I am presently using a Unomedical 9mm, 23 inch infusion set on a T:Slim X2 pump. One out of every 10 leaks. Five years ago I used Unomedical a 6mm, 23 inch infusion set on an Animas pump. One out of every 30 leaked. Ten years ago I used a Medtronic 6mm 23 inch infusion set. One out of every 100 leaked. Since I have been using a CGM system, I have been using the left side of my fatty ‘love handle’ area with a W pattern as my inset location and the right side of my fatty ‘love handle’ area as my sensor/transmitter location. Have any of you had a similar experience? I use an alcohol pad to clean, disinfect and de-grease the areas I use. It only happens when I give myself a larger bolus and never during basal. My thoughts are: 1. Over the past 12 years I have built up scar tissue creating resistance to the bolus. 2. The newer pumps feed insulin at a faster rate than older Medtronic. I check the cannula shape after each removal and have found one or two bent over the years, but only one leaking bent one and that was my fault. Any suggestions would be appreciated.
I’m curious what your total daily dose of pumped insulin is. It’s been pretty rare in my 33 years of pumping insulin to detect a leaking infusion set. More common to me is a rising BG that I attribute to poor site absorption.
I currently use the Medtronic Silhouette 13 mm cannula (angled) infusion set. I’ve not observed an obvious leak in over three years. My total daily dose of infused insulin is 30 units or less. A typical meal dose is 3 units. I suspect that a higher total daily dose as well as much higher meal doses puts one at higher risk of infusion site leakage.
Could you divide your bolus amount in half and deliver at two separate times about 30 minutes apart to ease the load on the infusion site? Or you could deliver bolus doses with a syringe, at least some of the time.
Maybe finding a totally new infusion site area could ease this problem. Experimenting could answer this question. Good luck!
“Unomedical” doesn’t tell me squat. That is the manufacturer and your set could be one of many. What is the model you are using?
How large? Can you split large doses to 2 boluses, and wait a few minutes in between them? Or try using a square or extended bolus, so that insulin is delivered more slowly over that time, hopefully avoiding the leak.
Thanks, I will try to split my dose between 25% now and 75% over the next two hours and try that for a week or two.
I cannot give you that information at present. I have an Apple laptop and the most recent update converted my 32 bit computer to a 64 bit and Tandem has yet to provide a an updated T:Slim updater that will work. Supposed to be out in the early part of 2020. Last record I have is 55 units per day. My basal is set to 1.1 units per hour. I know it is the inset as I smell the insulin and feel the wetness against my skin and the soaking into my clothes. When I am aware it is happening I will press gently against the center of the inset and that seem to help, and then monitor my next 4 hours and make mini adjustments so as not to stack. Just checked my pump over the last 30 days is 50.4 daily units. Thanks for providing the insight to check my pump directly. I am so confuser oriented I sometime fail to use my brain.
Why not just switch to the Auto-Soft sets instead?
I am using “AutoSoft XC” The ‘new’ NON-standard “luer” lock. My Animas had the standard Luer lock and it leaked also, but not as often. Nothing is ever perfect to satisfy me and I have learned to deal with the imperfections. I have noticed the Dexcom G4-5 Sensors have improved adhesive, so I know it can be done. Just sucks that the ‘minimum’ necessary requirements are the standard of any industry. Profit over product, accentuate the positive, neglect to mention the negative.
BS. I’ve never had an infusion set leak anywhere in 20 years
I am using the AutoSoft XCs at present. I may not be de-greasing enough with my single alcohol pads.
Not the XC, those are rebranded Insets.
I don’t think your inset infusion set is the source of the leak. The insulin is likely leaking on the outside of the cannula, a condition known as tunneling. If this is true then it means that the tissue at the infusion site is not able to absorb the rate of insulin that you are attempting to infuse.
Do you have scarring at the site? Can you feel some lumpiness when you press and slide your fingertips over the area of abdominal sites that you use? Are you reluctant to explore using a virgin area?
I am using what Tandem and CCS recommended. do you have a part number or more information?
Do you use the 90 or 30?
Usually over 10 units. The greater the quantity the faster the leak.
Switch to the Auto Soft 90s. I never liked the way the Insets plugged into the set when I disconnected and reinserted. The 90s feel more solid
To explore new areas is my next step. I have been using approximately a 3 x 5square inch area for 20+ years. What sites would you suggest next? Back of the arms? I have flexibility issues. Shorter than normal tendons and ligaments.
Thanks. Next order I will.
Anyplace where you have at least a small layer of fat and you can reach. I suspect that your 3" x 5" area is overused and scarred. You need to give this area a good long rest or you risk losing it permanently for the future. This can easily be the reason for your leaky sites.
Have you tried using the “love handle” area but further around toward your back? I’ve had good luck in this area and was able to access it more easily when I used the inset 30 infusion sets since they included an one-handed injection system. It looks like the Autosoft 30 infusion set is the Tandem equivalent to what I used for many years. It makes reaching around the love handle onto the back doable.
I don’t know if you’re male or female, but many females have good luck with using their thighs for insulin infusion. I have plenty of fat on my body but not on my legs.
Can you enlist the help of a spouse or partner to insert an infusion set in a new, harder to reach area? As a person who lives alone, I don’t have that luxury but you may.
By the way, I’ve been having great luck with using the backs of my upper arms for CGM sensors. Using this location takes some of the demand off of your abdomen.