Tuesday, April 03, 2007

Not all Skin Preps are created equal

I love my insulin pump, and I've had minimal issues with sites in my 8 years. The main thing I need to do is make sure I'm rotating my sites enough, and I'm fine. Ever since I've been on the pump, I have used the Sof-set and Skin Prep underneath the tape to reduce irriation. It has always worked well for me, sites have to be seriously yanked on or messed with to come off unexpectedly. So, a few months ago when I was ordering my test strips, I also ordered Skin Preps. Or so I thought. I hadn't needed to use them until a couple weeks ago, and discovered that not all skin preps are created equal. This is a picture of the skin preps I usually use:

Ingredients: Isopropyl Alcohol, Butyl Ester of PVM/MA Copolymer, Acetyl Tributyl Ctirate
However, this is what I received to use:

Ingredients: Purified Water, Diglycol/CHDM/Isophthalates/SIP Copolymer, Sorbitol, Glycerin, Octoxynol-9, Dimethicone Copolyopl, Diazolidinyl Urea, Methylparaben
(Editors note- my theory is that the glycerin was the culprit. Who puts something that is in soaps in a skin prep?)

Now, I notice that the packaging was different,but the box I received actually looked a lot more like the ones I usually use. So, I figured I'd give it a try. Then next day in the shower, I hear something drop, and I hadn't dropped anything. I look down, and there is my site, on the shower floor. Huh??? I've never had a site completely come off within a day, so this was strange. I figured, okay, at least I can just change the site-and at this point was suspicous of the skin prep. However, I don't like to forgo using it, and I figured once wasn't enough to blame on the skin prep- maybe there was another explaination. So, I gave it a second chance. And the next shower my theory of it being the skin prep was proven- site came out again. I quickly changed the site using just alcohol underneath and it seemed fine for the rest of the day. I went out with a friend and treated myself to a Starbucks frappacino, and guessed at the carb amount. 2 hours later I tested, knowing that my guesses on these things are often wrong, and I had been cautious since I had done a lot of walking that day and my site was in my left leg. I was 385, so I corrected, and I felt fine, so I thought it was just the frappacino. Well, the site must have been bad because at 530 the next morning I was 438 with ketones and feeling sick, and spent the rest of the day chasing that high down and flushing out the ketones with water. So, that's why I wanted to share this story- especially for anyone new to pump therapy. Luckily the week following that one day has been fine, and no more site issues have happened. And this past Saturday my blood sugars were the exact opposite because I woke up at 81- and spent most of my day under 141.

Time BG
539 438-manual shot and site change
640 387
800 259-correction
1100 443-food and correction
1219 410-correction, more water
218 235
400 174-set lower basal because I was walking a lot
616 169

Time BG
530 81
730 99- one of my best post breakfast reading
1030 129
1200 142
150 197
300 131
430 49-oops over did the carb ratio with my last snack

Isn't it amazing the difference a site and starting out the day right can make?


Shannon said...

Whoa, I didn't see the headers for "time" and "bg" and nearly fainted thinking you were in the 1,000 range, LOL!

That's how it is for us with Brendon's sites. He'll go in the 200's fooling us into thinking that he's going through a growth spurt, and we'll change his set that night and the next day see beautiful numbers.

Nothing more refreshing than a good day of numbers!

Bernard said...


Those are some scary numbers, I'll bet you felt lousy.

Thanks for the warning about these skin preps. I just use IV Prep on my site for the pump.

For the Dexcom, they just recommend alcohol, so that's what I'm using.

Kate said...

Sorry to scare you! I did create that in a table in word, but for some reason when I copy and pasted it the lines didn't copy.

Yeah, I was feeling pretty lousy for the until I broke out of the high numbers. I know with the sensor anything other than alcohol if it gets on the end of the sensor (especially if it has that lovely glycerin and sorbitol in it) can make the readings inaccurate which is why only alcohol is to be used under them.

Scott said...

Wow, I used Smith + Nephew skin preps when I was pumping, but was forced to use Skin-Tac H before that to ensure the site lasted longer than 1 shower!

I'm no longer pumping (but that could change), but its good to know that the adhesives with different brands varies so considerably.

Scott said...

BTW, I used Smith + Nephew IV Preps, not Skin Preps. Something to keep in mind!

Kate said...

Yeah, that's why I posted my experience. I have been pumping for a long time, and I even thought that maybe it wouldn't hurt to try something different. So, knowing there are some new pumpers in our blogging community, I thought it would be helpful to them to know what to pay attention to. I tried the IV Preps when I first started, but they didn't work for me, I forget why now. My skin is sensitive, I think it had something to do with that.

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