This is great news from Medtronic. Could be a game changer. Especially related to extended wear of infusion sets. Curious how this mitigates scar tissue etc. this couple with the new technology from the 780g could really offer us better technology than just the Cgm race.
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Super cool. I wish my Tandem infusion set laste a bit longer. I can get 4 days out of it but when I tried for five, the site was funky when I removed it. So 3-4 days it is with my auto soft 90.
Wonder if this other set is comparable?
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Just listened to this same topic, different company, today on Stacey Simms from December 7.
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I’m sure they will OEM to tandem. I only get 2 to 4 days too. What a difference a better set will make especially around absorption. We will see
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Good news for Medtronic users. Hope Tandem can do the same thing.
The infusion sets are all made by the same company, so it’s just a matter of time.
I wonder how they managed to leave it in for so long.
After 3 days, my site is inflamed, sometimes I get a hard spot, and it stops absorbing.
I would like to know what makes it different
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I share your skepticism, @Timothy, of using an infusion set for 7 days without risk to damaging the skin tissue (epidermis, dermis, sub-q fat). I have suffered tissue damage after just three days of infusion set use.
I have one recent three-day infusion set that left me with inflamed tissue under the skin. It has taken about 10 days to resolve and I still have a remnant small hardness that is yet to resolve. If I had let this infusion set remain for 7 days, I’m certain it would have ended badly.
I’m open to the possibility of a technical advance that would work to allow 7-day placement without any risk to skin infections or scarring. At this point, I’m thinking that they engineers have put in place a system that resists occlusion but I fear that taking care of the sub-skin tissue is not on their radar. I hope I’m wrong!
Just reading the technical reports, it looks like a few possibilities that we can consider: insulin isn’t just coming from a single opening, so the single point of accumulation is not there. The cannula may also go a bit deeper, so it is not only subdermal layer. And the materials may be different, not allowing microbial growth. Finally, the adhesives may be different, impacting the environment around the puncture site.
I am hopeful.
Tandem said on their R&D event the other day that they too were bringing longer wear infusion sets to market, but I admittedly glossed this one over. As excited as I am about new tech, I don’t see excitement in this particular one. Given that this news is 5 months old and almost nobody is talking about it, I don’t think I’m alone here.
Just because you CAN do something, doesn’t mean you should. If rotation and avoiding scar tissue is the key to maintaining infusible real estate, this idea of pushing the limits really scares me. Neither Medtronic nor Tandem has said what makes this possible. Unless there is something that stops immune response, this is a hard no for me. And if it does prevent immune response, how? The method might also be a hard no. If it’s truly an inert material, then maybe.
I also don’t see the point of this. The future pathways for both companies involve smaller, more discreet devices… Usually at the expense of smaller insulin volume capacity. If you’re in the habit of changing things together, for which the devices are usually designed for, it doesn’t make a lot of sense to me to have the infusion sets outlive the insulin capacity and/or lifespan. Three insulin is only supposedly good for three days once it touches the plastic, though many of us push that rule already.
I’m pretty OCD, and it already drives me crazy that I have so many more extra boxes of cartridges than infusion sets. And it’s rare that someone is looking for those spare cartridges, so they just pile up. Thus is the entire reason I choose to change them together.
And then what about insurance… Insurance doesn’t understand that “up to 7 days”, still might only mean 3 days of wear for someone. If it’s marketed for 7 days, what if they don’t let you have more? What if it turns into the battle for test strips when you have a CGM all over again?
Raises the classic caution, “be careful what you wish for.”
Depends how long you have had diabetes. I suppose we are all different. New sites are the holly grail in control in my opinion assuming you are doing the basic stuff like Cgm, activity and eating right etc. After years of using sites even with rotation your absorption for many has proven to decrease. This coupled with our changing lifestyles, age etc throws us in another level. It is not so much the extended wear but more of better abosorption behind a new delivery method. Also, having confidence that I might be able to leave a site in longer. Certainly will help kids, busy professionals and body types that have smaller percentages of fat. I know some who will sometimes leave current set in but attach new tubing only to address age issue. For example, I can change the resvoir or part of the tubing to also address insulin age when out of insulin or need partial new tubing without removing the site. I know some people that are also allergic to the tubing so they have to swap sites every 1 to two days. Certainly we all leave in sets longer as we have busy or something comes up like a delayed trip etc. specific to insurance, I echo your comment on 7 days may only last 3 or none for that matter. I pay cash like many self employed or non corporate types. We need better reliability and options as we can’t burn through expensive sets. I feel like we should get 30 percent more because sets never last and life happens. Specific to Cgm and pumps, I have been part of the we are not waiting and DIY community. Very far ahead of tandem, Dexcom and Medtronic as far as integrating components. I love being able to control the pump from my phone and the data I get. Very much a hack but these companies are slowly catching up but they are slowed down by not letting us have freedom of choice in choosing best of breed.
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They can get around those limitations because they are not going through the FDA. The FDA regulations are expensive and time consuming.
Of course it’s also safer and proven after getting through it.
There must be a middle ground somehow.
My insulin last just over 3 days, so not much benefit for me…
@Terry4, I used bent-needle infusion sets back on the mid- to late-90’s, and ended up with many areas of scar tissue.
Those locations can no longer can be used for sub-q injects, because the scar tissue has very little circulation through it, hence minimizing uptake of injected insulin.
I suggest to everyone: move your point-of-infusion to every possible location on your body, to minimize chance of creating scar tissue.
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Several months ago, I ran short of infusion sets and had to use the existing one for 7 days (changed the reservoir) until the new supply came in. A 5 inch diameter thickened area developed around the infusion site that retarded the insulin flow. My new infusion sets would not work effectively if inserted within 3” of the thick spot. It took about three weeks for the thick area to dissipate. I had been using 6 mm cannulas but found 9 mm cannulas worked without issues.
Uggh. I wonder if a angled infusion set would help as well. I hate them but just curious.
When I first tried out a pump in 1987, I was given some “bent needle” infusion sets. I found them so painful to use that I almost considered abandoning pump therapy altogether. Luckily, Medtronic had just come out with some “Sof-sets” that used an introducer needle which was withdrawn leaving only the teflon cannula at the site. While this is standard today, back then it was a revolutionary concept. Using the Soft-sets enabled me to continue using a pump.
Your practice of rotating infusion sites to avoid destroying future insulin absorption is a good one.
@Robyn_H I also have more cartridges than infusion sets due to bent cannulas that have had to be removed. With a full cartridge still in place.
I don’t know why or how the cannula bends if the insertion needle goes in easily and “feel” like it is inerted properly. Weird.
My insulin lasts almost 4 days (I’ve never admitted that here before since so many seem adamant about changing it at 2 days) so I just wish for a full 4 days with no losses due to bent cannulas. I have plenty of tissue! It isn’t as if I’m way thin and looking for tissue!
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PS. The only change I have noticed in 4 day rotations over 21 years on pump is the red dot from insertion takes longer to disappear. It used to be gone in a few hours, now can take a couple days or so but that’s it.
If something less than standard works for you for 21 years, it makes no sense to me for people to make adamant strictures for you do the same as them.
By the way, a few years back I started to change my cartridge and infusion site on independent schedules. This cuts down on the frequency of at least one required task. I change my cartridge about every 7-8 days and my infusion site every three days. This diminished work-load doesn’t seem like much but it surprisingly makes a difference to me.
One of the causes of bent cannulas that I’ve observed over the years is when the cannula tip touches an active muscle. My angled insertion Silhouette set mostly, but not entirely, eliminates that problem.
I make a practice of closely examining every removed infusion set to check for a bent cannula. I can often predict a bent cannula by the CGM glucose traces that slowly march higher without any reaction to insulin corrections.
Keep doing what you’re doing and don’t pay any attention to any tut-tutting that may arise! We are a fairly tolerant group here but we are, in the end, just humans.