I was looking into some insights as how users can wear the extended infusion set and avoid over using a site. Previously you would need to change out a site every 3 to 4 days and for some even sooner skin issues and hardening of a site. Now you can wear this infusion site and not worry about a site for over 6 days and the site will be ok? Thoughts?
This only works on people who have no allergies. I have allergies to the adhesive and it takes 2 days to start working it’s way into the site then it gets red and hard and stops absorbing. There is no way I can go 6 days . Besides I use 140 units every3 days so even though it’s possible to fill my pump um with 300, I’m going to move to a pump with a200 unit capacity as soon as it’s released
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Got it. But generally if no allergies I think you are saying no issues. I always thought there was some guidance about switching sites every 2 to 3 days regardless or you could not come back to it or it would be less effective.
I’ve used insulin pumps for more than 35 years. I’ve found that the amount of insulin that I pump directly affects the sensitivity of the site; the greater the insulin quantity delivered, the more insulin absorption is degraded.
I’ve come to believe that consistent absorption of insulin at an infusion site is the single largest factor that affects my blood glucose control success. I therefore, almost always, change my site every 72 hours.
I’m highly skeptical of this development of regular 72+ hour deployment of infusion sites. I may be wrong and will monitor how this bold claim plays out.
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These flat out scare the crap out of me. And it’s not just Medtronic, Tandem has one in the works, too.
Everything I’ve read says that the only innovation is that the insulin won’t react with the plastic, thus less prone to occlusions. And less scar tissue because of fewer punctures. I haven’t read anything about the new sets being immune resistant, which is what I understand the major limiting factor to be.
It’s the natural way of things. When your body can’t destroy an invader, it builds a cyst of scar tissue around it, essentially walling it off from the rest of the body. That takes usually 3-4 days or so, which is why we’re supposed to change the site before then. And it’s also why we stop absorbing insulin altogether if you wear a set too long. The insulin can’t penetrate the scar tissue.
Puncture wounds don’t generally cause scar tissue. It’s pretty rare for MDI patients to accumulate scar tissue, unless they’re using the same spot over and over again. They’re more prone to lipodystrophy (abnormal fat deposits that look lumpy and can feel tough/thick) than scar tissue. So why are the manufacturers promoting this guise???
Before I started pumping, I read enough about scar tissue accumulation and losing the ability to pump to be terrified of scar tissue buildup. It’s the same reason I’m so biased against steel sets, unless you have a reaction to the Teflon cannulas and have no other choice, because they’re so much harder on the flesh.
I will concede that what I’ve read thus far is primarily PR releases, and they might just be saying things the general public wants to read. Maybe there is a bigger advancement that makes them more biocompatible and they just haven’t talked about that. I certainly hope so!
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If it truly does last longer I hope Tandem comes out with something similar because maybe then I could actually make it the 3 days.
You can plug the tandem tubing into the Medtronic sets. Not sure if it’s true for the new extended one, but it’s true for the older versions.
Tandem stopped using standard Luer lock connectors a year or so back. It is now a proprietary connector. This means that Medtronic sets don’t connect to Tandem cartridges any longer.
It might be possible to connect a Tandem to Medtronic set at the set, but that would mean using two sets for every change.
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When I switched to tandem I used up all my old infusion sets and yes I threw out the Medtronic tubing but the sets connected the exact same way. Then I had all the extra sets for when they pulled out or failed
This is the first I’ve heard of the extended wear infusion set. The PR doesn’t really address how this new set prevents the need to change your site every 72 hours due to the presence of a foreign body.
I’m a Medtronic user and I already get “extended wear” from my sets by filling my reservoir for 6 days and after 3 days, just changing the cannula. You can buy cannula only sets and if money is an issue, this really helps cut costs. (I use about 30 units of insulin a day.)
I know many do this and the insulin is just fine after 6 days. IMO, this is just a lot of marketing hype.
Edit: Nov 2025 I now use the same tubing for 9 days. And Medtronic (boo!) has discontinued the cannula only product.
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I can’t leave anything in my skin past 3 days because it gets irritated and stops absorbing. I think it must be the insulin because my dexcom never gets irritated and I wear that for 10 days. Unless it’s the adhesive.
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Yes. Agree. Insulin related. I use the libre 3 - 15 days without issue.
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Are you still using the 7 day infusion sets? I am trying them right now. I don’t infuse very much insulin and hoping they don’t cause scar tissue.
i’ve been using the “extended wear” sets for a couple months now. i don’t use much insulin to begin with so don’t really see any real advantage…reservoir holds more insulin but i don’t fill it all the way anyway (more as a reminder for me to change the set sooner than later) as i tend to let it go for longer than it needs to.
My previous insurance didn’t cover extended wear infusion sets. I’m hoping my new coverage will. Did you order yours from Medtronic or any particular place?
I know this reply is late as I hadn’t been on here in a long time, but I never used them as I have a Tandem pump. To my knowledge Tandem has not come out with an extended wear one. Would be a lot cooler if they did though lol.
When I switched between pump manufacturers a few times, the cannula never changed so I could use different manufacturer sets with different pumps. The issue is the tubing which is not comparable.
I used varisoft and silhouette so I insert them manually and the plastic clip at the end is exactly the same on both. So you could use your pumps tubing with the extended cannula set.
But it’s a little wasteful to throw away the tubing every time, but you can at least try it and see if it works.
I’ve never had an easy time with cannulas lasting even 3 days, I often get site irritation.
My omnipod has given me a lot fewer issues. But even that sometimes will stop absorbing on the third day.
My body seems to put up with 50 units a day max, more than that and it just craps out.
Of course when absorbance issue begins I need more insulin and then it becomes less efficient so it is a horrible cycle. So when it starts I change my set or pod because there is no way to recover from that in my experience
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Terry4 - I am with you. Pumping for 30 yrs., and I’m lucky to go 3 days before replacing the insert. You used to be able to buy inserts only, but no longer.
Tandem purchased a tech company that was developing a tubing with a plastisizer more compatible with modern insulins. That company used to have a YT presentation on the science behind the reaction to tubing. Interestingly, some of the same people were behind the Snap pump, which I thought was the best pump at the time (took insulin pen carts instead of filling a cart).
I can’t find that video aagain, so here is a synopsis. When you insert a canula it causes tissue damage, resulting in a reaction, and some scar tissue build up. The plastisizer of the tubing causes insulin degradation of the terminal peptides that prevent the insulin from aggregating, and subsequently sticking to the tubing (and the insulin cartridge). That also causes inflammation at the end of the tubing, and a granulocytic reaction causing poor absorption and scarring. Sometimes a pool of insulin will formm and be released later (not very much). These studies have all been done in pigs, which have skin most closely resembling human skin. The extended wear has a different platisizer, and does not cause, or more slowly cause, the tissue reaction.
Steel canulas do not have this issue with the insulin, and using them may help. Also, switching to a longer canula my help avoid more superficial scar tissue.
So even with these extended wear less scarring will occur. BTW, this is why you should not re-use pump tubing and cartridges. Are the extended wear right for you? Well, as I said I am lucky to get 3 days wear, and sometimes I change out sites because of poor absorption, or irritation during physical activity. I can no longer use sites around my tummy, and am going more towards the sides and back.
I had been on MDI from 1980-1995, and needles were much larger and longer. The insulin needles are much finer and shorter, hence less scar tissue. This year I enter my 63rd year of T1D!
Mike
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That is great detail. Not sure I follow concerning reusing pump tubing example. I understand removing the cannula and replacing with a new…
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Me, neither. I keep using the same tubing and cartridge until the cartridge is empty (about 5-7 days) while I change the infusion set every 2-3 days. Haven’t noticed a problem but I’m interested if there’s more to it.
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