Research on 7-day infusion sets and lipohypertrophy?

[Boerenkool]

Does anybody know if there is any research on 7-day infusion sets and the risk of developing lipohypertrophy? They sent me those Minimed Extended infusion sets, because they don’t manufacture enough Mio Advance sets anymore apparently. Minimed’s advertising is all about the wonderful comfort of wearing a set for seven days and what magic they have done to prevent blockages, but there’s an elephant in the room… We’ve been told forever about the importance of diligently changing sets every three days and rotating infusion sites, because of lipohypertrophy. What happened to that story? Crickets… ?
Do these sets somehow counter development of lipohypertrophy? Is there any research comparing 3-day and 7-day infusion sets? I haven’t been able to find any information.

[Terry]

@Boerenkool

Do these sets somehow counter development of lipohypertrophy?

As someone who has used a pump for the last 39 years and has experienced hypertrophy even though I have changed sites every three days. Count me as a skeptic.

[jbowler]

@Boerenkool

We’ve been told forever about the importance of diligently changing sets every three days

Last time I looked there is quite a lot of research on that. Basically it looks at what happens after 3 days and it suggests that problems worsen more rapidly. I’m not sure that proves anything. Some clinical practice in hospitals and care centres has a much lower tolerance:

The current evidence base for the feasibility of 48-hour continuous...

But then, from that paper:

In contrast to UK clinical practice, Spanish Palliative Care centres regularly infuse multiple-drug containing CSCIs to patients over a 5- to 7-day period via either a syringe pump or PVC cassette[8].

That’s not insulin but for sure insulin was being injected into a significant number of those patients.

My own experience (so not research) is that most of the time I’m fine up to 80 hours with an Omnipod and, of course, I can’t go any longer. I did, however, recently have a possible case of lipohypertrophy on my right front thigh. I’ve avoided my front thighs for 30 or more years because I basically shot up there for the first 24 years and they were duly shot up. I started putting the 'pod there a month or so ago and had a big, bad, hard lump last time. The 'pod worked just fine (better than other sites).

I’d say, “Suck it and see.” Just watch what happens and take care after day 3 the first and second time. I’m getting good results out of my thighs despite one adverse reaction so I’ll keep going until they fail.

[jbowler]

There’s the AI-linked topic:

Infusion sites: how long do yours last?

WE never go more than 3 days, because of the fear of lipodystrophy. However, i think the length of time a site can go before it gets occluded with gunk from the immune system is anywhere from 1 to 7 days for different people. Theoretically at least, then, there are people who can use a site for 6 days without a decrease in insulin in the short-term. In the long term though I think they’re still setting themselves up for scar tissue and fat accumulations that will reduce insulin absorption. Pers…

So far as I could see the kind of information @michel was looking for is on TuD. Was on TuD.

It makes sense to me that there should be a gradual degradation; an exponential one where the problems simply multiply up from day 0. @eric 's summarized TuD thread seems, to me, to reflect that.

[Eric]

@jbowler

@eric 's summarized TuD thread seems, to me, to reflect that.

I certainly wish I could still see that!