For those of us who use insulin pumps, we need insulin delivery to be seamless. Interrupted delivery can mean a major change in blood sugar, and it often happens at times when we are not prepared. While there are several reasons for interruptions, such as air bubbles in the tubing, periods of disconnection or insulin delivery suspension, it’s extremely frustrating when it happens because our insulin pump site doesn’t stay stuck to the skin. Shouldn’t that adhesive hold for at least three days?
Unfortunately everyone’s activity level and skin (and the oil it makes naturally) is a bit different. Some people have no issues with a site staying securely attached. In fact, they have to use something to loosen the adhesive in order to take it off! Others fight to keep it stuck even hours after a new site has been attached. Different times of the year such as summer can mean sweaty skin that decreases the adhesive quality of infusion sets or pod adhesive. Different activities (heavy exercise, a day at the beach, time in the pool) can also create adhesive challenges.
Where to Start
Surprisingly, one of the best strategies for keeping you pump site in place is to choose the right body part. Pods and infusion sets placed on the arms, legs (compared to the lower back and buttocks) are more likely to get bumped. The skin on the arms and legs (as well as the abdomen) also tends to perspire more, pull/stretch more, and have greater oil secretion. Likewise, hairless sites tend to hold in place better than hairy sites. So choose your body part wisely!
When placing a Pod or infusion set on your skin, make sure that the site is clean. Things like the natural oil in skin, moisturizers (lotions or moisturizing soap) as well as dirt can decrease the “stick” of the adhesive. Use an alcohol pad or soap and water to clean the site and then ensure that it is entirely dry.
Many options are available to help keep the adhesive in place, and remove it when it’s time.
Skin Preparation and Adhesive Removal Products
Some people use Antiperspirant (solid or spray instead of the cream or gel type). Put it on the skin where the infusion set will be placed and wait until the area is completely dry before attaching the infusion set/Pod.
There are sticky products like IV Prep (which cleans the oil from the skin and makes the skin sticky which helps the site stay attached). There are also products like Mastisol or Skin Tac which are kind of like a rubber cement for skin. When placed on the skin before the infusion set is inserted, they help to make a barrier to prevent the skin’s oils from loosening the adhesive. These are very sticky and usually require a product like Detachol to remove the site from the skin. Another alternative for easy removal is to soak a cotton ball in baby oil, dab it around the adhesive and let sit for a few minutes before pulling off the Pod or infusion set.
Some tapes are a bit like a thin plastic tape, but will fit over or under the Pod or infusion set adhesive to keep it securely attached. These thin tapes can be used under the Pod or infusion set and will allow the set to be inserted through the “tape,” create a barrier (which can help those with skin allergy to the Pod or infusion set adhesive as well as keep it stuck), and keep the site intact. These include:
Hypafix, Opsite Flexifix (by Smith and Nephew), Tegaderm, and IV3000. Another good option if you have skin allergies is ToughPads by Johnson and Johnson.
These types of tape can also be used over the top of the Pod or infusion set adhesive, if needed. Smith & Nephew’s Infusion Set IV 3000 is popular because it has a pre-cut hole to allow access to the infusion set’s disconnect mechanism.
Other types of tape are a bit more like fabric and some come pre-cut in fancy shapes and designs to make your pump site a bit more fun and less “medical” looking. These include:
Granted, there are about as many products available for keeping that site stuck as there are skin types. It often takes some trial and error to find the product that works best for you. But keeping yourself connected is well worth it!
-Gary Scheiner MS, CDE and the Clinical Team at Integrated Diabetes Services