence my blood sugar. Usually I see a spike after changing sites. I change sites as much as possible, but working around my yard, garden , and other activities do not allow some locations unless I just sit and don’t do anything. As I have gotten older my belly has gotten much bigger and my weight has increased by 30 percent. My A1C has been under 7 for the past year and I have no idea what is next ! How to decrease my weight and get better reaction from the insulin ?
Thanks for reaching out, David and nice work on your A1c. This is a good conversation to have with your healthcare team. They may suggestions if your goal is getting slimmer. They can make the best recommendations based on your individual needs.
I’m an 83 yo T1D. Started injecting insulin 62 years ago. On a pump for 17 years. I change the canula (infusion device) every other day. When I was injecting with a syringe, I rotated sites according to the diagram in the article. With the pump, the canula, I find considerable discomfort wearing it on my hips. When I wear it on my thigh, I keep the pocket empty over that thigh. Most of the time, I rotate around my abdomen slightly below my rib cage. Starting about 3 inches to the left of my belly button, I place the canula. The next time I place the canula a little to the right of the existing one. I continue that movement time after time, thus giving each site several weeks to heal. I am still healthy and very active.
Wish I had this information 3 summers ago. I would have been prepared for no insulin getting into my system. Very scary.
Helped me a lot
How does one manage to inject insulin into upper arms with an insulin pen? You have to have one thumb on top of pen and the other hand has to grab the skin. I need to use my arms due to Lipohypertrophy . Too many lipomas to use abdomen or thighs.
Can I inject on outer arm above elbow? Or, outer part of thigh above knee?
Hi, Paula. This would be a great conversation to have with your healthcare team. They know your needs best and can give you the best advice.
I’ve been pumping insulin since 1985 and sadly these bumps and lumps will form over time. You may even eventually have a buildup of what feels and looks like fat roll or rolls. I have rotated through 8 different site over 35 yrs and it will happen sadly and sorry to say. I only use sites for 3 or less and never on the same site side of my body. Maybe I am wrong I don’t know but if somebody can tell me or help me what I am doing wrong I’m all ears and open to suggestions.
i am injecting insulin since last 6 years in my abdomen, i had faced the lump problems couple of months ago then i had broaden the circle of injecting area upto slight near than kidneys and left the closed circle for couple of weeks, i have achieved good absorbing and control on sugar. i was taking 65 units in morning and 54 in evening now same control is achieved on 38 units in morning and 28 in evening. my readings before insulin shots are 98 in morning before shot and 95 to 110 before shot in evening.
I was just curious to see if there was a better alternative that some people might use.
I had apparently developed lumps and bumps in the right side of my abdomen from injecting diabetic medications, and at least once reusing insulin needles. I began throwing up usually evening every day for a week and a half before I realized the bumps had grown into masses, with concurrent blisters. My Dr told me I most likely have a staff infection. XXXXXXX did not seem to be working much, so he put me on XXXXXXXXXX XXX every six hours. I’m very worried about this. For this reason, I do not recommend anyone to inject into the stomach area, or at least feel the stomach area daily to make sure you know what’s going on ASAP. The bumps and lumps can quickly become infected, without any knowledge of them, or any pain or itching until they become infectious masses!
So ive been using an insulin injection since I was like 7 or something and I’m 18 now . I’ve never really paid much attention to it until I a person who was waxing my legs noticed my thighs , I started noticing the bumps more then and I knew it might be because of the insulin because I’ve been injecting at the same place for the longest time , I’ve switched it up mostly but when it’s a higher amount of insulin I usually still inject into my thighs , I will change the position to my butt or something when it’s a higher amount ( just read that in a comment , didnt think about that place idk why) but do you have any suggestions on what I could do about my thighs? ( I am going to talk to my doctor when I see him though)
Iam 22 years ols, I have been taking insulin since iam 8years old,I have a lot of lumps in my thighs, I want to know whether there is any medicine or something else to cure the lumps that were already formed, I hope I would get an answer for my question and it would be very useful for me. Iam loosing my self confidence at the time I look at that lumps, Iam scared that those will be keep on increasing as I Should take insulin lifelong, please give me some solution
Hi, Sravanthi. This is a good conversation to have with your healthcare team. They can make the best recommendation based on your individual needs. Good luck to you.
This was great information. Very east to understand. THANKS!
I have had type 2 diabetes for many years. I am now 70 years old. I have never had trouble with injection site lumps before tonight. But right after I gave myself my insulin a small bump appeared. I think I held my pen a little higher than usual because I was afraid it might hurt. I thought perhaps the insulin went into the skin rather than into the blood stream. Is that possible? Or does it always enter the skin. Have I developed my first lipohydro… site?
Hello ive had type 1 diabetes since i was 4 and i have same problems is there any ways to get the lumps to go away?
Marvin, the only tried and tested way is time, but check with your healthcare team for suggestions they may have for you.
Is there a.way to make these lumps/bumps go away?
Don’t we wish, Tennille! Rotate away from the affected site and allowing it to heal and in time, they should go away.
Hi, I’ve been a type 2 diabetic since 1998. Recently the doc changed my diagnosis to type 1.5 and I was able to get a pump. I started out with the standard Quick-set, but because of all the scar tissue I was having a lot of failures. I just recently changed to the Sure-T set and I’m getting much better results, however just after the last site change I noticed a bruise at the site of the insertion and again at the anchor point. Both were the size of the sticky pad. Three two days later the anchor point is fading, but the insertion site is now huge. I am due to change again today. My rotation would take me back to the bruised area. I’m new to the pump and haven’t tied the arm yet, but today I’ll probably go there.
My question is, you say to rotate, but what is an acceptable amount of time before you can safely come back to an area? I know I probable couldn’t hit the exact site again if I tried, I’m talking about the general area, maybe to 2-3 inch area.
Cary, I am very sorry to hear this. This is a good conversation to have with our 24-Hour HelpLine. They can discuss rotation and how close is appropriate for your next insertion. Please give them a call at 800.646.4633, option 1. You also might find this page helpful: https://www.medtronicdiabetes.com/customer-support/insertion-site-management/site-rotation.
why is it when i do my shot in the stomach area it swells and get real red and burns, but when i do it in my thigh I do not get that reaction.
Cindy, this is a great conversation to have with your healthcare team.
Hi, I have a question for anyone who can answer it. I have been a diabetic for over 20 years now and for the past year now I have been on the pump. Which is great and a big improvement on the levels. My question is: what other locations can I use for my infusion set bc the areas I use are my bully and legs and that is it. I did hear you could use your arms but not sure now that would go. Feels like I would lose range of motion there with the hose. I also heard you use your butt, but not sure of the area on where. Wouldn’t want to sit on it, I don’t think that would be comfortable. Thanks for any information
Hi Bill, thanks for reaching out. The approved locations for infusion set placement can be found here: https://www.medtronicdiabetes.com/customer-support/insertion-site-management/infusion-placement#locations. We do recommend discussing a new location with your healthcare team to see what is best for you.
My name is Dennis. I have been taking insulin pens for about six months and have lipohypertherapy over 70% of my abdomen. I am running out of areas to inject. I stopped taking my blood thinner on 1/15/17 and it has helped a little but the areas do not go away even with arnica and if I inject in an area that is already bruised the pain is worse than a normal injection. i do not want to stop my blood thinners. How can I keep from bruising and how can I erase these bruises? Some are 3 months old and unfazed by arnica
I’m sorry to hear about the bruising Dennis. For your individual case, it’s best to reach out to your healthcare team to see if they have any recommendations to help you.
I have been on the pump since march of 2016. When I first went on the pump, I had no issues with the therapy, however as time went on I started to get bumps, redness, and pain at the sites of the cannula. One was so bad that my whole lower abdomen was red and painful. I went to my doctor and she said that this problem is due to the injection of insulin and that I need to rotate sites more often. I do rotate my sites on every change out without success. I now know that I cannot use my abdomen or thigh for my sites of injection any more due to the lumps. I will try using the love handles and buttocks for the change outs. I did find something that worked on my last two change outs to a certain degree, after removing the cannula at change out, massage the site with an alcohol swab in a hard circular motion. I did this on my abdomen, no lumps formed during those change outs to my surprise. At least this worked for me. But, I will still use other sites since my abdomen is still lumped up.
where exactly do you put the injection in your leg and what part of your stomach….I get bruises from the needles is this normal?
Hi Kathay, for information on insertion site management please visit the Selecting the Best Infusion Set Site page on our website here – http://bit.ly/22mvmQb
I ve been on insulin injection for over two yrs nw.i administer d injection on my thighs but ryt nw all d sites are swollen ad red. Wit alot of black spot which re really annoying. Is dere anyfin i can do to get rid of all dis marks on my thighs tnx
Hi Francis, thanks for your question. We recommend you consult your healthcare team about this as they can give you the best advice to meet your individual needs. You may also be interested in our i-Port Advance injection port blog which you may read here – http://bit.ly/1PqaAq4.
I have major bumps next to my belly buttons on both size. I’m not sure how to get rid of the bumps; do I need to exercise only or is there anything else.
Shico, this sounds like a great question for your healthcare team as they can give you the best advice to meet your individual needs. If you have any questions related to a Medtronic device, let me know and I can connect you with someone.
I have had type 1 diabetes since I was 18 been on pump therapy since I was 26 now 37 overall much better control on the pump compared to shots but have issues with leaking, no rhyme or reason to it am very diligent about site rotation but can b very frustrating when it happens and apparently no real answers find myself constantly checking site now almost every time I give bolus to try to catch early if it is leaking
Craig, I’m happy to hear you’re doing well on insulin pump therapy, but am sorry your infusion set site is leaking. I understand how this would be frustrating. I’ll have a member from my team reach out to help.
Congress did not approve the CGM bills presented last year.
There is a great need to have Preventive medical care for many diabetics on
Medicare.
There are many people like me who are NOT benefiting from the CGM system because
Medicare will not and has not made a decision to cover the continuous glucose
monitoring system in nearly two years.
My endocrinologist has prescribed the CGM to warn me of these occurences. Even
with the endocrinologist’s letter that states the CGM is a medically necessary, there has
been no reply.
The CGM system is expensive however, it’s annual cost is low when measured
against the cost of one ER or hospital stay due to a serious low and or high blood glucose event.
There is an urgent need to have Preventive medical care like the CGM system
approved for insurance coverage now.
What can be done to push CGM legislation forward for Congress to approve this
vital technology.
How long must we continue to wait for approva?
Thank You for all you are doing.
Roy Taylor
I’ve been using a pump for a few months and the results have been very inconsistent. I switch my sites every three days and always rotate areas. I was told by my healthcare provider that I should focus on the abdomen because of my build. However, insulin absorption seems to be hit or miss. Any thoughts?
Josh, I’m sorry to hear you’ve been experiencing inconsistent insulin absorption results. As you are doing, we recommend rotating your insertion site each time you change the infusion set, as it can help keep the tissue healthy and allows previous sites to completely heal before reusing them. Your healthcare team is your best resource for advice to determine the sites that will work best for you. I will also have someone from my team connect with you to try and help.
The advice to rotate is not helpful. When I was a kid I rotated between my arms, legs, butt, and stomach. I got lumps everywhere and honestly, there are only so many places to hit without hitting muscle if you’re thinner. I got an insulin pump fifteen years ago. I rotate every four days or so switching sides and moving it around mostly the love handle area (again, I can’t move it too many places because I don’t have a ton of body fat and it really hurts when I inject into muscle). I can’t put the pump in my arms or back or butt or legs because I’m also an athlete and having the pump in those locations doesn’t work. So I’m stuck with big love handle ridges even though I have next to no fat on the rest of my body. It’s really frustrating. And quite embarrassing. I won’t wear a lot of nicer looking but tighter clothing because of these ridges. If I do, I try to wear men’s boxer briefs that have a large, wide band (than any sort of women’s underwear does) so that I can pull that up to compress the ridges (it also doesn’t slip out of place and down as do women’s boy shorts). That works okay … it’s sad to have to do this, but better than having them stick out like I’ve got rolls when my body fat is actually pretty low for a woman.
Hi Katie. I am sorry to hear you are having a hard time finding new locations on your body to rotate your sites. I’m sure this is very frustrating and uncomfortable. I will have someone from my team connect with you to see if there is anything we can do to help. Please let me know if there’s anything else I can help you with.
My 9 year old daughter has had Type 1 diabetes for 3 years. At this time, she cannot have a pump, she uses both fast-acting and long-acting insulins. The only sites we can use for her long-acting insulin are her outer thighs and upper left arm (her belly and right arm are used for fast-acting insulin and the sites can’t be mixed). Both outer thighs are hard and swollen, hot to touch, and really irritate her. Her pediatrician, endocrinologist, and diabetes case manager said there’s nothing that can be done, there’s no other area to rotate out to. My poor child already has this horrible disease…I don’t know what to do, any suggestions at all, does anybody else have information that the doc’s out here don’t know?
Dawn, I’m so sorry to hear about this. I can imagine this is very uncomfortable for your daughter, and frustrating as a parent. We do offer i-Port Advance, which is indicated for people who administer multiple daily injections of physician prescribed medications, including insulin. It can be used for three days and is indicated for use with both insulin pens and syringes. You can find more information here: i-port.com. If you are interested in learning more, please send me an email at loopblog@medtronic.com with your contact information and I’ll have a member of my team connect with you.
Hi, I’ve been Type I for 40 years (I’m 55) and on a pump since 2007. I have large pin cushion size lumps on both of my thighs becasue this is the easiest place to place the pump. I have to wear large pants than I normally would because of them. I’m pretty sure that my insulin absorbion rate is getting worse becasue of them, soooo I have to give myself more insulin and the pin cushions get larger … it’s a vicious circle. Can someone comment as to whether or not liposuction or laserliposuction is a real alternative to reducing these? I saw my doctor yesterday and he really had no answer except to ‘rotate’ my sites. Looking for some help here.
Dave, I’m sorry to hear you’ve been experiencing lumps on your thighs. I can image this must uncomfortable and bothersome. Your healthcare team is your best resource for advice. Like your doctor suggested, we do recommend rotating your insertion site each time you change the infusion set, as it can help keep the tissue healthy and allows previous sites to completely heal before reusing them.
Here is some information on site rotation management that you may find helpful:
1. Site Rotation: http://www.medtronicdiabetes.com/customer-support/insertion-site-management/site-rotation
2. Selecting the Best Infusion Set Site: http://www.medtronicdiabetes.com/customer-support/insertion-site-management/infusion-placement
3. Trying a New Infusion Set Site Location: http://www.loop-blog.com/blog/Trying-a-New-Infusion-Set-Site-Location
Please let me know if you’d like me to connect you with someone from my team, or if you have any other questions.
Hello,
Ive been using the sure t infusion set for a while now. I got type 1 on my 5th birthday/Christmas and started the pump when I was around 13. I am 23 now so 10 years so far with it. I have a lot of issues with my sites including hard bumps, bruising, bleeding, and I struggle with rotation also. I used to use the quik set and put it in the abdomen and upper hip area and it worked pretty good but back around 2009 I had nothing but issues with the quik set. The tape used to stick to the inserter and I kept stabbing it over and over until it would work. I am sort of anal with getting my sets in perfect so if it was not laying flat of whatever the case I would tear it out and start over. After a while I was done with the quick set. I tried all different sets after that. The mio, silhouette, sure t, everything you can possibly think of. u went with the silohuette for a little while but the length of the needle scared the crap out of me and it took an hour for me to just insert the thing. Then I went with the mio. Wasnt bad, kind of like the quick set but the inserter was much wider than the quick set so that swayed me away from it. So I wound up with the sure t next. I was very apprehensive about a needle in my skin 24/7 but I started using it and kind of liked it. Better absorption, great readings, I couldnt go wrong. But now after all the stabbing and everything, my skins a mess. Rotating at this point is hard. My upper hip doesnt work well with the sure t so I just go with my abdomen. My hip sent me to the er once bc I could not get the set out of my skin, that was fun. So now I stick with the abdomen and keep moving it around. I get 24 boxes a month because of how bad my skin is. I fought my doctor because I kept running out constantly and I have learned to realize this is never going away. Ive been to dermatologists and they simply tell me heres a cream you just got to deal with it, take it one day at a time. Stay strong!
Hi Holly. I am sorry to hear you’ve been experiencing difficulty with site insertion and rotation. I can image this can be very frustrating, and uncomfortable. Here is some information on site rotation management that you may find helpful:
1. Site Rotation: http://www.medtronicdiabetes.com/customer-support/insertion-site-management/site-rotation
2. Selecting the Best Infusion Set Site: http://www.medtronicdiabetes.com/customer-support/insertion-site-management/infusion-placement
3. Trying a New Infusion Set Site Location: http://www.loop-blog.com/blog/Trying-a-New-Infusion-Set-Site-Location
Please let me know if you would like someone from my team to connect with you to discuss your options, or if there’s anything else I can help you with.
Can these lumps or bumps affect if you are pregnant? It is the first one I get and didnt know what it was so I panicked a bit but reading this helped a bit to clam down. Guess will discuss at my next dr visit.
Hi Ana. I agree, it’s a question best asked to your doctor, as they can give you the best advice to meet your individual needs. If you have any questions related to your Medtronic device, let me know and I can connect you with someone.
I have juvenile diabetes. Diagnosed when I was 18 months old. I am now 21 years old and have been on the insulin pump since I was 8 years old. I try to rotate my insulin site as much as possible, but it always itches severely when I put the site in my arm or leg, so I have to stick to putting it in my stomach or bottom. I have had these very small bumps that almost look like goosebumps in the areas I put my site in. They do not itch and are not puss filled. However, I am very self conscious about them. I was wondering if they are related to an allergy to the infusion set, are simply scarred tissue, or what?
Hi Mistie, I’m sorry that you experience some uncomfortableness when rotating your sites. I will have a member of my team reach out to you to offer any suggestions to try to help. You may want to talk to your healthcare team regarding the bumps you’re concerned about. They’ll be able to best address your questions and needs.
I have been a type 1 diabetic since I was 17 mths old. I am now 20yrs old and have started noticing lumps n my abdomen area. I have been messaging them, dieting, exercising, etc, and can’t seem to get rid of them. I sometimes hate my body, because my body frame is small but there’s two big lumps on each side of my stomach. I been on web sites and still no one has an answer to my question, which is “How can I get rid of these lumps”?
Hi Iyunaa. I am sorry to hear about the reoccurring lumps on your abdomen area. For information on site rotation and location for your infusion sets, check out our website at http://www.medtronicdiabetes.com/customer-support/insertion-site-management/infusion-placement. I would like to connect you with a member from my team to discuss this with you, so will have someone follow up with you soon.
if i used my bottom my bloods go very high if i used my thighs the same thing happens
Have had diabetes for 47 years, on the pump for 4 yrs. Have much scar tissue in abdomen so have moved to my sides & changed to a sure-T infusion set. Have Polymyalgia Rheumatica for 4 yrs & consequently due to pain , can’t do it myself so my husband has to do it. Am running out of places there. Also have degenerative disc disease & just got a back brace which does not get along with the infusion sets. Any suggestions would be helpful.
Hi Betts, I’m sorry you’re experiencing these problems. I’ll have someone from our 24-Hour HelpLine team contact you to see if there is any way we can help.
Thanks for sharing Dyanna and Cathy, we understand that all of our customers have individual experiences and we’re glad you’ve found what works for you.
Read these emails and thought I would make a comment. I have been on pump therapy for 28 1/2 years. I too have some of these issues, but they go away after a few days. I think the bleeding is caused when we hit a small capillary under the skin. Use a tissue to stop the bleeding, but if it continues a bandadi works just as well. amy best advice for everyone is find an Insulin Pump group that meets xregularly with a Diabetes Nurse Educator. Many of your problems will be answered by others who have found simple solutions. I live outside of the Chicgo area and the group meets at Elmhurst Hospital the first Tuesday of the month. We would love to see some new faces if you live close. We also have specialsits who come to tell us about the latest things related to pump therapy or our health. I change my sites every two days as I learned the insulin crystalizes in the tubing. Good luck with your therapy. I would like to have one month “off” when I didn’t have to think about blood sugars and where my pump is located. I do not use the CGM at this time, but have been thinking more about it. Again, good luck.
I saw this article, and was curious….I only have used my stomach for past 15 years I have bruising and lots of scars but the hardening doesn’t occur, just rotate on a larger scale….I have use almost every spot till my love handles reach my spin…it’s better to have correct medication then have to waste equipment, and time.
Angela and Gary, thank you both for your comments and I’m sorry to hear that you sometimes have trouble with your infusion sets. I’ll have our HelpLine team reach out to you both to try to help.
You would think with the advancement in therapies, there might be a solution to lipohypertrophy. Will Liposuction work? How about Ultrasound to disrupt the bumps? Are there any Laser technologies available?
Interesting question Robert! This is definitely not my area of expertise, but perhaps someone on your healthcare team can help you find an answer?
I am a type 1 “Brittle” diabetic due to removal of my pancreas in November 2008. My readings go from low 50’s to off the chart. I have been told I’m carb sensitive and insulin resistant. Sooo…what do I do? I do have a CGM, but it’s rarely in sync with my actual reading. With being a Brittle diabetic…it alarms all the time, which gets on my nerves at times. Also….I am slim, very, very body fat, especially in the stomach area. I have used every inch that is available for a good spot for my infusion and CGM. I had a “Whipple” in 2008…hence the Type 1. Good sized “frown” scar and I can’t get too close to that. Have tried outside my area but usually get “no delivery” alarms. Also, CGM many times will hit a vessel and bleed like crazy. Got any good ideas?
I’ve been using pumps for 12 years, and totally wasted my abdomen before being told about this issue. Now I avoid it completely, using my “love handles” on the side and back, my arms, on the outside down to about 4 inches above my elbow, and the inside of my thighs. I’ve had trouble with the outside of my thighs – sometimes ripping out the set when I pull my pants up. 🙂 I’ve found I can’t use the fattest parts of my arms and thighs, as the insulin doesn’t absorb very well. I have to find spots closer to the muscle tissue – just not too close!
Naomi only refers to someone else. Want to know, from someone who knows, how do we get rid of the large lump from all the injections??
I have been a diabetic all my life. Started using the insulin pump in 2000. I do the rotation every 3 days. My problem is not lumps but indentations(stomach, buttocks and thighs), this leaves no fat to put the infusion sets in. Any suggestions.
What about when you do change your insertion sites on a steady rotation and you skin GOES INWARD or SINKS????? One of my butt cheeks is soooo “dented” inward it is amazingly bad. It is starting on my upper thighs as well. Thanks!
Hi Kelly,
I have the exact same problem! My upper legs/hips are indented, one side more than the other. I’ve had Type 1 for ten years, been on the pump for 6. I’ve always used this area, and just switch sides. I am going to try and move the sites to my lower stomach and see if the indentation goes away. Have you found out anything from your post that you could share. I can let you know how it goes with me. Thanks
Stephanie, it’s important to rotate your infusion set site each time you change your infusion set to help keep your tissue healthy and allow previous sites to heal before reusing them. I recommend talking with your healthcare team to find an insertion site that works best for you. You may find this article on site rotation helpful, too: http://www.loop-blog.com/4-tips-for-infusion-set-and-sensor-site-rotations/
It’s called lipoatrophy. When you repeatedly inject insulin in the same areas you can get lipohypertrophy (abnormal accumulation of fat) or lipoatrophy (loss of fat tissue). I had huge indents in my legs a year into my diagnosis…the only thing that will help is time…your body needs time to heal. I think it probably took me 6 months to a year for the fat to reaccumulate.
Been a type 1 diabetic for 58 yrs, on insulin pump for 3 yrs. I occasionally get bleeding when I take out the infusion set, the a bruise appears, goes away in a couple of days. I use the top of my legs for infusion, and top of my stomach area, and away around the belly part. I have used a message machine to work on the stomach area, which seems to help. I really like being on the pump because I hated taking 6 needles a day prior to pump. Have been involved in a lot of studies in the London, ON area over the years, doing a water/intake study now. Was involved in a long term study for having diabetes for so long at St Joseph’s Hospital, in London. For having diabetes so long I really don’t have too many problems, either than CKA, on a strict low sodium, potassium carb diet. I have always had an endocronist looking after my diabetes, and now a Kidney Specialist. I was a child when I got diabetes, have 4 children, none are diabetic.
Can you tell me what causes the bleeding and the itching.
I started using the insulin pump about the middle of July, 2013. For several years I have had insulin site reactions when I gave myself shots. Now I am having them where I insert the insulin into my stomach. Works great the first 20 hours, but then does not seem to absorb as it should. I’ve talked to my health care staff and no one seems to know what to do. I’m getting very frustrated because I love the simplicity of the pump. Where can I find some assistance. Everyone seems to be scratching their heads.
Lisa, I’m sorry to hear you’re having a hard time. I’ll have someone from my team reach out to you shortly to see if there is anything we can do to help.
I have a lump that is hanging , what can I do to reduce the size. at first I thought it was a hernia but my NP told me it was from taking Insulin but she did not tell me any ways to reduce it.
Debbie – this is a great conversation to have with your healthcare team as they can best address your individual needs.
I’ve been using the insulin pump for a few years now and the best place for me to place mine was the back of my arms. Worked great until I noticed the lumps/bumps. Now they are very large and unattractive. I look as though I have giant sacs under my arm. Could anyone please inlighten me on how to fix this problem???
Hi Lauren, if you’d like to chat with our 24 HelpLine about this, please give us a call at 800-646-4633, option 1.
Is there anything I can do to reduce or eliminate the bumps. I currently have bumps that are highly irritating.. I thought that if I use a heated damp towel on the area, that could do the trick. Any ideas?
Hi Barry, I’m sorry to hear that. This sounds like a great question for your healthcare team as they can give you the best advice to meet your individual needs. If you have any questions related to a Medtronic device, let me know and I can connect you with someone.
Naomi – it seems you have an auto response – “sorry, can’t help you,speak to your healthcare team” – Some of this stuff is really basic – DO YOU KNOW OF ANYTHING THAT HELPS WITH THE LUMPS/PAIN/SWELLING? – Massage? some therapeutic oil? anything? – If not – why don’t you just close this thread. What’s the point of you repeating your non-answer over and over again. Why don’t you let one of those “24-Hour HelpLine team members” get on and answer these concerns?
I’m sorry you’re frustrated with the response we’ve given, Carol. We do recommend that our customers call the 24-Hour HelpLine if they experience any specific issues, as this is easier to handle over the phone instead of in writing. If you experience a lump, move your infusion set to new area and allow for the tissue to heal before using the site again. The amount of time it takes to heal the tissue just depends on your body. Because we do not know your specific medical situation, we recommend speaking with your healthcare professional, who would have a better understanding of your specific needs and can give you advice specific to meet those needs.
hi hear hear right on i totally agree with you. Get off the site if you can’t answer the simple question. I have been getting more and more lumps in my abdomen and they hurt. I wanted to know the same questions you asked. How do you get rid of them? I move it around all the time doesn’t seem to work. I haven’t tried anywhere else. I am afraid of going anywhere else it looks disgusting, a sac of fat hanging with bruises. Did anyone answer your questions if so please share help victoria.
Hi Victoria, I’m sorry to hear you’re experiencing lumps and bumps (lipohypertrophy) from insulin therapy. Try to avoid using the areas of your body that have lipohypertrohy for your infusion set site, allowing the sites to heal before using them again. You may also find this article helpful: http://www.healthline.com/health/diabetes/lipohypertrophy#2. Since we’re not medical professionals, we recommend talking with your healthcare team about solutions that fit your specific needs to help you rid of lipohypertrophy.
I have just started Insulin Injection . Is there an Ointment / Cream which can soften the Skin
Hi Chari, I’m not qualified to give any kind of medical advice. I recommend that you ask your healthcare team as they can give you the best advice to meet your individual needs. If you have any questions related to your device, let me know and I can connect you with someone.
Been on insulin since December, 12. Have had no real problems. But, now I have a lunp in my abdomen that has enlarged since noticed about 4 days ago. About the size of a quarter, from, originally about 1 inch long and 1/3 inch wide. Also redness on surface at the site. No pain
Dale, I’m sorry to hear that. It sounds like you should consult your healthcare team as they can give you the best advice about this. If you have any questions related to a Medtronic device, let me know and I can connect you with someone.
I’ve only been using insulin for about a year and I only have this on my legs. However the areas bruise, the lump appears and it itches like crazy. I wonder if it’s the type of insulin might also help. Instead of using synthetic insulin or animal based….I actually asked if I was allergic to the brand I was using. I know the body produces it naturally but it’s not pure there are additives added to the medication. Could it be a problem like that?
Nicole, I’m sorry to hear you’re experiencing this. However, I’m not qualified to give medical advice. This is a question best asked to your healthcare team as they can answer questions specific to you and your needs. If you have any questions about a Medtronic device, let me know and I’d be happy to connect you with someone.
I do rotate my shots all the time, but it doesn’t seem to matter where I give the shots it always leaves a bump and they hurt to touch..
Kate, I’m sorry to hear that. This sounds like a great question for your healthcare team as they can give you the best advice to meet your individual needs. If you have any questions related to a Medtronic device, let me know and I can connect you with someone to help.
Kate – Have you learned anything new about your reactions? Do you also react to insulin shots? I am curious because I am a type 1 that is suspected of having allergy to insulin. I am working with the Barbara Davis Center with this issue, and they would like more cases to study. Do you know anything else about your reactions?
I am going though the thing what shough I do
I also rotate sites but still get large bumps. I don’t think I am absorbing the insulin because in the last few months my A1C has gone from 7.0 to 9.3!!!! What am I gonna do?????
I’m sorry to hear this, Tommie. This is a good conversation to have with your healthcare team. They can make the best recommendation based on your individual needs.
I can relate to Robin and Rachel. I’ve been on a CGM since June 2009. I’m having trouble finding insertion sites. My abdomen isn’t good for the CGM b/c of lipothypertrophy (I’ve been on a pump for 25 years) and I’m currently using my hips and upper buttocks for the CGM, but I’m really struggling with finding new places. Any suggestions? Has anyone used the thigh area for the CGM?
@Teresa the Medtronic sensor is actually only approved for use in the belly area. For infusion sites, there are more approved options (arm, thigh, top of buttocks). You can find more about site rotation and selecting sensor and infusion sites here: http://www.medtronicdiabetes.net/support/insertion-site-management. And if you’re having trouble with lipohypertrophy, I’d definitely check in with your healthcare team. They’ll likely have additional guidance for you.
Lots of outdated correspondence here.
What’s up with that ???
Thanks, John, for reaching out. As mentioned at the beginning of this blog, it’s one of our most popular blogs of all time and still relevant to the community so we decided to share so those who weren’t aware of it could still benefit. Hope you enjoyed it!
I have been diabetic for 20+ years and was put on insulin pump therapy in October 2011. I have problems when a site works for the first day then it is as if I have no insulin working after that. I was told to only use my abdomen, so I can’t change sites a lot, but, I am running out of sets from changing them so much to try to find a site that works. Any ideas?
Robin, I have had an insulin pump for almost ten years and would love to know the answer to that. I believe I must now have lipohypertrophy. Two days ago I was trying to insert CGM and took it out because of pain and all the sudden discovering a large lump which has turned into a huge bruise and smaller lump. I go through spots that work for a while and then it is like they become “immune” so to speak. I wish I had an answer because when this happens I tend to get pretty upset.
@Rachel I’m sorry to hear that. I’ve sent your comment to someone from our HelpLine team who will reach out to you shortly to try to help.
I have had diabetes type 1 since I was six and am 48. Never have used an insulin pump before. I have used injections ever since i was diagnosed.
A few years ago I saw a picture of some boys who had pumps and only 10 years old!!
I have always wondered what is it like using one of those?
George, if you’re interested in chatting with someone who uses an insulin pump, we have a great group of MiniMed Ambassadors who you can reach out to: http://www.minimedambassadors.com.
I was on an insulin pump for 3 years, unfortunately it didn’t fit my lifestyle but I was never told to only insert canulas in the tummy area, I used to wear them in my legs & even round the soft tissue at the bottom of my back, I never had any problems with insulin being absorbed.
Robin I’m the same way as you. I done it in my legs and 4 days later like my muscles went on my legs.
I have been taking infections in my stomach since 2003. I have two lumps very big lumps on my stomach. They are embarrassing and I hate them. I’ve lost over 100 pounds and it’s very noticeable. Do they ever go away? Afraid to take the shots anywhere else because of this. I’m a type 1 and will always have to take insulin. Please help. I’m not over weight. I use to be over 4 years ago.
This is great! I had been putting my infusion sites on my “love handles” for a while because that was the easist location for me, and for a while, the most predictable. Well, I think I overused those sites because I started to have absorption issues. Now that it is winter and my sleeves are longer, I am having some good luck using the back of my arms.
You sound exactly like my 9 year old daughter, Zoe Everytime we tried her tummy area, we hit a vein. She preferred her sides but now it’s beginning to form lumps, so she finally allowed me to try the back of her arm!!
I really appreciate this article, some decisions are particularly hard to make, when, for example, I’ve used the same location for years, taken long breaks, come back, and I’m curious how one can contribute the the healing process, how to speed up, in a sustainable way, healing from Lipohypertrophy, and also, could you write an article, regarding how to avoid hitting blood vessels? Maybe I’m just being silly and it’s simply a matter of choosing areas with more fat, but I just had the frustrating experience of having 3 failed sites in a row, all due to bleeding. Maybe it has to do with the Quick-serter and the length of the needle of the quick set? I have been using the same quick serter, all along for Paradigm quick sets, usually using 6 mm canulas, since i have very little fat and I am finding it hard to, in a predictable fashion, choose the spots that will most likely be good for insulin absortion, taking all factors into consideration? I know I need to experiment more, or else I’ll go crazy thinking doing the same thing but slightly different will somehow give me considerably better results!
Thanks for reaching out, Chris. This sounds like a good conversation to have with our 24-Hour Technical Support team. They may have suggestions available, including a different infusion set type. You can reach our teammates at 800.646.4633, option 1.
Does the back of the arm hurt more? I’m thinking about switching to that area. I only weight 125lbs so some of the other areas besides the abdomen I can’t really do because it’s so so painful. Thank you
I always thought that using the back “fatty flaps” of my arms or “triceps” would be painful but I have no other choice since i have extreme bloat from Gastroparesis & can no longer use my stomach for some reason. But it does not hurt! I sometimes find that the infusion set will peel away onits own when being used on my arms, maybe from the way i sleep or running against clothes, but what helps is Tegaderm Transparent Dressing. I cut a hole in the center of the bandage, just enough so the set pokes out and it works like a charm, no more lifting. It’s clear and waterproof too.
I never had this lifting issue before but it started happening recently. The tricep area does not hurt and is a nice relief from the other areas more frequented.
Mindy, You should consider changing arms.
Yes thats true, What I usually do is change arm every 3-5 days, and in like a month of doing this, ill change to the tummy area to let my arms rest, it really does help me.
What happens when you massage a insulin lump to break it up? I just tried using a massage gun on my lump on my butt and it got really red, itchy and looks like it might bruise and some stretch marks are showing up. Any explanations?
Shana, this is a good conversation to have with your healthcare team, as reactions to these types of treatments are specific to the individual.