Insertion site management

Sites should be rotated each time you change the infusion set or glucose sensor. This keeps the tissue healthy and allows previous sites to completely heal before reusing them. Remember, controlling your glucose levels becomes more difficult over time when you infuse insulin in the same area. Check your blood glucose 2 to 3 hours after changing your infusion set. This is the only way to confirm your infusion set is properly inserted and that you are receiving insulin.

Change your infusion set every 2 to 3 days to help prevent infection.

Change your reservoir as indicated by your insulin manufacturer.

TIP: Only fill your reservoir with the insulin you need for 3 days or as prescribed by your doctor.

The diagram below shows the best body areas (shaded) for infusion set insertion. You should consult your healthcare provider to determine the sites that will work best for you.

Your infusion sites should be at least:

• 5.0 cm away from your sensor site
• 5.0 cm away from your belly button
• 7.5 cm away from the previous site.

Avoid inserting the infusion set:

• into the 5 cm (2 inches) area around your belly button
• where your body naturally bends a great deal
• in areas where clothing might cause irritation (for example your beltline)
• where you have scarred or hardened tissue or stretch marks.

The visuals below may help you rotate your sites in an organised way. For best results, use both methods, switching between the two.

"Clock" rotation

"M" or "W" rotation

Keep the site clean-shaven and try removing dead surface skin cells with a facial scrub, brush or washcloth with soap. Then rinse with water followed by an alcohol wipe.

• Stretch skin tightly before using a prep wipe or tape.
• After you apply the tape, go back around the edge of the tape with your finger to seal the edges to your skin.
• Avoid placing your infusion or sensor site at your waistband, which could rub and loosen the tape.
• Remember tape won't stick well on top of skin where you’ve used lotion

If possible, plan to change your site when you have a shower so you can clean the site well. Before you shower, remove your old infusion set. If your skin appears to be sticky, clean off the old adhesive with an adhesive remover. In the shower, wash the area with soap. If your site change is not around your shower time, be sure to wash your hands with soap and water as well as the areas you intend to insert your infusion set.

• Disinfect the skin with isopropyl alcohol or an alcohol wipe.
• Let skin dry thoroughly before applying either the infusion set or the adhesive.
• Apply a prep wipe in a large area around the site, allowing it to become sticky.
• Touch as little of the adhesive as possible on the infusion set to avoid getting skin oils on it.
• Insert your infusion set following the process and techniques your healthcare professional/trainer showed you or review your infusion set’s support video.
• On days you know you will be very active, sweating or swimming, cover the site with additional adhesive tape.
• You can try using additional tape on the corners to prevent them from peeling up and lifting the entire infusion site out.
• Check regularly to make sure the tubing is not pulling on the site and adding stress on the adhesive.
• When you have any issues with the adhesive, try another site.

Method:

"Open face" sandwich method

IMPORTANT: The sandwich method should be used with infusion sets only. Do NOT use the sandwich method with sensors because the sensor electrode is sensitive and could become damaged if inserted through anything other than dry skin prepped with alcohol.

• Prepare the skin and allow it to dry.
• Apply a clear adhesive dressing directly to your skin.
• Insert the infusion set through the clear adhesive dressing (follow the instructions for inserting infusion sets). The adhesive on the infusion set will be sticking to the clear adhesive dressing instead of sticking directly to your skin.

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