Leaky Sites

Ok so my 13 year old daughter uses the Inset 30’s and all of the sudden we seem to keep getting leaky sites. When we first started we were having issues with cannula irritation and a couple leaky sites, the BG team at Animas determined that her cannula was not staying tight so they had me start putting down a layer of IV 3000 and injecting through that. That seemed to do the trick and the redness and irritation at the injection site went away along with the leaking. Now to this week, Friday afternoon I did a site change like normal then Sunday evening we were watching a movie and she said she could smell insulin, since she had been running higher since lunch and was creeping into the upper 200’s I changed her site and sure enough it was pooling under the site. I corrected and Monday went well until bedtime when she started running high again (she gets those puberty hormones and spikes at night sometimes). I corrected her and got her in target before breakfast (took a good deal of insulin which is also normal sometimes), then at lunch my husband bolused and the insulin ended up pooling at her site but this time on the outside. So hubby did a site change, we upped the basal because we weren’t sure how much had leaked and went on. Her numbers steadily rose and I had her correct at about 5 figuring less of the lunch bolus had gotten in than we had expected, with no luck. When I got home from work at 6 I looked at her site and it looked ok at first glance, but after I pulled it I noticed that the cannula had never actually went in (I swear it looked like it did before I pulled it, it just looked shallow) and was actually between the IV 3000 and the adhesive on the site. So on Tuesday night I changed it again Wednesday went well, but now today she was having some issues coming in range, nothing huge it was just like she was not correcting with meals, but was coming back to her pre-meal number (which started a little high) from breakfast and lunch. Then she just had a snack and texted me a picture of an obviously leaking site…

Now there are a lot of times that she cannot do 3 day site changes due to a high TDD, however since these are issues with leaking I have not been changing her reservoirs with the sites because that would be a ton of insulin I was throwing out. I am not having an issue with changing her site every two days, but I am having an issue with the leaking being the reason because her numbers are averaging higher due to it.

Does anyone have any advise or tricks you may have learned?

Yes get some samples of Sure T sets

Have you tried a straight set?

I am currently in the process of changing from the T30 to T90 sets due to these issues, along with a painful site more often than not.
I used the T90’s for over a week, and had almost zero site irritation and no more leaky sites.
Until I get my new sets in, I have been changing my t30 sites every two days.

Also, how you hold the t30 inserted makes a BIG difference!
My endo told me to hold it down with two fingers, one on each tab while the other hand releases it.
That way ended up being the worst way for me.
I now only hold it with one hand, and barely use any pressure holding the inserter against the skin. This works a lot better!

And although I am not a teen, I am fairly thin. This is why I went with the T30.
Ends up I get better BG numbers with the T90 as well. Of course, YDMV.

One very simple and inexpensive way I’ve been able to prevent sites from leaking or and lasting the full 3 days I’m supposed to keep the site is to do a combo-bolus or wave bolus. People call it different things so I’ll try to explain. It’s where you do part of your insulin bolus first and then do the remainder over a period of timer after that. I’ve only experiences Animas pumps so I’m not sure what features are or aren’t available on other pumps.

I’m not sure if it’s that the body can only absorb insulin at the site certain rate in a given time window that causes the problem or the pressure causes the tubing to go bad. On the Animas pumps it’s called a combo-bolus. You can find it in the bolus menu at the bottom. I do 25% of the insulin up front and then over the next 8 -10 minutes, (.1 of an hour according to the pump) it does the rest of the insulin. This allows me to keep sites in my arms from leaking/going bad early. Before that I had a really hard time being able to keep sites that I put in my arms for the full 3 days.