Insuline depots under the skin

[Bjorne]

Hello,

I have had diabetes since I was about 1½ year old. I am soon turning 18 and I am a pump-user since two years ago. After the years of using pens and shots I have "insulin depots" (ie. bulbs with old insulin under the skin) which does not want do disappear. As some if these are on the stomack which makes me look kind of weird I've been thinking of surgery. I've read that you can have them removed. I'm just wondering, how is the procedure? Do you just go to the doctor and he sends you to an expert? (not very likely that it will go that smooth but..)

And when the surgery is carried out does it look "normal" afterwards and what risks are there?

Thanks!

[Cinnabon]

Hello,

I'm just wondering, how is the procedure? Do you just go to the doctor and he sends you to an expert? (not very likely that it will go that smooth but..)

And when the surgery is carried out does it look "normal" afterwards and what risks are there?



I think what you are probably looking at is a reular tummy tuck. I have them too and they are so ODD!!! I didnt know they were called like that, lol. I believe a plastic surgeon would be good and of course bloodwork would be requested from your Endo. Don't know if your insurance covers that or that your Endo will send you to one, but asking never hurt, Good luck.

[Cielo]

How big are these deposits? I thought they were only about the size of a pea or kernel of corn....I find it odd that they'd require surgery to be removed. If it's just insulin, couldn't they just inject a needle into the deposit and withdraw it that way? Or does the insulin stop being a liquid and become a solid?

[Bjorne]

If it's just insulin, couldn't they just inject a needle into the deposit and withdraw it that way? Or does the insulin stop being a liquid and become a solid?

I don't know hehe, I saw a tv programme while ago and there was this woman who had removed insulin depots on her stomach.

Well, mine are about 2.5x7cm (1x2.8 inches) on both side of the stomack, so it looks strange since I'm very thin and still have a big "belly" just on a specific area :(

If they were removed skin would be set free so perhaps some skin would have to be removed, but since Im young it can probably shrink itself. The TV programme wasn't about diabetes it was just a woman walking by or something, very short, so I didn't get much information from it

[Cinnabon]

I was told mine where scar tissue and I would need a tummy tuck due to the exact same thing, the skin would just be left over. Unless they are that small as Cielo said, then surgery would be too much. Usually plastic surgeons first visits are free, you can go check it out.

[Jak]

The bumps you are talking about are not insulin trapped under the skin. They are actually fat deposits which form at the injection site. It's caused by the insulin, but it is not insulin.

I've had surgery for such deposits on my legs, but I would not recommend it. For one thing, once you've had the surgery, the site where they removed the excess tissue no longer absorbs insulin the way it did before. I have been unable to use my legs for injections since I had the surgery in 1977. The poor absorption means that if you do try to use such a site, you will require much more insulin and will probably still not be able to get good control. It seems we have all too few good sites for injections/pump sites to begin with, why waste any? If I'd been told I would lose the legs as injections sites, I wouldn't have been so quick to go for the surgery.

The second reason I would not recommend the surgery is that if often cause a person to lose feeling at the site of the surgery. Most of the area where I had the deposits removed still lack feeling. They are totally numb even 28 years after my surgery.

I have to be careful not to injure the area because I won't feel it until the damage is done. A case in point: I was wearing a tight (although not too tight) pair of jeans and I put my car keys in my pocket when I went for a walk with my father. I could feel the pressure from the keys being there, but I did not feel the pain of one key which was digging into my leg with each step. I actually created a small hole in my leg which I did not feel at all.

My legs still do not look normal. It may depend on the skill of the surgeon, but in that case, my surgeon was not very good.

If you do decide to proceed with the operation on your abdomen, I think they would just do a liposuction. The procedure was not available when I had mine done, and I have massive scars (though faded now) on each leg. Liposuction would likely give you a better cosmetic result.

As for how to go about it, in my case I asked my internest about whether anything could be done about the excess tissue build up on my legs. I specifically asked him about plastic surgery. He said he would inquire first whether the (Canadian) medicare system would cover the costs of the surgery. He sent a letter to the government and they agreed to cover the cost since it was medical in nature and not merely cosmetic. When he got the response, the internist sent me to see a plastic surgeon who agreed to do it, but who explained nothing about the risks or consequences. From there it was just a matter of waiting for a hospital date and getting it done.

I know that if I had the choice to make again, it is doubtful I would choose to have the surgery. In fact, I have those same deposits on my abdomen and I am not even thinking about having surgery for it.

If you do decide to have this type of surgery done, keep in mind that it is not risk-free and that you may be left with some side-effects that you don't like, but which it is too late to do anything about.

Jackie

[Bjorne]

I'm sorry to hear that, but the deposits prevents insulin from being absorbed well too, and I don't use my stomack since I have an insulinpump (I use my benind :)). How did they remove them in 1977? Liposuctions are very common today for cosmetic purposes and some people have done them multiple times so are they not quite safe?

Since I live in Sweden we have governmental health care covering all areas except extreme cosmetic operations, so the social insurence system would cover my costs. If it doesn't, my private insurence covers "disfiguring scars and alike caused by accident or disease" (which are not covered by the social insurence).

But as you say there's always a risk with an operation, I've booked a time with my doctor so I can ask him what the odds are etc :)

[Bjorne]

Hello again, apparently these depos can be removed using ultra-sound! A directional unltra-sound is sent against them which makes them start moving (the fat in them) making the blood stream "catch" them and move them to the liver which then disposes them "the atural way". This treatment doesn't require any kind of drugs to be taken and the ultra sound only takes max 20 minutes. It has no side-effects either, the fat which the depos are made of are just taken away and the skin will tighten up after a few weeks!

Have anyone heard of this?

[Belinda]

I am going to ask when I go in to the endo....my mom always told me I need to go to a massage therapy to get rid of the bumps. They were bad on my thighs but now that I pump and never use the legs anymore it is better