So I spent 7 hours in ER today. Mild DKA. Changed my infusion first thing this morning and 2 hours later BG was almost 400. Changed the set again and notice the first set had a 90 degree bend at the end, so I thought that was the problem. My BG proceeded to exceed 600 and I had an appointment with my endo in an hour so I toughed it out only to have them send me to the ER. So after IV insulin my BG came down and they sent me home thinking I had a bad bottle of insulin. I changed the insulin bottle and the set only to discover another bent cannula. I’m using the animas inset 90 degree set. Has anyone else had this problem with the inset?
Auto insertion sets are know to do this, for some people it happens more often. I use a manual slant set and have never had a bad insertion.
I would report the issue to the FDA as a medical device failure. If enough people report and track potential lot numbers that are having problems might get something done sooner.
http://www.fda.gov/Safety/MedWatch/HowToReport/default.htm
On the post change high front would recommend that when you see a high post site change that you should correct by syringe. You can pull the dose from the pump and administer via syringe. When you are high like that dosing from pump does not always work quickly, and if you get a correction from the insulin you pulled from pump you know that the insulin is good. Which makes it easier figure out you gave a bad set.
Since your using straight sets, you might want to try out metal sets like the contact detach, they are manual insertion and since they are metal will not bend.
I have not had an unexplained high from a set yet, but I had some problems with the soft cannula's. I switched with a lot of apprehension to the Contact Detach steel cannula, and am so glad that I did. The needle is short at just 6mm and even with my extremely thin body composition, 5'9" 143 pounds, I rarely feel or notice the set. The other bonus is the second patch that insulates the cannula from the tugging of the tubing, which helps keep the sight secure. No bent cannulas, and rarely gets tugged out by the tubing, also if for some reason it gets tugged out you could reset it and tape it down, until you could get to a point where it would be convenient to change the set out.
Your pump rep might be able to send a couple of samples to try.
This has happened to me a number of times using the 90 degree inset. Maybe 3 times within 8 months. I am working with Animas to get the set changes to a slant set. Luckily, I have always caught it before it got too far above 200 thanks to my dexcom.
I had a couple of bent canula fails myself with the Inset set, with the expected high BGs. Fortunately, frequent monitoring revealed the problem in time to get it fixed. Had to go through 2 sets, but my Tandem rep quickly sent me replacements. Learned that it's all about body placement for me. I just don't have enough of a fat layer in my abdomen, so switching to the "love handle" area did the trick. Haven't had a problem since then.
Just like Bill, since I switched to the love handle from the front stomach area I have not had a problem with an infusion set yet.
Unfortunately this happens to me quite often with the animas and often hit mid 350s because of it...I keep a set of syringes to bolus when this happens. My problem is being overweight I need the 9mm and the slanted do not absorb right. I have tried steel sets, but got a horrible site infection from one and the antibiotics resulted in C-def.... I try taking my time with the inset to limit the occurrence.
Thanks to everyone for your replies. I'm not a thin person so I doubt that running into muscle would bend the cannula but I will talk to the Tandem rep and see about metal sets. I used a minimed years ago and they did not have auto-insert sets then but you just manually backed out the insertion needle, never had a problem. I am starting to think my particular problem may only be partially related to the inset bent cannula as I had a pretty good night with BG at 158 in AM but as soon as I ate my BG skyrocketed to 348 and it has taken 2 corrections and 4 hours to come back to 147. I have checked my pump settings multiple times and they reflect my normal routine. Just waiting now to hear back from endo...
I recently started having issues with the Insets. I a couple of weeks ago, I switched to the Accu-chek Ultraflex. I haven't had an issue yet, and my BG's are better overall. Maybe call Accu-chek or your distributor (if you have one) to see if you can get a few samples.
I just had my second bent cannula in a month. It was the 90 inset. I also have manual comfort shorts and have never had a problem. I’m sending back one box of insets. Has anyone tried the inset 30?? I like the idea of not manually inserting and I seem to be more comfortable with the 30 angle.
Well, after requesting some samples of this type of set, now I am really thinking twice about sticking (no pun intended) with my Silhouette angled sets....:-(
Call the manufacturer... this isn't a T:Slim problem it's an inset problem. They will replace the sets and often will want the bad ones back to look at them.
If the cannula slides up on the autoinserter needle, it can kink when it hits the skin. So examine it closely before you autoinject. Once the cannula is under the skin straight, it’s a bit hard to imagine it kinking itself more than subtly, it’s in a linear wound, it would take a lot for it create a new path under the skin.
I just switched to T:Slim after being w/ Medtronic for about 24 years. It was a huge change for me. I’ve always used a manual insert & I got a 3 month supply of some auto insert. I hate the loss of control & for the first time in all my year got 2 bent sets. So I put a new order in to go back to Medtronic soft set w/ manual inserts. Hopefully I’ll get back to my comfort zone of doing it myself. My trainer did come back out and she showed me every kind of infusion set they have or that I could get. Very helpful. You just might need a different set. Good luck. And whenever I get those highs that are a mystery I go to injections first than trouble shot.