Okay Help!.. I’m convinced it’s my infusion sites are failing. I eat the same thing daily workout same time and test 20 times a day. My AlC is 5.0 I know my body in and out. There is shift in my energy and focus and my next meal I am elevated. I can almost predict it before it happens but other times I will not eat for fear of being elevated and have to be on my game at work or with clients. The only solution is to go and change my set … I’m usually better within an hour. But there are weeks I will change my sets 5 or 6 times.
I can live my life as I diabetic and do everything right but I need to know I can at least get the insulin … Right! I see a message therapist weekly to work the tissue and release any scaring that might occur under the skin. Does anyone else think that might happen to them? I am really losing my mind.
Hi Alison,
It sounds like stress may be affecting your blood sugars. Also, which infusion set are you using? There are a couple of options for Medtronic but I’m not sure if that is the pump you have. I have noticed that after 2-3 days with one set, it doesn’t “seem” to have the same absorption rate as it does the first day. My advice would be to rotate consistently! I can’t wait until some genius invents something smaller, faster and more efficient than today’s insulin pump.
How long have you been on the pump? My first month or two I was having “bad sets” from one thing or another quite often. Now that I’m at about 3.5 months it happens much less often. I did switch from using stomach (which felt “in the way”) to hip and leg, and I did try different types of sets thinking that was the problem. But bottom line, some subtle thing in putting them in, I wasn’t doing well (I’m not great on hand eye coordination).
If you’re new to pumping it will get better. If not, then I would definitely try different type sets. Also, how often do you actually see the problem? When I was having so many problems, sometimes they weren’t evident, but more often they were: bent cannula, cannula had come out, blood at site, etc. If you NEVER see evidence of the site being bad in some way, I would look for other reasons. The insulin you are using? Temperature? The cartridge, etc.
Different lot of insulin? Are you getting air bubbles in the tubing? Have you changed the method of insertion?
I would try a new bottle of insulin first…
Which sets are you using? I started on the Quick-set ones but switched to Silhouettes and have had pretty much zero problems with them. I like sticking the needle in myself, without the gizmo more and it seems like I can tell if there’s subcutaneous “clutter” and steer around it.
It goes in fairly far but, since I pinch my skin up, it’s sort of like another way to check for scar tissue underneath? It’s a long and sharp needle but it’s very slim and I don’t find it bad at all and prefer it to the other kind I had. I think I get 10 of the Silhouettes, I would have to check though, I just fish them out of the box as needed. To put it in, you peel the front 1/2 of the sticker and hold that in your dominant hand while pinching with your junior hand and just stick it in. I think there’s an inserter gizmo you can get but I just tried them and liked them a lot. I think they stick a lot better as I was pretty involved in martial arts when I started pumping and still run several times/ week.
As for the inserter for the silhouettes is can cause tearing and bruising of the skin. I have it but I prefer to do it manually like you acidrock23.
So I have had the pump for almost 9 years. I use all the sets… silhouettes for stomach and love handles, quick sets 6 mm for arms and sides, 9 mm for butt (I absorb bad there) and the Sure T for higher up in the sides or butt.
I check for air bubbles 1 -4 times a day but I only give 15 units a day so it tends to go slow and I catch them before they come close to the end. I change out my insulin (humolog) every 3 days.
I used to have anxiety panic disorder so I understand stress and blood sugar. My life right now seems simple compared to where I come from. So I can’t that is it either. I teach diabetes prevention to type 2’s and I am a holistic health coach so I am constantly aware of my internal self and where I am. I don’t know I am just meticulous with my diet and spike far beyond the amount of food I am eating till I change out the set. And the drop is usually immediate as long as I go in the stomach.
What makes me think it is the set is when I pull out the set 9 times out of 10 it will be half empty or if I squeeze the area it came from clear fluid comes out and it smells like insulin. My thinking is that it was pocketing in old scar tissue…. Do you think that is possible?
Question - do you have more trouble with one area or one type of set - maybe try different sets in different area?
Have you lost/gained weight? (I had horrible absorption, almost like you but only pumping 3 yrs, tried other sets, finally decided secondary to weight loss and figured needed 6mm not 9mm and problem solved)
Hormonal changes? I was on MDI when had those hormones, that was fun! (I like the no hormone life! LOL!)
Vitamin E cream? I understand may help scar tissue, controversial results noted.
Pump actually wearing out?
Hope you figure it out - annoying when all goes well and then we get slapped with wet towel when least expecting it!
I’m not sure about the scar tissue issue as I’ve only been pumping for 3 years. I don’t have a lot of real estate as I do the CGM on one side of my abdomen and the infusion sets on the other. I should start rotating a bit more I think?
I would rotate as much as I can. That’s when I started having someone work the tissue and the texture and feel of my skin went back to normal instead of a little hard. Now that I do it I couldn’t go without it.
I’m so anal I will not wear the monitor I test 20 times a day. I feel like if I’ve got this for the rest of my life I better conserve all I can. But I’m totally OCD… 
I’m going to ask about the vitamin E cream… but I did try both the 9 and 6 mm too… this is random it can be once a week or 4 times. I don’t think its hormone related cause I have a long history of that stuff too. But thank you for all your ideas.
It could be the potency of the insulin. I find sometimes after 36 hours and always after 48 hours, my insulin goes to a lower potency. One way to test this is replace the cartridge and reprime the tubing with fresh insulin and not change the infusion set. I have had this correct my glucose quicqly. Conversely to confirm that it is the infusion set, try a new infusion set with the old cartridge. Its a process of elimination. I had to do this with the AccuChek infusion sets which were later recalled. I have seen some cases of the MM sets kinking and becoming ineffective - currently using the Animas Insets - Good Luck and happy Troubleshooting.
I had an issue with infusion sets a few years back while I was using the pump. It turned out I lost a lot fat tissue and the infusion set was going through to muscle. I got a shallower set from medtronics and the problem went a way. I think the first one was 9mm and the ones that worked were 5. Don’t hold me to those numbers since I went back to injections when the warranty finally went on the pump.
Hi Alison, everyone,
First a quick intro. My name’s Matt and I’ve been a T1 diabetic for about 18 years. I’ve been on a pump for about 6 months, and I finally doing the whole ‘carb counting’ properly during the last year (as part of the crazy application process for the pump - it taught me a lot…). I already learned a lot from reading posts here, and thanks for letting me join!
I also had some weird problems with infusion sets failing a month or so back. Each time I kept trying to explain it away with something I’d ate or a bad site choice. I didn’t understand how sites could last 48 hours previously, and then work fine with each new set but then gradually fail. Then, I found this forum and read some reports of insulin crystallizing in the sets, especially with Humulog (which I was on then). At first I tried some even older penfill Novolog that I still had, one vial worked and with the next I had the same problem. What I conclude from all of this is that [any] insulin has a much shorter expiry when its being used for a pump. Perhaps Humulog is worse, I switched back to Novolog now. All of this insulin was kept in the refrigerator and was well before the expiry. I don’t know if that could be your problem, but I would suspect the insulin. The Medtronic helpline was fantastically helpful - he couldn’t imagine it had anything to do with the insulin and said “maybe I have something under my skin”. As a new pumper I had no idea what he meant, but I guess now he maybe meant scar tissue. Something that no one really warned me about (just the normal, make sure you rotate your sites so that you get good absorption). Its kindof worrying to read here that I could damage sites so badly that they are never useable again? I am using a mixture of Quicksets and Silhouettes, the shortest lengths they have, as I’m fairly thin…
Brock can I ask if you have the problems on the shots than on the pump? I just couldn’t imagine going back I only bolus .2 at meals… you can’t get that on needles.