I started pumping with a MiniMed 507 in Dec 1996. While I have not had any consistently continuing infusion problems in past, recently my sites seem to no longer work. Specifically, my Blood Glucoses (BGs) no longer drop even after multiple correction boluses.
If instead of a pump bolus I correct via an injection, then my BGs do drop, so I don’t think my (Novolog) insulin is the problem. I have always rotated my sites and I am not aware of having scar tissue. Also, I am experiencing poor site absorption even when using my belly. I personally preferred to not use my abdomen so I would not expect problems there, but I do have problems there.
I am posting here because I’m at my wit’s end. I’m not sure what to do other than go back to using injections. I don’t really want to do that. (It’s been so long since I used MDI, that I’m not really sure I remember how to do that!)
Anyone have any ideas and/or suggestions?
Additional tedious details:
I’m currently using a Medtronic 630G pump. I have been using Medtronic’s 6mm Quick-Set infusion set until recently when I started having site absorption problems. I tried switching back to using 17mm Medtronic Silhouettes about two weeks ago, but the absorption problems are still with me.
I’m sad to hear that you are having difficulty. This is one of my great fears. I’ve been pumping since 1999, and I hope to keep on until there’s a cure, or I’m no longer here, whichever comes first.
Some years ago … maybe 3 or 4(?) I was having a similar problem. I found I had to find some areas that I hadn’t used for a long, long time, and maybe a few where I had never used an infusion set.
In doing that, I also discovered that for some of my frequently used, but hard to reach areas, I hadn’t been rotating sufficiently.
The short story is by giving my “regular” areas some rest and exploring some new areas, I was able to “renew” the absorption. I’m now much more stringent on where I place a new site. I always go from the left side of my body to the right.
I have been having trouble the last few days as well. Found that the cannulae were bent at 90 degrees. Not just one but several consecutive ones from the new box. These are Tandem insets. I still have quite a few insets left from my Tandem Ping so I used the inset and connected the Tandem tubing to it. No more problems. I wonder if they have had a run of defective ones. The Animas insets look like the ones from Tandem, however, they are coarser and the inserting mechanism is not as aggressive. It has been working all day and BGs are coming down nicely now.
I agree with @Dave44. A metal infusion set might be the way to go. I started pumping in 1990 and we only had metal. They were very uncomfortable. So when the Teflon types came out, I made the switch. Used then for years with no problems.
I than switched to a Tandem pump and had a few occlusion alarms. So I meet with pump trainer and she brought different samples and I went with the TruSteel and haven’t looked back. I use the 6 mm needle length and find them pretty comfortable. Once in awhile it hurts when twisting but I find after some time, it settles in.
I would see if your pump rep can give you a few samples. I find many pump issues aren’t pump issues, it’s infusion set issues. Good luck trying to find the right one!
Absolutely! Get samples of everything they offer, and make sure you get a box of each. Success with one or two sets is no indication of what will happen long term.
@irrational_John, I’m facing the same issue. I’ve been using (overusing) my abdomen exclusively for 30 years. I started with SS sets in the beginning then switched to Teflon sets. I switched back to SS cannula sets in November and things improved but I still had problems.
Three weeks ago I started using my thighs and so far I have a 100% success rate. What a joy to put in an infusion set with confidence it will work.
I plan on using my thighs exclusively for at least 6 months so my abdomen will recover, then start to weave a few abdomen sites back into the mix.
What are “SS sets”? I assume you mean something with a metal cannula, but I don’t know which/whose sets you are referring to.
I called Medtronic yesterday and requested some samples. Since I am currently using the 6mm cannula Medtronic QuickSet, I figured it couldn’t hurt to try the 9mm QuickSet. I also asked for samples of the Sure-T, but was only able to get the 6mm version of the Sure-T. Apparently there were no samples of the longer cannula Sure-T (8mm or 10mm) “in stock”.
The sets should arrive this coming Friday. I hope they make a difference.
Those we stainless steel cannula sets I used many years ago with my first Diesetronic pump. Don’t even remember the brand. The stainless steel sets I’m using in certain situations today are Tandem Tru-steel 6mm. These are identical to the Medtronic Sure -T except for the pump connection. I have samples of the 9mm version but have yet to test them. As I said, I switched to using my thighs with great success. In this case I’m using soft-cannula sets - Tandem Autosoft 90, 6mm.
I had infusion site failures after 5 years on the pump, and never went back…for me MDI is fine, but tresiba definitely was the key for me. Some people have problems, but I dont…definitely something to look into if the stainless steel infusion sets don’t help…mdi with a Cgm is better than a pump without A Cgm. Pumps are not for everyone
I have a similar opinion about Tresiba based my experience using it when I went on a pump holiday. Smooth and predictable. In fact, when I went back to my pump I continued using it for 80% or my basal and delivered the balance with my pump so I could still vary my basal profile. I reluctantly had to give back 100% of basal control to my pump so I could take advantage of Basal-IQ.
Roger, if your site failures were due to the use of cannula-type sets such as Quick Sets or other Teflon sets, I wonder did you ever try steel sets? I HAD to change a long time ago because I was getting kinked cannulas as often as twice a week, after a number of years w/o many such failures. Medtronic tech support didn’t even tell me about Sure-T’s when I called to complain about kinked cannulas. I found out about ST’s from a newsgroup, so I called back and asked for samples,which Medtronic sent me. It’s been smooth sailing ever since. I think that was over 15 years ago.
I appreciate your advice, my Infusion sets used to fail after 1 day if it was in the summer, or during activities, and I think I probably use too much Insulin for most pumps…my diabetes educators suggested using less tresiba to compensate and varying the basal, but it seemed counterintuitive. At any rate, the adhesive never lasted 72 hours, and I’d often run out of supplies… now I have Cigna with a $2500 deduction that I try my hardest every year to avoid…
Good luck with a resolution, Roger. Adhesion issues have quite a few fixes such as the use of Skin Tac (just one of several products) applied to the skin and allowed to dry a bit (1-2 minutes, or less if you force-dry it) prior to set installation. Sets such as Sure-T’s can be covered with a transparent dressing such as what I use, IV3000. Other types of sets usually can’t be totally covered with a dressing due to the connector being right on top of the set.
I’m fine with a Cgm and MDI… my favorite set up would be the 1 year eversense and a combination of an autopen and humapen savvio with bluetooth, but MDI is fine…coughed too much after 1 year on affrezza…and even if my insurance deductible was 0, I’d still choose MDI…I also have skin tac, mastisol, turbot latex(waste of money), flexfit (currently use for libre and miao miao2), and iv3000, but the Medtronic infusion sets would still only last 1 or 2 days and I snacked too much…with MDI, you tend to think twice before snacking on carbs
I first tried Mastisol. Big mistake, IMO. It was super-expensive, like the cost of fine perfume, and stinks. I like Skin Tac far better and most people that discuss this stuff mention Skin Tac, rather than Mastisol.
I agree, not pumping can reduce snacking. I took a 1 year pump break to lose some weight. It worked but I had to go back on it because I didn’t have the control I wanted, being periodically very active.
