Continual Site Failure

Hi there! I am total need of help...

I've been diabetic since 1998, and on an insulin pump (Minimed) since 2000 - but over the last month have been experiencing serious problems with failed infusion sets. I now expect a really bad level over 15mmol (270) every other day, which then takes ages to get down again. Sometimes a set is fine for a couple of days, then others fail after 1 day, and others fail pretty much straight away.

I have tried moving the set (a QuickSet 6mm) around, from lower to upper abdomen, upper buttocks and thighs too, none of which seem to want to work very well.

I'm going to see the nurse on Friday, where she says she'll explain to me some new types of sets, and perhaps I can try those out, but I don't know if actually I just need a pump holiday to allow my body to recuperate? I've been eating well and exercising regularly, and I've done lots of basal testing. I literally think I've tried every option...but I'm now getting so dozy that I can't think straight. Has 10 years on the pump left me with too much scar tissue to function well? After a month of bad levels - which has never happened to such an extent before - I've had enough. I can't trust my insulin pump any more, and I am seriously questioning whether I should ask to switch back to injections.

Any advice would be wonderful!

It is possible to develop allergic reactions against the teflon of the Quickset canula. Have you tried sets with steel canulas - like the SURE-T for example?

Actually I think it would be a positive experiment to switch back to shots for a while. I would recommend NovoLog combined with 2 shots of Levemir for that. It might work better than you think OR it will help you to refocus on the positive sides of pumping.

I didn't like the QuikSet's as much as I like the Silhouette. I have hardly had any problems with sites at all, although I've been pumping for maybe 3 3/4 year rather than 10. There's an inserter but I sort of prefer to stick them in manually as they seem to get in there more securely? Maybe they can give you a spare. MM might send you one if you ask?

I have the same problem, and no good solution. It seems the skin stops absorbing after a while, I suppose the infusion of constand insulin over time thickens the skin and makes it less absorbing. Trouble is you tend to raise the base rates to cover it and then find a "good" site and get hypoglycemia!

Anyone with a really good answer needs to publish it, please.

I haven't tried the Sure-T - I must admit that the idea of a permanent needle doesn't really appeal. But then neither does blindness or kidney failure... so if that's what my nurse recommends, I'll be sure to give them a go!

Thanks for the suggestion for switching back to shots for a while - like you say, even if it helps to refocus, then that'll be of benefit :)

I used to have the Silhouette, a long while ago, but it might be worth trying them again. Interesting what you say about manual insertion - I think that makes a lot of sense, I used to put them in myself, but now use an inserter. Do you rotate your sites to different places?

We use the Silhouettes and while site failures aren't uncommon, most of the time they're caused by the fact that my son is very bouncy and does things like slide down the stairs on his butt (the only place on him with enough fat for a site to stick well), which is guaranteed to cost us a site. We do rotate location though, and mostly do insert them manually. I only use the inserter if I am putting a site in without my contact lenses or glasses on (and even then, usually only because it's being done in the wee hours of the night after I've found Eric sky high with ketones because of a site failure).

I am legally blind and put in Comforts (same as Silhouettes) manually all the time using only touch. :) The huge insertion device thing kind of scares me ...

I've never used a Minimed pump, but from what my pump trainer/nurse said about them, I gather they are one of the most unreliable sets out there. She says she doesn't recommend them to anyone because they tend to get kinked so easily.

Hi Alissa. Earlier this year I was having a lot of problems with Quickset Infusion sets. I called minimed and they sent me some samples of other infusion set 2 each of thier other 4 different types. Sample sets may be of a great help to you. It helped me learn what would work for me and what I could work with. I have since switched to the mios with no problems yet (knock on wood). I was seriously considering exploring putting infusion sets on my legs, butt, etc. before I found out that the mio works better.

That's really helpful, thanks! Silhouettes certainly seem highly does manual insertion.

It's so true - I'm currently on a rollercoaster with my levels. I've decided that until Friday, when I see my nurse, I'll inject for boluses, and keep the pump running for basals... we'll see how that goes as a temporary fix. But it seems like manually inserting Silhouettes is a good way forward according to the above comments :)

I'm very glad it's not just me going through this problem!

Very helpful thanks! I've not heard of the Mio before, but I'll be sure to ask my nurse about it and do a little Google search. Interesting to hear that you've been able to stick with the same area...

I have been using the Silhouette since I started using a pump 11 years ago. I usually manually insert. I did try the inserter with it, but found that it was so forceful that it bent the introducer needle and caused bruising at the site. I was having difficulty reaching around to my back to insert the silhouette so I asked for samples of the MIO from my local rep. They come in their own "pod", which is an inserter. I was able to reach spots that I wouldn't have been able to reach by manually inserting the silhouette. I think the MIO will allow me to use more sites, giving my abdomen more of a break. Good luck!

I don’t move that much but had some pullouts over the summer, on long runs, as my supply belt thingy got snagged on tubes, while I was sweating a lot. I tried over my hipbone in the back and it worked well as a change of scenery.

I manually insert my QuickSet too. I just started with my pump a few weeks ago but had a rough couple of days with the sites not infusing. The MM rep suggested pinching my skin up when I insert and this has worked wonderfully no more bad infusion sites.

I have used quick sets since I began pumping, getting close to 4 years now. Problems have cropped up over time, however, here is what I found works for me. I no longer use sking tac prior to inserting the quick set (I use the inserter), I found I tended to get immediate failures if I applied skin tac before insertion about 50% of the time. Now, I insert and then use skin tac on the top of the quickset tape, seems to help hold for a full 3 days of use. I rotate sites - butt/thigh - 1,2,3,4. Stomach if exclusively for CGMS.

Have you lost/gained weight? When I lost weight, I had bad times keeping life controlled, was using 9mm. Worked w/MM, they suggested 6mm cannula - sent samples (of everything, just ask!), used the 6mm (they sent two), both no problem. Have switched now to 6mm and no trouble. You may try a longer cannula to see if it makes a difference.

I always time a site change when I can do a large bolus and then watch sugars. I have found if the site is going to fail secondary to bent cannula with insertion, you will usually get insulin leakage around the site then. I just use a tissue (kleenex) to check (unhook like when you shower, press around the site about 30 seconds to a minute after the bolus completes). If you see/smell insulin on the tissue, plan on it being bad.

Otherwise all I can suggest is a trial of different sets. Maybe there is something that will be more suitable for you at this time! Good luck!

Hi Alissa,

I'd recommend the following three options:


Lots of Minimed folks have had trouble with plastic infusion sets over the years, and our old member _Dave used to always suggest the steel Sure-T. Pretty much everyone who tried them wound up with excellent results.

I'm sure you could get a few freebee Sure-T's from Medtronics, for a trial run.

Good luck and cheers, Mike

All useful advice here. Try a few different sets at no charge from Medtronic. Also try a a different can length. Hang in there!

I stopped using the QS now and use the Sils and Sure-T. Try those.

UPDATE: So I went to visit my nurse, and she gave me loads of new types of sets to try and sites to test out. I tried them all! Had to change every single day, due to their not working... so I got through a few.

So, I have gone on a pump holiday/vacation for now. I am on MDI with Lantus and Humalog, and so far it's been ok - I know it will have it's ups and downs, just like the pump. And actually if it reminds me of why it's good to use the pump, and restores my faith in it, then that'd be a benefit.

For full details of my reverting to injections, see: Goodbye Pump, Hello Pen.