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It is important keep skin healthy when using diabetes devices. Insulin pump infusion sets and CGM sensors require adhesive to stay on the skin. These devices need to stick well enough to stay on, but also come off without hurting the skin.
Those who are young, have asthma, allergies, and/or eczema may be more sensitive to adhesives. They are more likely to get rashes or skin irritation when using diabetes devices. Others who are active or have sweaty or oily skin may have trouble getting devices to stick.
This handout offers ideas to help with diabetes device adhesives and skin problems. Talk to your diabetes team if you have questions.
General Skin Care
Shower or bathe in warm (not hot) water.
Wash with mild soap and rinse well.
Pat the skin dry with a towel.
Apply unscented lotion or cream to lock in moisture. (Avoid areas where you will place a device.)
After you remove a device, apply a thick cream or ointment to help heal. (such as Eucerin®, Aquaphor® Vanicream®, or Vaseline®).
Getting a Site Ready
Choose a site that has healthy skin and has not been used for a while. Make sure it is
fairly flat and away from places that bend and flex. Rotate sites used for a device. If possible, allow at least 1 week for skin to heal before reusing a site.
Clean the area where the sensor or infusion set will be inserted. Use soap (without added oils) and water and gently scrub the area. Isopropyl alcohol wipes can also be used. (Isopropyl alcohol may increase skin problems for some).
Allow skin to dry completely. A blow dryer could be used on a cool setting to help skin dry. (Do not use heat for risk of burning the skin.)
Adhesives will come off easily when warm and moist after a shower or bath. You can also soak the patch with an oil before you take it off. Baby, mineral, coconut, or olive oils can be used.
If oils don’t work, you can try adhesive removers. Examples include Uni-solve®, Tac Away®, Allkare wipes®, and Detachol®. These may cause more skin problems. Only try them if other options don’t work. If you use them, wash skin well with warm water and a mild soap.
When you remove a device, loosen the edges with your fingers. Gently pull back on the dressing. Use the fingers of your other hand to gently push down on the skin. This reduces damage to the top layer of skin.
Redness/Irritation at Device Site
Before placing the sensor or infusion set, apply a liquid barrier to skin and allow to dry all the way. These products create a clear, flexible film between the skin and any adhesive. Leave a small area of skin without the barrier on it where you will insert the sensor. Some of these products are: IV Prep®, SurePrep®, Skin Prep®/No Sting Skin Prep®, Cavilon® No Sting Barrier, or AllKare® protective barrier wipe.
If you still have redness, or you the liquid skin barriers cause irritation, put a dressing on the skin before you place the sensor/infusion set. The set will then stick to the dressing and not touch your skin. Cut small hole in center of dressing before applying for inserting the sensor. Try a thin, transparent dressing like IV3000®, Tegaderm™, Tegaderm® HP, or Opsite® Flexifix.
If you cannot use a thin dressing or need a stronger barrier, try a hydrocolloid dressing. These include Duoderm®, Band-aid Toughpads®, and Dynaderm™. These dressings are thick, so are better for use with CGM. These dressings can be very costly.
If a site is red and itchy after the device is removed, you can apply an over-the-counter hydrocortisone cream or ointment. Do not use for more than a few days (unless told to do so by a provider).
For areas of skin that are open, clean the area gently with soap and water. Apply an antibiotic ointment to help the skin heal and reduce risk of infection.
Some families use Flonase® nasal mist (fluticasone) before device placement to reduce irritation. To use, put 1-2 sprays of the mist onto clean skin and let dry before inserting the device. Important: This is an unstudied use of this medicine. We don’t know if there are any risks when using Flonase® in this way.
Tips if Devices Fall Off or Don’t Stick
Make sure the device is placed on very clean, completely dry skin.
Make sure clothing or body movements don’t put a lot of stress on the adhesive. If needed, use a different site.
If placing the pump site or sensor in an area that tends to be moist/sweaty, clean the site first. Then apply an unscented antiperspirant spray. Wait 10-15 minutes to dry and then place device.
Dexcom and Omnipod both offer overlay patches to apply over the device to help them stick. They work best if applied at the same time as the site or sensor. Other products include: Grifgrips, Simpatch™, RockaDex, and Expressionmed®.
To reinforce adhesive that is peeling up, some good options include: Hypafix® tape, Blenderm™, Transpore™ surgical tape, and kinesiology tape.
There are many liquid products that can help the device stick better. They are applied to clean, dry skin before the device. You can also apply the liquid to the top of the site or sensor adhesive. These liquids may cause skin irritation for some. Apply to a small area to test for reaction before using under your device. Products (listed from least to most adhesive) include:
Skin prep/No-Sting Skin Prep
Mastisol® (more likely to cause irritation)