Infusion set problems

I started using an insulin pump about a month ago. I really liked it at first, but lately, almost every time I have a site change, the cannula gets bent or kinked and my BG skyrockets before I realize what’s going on. This is causing a lot of extra anxiety.

I started off using Mio infusion sets because I hate needles. I called my MM trainer and she had me try the silhouette, which worked fine when she inserted it, but when I tried to do it myself, it was very painful (and bloody) and I just couldn’t do it. Plus, it seems to leave a much larger scar than the Mio. If this is my only solution, I think I would rather go back to MDI.

Does anyone have any tips for the insertion process that will help with this problem? Or any general advice on how to deal with this? I’m ready to give up.

My suggestion is to call Minimed, talk to their support people, and request a sample of their different infusion sets. I have done this in the past when trying to figure out if the problem was me (bad insertion, kink, etc.) or them (bad set). MM has always been good about working with me. Now, they will not send you the inserter if one is needed for the set (like quick set) but you can try them out at no cost to you.
I started with quick-sets, read about all sorts of kinked cannulas, problems, etc - only problem I have had was related to needing to change the cannula length from 9mm to 6mm secondary to weight loss after beginning pumping. I tried the Mio, didn’t like - seemed to hard to get the blooming thing inserted and then detached without tearing it all out.
Also, something to think about - many of us (like me) have a tendency with a site change to have an increased blood sugar with a site change. I ALWAYS do a site change when I can bolus a “large amount” (for me, that is between 1.5 and 2 units), and I test, test, and test tweaking the numbers a lot more aggressively than I would otherwise. I try to never do a site change before bed, unless I want to run higher than normal during the night. Others will say they do not have a problem with this, but something to think about.

When you try different infusion sets, be sure to try the Sure-T. I’ve tried most of them (hate the Silhouette), and far and away prefer the Sure-T. It is a metal needle which can be removed and moved nearby if the site is uncomfortable. There is no inserter. Don’t give up, there’s bound to be one that works for you.

I like the Silhouettes a lot but just insert them by hand, instead of with the gizmo? I didn’t actually get a gizmo. Pinch and stick and they pretty much always go in pretty smoothly for me. I have a couple of spots that bleed but sort of know where they are. I will just clean up the blood and use the spot too, as they seem to work fine there.

I used the Silhouettes for years before there was even a gizmo to insert them with. BUT, if you hate needles, you probably wouldn’t like the Silhouettes.
I’m currently using the Quick-Set – the only problem I’ve had is that sometimes the dressing sticks to the Serter. But I think they fixed that problem. With the Quick-Set, you don’t really have to look at the needle, and you just set it down flat on your skin, and push the buttons, and it’s in. I think I had a kinked set once. Only once in my 12 year pumping career have I had a gusher, which is a lot of blood coming out when you remove the set. I’ve never had any blood or bruises putting the set in.

Maybe you could set up a session with your trainer to try out the different sets WITH the serters – trying to do them by hand is just not the same, and with your needle phobia, makes it unnecessarily difficult.

I agree with Natalie. I think your best bet with your needle phobia would be the Quick-Set WITH the inserter. I have never been able to put the infusion sets in with enough force without the serter- it would almost always kink (I just could never bring myself to insert with enough force and fast enough that I could ever get good results without the serter). I now use the Animas pump with the inserter that is pretty much the same thing as the Mio. I have way more problems with the Mio type set up than I ever had with the Quick Sets.



I know this has caused a whole lot of anxiety and inconvience but don’t give up. We all have an occasion here and there where multiple infusion sets/sites will give problems one after another. I know how it feels. Just stick with it and you will get in figured out! I got to the point once I decided to go back to shots. After 2 days of that I decided no matter what frustrations I had with the pump it was 10x better than MDI.

I would recommend the Minimed QuickSet from Medtronic. It has an QuickSerter which you can use to insert the Set.
I use it every time, and it dosn’t hurt, you only feel the snap which isn’t painful.
The QuickSet is a great infusion set and it is detachable.

http://www.minimed.com/products/infusionsets/quickset.html

Best regards

Oops, I just realized the Mio and Sure-T are about the same. I also like the Quick-set (with inserter), and have some of each.Good luck.

Thanks guys! I called MM, and they’re sending me samples of the quickset and sure-t. I really hope I find something that works. I tried using the silhouette again yesterday, inserting it manually, but I just couldn’t do it. I think I’m not tough enough for diabetes.

It’s not that you’re not tough enough for diabetes – I mean, who could insert a friggin’ HAT pin under their skin??? I used to do it because there wasn’t any other choice for a disconnectable set, there was no Serter, and I did it s-l-o-w-l-y!!! Now, after getting used to the Quick-Set, I don’t think I could go back.

But I think it’s imperative that you get the Serter for the Quick-Set – too hard to insert it manually, even though the needle is shorter and less intimidating. Even if you have to buy one, I think it’s worth it. I don’t know what it costs, but I’m sure you could look on the MM website or call them.

Good luck, and I’m really hoping you find a happy solution!

Thanks Natalie! I appreciate the encouragement.

Luckily MM sent me the samples with the inserter, and so far I haven’t had any problems. They seem much easier to insert. I just called to switch my order. I really hope this solves the problem.

Hi Ilana,

I too have experienced the same problems with the infusion sets. When I brought the complaints to my minimed rep’s attention she advised me that one of the reasons could be the amount of scar tissue that I have in the area that I am trying to infuse. For example I tend to have more problems when infusing on my stomach, but a lot less when I do it on my sides, or lower back. Rotate your sites as often as you can.

Another suggestion I would have is to make sure that your skin is warm when infusing. I know that this seems to help me with the stinging sensation. If the skin feels tough my suggestion is to avoid that area for at least month or more if you can. Another suggestion would be to make sure that you are applying enough pressure to the inserter against your skin. It needs to be against the skin firmly to ensure that it breaks the skin and doesn’t break then enter the skin. Finally before removing the needle, give it a slight turn. This helps make sure the cannula stays in place as you take out the needle.

Good Luck!

That’s great that they sent you in serter with the samples! The have a serter for the sils too - if you have some left - it kind of powerhouses them in - so I insert manually.

Thanks for all of the suggestions. I don’t think it’s scar tissue, since I’ve only had diabetes for a few months. Plus, I’ve been careful to rotate my sites. What kind of infusion set do you use?

The quickset worked for a few weeks, but yesterday I went through 3 sets, and none of them seemed to work. I must be doing something really wrong, but I can’t seem to figure it out. Oh well… I decided to just go back to MDI for now. Insulin pumps are not for everyone.

Hey Ilana. I’m so sorry you’re having all these problems. I’ve been struggling with sets too but seem to be getting clarity as to what works better (I’m not familiar with the minimed sets so we’d be talking apples and oranges.) I was wondering how you would feel about getting some help at our group? You could bring in your sets and maybe one of the experienced people could give you a hint about your technique. I could even send an e-mail before the group and request some people who need to change sets do it in group to demonstrate!



Think about it!



Whatever you decide to do in the meantime, just take care of yourself, and be sure and celebrate Valentines Day. Over and beyond whatever we celebrate with partners we should celebrate loving ourselves!

Thanks Zoe! I’ll see how I feel in a month… but it’s actually been really nice not wearing the pump for the last 2 days. It might just not be the right thing for me, at least not now. I’ll give it a couple of days and see if I miss it.

I’m glad you’re getting your problems sorted. Have you gotten any good advice on infusion sets and sites?

Happy Valentines Day to you too! Looking forward to the next meeting. I love our group :wink:

Yep, it definitely sounds like you need a break and then can think more about it down the road.

For me, yes, I’m not totally there yet, but I feel I’m getting there. I’ve posted my questions when I was frustrated either on the Pumper’s Forum or the Animas forum. I’ve asked questions and gotten people’s input on: The different kinds of infusion sets, different sites, canula size, techniques to insert, problems that happen with sites, how to trouble shoot when I have highs. I also really read and re-read Pumping Insulin. I was really struck by what the women in our group said about how they only have problems with sets 5% of the time. John Walsh says the same thing, that you have a lot of problems at first and it gets easier, so I figured I’m paying my dues right now and it’s all a learning experience.

But yes, if you give it your best shot (no pun) and decide it isn’t for you, that’s okay too!