Hi all

I have been pumping since 1/8 and really love it. But I’m a little frustrated because today was the second day I had problems with my sets. The first day on insulin I shot immediately up into the 200s and couldn’t get down despite corrections, so I did a correction with a pen and then changed my set and saw the cannula was bent. Then yesterday I was having moderately high numbers like 145 before a meal. Today I woke up at 173 and then jumped to 202 and 309 after breakfast. I haven’t been in the 300s since before I started insulin two years ago!! I immediately changed the set and didn’t notice anything to blame but I am now coming down.

So people have told me that problems are not unusual but two problems in 2 1/2 weeks seems like a lot. So I’m wondering first of all if there are any “tricks” that people use when inserting their sets. I still have to follow the instructions step by step to get through the process but I’m wondering if there is some “technique” you can share with me. Second of all, I’m using the straight in Animas set. Is that prone to more problems? If so, I will get a different type when I reorder; I do need to use these up first. Also for financial reasons I want to stick with Animas problems as they are covered by my insurance.

Thanks for any suggestions about technique or set choice.

Hi Zoe - my 5-year-old son is our Animas Ping pumper. We use Inset 30’s for him (the angled ones).

The first month or two with his new pump was much more difficult than the following 14-16 months have been. I’ve learned that the area must be soft and ready (hard or dry skin makes it more difficult)… I’ve learned that the angle of insertion is important… that the little “feet” of the little inset device must be as close to parallel with the skin as possible… I’ve learned that if the inset hesitates… like it doesn’t seem to go in smoothly… then you might as we re-do it right then. Sometimes we just get a bad one, but not very often. If I do his new infusion set and I can see the little tube penetrating the skin anywhere inside the little view window then it’s probably ok. I may be making it sound more difficult than it is… with some practice it should get easier for you. They’re not as picky probably as I make them sound… we’ve had a few times when I thought that the set didn’t get put in right but we stuck with it just to see… and it worked fine.

I haven’t had a bad insertion from the very beginning in months. I’ve certainly had a few go bad within 1 - 1.5 days on occasion but usually we get the full 3 days out of them.

Are you swimming? Are you taking once or twice daily baths/showers?

When my son takes a bath, it pretty much destroys his insertion site. That’s when we do his changes. As a result he only bathes on set change days. We feel this is ok for now. Sometimes we have to do a set change in the middle of the night… that sucks… but not very often.

If you’re bathing or swimming fairly often then you might consider covering the site with something stronger like the IV3000’s (ask your Animas rep). Otherwise, you might just need some practice!

Trying the Inset 30’s is probably also worth a try… but if you’re already using the 90’s then I might stick with them for a bit longer before switching.

i have no familiarity with those sets but occasionally i have similar problems with my cleo90’s. when it’s all going well i can go for a month with no problems. and then bam, i lose a set, the next 3 or 4 i insert all go in bent and have to be replaced, etc.
i glue mine down with skintac and cover them with a little piece of the small IV3000 with a hole cut out of the middle because i’m not very adhesive and they shift around on my skin otherwise. do you find that the bends in your cannulas are near the tip or the the base, closer to the surface of your skin? i find that when they are closer to the surface of my skin it’s because the infusion set shifted after insertion. but then they are closer to the tip it’s because they bent on the way in.
what length cannula do you use?

Thanks, guys, it’s nice to know it will get better! I appreciate the specifics and will be sure and line it up firmly. When you mention the inset going in “smoothly”, Chris: I do notice that sometimes it seems to be a two step process. In other words when I squeeze the circles it clicks but then I have to squeeze them again before it is in right. I think I’m being nervous about squeezing, so I’ll try giving it one good hard squeeze and maybe that will help?

I do take a bath most days; not because I need it to be clean, but because I love baths! When you say his bath “destroys his insertion site”, do you mean you can actually see the adhesive pulled up? Mine always still looks attached and I always pat it dry and push on it. If that could still be causing a problem, despite looking fine I’ll order some of those IV3000s you both mention.

I only actually saw the cannula bent the first time but think from the numbers that time was bent right away and the incident this morning I’m still a bit puzzled about the cause of as it didn’t look bent. I believe the length is 9mm.

Hi Zoe - this is just beginning pumping, my first 4 weeks or longer were horrible, more 300s than I’d had in a long time, it takes time for you to find out your best method of insertion & which sites work best for you. I nearly gave up on pumping, so glad I persevered, my A1C is now between 5.7 & 6.2, very few BGs above 200 but too many lows. So hang in there.

I would try the Inset30s, the angled sets do kink less. If you have an unsealed box of infusion sets Animas will exchange them, especially as you are a beginner. I found what works for me in Inset30s in my stomach & Insets in my buttocks. Also make sure you avoid any areas where there may be tissue build up.

Hey Zoe!

Yeah, that’s right. Don’t hesitate… go for it! When you commit to picking a place, then just do it. Make sure that mechanism releases with full force. Usually I’ll use two hands… once I release the needle I’ll take my second hand and physically hold onto the adhesive part so it stays firmly on the skin while I pull the needle back out. I do this because one time I had it come back off with the inserter… it’s hard enough to do this on a 5-year-old without having to do it twice!

By “destroyed” - yes, that’s exactly what I mean. When he gets out of the tub you can clearly see the sides and most of the adhesive is no longer sticking. Sometimes it falls right out, but other times it’ll come off with a very gentle tug. It’s probably just how his skin works.

All the same - are you capping your canula/set before you get in the tub? Or do you leave your pump on? Maybe your cap isn’t sealing well… I can imagine that if any water got in there, that might be an issue. If you leave your pump on, hot or warm water can ruin your Insulin… maybe that’s your problem?

I’ve seen a few bent canulas, but not many. Sometimes the site goes bad and we can never figure out why.

Hi Zoe -
Are you sure your insurance will only cover Animas? I thought that as well, but it wasn’t the case. I still get my cartridges directly from Animas, but I get my infusion set from Liberty Medical. Why? Because I did not like the Animas products. Speaking to the bent cannula, that is one of the reasons I gave up on any teflon sets - the other is that I have a slight allergy to the teflon. Instead, I use steel. I found I preferred very clean steel to the petroleum product plastic or teflon…and no, you don’t “feel” the steel. Animas has a steel alternative but I hate the Contact Detach because I was always ripping them out (don’t like the extra “tail” - I prefer direct site detachment). After trying many, many, many, I settled on the Orbit Micro - here’s the link I didn’t like the Cleo because it didn’t stick and I have didn’t want extra sticky stuff or bandages on top of the infusion set.

But the bottom line is, yes, as others have said, you will learn the “feel” of whether a set is in well, in a good spot, etc.

Thanks, everyone. ! Yes, Chris, I disconnect and put the little plastic thing into the set. I told my trainer I like very hot baths so she agreed I should disconnect. And the adhesive always looks like it is nicely attached when I get out. She also did teach me to hold my finger down on the adhesive as I pull out the inserter, but I should practice too making sure I pull it out straight. This is probably the most use I’ve made of my poor hand/eye coordination skills in years…lol.

No, I’m nowhere even slightly close to thinking about quitting - I love my pump! Just making my way through all these new things to learn. I’ll practice better technique and then try some angled sets; my sales rep had talked me into the straight ones saying that unless I’m a kid or very active (nope, far from both definitions! ) they would be best.

I did think insurance was specific to Animas, Cheri. But in addition to insurance I get a 30% discount on Animas due to my income level. So hopefully I can make Animas products work for me.

I’m still not sure of how to “feel” if a set is in well. It seems I have a bit of soreness right after insertion, but then it goes away. When I had the bent cannula that irritated feeling persisted. This morning when my numbers were so high that feeling was back despite having changed it on Sunday. So I guess that must be the feeling you mean?

i like to soak in a bath once a week or so and i find that i need to replace the IV3000 i cover it with, but if the site is glued down with skintac i don’t lose the whole site too often. the cleo90 doesn’t have a cap for the infusion site and it’s not a problem to get it wet, no worries about water getting in there. makes me wonder about the animas sets, if the cap is actually necessary?

i find the biggest indicator for me of a ‘bad set’ is itching. it starts to itch like mad. and sure enough when i take it out, somethings bent or clogged or whatever.

Salutations Zoe,

When I first started my Animas, it was definitely a lifestyle change!! LOL… After awhile, you’ll find more creative ways to minimize issues. One thing I do recommend to look out for, is too make sure your not putting the infusion set in to muscle. This tends to not only hurt more, but also bend the cannula. Only use the standard site recommendations (back of arm, stomach, behind stomach, and top of front legs (areas that contain the most fat))

Also note that a cannula can bend when your doing a heavy workout. If your doing a very rigorous workout, I recommend putting the infusion set in the most fatty area of your stomach.

Make sure that you don’t bend the tubs too much, as this sometimes can cause clogging. The tubing should be nice and loose, yet out of anyway were it can get snagged.

I don’t know, Marti, I thought the cap was for hygeine as well as worrying about water. The idea of an open port sitting in a bath with germs doesn’t seem good.

Like Chris said, I don’t see the adhesive pulled up after my bath, so I would guess it’s fine, but I’m wondering if some of you put those IV3000s on top of your sets routinely to keep the whole thing in place better?

Thanks, Yogi. I am just using my stomach as I was taught with injections that had the best absorption, but I suppose in time I’ll need to use other sites as you need more space for a set and I could get scar tissue using the same spot. I can’t imagine using my buttocks or back of arms…I have enough trouble doing things right in view let alone behind me…lol.

I don’t workout so that’s not an issue for me.Do you use those IV3000 things?Maybe it is good to use those routinely as I’m starting to feel fragile with this thing, like when I bend or if my cat walks on it!

Thanks, marti, I’ll watch out for itching as well as soreness.

oh yes, i always use IV3000 since nothing tends to stick to me at all otherwise. not bandaids, not anything. i’m not very adhesive.
the way the diabetes educator explained it to me, for the cleo90’s at least, is that the opening of the port is so small that fluid has to be forced into it by pressure. insulin doesn’t just run into it, the pump has to PUMP it there. so water running over it won’t accidentally get in there unless you are putting the shower spray nozzle right on it at the just right angle.

i met a roller derby girl who puts her infusion sets [medtronic] on the upper curve of her butt. said it kept them out of the way of impact. i’ve never tried it myself.
zoe, just get used to carrying spare sets/gear with you and not being afraid to change it whenever you need to. i’m lucky that i work in the pharmaceutical field and half my coworkers want to be nurses so they actually ask if they can watch me change my infusion set. but i’ve done it in a movie theatre, the parking lot of many a shopping center and even a restaurant.
sometimes they just come out. you wore the ‘wrong’ pants and the waistband knocks it out, etc.
when in doubt, learn the smell of insulin. if you smell bandaids = you’re leaking.
see if your doctor can overprescribe the sets, or, like i do, when you get a good one, wear it an extra day. if you do that often enough and have no problems, you can be a whole spare box [or more] ahead in case of lost sets.
and no, it’s not going to kill you if you don’t change your set every time you change your cartridge.

Ah, I see. I don’t know, I just put the cap on; an open port still concerns me in terms of infection, maybe it’s not necessary but it’s no biggie.

I guess I’m “more adhesive” because the sticky part of the set seems to stay on me just fine despite my addiction to hot baths. (I can’t live without them! When I lived in Guatemala most houses just had showers, so I had my shower turned into a bath! Now there was a project I would just as soon forget, but the end result was beautiful blue tile patterns!)

Another trick when removing the Inset inserter, is to hold down the outer plastic part, & gently pull up the middle white springy thing, & then pull up the whole thing, this holds down the adhesive tape while the inserter needle releases from the cannula.

I think you should try the Inset30s, my friend in the UK started pumping a year ago & had terrible trouble with Insets, since switching things have been much better.

I am hardly athletic, walks & gardening is it, but I prefer the angled Inset30. Ask Animas for a sample, they have special 2 packs. Also the Inset30 has a window so you can see any blood around the point that the canula enters the skin & also if it starts to look red. As I said they will probably exchange an unopened box of Insets,

Hey Zoe,

Funny you should post about this today. I’ve had to change my infusion set 3-4 times in the last two weeks for problems of high bs and bent cannulas. I talked to Animas today and they told me that usually it is an error in technique. According to Animas, once the insertion is done and you are pulling the insertion device and needle away from your body, you should hold onto the white part in the center. I was holding onto the outside edge of the gray inserter. They said that doing that can actually cause the cannula to back out some because of the spring mechanism and cause the bending. I don’t know if that’s the case or not. I’ve had my pump since September and haven’t changed the way I pull back and have only had a major problem with the cannulas in the last couple of weeks. I’ll do it their way and see if that makes a difference. If not, they told me to call back,it may just be “a more sensitive batch of infusion sets”.

OK Carman, since you just got the info from Animas, I figured I better understand it too! I just fished my insertion device out of the garbage (yeah I know…yuck!) because I didn’t know what you meant by grey part and white part. Yep, I was doing it wrong too! I put one finger on the adhesive to make sure it doesn’t get pulled up and then I have been pulling the insertion device up by the round (grey) edges. Now that you mention it I vaguely remember my trainer telling me to put one hand on the adhesive and the other on the center of the white part of the device but I only remembered 1/2!

Thanks for sharing this info! I had not planned to see a bs of 300 again in this lifetime! Really drives home how insulin dependent we truly are!

Wow, Marti - parking lots and restaurants! I’m still at the point of “needing” a cappuchino, then I lay everything all out on my kitchen table and methodically follow three sets of directions! I actually got down to 15 minutes last time! (started at an hour!) I am soooo not mechanical, but I am pretty logical which saves me!

Thanks, Annabella, I will try the 30. I was wondering what someone meant by “looking inside the window”. I like that!