How often should I change my infusion set?

Commonly every two to three days, though the exact interval depends on the set and your team and manufacturer guidance. Leaving it longer raises the risk of blockage, infection and poor absorption. Keep spare sets and reservoirs to hand and build the change into a routine.

Why do I need to rotate sites?

Using the same small area repeatedly leads to lipohypertrophy, lumpy or scarred fatty tissue that absorbs insulin erratically and causes unexpected highs and lows. Rotating between areas such as the abdomen, buttocks, thighs and upper arms lets each spot recover and protects your control.

What are the signs of an infusion site problem?

Redness, pain, swelling, warmth or pus can mean infection, and leaking or a smell of insulin at the site means insulin is not going in. Any of these means move to a fresh site, and seek advice if infection is spreading. Also suspect the site whenever glucose is unexpectedly high.

Why can a pump fail silently?

A cannula can kink, pull out a little, or block while the pump keeps running and looks normal, so no insulin actually reaches you. Because a pump uses only rapid-acting insulin, this lets glucose and ketones climb fast. Unexplained highs should always make you suspect the site.

What do I do about a persistent high glucose on a pump?

Suspect the site: check it, usually change the whole infusion set and reservoir, check for ketones, and give a correction by pen rather than the possibly-failed pump, then recheck. This is the standard NHS pump response. Seek urgent help if ketones rise or you feel unwell.

Insulin Pump Site Care & Changing Infusion Sets

Written & reviewed by the BestDoctors.sg editorial team · Last updated 28 Aug 2026 · General information, not medical advice

The infusion set is where an insulin pump meets your body, and looking after it well is one of the most important parts of pump life. Good site care keeps insulin absorbing reliably, protects your skin, and, crucially, guards against the silent failures that can lead to high glucose and DKA. This guide explains the principles of site care, which your diabetes team teaches you hands-on for your particular device.

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In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.

This is general information, not a substitute for your team’s training. Because a pump uses only rapid-acting insulin, a failed or blocked site means insulin stops and glucose and ketones can rise fast. Unexplained high glucose means check the site, change the set, check ketones, and correct by pen. Call 995 for signs of DKA.

The infusion set

The infusion set is what delivers the insulin. A small soft cannula, or sometimes a fine steel needle, sits under the skin, connected either by tubing to a tubed pump or built into a patch pump. It is inserted with a spring-loaded device or by hand, and it stays in place for a few days at a time before being moved. Getting comfortable with inserting and securing it is part of the training you receive when you start, and most people find it becomes quick and painless with practice. Choosing an insertion spot with a little fatty tissue, and avoiding the waistband and areas that rub, helps the set stay put and work well.

Changing the set regularly

Infusion sets are changed regularly, commonly every two to three days, though the exact interval depends on the set and your team and manufacturer guidance. Leaving a set in too long raises the risk of blockage, infection and poor insulin absorption, all of which can push your glucose up. Building the change into a routine, and always having spare sets and reservoirs to hand, keeps things running smoothly and avoids being caught out.

Rotating sites

Just as important as changing the set is moving where it goes each time. Rotating between different areas, such as the abdomen, upper buttocks and hips, thighs and upper arms, gives each spot time to recover. Using the same small area over and over leads to problems with absorption, so a simple habit of stepping around your available sites, rather than returning to a favourite, protects both your skin and your control.

Lipohypertrophy

Poor rotation can cause lipohypertrophy, which is lumpy, thickened or scarred fatty tissue under the skin where sites have been overused. Insulin absorbed from these lumps is erratic and unpredictable, causing unexpected highs and lows even when everything else is right. The lumps can feel firmer than normal tissue. Your team can check your sites, and the fix is prevention: rotate well, and give affected areas a long rest so they can recover.

Clean technique and watching the site

Site care uses a clean technique your team teaches: wash your hands and clean the skin, and if you use an antiseptic, let it dry before inserting, both to help the set stick and to reduce infection risk. Then keep an eye on the site. Redness, pain, swelling, warmth or pus can signal infection, and leaking or a smell of insulin at the site is a sign that insulin is not going in. Any of these means it is time to move to a fresh site, and to seek advice if infection is spreading.

Silent failure and unexplained highs

This is the critical link to understand. A cannula can kink, pull out a little, or block, and the pump may keep running and appear normal while no insulin is actually reaching you. Because a pump uses only rapid-acting insulin, this silent failure lets glucose and ketones climb fast. So any unexplained or persistent high glucose should make you suspect the site: check it, and usually change the whole infusion set and reservoir, check for ketones, and give a correction dose by pen rather than the possibly-failed pump, then recheck. NHS pump guidance, such as from UCLH, is built around exactly this response.

Adhesive and skin care

Skin and adhesive issues, such as irritation, itch, or a set that will not stick well, are common and manageable. Barrier wipes and films, gentle adhesive removers, and rotating where adhesives sit all help, and your team can suggest products that suit sensitive skin, which matters in Singapore’s heat and humidity where sweat can loosen adhesives. Looking after your skin keeps sites comfortable and reliable. Small habits, like carrying a spare set at all times and setting a phone reminder for the next scheduled change, turn site care from a worry into a simple routine that takes only a couple of minutes every few days. Your diabetes team and Diabetes Singapore can help with practical tips and troubleshooting.

Sources

Diabetes.co.uk — Infusion sets: diabetes.co.uk
Diabetes.co.uk — Insulin pump problems: diabetes.co.uk
UCLH NHS — High glucose and ketones with insulin pumps: uclh.nhs.uk
Diabetes UK — Insulin pumps: diabetes.org.uk

General information only. This guide supports, but does not replace, the advice of your diabetes team (your endocrinologist and diabetes nurse educator), who set your insulin and settings and train you on your devices. Never make big changes to your settings alone, and always keep backup insulin pens and ketone testing. An insulin pump uses only rapid-acting insulin, so if delivery stops, glucose and ketones can rise fast: unexplained high glucose means check the site, change the set and give insulin by pen. Call 995 for signs of diabetic ketoacidosis (high glucose with ketones, vomiting, tummy pain, deep or rapid breathing, drowsiness) or for a severe hypo (unable to treat yourself, fitting or unconscious). If you are struggling emotionally, you are not alone: the Samaritans of Singapore (SOS) are on 1767 and mindline.sg on 1771.

Insulin Pump Site Care & Changing Sets (Singapore)