Wil Dubois

Happy Saturday, and welcome back to our weekly advice column, Ask D'Mine, hosted by veteran type 1, diabetes author and educator Wil Dubois.

This week, Wil takes on two questions on skin issues -- one about bumps, and the other about rashes and other not-so-fun reactions to the medical adhesives on diabetes devices.

{Got your own questions? Email us at AskDMine@diabetesmine.com}



Cassie, type awesome from Vermont, writes: My husband is 35 and he has a lump between his testicles and his butt. He won’t go to the doctor but complains everyday. What’s your advice?

Wil@Ask D’Mine answers: I bet if that lump were a few inches more to the anterior he’d be pounding on his doc’s door. Two things I’ve noticed over my years of service in the medical trenches is that (1) men don’t go to doctors, and (2) unless, that is, their penises stop functioning. Then they go.

You know, a drug rep once told me (so it must be true, right?) that the number one advance in diabetes care didn’t come from diabetes pharma. It came from Viagra. Apparently the largest spike in new diagnoses of type 2 diabetes followed the introduction of the little blue pill. As men with erectile dysfunction filled waiting rooms across the country, many of them were discovered to have diabetes, a common smoking gun in pistols that won’t shoot.

I apologize. That was pushing the metaphor limit, wasn’t it?

So anyway, your man, sadly, falls into group number one: Those that don’t/won’t go to the doctor even to have something that’s bothering them checked out. I see this all the time but I don’t understand it. I don’t think it’s fear, as men as a group are generally fearless to the point of recklessness. It’s not a resistance to being nurtured, since as everyone knows, when we men catch the common cold we turn into big babies and like to be cared for. I don’t think it’s embarrassment either, as men are generally rather crass when it comes to bodily stuff.

Of course not everything in the world has an explanation. Some things, like gravity, the speed of sound, and male medical resistance just are.

Now, as to the lump that’s a bump in your road, I’m not qualified to say what it might be, and even if I were qualified, it’s probably not the type of thing that can be diagnosed by email. But generally speaking, lumps come in two flavors: Bothersome and scary. Bothersome lumps can be harmless cysts, fats, and queer growths. Scary lumps are cancers.

But bothersome or cancerous, time is the enemy. Even long-term harmless lumps tend to get more bothersome with time. Worse yet, if left in place, they can sometimes morph into something more sinister. As to cancer, any cancer is best attacked on the beachhead. You want to pound it to pieces in the first place it grows, because once it gets out to other parts of the body the prognosis, as doctors like to say, is grim.

In terms of getting your guy to the doc to have this checked and dealt with, clearly he’s not going to do it on his own. I’m assuming you’ve tried to talk sense into him, but clearly logic has failed. 

Honey, it’s time for the nuclear option. Here’s where you need to break out your feminine wiles. Beg, whine, cry, trick, entice, and if all else fails, throw plates at his head. Trust me on this: The only thing that we men can never ultimately resist is the determination of the Alpha females in our lives. All men know that resistance is futile when it comes to girlfriends, wives, and mothers—some men just fight it for longer than others. Me? I just let my wife have anything she wants. The end result is always the same anyway, and it saves me a lot of stress.

But I’ve been married a very long time.

So that’s my advice, Cassie. You need to use any and every trick in your book. Is that unfair? Hell no. As his wife, you’ve got skin in this game. At the least he’s driving you nuts with his bitching about the lump near his nuts; and at the worst he’s setting you up to be a widow.


Ferg, type 1 from Australia, writes: I have started developing red, very itchy reactions to my Dexcom CGM Sensors. I had used them happily, with no reaction, for a year or so. I do not consider myself someone with sensitive skin. Sadly, over the last six weeks or so, this has changed markedly, and even though their position on my body changes, the reactions appear within a day or so. I’m wondering if you have any suggestions or “hacks,” if you will? Fearing I may have to give up my valuable CGM....

Wil@Ask D’Mine answers: Damn those adhesives! As if diabetes weren’t a big enough hassle as it is, the stupid human skin doesn’t like to have something glued to it for a week (or more, depending on your insurance).

But of course I have some hacks. A whole bag full, in fact. But first some basics.

The sticky stuff—from both sensors and insulin pump infusion sets—bothers clean, dry skin the least. That means the optimum time to put one on is right out of the shower or tub. And for God’s sake, don’t put any lotion on your skin first. And for your own sake, don’t use the stupid alcohol prep pads on the skin first either; that just dries out the skin, making it more sensitive, plus the alcohol doesn’t kill any germs anyway.

Assuming you are doing all of that “right,” you’ve developed an allergy to the sticky stuff. So much for the theory that you can gain immunity to a poison by ingesting small amounts daily. Sadly, when it comes to the human body, the opposite is true. Familiarity breeds contempt.

So now what? Dexcom only uses one adhesive, and actually insiders in the biz tell me that there are really only one or two makers of medical sticky stuff. No matter what brand you use, it’s likely made by the same outfit, sort of like that Stallone movie where all restaurants are Taco Bell.

The hack, therefore, is to stick something else to your skin and stick the sensor pad to that something else.

I’d start with a SkinPrep pad, which in medicine is known as a “barrier wipe.” What’s a barrier wipe? Well, it’s sort of like a liquid Band-Aid. You sponge it on your skin and as it dries, it forms a ultra-thin film. The film is engineered to stay put on the skin and creates a surface that sticky pads stick to like magnets! You can think of SkinPrep as a flat condom. It creates a protective barrier between your epidermis and your sensor tape. IV prep is another alternative that works for some folks, but it’s flammable until it dries, so no smoking during sensor changes!

Barrier wipes work for most folks. But if you develop an allergy to the barrier fluid, you’ll have to take it to the next level and break out Tegaderm, a transparent film dressing. Instead of a liquid, it’s a skin-thin breathable plastic with skin-friendly sticky stuff on one side and a smooth outer surface. Some folks in the CGM biz claim that inserting sensors though Tegaderm is bad news, as the inserter needle can carry a small piece of the film into your subQ fat, both a potential health hazard and possibly interfere with the sensor. The workaround is to punch a small hole in the dressing before you put it on your skin and be sure to line up the inserter so you are shooting through the hole. Make the hole small enough to avoid much skin contact with the sensor’s adhesive pad but large enough to make a bulls-eye easy.

So there you go, a few hacks from us on the top of the world for our D-brothers and sisters down under!


Disclaimer: This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

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This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.