Hello all,
Just looking for a little insight on a problem that’s been going on for a couple of weeks now. I insert a new infusion site, which I rotate around to a new spot each time. After about 12-18 hours of my body responding as usual to normal boluses with steady BG rates, I notice it takes more and more insulin to bring my levels into range. And then it just seems to stop working altogether.
When I pull out the site (after only about a half day’s wear), it looks like the insulin has sort of beaded up around the cannula and it’s clear there are air bubbles or something that is impeding insulin from coming out. No swelling or bleeding occurs (usually) at the site spot after I remove the infusion set.
I called Medtronic to complain, and they send me replacement sites but tell me it’s probably a bad shipment of insulin. I call Express Scripts, and they agree to send replacement vials of insulin, but tell me it’s a problem with the infusion sets.
Has anyone experienced this problem before? I’ve traded out new insulin vials, and tried site changes all over my body with the same results. I’ve included a picture of what I see after pulling out the site after about 12 hours.
I have some pics below that try to capture what I’m seeing. Thank you!
I use different insertion sets for different areas of body (for decade used quick set and silhouette (on stomach) as the quicksets started having issues there. I now use three different sets and the only place I use Quick set now is on arm (as it can be installed and handled with one hand, would not have a chance of getting silhouette with just one hand. For some reason quick sets were doing almost what you’re describing on my buttock after years of no problems. Now use MIO there and no problem. Oddly MIO is still a vertical canulla like the Quick set but works much better. Would probably use them on arm also but they don’t have them with long enough tubing.
See if MM will let you try the MIO just for hell of it!
Unfortunately, I don’t think pulling the infusion set is going to tell you much, because as soon as you do, air will be introduced, However, you could push (via bolus or prime) enough insulin to see if there is something amiss in the connector and introducing air.
Another thing to consider is your site rotation. Try going to some more extreme locations well away from your “normal” spots. I have found it easy to fall into using a narrow area for site rotations, creating a situation where the absorption falls off in a much shorter time frame.
Unless your insulin has been subjected to temperature extremes during shipment to you, or improper storage at home, it’s highly unlikely to be bad insulin. A quick check would be to deliver a bolus/correction using a syringe from the same vial that you used to fill your cartridge. If your BG doesn’t respond, then it could be an insulin problem.
Yoga is probably very right here as that is what ultimately led me to using different sets in order to get more sites in the rotation and allow longer heal intervals between use. I went from 4 sites to 8…
Thanks, guys. I’ve never tried using different sets for different sites. And I’ve never used my arm for infusion sites or my Dexcom. For those of you that do, where do you put it? I lift weights and exercise and I’m concerned it would get tangled And in the way.
Also, my BG levels have slowly come back to normal after another bolus. So is it possible I’m dealing with a slow absorption issue? Could that be caused by problems with the site? The effects of the bolus just seem to be taking 3-4 hours where I used to see results right away, with a peak drop at 2 hours post.
When I was having site absorption problems a few years back, I experimented with different infusion sets (changed from the Inset 30 to the Quickset 6mm) and tried sites I had never used before (virgin sites). I started using the love handles and further around on my back. This combination of things worked like a charm. I learned that I can connect to a site on my back trusting my sense of feel instead on depending only on a direct visual.
Hi @cauthren, I’ve been using the Quik Sets for a year and half and have never run into any issues, but not ruling it out and totally believe you that its probably the infusion sets. I’ve tried the Silouhettes and was allergic to the plastic cannula. I developed severe skin infections after using those for a year. Then I switched to T-Sures. Totally agree, the needle is painful and for me was inconsistent. My suggestion is like that of @JC14, try the MIOs. I have never tried them but thought about it a lot. I hear there is a disposable inserter with each package. I totally recommend calling Medtronic and getting free samples and calling your local Medtronic rep and getting more free samples. Sometimes it takes awhile to see if a new infusion set really works for you. If necessary, ask your endo’s office for samples too. Bottom line, you shouldn’t have to pay for trying out the Mios since you are having issues that are not user initiated. That is until you are done with your trial time, then you know you will have to pay.
I’ve called Medtronic before and they will send out free samples, especially when you are having issues. I’ve done it lots of times.
Wish you the best,
Busybee
Yeah, I think you would have a problem with working out and insertion set on tricep… Thinking back I want to say I stopped pumping weights around the same time I started pumping insulin, lol. Or it just may have coincided with getting older and lazier. How many sites do you rotate?
I rotate amongst sites (along with my CGM) in my butt, back (obliques), abdomen, and leg (thigh).
I should also add I switched over to a tandem pump in July after 17+ years with Medtronic. This switch mostly was due to the frequent “no delivery” alarms I would get when I tried to bolus. Haven’t really had problems until now.
Are the Mio or any of the other sites you guys recommend t slim-compatible?
An excellent range of sites, I do all of those, but the thigh is extremely rare. I found that for my butt and obliques I wasn’t using as much real estate as possible, so even though each area gets a 20 - 24 day break, I was having absorption issues there. Once I consciously thought about expanding those areas, my problems mostly went away.
If you insisted on sticking with the Quick Sets, that was your problem. seriously. I nearly gave up pumping (perish the thought) quite a few years ago ONLY because I kept having issues with QS. Once I switched to Sure-T’s I was able to resume pumping and not keep getting those d&mn “no delivery” problems. Too bad you don’t like other sets. good luck. I’ve absolutely no other viable suggestions for you.
What insulin are you pumping. I had that problem with Apidra. After a certain amount of time nothing could bring my BG down.
I am not sure if it is the quickset but I am pretty positive all my sets look like that after I pull them out. Another thing that might be wrong is if you are using the wrong size 6mm vs 9 mm?
