How I Prevent Insulin Pump Site Infections

Since I was diagnosed with Type 1 Diabetes in 2000, I’ve been to the hospital 2 times for diabetes-related incidents.

At 5 pm on March 27th, 2017 I drove to the Emergency Room and was at the hospital for 3 days.

Then, on October 7th of 2019 yet again, for the second time.

Both times were from the same thing: insulin pump site infections.

And while a large part of me wishes that I could go back in time to prevent both infections implementing what I know now, there’s a small part that is grateful for the experience. Because now I can share my experience and maybe even help YOU prevent yourself from landing in one of those not so chic hospital gowns:) (i.e I happily volunteer as tribute!)

First I’m going to share some key parts of what I experienced, followed by my current strategy that seems to be working for preventing site infections from occurring.

My experience/ What I learned:

Both times in the hospital taught me how quickly the infection escalates, and how the outcome is much better if intervened at an earlier time.

The first infection in 2017 progressed like this: I went to bed on a Saturday night with my site, which was on my tricep a few inches above my elbow, feeling tender. By the time I woke up on Sunday, my arm was really bothering me, and when I took the site off to change it, I noticed redness radiating out in a circle. It hurt to touch…not unbearable…but not comfortable either.

My mom decided to come with me to a walk-in clinic around 10 am, and they prescribed me an oral antibiotic. I went about my day, hoping the antibiotics would “kick in”, but by 6 pm the redness was starting to radiate and travel up my arm. We made the decision to go to the E.R, and it was there that they put me on a different drip of an IV drip of antibiotics, and then sent me home with oral ones to take.

Monday morning I woke up with the redness looking pretty much the same as the night before, but my 4ish that afternoon, things changed. You could tell that the redness was spreading further and the site was warm to the touch.

I went back to the hospital that evening and after examination, I was admitted for 3 days so they could monitor my arm. They eventually had to knock me out and drain the abscess that was forming. I was left with a scar that size of a paper clip. Every time I see it in the mirror, it always reminds me that us T1D’s are resilient, but not invincible.

With the second infection in 2019, I recognized the signs earlier, but not still early enough. I ended up having to go to the E.R again for a thigh infection, but this time they took a portable ultrasound machine, saw no abscess had started to form yet, and gave me oral antibiotics to take home.

I started to see improvements within 24-48 hours and was really glad I intervened when I did.

After the second time of this happening, I was determined to reflect and figure out to prevent history from repeating itself anymore.

Here’s what has worked for me in avoiding pump site infections from escalating:

1.Keep your site clean! I know this one sounds obvious, but I sware the longer you have diabetes, the lazier some of us get. The common thread between both pump site infections was from bacteria getting under the site. On the first infection, I’m almost positive I did not use an alcohol swab before applying the site. On the second one, I had slightly ripped off the top half of the site while working out, and instead of changing it, I pressed it back down in hopes of getting a few more hours/day out of it. Moral of the story: think STERILE CLEAN.

 

2.Know the difference between site irritation + infection. In my experience, pump site irritations from the adhesives can be red but tend to lean on the itchier side. An infection forming, on the other hand, feels more tender for me to touch and will gradually feel hard under the skin close to the needle center if an abscess is forming. If you start to feel any tenderness while pushing down on the site, take it off immediately…don’t wait!!!

 

3.Circle the site. If you take off the site and notice it’s slightly more red than usual and want to keep an eye on it, circle the area with the pen( see photo above). If over the next 12 hours you realize the redness is spreading beyond the circle, that’s when you might want to take some action.

 

4.Drain the site. *Disclaimer: this one might sound gross and is not medical advice but just what has worked for me * This past week I took off my pump early because it started to feel tender ( step #2: check!). After I took it off, I watched over the next 12 hours that the redness was spreading and it started to feel harder under the skin…like an abscess might be forming. I decided to take a hot shower, really letting the water hit the site (which was on my hip) which I find helps open up the abscess. When I got out of the shower, I started to use my fingers to kind of squeeze everything to the center, almost like you’re popping a pimple. It didn’t take long for it to open up and for puss to start draining out. I immediately felt relief and saw it improve drastically within 24 hours.

 

5.Get yourself some neosporin, vitamin E oil, + a topical antibiotic. I’ve tried a lot of different creams, essentials oils, ect, but this specific combo has worked magic for me. Either put this on right after you pull the pump site off when there is still a small opening, or after you squeeze it open + drain it

 

6.Don’t wait, go to the E.R or doctor if you’re questioning it. Lastly, if you catch it too late and it gets progressively worse, go see a medical professional sooner than later! Timing really makes all the difference.

 

Let me know in the comments below if you found this blog post helpful and go-ahead and share it with someone who you think might benefit from reading it! 

  1. Rose says:

    Did you experience insulin resistance during the infection? Can there be an abscess without any visible redness on the surface of the skin? I can feel a hard little lump and it has been over a week.
    Thank you

    • Genevieve says:

      A small hard lump with no other symptoms of an infection but insulin resistance is probably lipohypertrophy. It’s quite common with insulin pump use and is not a cause for concern. However, you should probably avoid doing new sites near that area till it goes down.

  2. Hannah Mouritsen says:

    Thank you for this post! I have a little infected abscess about size of the one on your thigh and the hot water is really helping the abscess shrink down! I’ve circled it like you said and I’ll keep a close eye on it thanks to this post

  3. Emily P says:

    Appreciate this! Just had a pump site with constant occlusions – I took it off and tonight it felt warm and hard. I’ve drained what I could and now have some triple antibiotic and a bandaid on. Am going to keep watch!!

    • Katherine Jarvis says:

      Just got my first omnipod site abscess and currently sitting in urgent care on a Saturday because I don’t want to wait for things to get worse! Thanks for your article, it made me feel ok to give in and get a doctor’s opinion. Not sure why it happened, I cleaned the site well like usual but it started hurting yesterday and I didn’t remove it. I did try a new site on my bicep/inner arm area so maybe my body doesn’t like it there.

  4. Khristina says:

    I’only started the Omnipod in August. I have had a lot of itchiness and sometimes tenderness.

    Yesterday I woke up with my usually well controlled levels in the 20s and refusing to budge. I thought I’d do a pod change to be on the safe side. It was sore and red, with what looked like pus coming out. Also a big lump By 5 the redness was spreading and I called the doc and managed to get some antibiotics.
    Through the night my levels remained under ten and I thought all was getting better. I drew around the redness, it is slightly out, and the lump remain. Levels again have been raised throughout the day. I will see what it’s like in the morning. I really do not want to end up in hospital. 🤦🏻‍♀️ Your post has been very helpful. Thankyou Lauren.

  5. Amanda Brown says:

    Do your sites get itchy and need changed after a sweaty workout? Mine do, and they are frequently irritated, sometimes infected. Any tips for how to prevent it? I change mine every other day and mostly clean with alcohol wipes before putting on and after taking off site.

  6. Haley says:

    I usually notice that the site becomes extremely itchy and sometimes tender. When that happens, I change the site and immediately squeeze. Stuff almost always comes out of it. Thank you for the tips!

    Off topic: I’m hypersensitive to the adhesive, and I was wondering if anyone has any tips for this issue. I constantly have to change sites because a small rash forms causing scabbing.

    • Mary says:

      My daughter is sensitive to adhesive. For her, spraying the site first with Flonase helped immensely. I check for infection with each site change and spray Flonase after removal as well. If infected, I gently squeeze any superficial pus out and apply topical antibiotics for a a few days until clear.

  7. Caroline C says:

    this is so so helpful. thanks to this article and picture i realized I had the same issue and thanks to laurens advise i was able to get ahead of it and schedule an emergent trip to my primary! they put me on an antibiotic right away. also the hot showers really work!

  8. Mackenzie Hackney says:

    Thank you for sharing, this has helped me so much! I struggle with changing my sites every 2-3 days. Did you leave yours in long than suggested and did this contribute to the infection?

  9. Anna says:

    Hey

    I am using an omnipod and have been diagnosed with cellulitis. X2 hefty antibiotics and still have hard red lump and rash spreading. Would love to share my pictures and how it’s grown. Can I upload pictures for your advice? Thanks Anna

  10. Hector says:

    Me lo ecambido por todo me cuerpo y infección por todo lados y horo donde lo tengo todo negro

  11. Annette Mandarano says:

    This article helped me understand my problem. But when doing everything right and still having an issue. Why does this happen and worse my last 4 pods have cause these lumps and the first one is infected pretty bad 2nd 3rd and 4th I removed early and all were placed in Virginia areas. Just put one on my stomach hopefully it won’t happen again.

  12. Deanna says:

    So about two days ago my infusion set got ripped out of my leg. I put in a new one and thought nothing of it. Today it is swollen, red, very tender and hard to the touch. Is it likely an infection?

  13. Lisa says:

    Thank you for your tips! I have to deal with an infection for the fourth time right now, it is relieving to read I’m not the only one dealing with this. I definitely want to try your tips, especially number 5. Do you happen to know the name of the cream you’re using right now that’s effective? Thanks in advance! Lisa

  14. Wendi Ouellette says:

    I have gotten 3 different abscesses that got infected. One I actually had to have surgically removed and drained. My last infection from it was Cellulitis, which can be life threatening. Has any of you called an attorney to go after Omnipod for pain n suffering?

  15. Angie says:

    I have been searching for awhile for anyone else with these issues. Mine are horrible and last for months and then leave terrible scars. I’m so frustrated with the medical community and not able to help. I currently have 4 abscess, , 3 on my thighs and 1 on my abdomen. They are tender have to be cleaned and covered or ooz on my clothes. I am even currently on twice daily antibiotics to try help , which has done nothing other than take my appetite away. I’ve tried going off the pump but I’m far too brittle and cannot control it without the pump. Do you have any advice?

  16. Kathie says:

    Thank you for your post ! My daughter (30 ) clearly has an infected site ..first time ! The redness was after one night of her site ! Was clean and she felt it was from lying on her side ! I changed it and the redness has gotten to be about the size of your picture ! Bandaged and put neosporin ! Today when I removed the bandage the center popped an drained a lot ! Cleaned and rebandaged ! She said is sore but feels better ! I will watch it and if not better in next few hours will bring her to urgent care ! Thank you your post just reenforced what I thought !

  17. Stephen Teaman says:

    I had an infection turn abscess then proceed to cellulitis, treated by bactrim and a topical ointment. Found out that I was allergic to the bactrim and then went into cardiac arrest ending up with swollen lymph nodes and pericarditis now awaiting for a biopsy. I have had nothing but trouble with the omnipod 5 dash system and am awaiting for my endocrinologist to get me into something less infectious.

  18. Debi Corson says:

    I find if i change my site every 2 days i have NO irritation at all. By 3rd day my body hates the canula.

  19. Andy says:

    Read this with interest. I’m type 1 on a pump and have been on tru steel 4 months with no dramas. I was having a LOT of bent cannula with autosoft 90 so thought I’d try tru steel. They been fine – bar this story.

    4 weeks ago a cannula site became sore. I took the cannula off after 3 days and noted it was red and hot to touch. I thought sure its infected and carried on regardless. Keep the area clean and keep an eye on it. It didn’t go down and presented eventually as a big sore lump that came to a head – like a spot.
    Now almost 4 weeks later I have a wound that is being cleaned dressed and packed every two days. The first visit saw the access/ site well- drained and 7 cm of aquacel ribbon packed into it. This has continued over the last 3/4 weeks and is now almost shrunk to the degree that it is finished treatment.

    However,lo and behold a second site on the opposite side has become sore after 2 days. Sore, red,warm. Immediately mentioned it at one of my.wound appointments and again started a course of flucloxicillin. This does not appear to have made the infection subside and I suspect.ill now have the same month of trauma care.

    Really really frustrating.

Leave a Reply

Your email address will not be published. Required fields are marked *