Jan 2011 newsletter FEATURE: Top tips for diabetic skin health

Soothe operators: From finger-pricking and injecting to infusing, you can save your skin with a choice from creams to clothing.

By Sue Marshall

Everyone with insulin-dependent diabetes must wake up one day and think, “I am a human pin-cushion”. There’s not much more to be said, as it’s true. Most of us puncture our own skin about 6-8 times a day due to the need to blood test and inject. It’s a lot of intrusion for our skin to have to handle. Ignoring the pricks to our fingers, our arms, legs and tummies have a prickly time of it with daily injections, even if we do rotate our sites. If you’re on a pump then you replace multiple-injections with infusion sets, but they stay in place for three days at a time. They can be a bit itchy (to say the least) but that passes and then you barely know it’s there. When you take the set out you might have a little hole left that would benefit from some extra TLC for a few days. All these minor skin injuries will heal, but you can give your skin a helping hand.

Fit kit

With skin described as the largest organ of our body, we owe it some respect! First, think about your equipment. Minimise skin damage and irritation by using the best equipment and ‘best practice’ when it comes to injection technique (see top tips at the end of the article).

An example of fit-for-purpose kit is the I-port, an injection port which gives insulin injectors a way to give themselves their doses without having to puncture the skin for each dose. This is especially useful for parents of small children with diabetes. Each i-port stays in place for up to three days and does not need to be removed for most daily activities (like taking a bath or shower). Basically, once you’ve popped one in, you don’t have to do another one for a few days and you use the i-port as the injection site during that period.

The company was founded by Catherine Patton, three years after she was diagnosed with type 1 diabetes while pregnant with her first child. Monday Medical promotes and distributes the i-port in Europe.

The new 4mm needle from BD (available on prescription) is described as doing less damage to skin as it’s both super short and super sharp which should lead to less pain and a greater adherence to site rotation – the art of putting a new jab into a difference bit of skin each time.

For pump users, pump equipment has evolved so that there is a little more choice with efforts having been made to improve the usability and comfort of the infusion sets in particular. The infusion set is the part that actually sits in the skin delivering the insulin. Usually made of plastic, there are now some variations that may reduce irritation and localized inflammation by using other materials.

Medtronic’s Sure-T infusion set is a steel needle infusion set with an additional adhesive pad to provide extra security against needle dislodging. The Sure-T infusion set is intended for insulin pump users who prefer using a very fine 29g needle to infuse their insulin rather than a cannula. The simplicity and enhanced security of Sure-T make it a good choice for infants, young children, adults and women during pregnancy.

It features a 29g very fine needle with a separate tubing connector is 10cm away from the actual infusion site, allowing for disconnection without touching infusion site (less irritation at the actual site itself). There is an additional adhesive pad for extra security.

In addition, Medtronic’s Polyfin infusion set has a steel needle that is recommended if you are sensitive or allergic to Teflon. Its Quick-Release (QR) disconnection is useful in case of reduced vision or dexterity. A very flat and discreet infusion set, the Quick-Release tubing disconnection is 10 cm from insertion site for ease of handling.

For both the Sure-T and Polyfin infusion sets, insertion is a simple manual undertaking suitable for those who do not like to ‘bang in’ their infusion sets.

Meanwhile, Accu-Chek’s Flex Link infusion set is designed for easy-to-handle insertion, using a thinner and shorter introducer needle than before. A blue holder cap also helps make insertion simple. A reversible connection makes connecting and disconnecting easy. Its flat cannula housing with round edges makes it comfortable to wear and helps avoids snagging. Very newly available is the Accu-Chek FlexLink Plus infusion set also includes ‘Safe-In’ technology. Safe-In activates the introducer needle only when it’s needed, minimising needle interaction during insertion and disposal.

Skin calming

With multiple blood tests injections, the use of infusion sets, even continuous glucose monitor sensors, someone with diabetes might need recourse to something that will soothe sore skin and reduce any itchiness that might be caused by some of the equipment some of us have to grapple with.

So the general skin-puncturing bit having been done, over time you might just want to treat your skin with some soothing and healing creams or oils. Most of these skin soothers are available from chemists and major supermarkets, or ask your pharmacist about them.

A simple solution to put on a sore spot is Lanes’ Teatree and Witch Hazel cream treats and soothes cuts and stings, minor skin conditions. For something a little harder hitting, Flamozil is a paraben-free hydrocolloid gel which uses Silver Citrate as a preservative and can be used for the care of local, dry or moist wounds. It indirectly promotes wound healing by regulating the microenvironment of a wound. It can be used for acute or chronic wounds such as leg sores, ulcers, surgical wounds as well as grazed skin and superficial burns.

Used twice a day for a minimum of three months, Bio-Oil is likely to reduce or reverse the effects of scars, stretch marks, uneven skin tone, aging and dehydrated skin. The oil uses a blend of calendula, lavender, rosemary and chamomile. All of these all known to have skin soothing and calming properties as well as smelling rather gorgeous. It also contains vitamins A (for elasticity, texture and tone) and E (an antioxidant that helps increase moisture in the skin). It also contains PurCellin Oil, a trademarked delivery system for these ingredients formulated so they can be easily spread and absorbed.

Your skin keeps your insides in, it’s your interface with the world and the environment immediately around you. Easily ignored, your skin wraps you up and protects you, so take some time to boost it so it can keep doing the best job it can for you!

Desang Diabetes Magazine is our free-to-receive digital journal (see below). We cover diabetes news, diabetes management equipment (diabetes ‘kit’ such as insulin pumps and continuous glucose monitoring equipment) and news about food suitable for a diabetic diet including a regular Making Carbs Count column. We just need your email address to subscribe you (it really is free, and you can easily unsubscribe should you wish to).

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