Feedback on Tandem infusion set choices

I just started on the Tslim pump in April after nearly ten years on the Medtronic. I’m still climbing the learning curve on filling up and using new kinds of infusion sets.

My provider, CCS Medical, started me out on the autosoft XC and I found it pretty easy to attach and especially to disconnect for showering or charging without having to carry an extension cord around!

Then in July without warning they sent me my next 90-day order and swapped out the XC for a 90-day supply of type autosoft 90. They assured me (and so did Tandem’s website) that the type 90 and type XC are medically interchangeable.

Okaaayyyy…I said, in a tone of voice indicating I knew there was a walrus on my front yard, I just didn’t understand why!

But the connection btwn tubing and cannula is very different IMO and I’m having a LOT of trouble disconnecting and reconnecting tubing on the 90. I’m certain I wiggle and twist and pbly bend the cannula once it’s in me, trying to disconnect, etc.

The problem this leads to is frequent failure of the insulin being delivered by the pump to actually get INTO ME. My BG soars after eating and won’t come down (below 300 I’m talking about) for several hours! Frequently not until I switch out a completely new infusion set AND give myself a dose with a needle!

Tandem and CCS Medical both told me T has a manufacturing supply issue and a shortage of type XC. T assured me they’re working on that. Okaaaayyyy…I said (see above re walruses).

Anyone else have trouble disconnecting and reconnecting the type 90? Anybody else have solid evidence the insulin isn’t going where it’s supposed to regardless of what your pump SAYS is happening? Anyone have a solution?

I only know the Autosoft 90, and wasn’t spoiled with anything different or better. Disconnecting the tubing from the insertion cannula requires just a pinch for me, no problems with it disconnecting or kinking yet.

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I hate you! :stuck_out_tongue_closed_eyes::stuck_out_tongue_closed_eyes::stuck_out_tongue_closed_eyes:

Seriously, the pinch doesn’t do it for me at all. I guess I’ll just have to try harder.

Thx.

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Well I just got a new box and hope I didn’t just jinx myself.
But when I say “pinch” I mean I squeeze both little tabs the same amount (from the sides) and pull straight out from the cannula parallel to the skin and in the direction of the tubing, not away from my body.
Putting it back in after a shower is a bit harder to line up.
I assume you also got the plug that goes in for swimming?
Id suggest playing with an old set, try to disconnect and reconnect until the pattern is practiced. Maybe you’re already doing all this stuff. . .

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Yeah I’m working on it. For me, when I pinch I don’t seem to feel the tabs move much. Like I said I have to practice more. I know I need to pull it out straight. I just don’t seem to have the hang of it yet. Even when I pinch and pull it seems as if the whole set, cannula and all, moves sideways in the direction I’m pulling. And that’s what’s affecting the part inside me I think, leading to the insulin delivery problems at the root of my real concern which is elevated BG and hours of inability to reverse it.

Two nights ago I gave myself 11 units by pump, with no discernible reduction at all in BG, for four hours, until I switched to another set and gave myself 4 more units by needle! It’s just not supposed to work that way.

Yes, practicing with a old set is a good suggestion too. Thx for all your feedback and support!

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The Autosoft 90 is the more popular set, just because that’s what the suppliers tell people to get when they don’t know what to choose , but for those of us who have tried both, the preference is nearly unanimous in favor of the Autosoft XC. It is most definitely the better design.

I have no way of knowing, but I suspect that the “supply issue” has to do with the Unomedical (the company that makes infusion sets for everyone) is forcing them to streamline production in the wake of Covid troubles, and since the Autosoft 90 is the more popular choice by the numbers, that’s the one that’s being produced still.

They should just snap together without any wiggling or twisting, they’ve got to be lined up EXACTLY, though. There’s no wiggle room and it doesn’t guide itself into place as easily as the XCs do. If you can’t see the set clearly, it might help to use a mirror or even have someone else plug it in for you. And there’s always the possibility of just never disconnecting it. Some people are trained to fill the tubing and set with insulin before it’s applied to the skin, then that eliminates the need to disconnect while filling the tubing. You can even wear the pump in the shower (it can be submerged up to 3 feet deep for 30 minutes, so shower splashes are well within the guidelines).

The only real trick I have is that the instructions for the Autosoft 90s tell you to press down on the raised receptical part of the infusion set, sort of stabilizing it, as you plug the tubing in. Or at least they did 5 years ago, last I looked. That’s how I learned to do it and the instinct is still there… But that doesn’t work with the XCs. I actually CANNOT connect the XC tubing if I’m pressing on it, whereas I had to press on the Autosoft 90s. So maybe that little bit of pressure is what you’re missing? At least it would pin the set in place so you can’t yank it out while trying to connect.

I too have had trouble with the pinch - especially on a new set. JUST switched from a Medtronic system after 10 years of trouble-free usage. My first T:Slim set was nearly impossible to disconnect. My second was much easier. I am now on my 3rd set. The amount of pressure needed in the pinch seems variable with each set. What I did today is shortly after installation, I inserted/reinserted the plug several times. It seems to loosen up the latches a little and makes future detachments easier.

Maybe you should try some different types of sets. TruSteel and VariSoft are both more reliable IMO than the AutoSoft 90 sets. But they rely on manual insertion. I use TruSteel and it does take some adjustment to having the tiny metal needle but you never have to worry a kinked canula. But I wonder if detaching the tubing would have the same issue you’re having with the AutoSofts because I do have to squeeze the sides? It seems to be a universal problem right now that the XCs are not available so maybe you need to follow the advice of @Boreas and practice. Good luck figuring out a solution.

They are all made by the same company.
When I switched from Medtronic to tandem, I was able to use the Medtronic sets with my tandem. The work the same.
The tubing is different though.

I regularly use certain Medtronic sets with my Tandem pump by substituting tubing. And I used up my old Animas sets with the same trick. But I think it is easier with some types of sets than others and it takes a fair amount of expertise to understand how to do it.

But you’re right that Unomedical makes most of the sets for all pump brands.

Just a note, while VariSoft is a manually inserted set, there is a nearly identical set that comes with its own auto inserter. Its called the AutoSoft 30 and it inserts at an angle like the VariSoft. While the VariSoft is designed for insertion at variable angles the auto inserter of the AutoSoft 30 is designed to insert at a 30 degree.

I tried out AutoSoft 30’s and found the insertion to be overly complex. Plus I lost the advantage of VariSoft where I could vary the depth and angle of insertion. Of course I had used manually inserted Silhouette/Comfort Short/VariSoft for about 15 years and wasn’t prone to changing.

Like you I used Silhouette/VariSoft sets for years, I had no problems. With the Silhouette set I preferred manual insertion over using the Sil-Serter auto inserter sold by Medtronic, that thing reminded me of being harpooned, I only used that thing once.

I started with AutoSoft 30 sets when my supplier shipped them instead of VariSoft sets. When I first opened one I scratched my head trying to figure out how it worked, it just looks complicated in the instructions sent with it. But really the only thing complicated is getting it out of the package. Once it is unpackaged and cocked insertion is a breeze. 30 degrees seems like the perfect angle for me and I like the fact that AutoSoft 30’s consistently insert at that angle.

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I go much steeper than 30 degrees. I put in my sets almost parallel to my skin. It works best to not hit muscle and also not come out.
I can also feel if I’m putting it in a vein before it goes deep. I can actually feel a vein before I break the skin. The skin over a vein has more nerves than skin that’s not.

That is the best reason to do manual insertion.