Need advice! Is my body rejecting infusion sets?

Diabetes Technology Insulin Pumps
#1

Hi i'm beginning to wonder if my body hates my infusion sets- i'm using minimed, After 18 years of injections I started pumping November 2009

My first month of pumping went great- i was using quickset 9mm

Then in Dec my blood sugars would go high for no reason and i figured out that my infusion set wasnt working- after numerous times i switched to quickset 6mm canulas

only once out of at least 10 times did i get the "no delivery alarm". the only way i knew i had a problem was that my bg's would skyrocket

so i called MM again and they sent me silouettes- seemed to go ok for the first one but then i ran into the same issue many times.

i met with a pump trainer and she said i was doing everything correctly (insertion etc)

my silouettes are working from 0-24 hours. today my silouette quit, i put in a new one, then no delivery alarm again. so thought maybe my body doesnt like the cannulas and i tried the sure T (metal needle insead of cannula)

then i got 3 no delivery alarms in a row.

i believe i've narrowed everything down to infusion set problems- i ran diagnostic tests on my pump many times, my tubing is never kinked etc.

anyone have advice? i dont want to go back to injections because pumping has made me feel so much better

#2

I had this problem. I was allergic to the cannula. I switched to Sure-T’s and the problem has since been resolved.

#3

Ouch - I feel for you Heather, as I’ve only been pumping 2 years now, and to give it up (which may happen when I no longer have private insurance) - is a scary thing for me to think about giving up - as pumping gives us so much freedom I feel).

Now, I was having probs with the teflon cannula (allergic issues but no issues with my pump not delivering the juice of life) - just skin irritation. Then tried a few different brands of stainless steel infusion sets (Orbit and another one). I’ve found the Sure-T (or in my case with Animas - they call it Contact Detach) 9 mm needle works for me - but not the 6 mm. You say you tried the Sure-T’s tho’ and it didn’t work for you - sigh.

Where are you placing your infusion sets? Perhaps in an area where there is scarring from MDI (multiple doseage injections?) and then absorption would be a problem? I’m new to pumping, so I’m probably not the best one to give out advise, but just trying to trouble shoot here and get some ideas flowing.

#4

I’ve been having a similar problem… started pumping in November as well. Any teflon cannula seems to be problematic for me. I’ve had problems with Sure-T’s as well, I can use them at most 2 days, sometimes less. And I’ve got “No Delivery” alarms with Sure-T’s after that time… so not an initial insertion problem.

One thing that seems to be working, is that I bought some Orbit infusion sets. The Orbit 90 (teflon cannula) didn’t work out, too many kinks and similar problems. The Orbit Micro (metal needle, 90 degree) seem to be working, but again only for 48 hours.

Seems some brands just have a different reaction than others. You may need to use the 50/50 reservoirs and try a couple different brands with luer connectors before you hit on something your body doesn’t hate.

It’s very frustrating though to determine this through trial and error, especially when the failed cases result in waking up with sky high BG or having to swap an infusion set at the office in the middle of the work day.

  • Jeff
#5

I had trouble with the canulas and several of my patients do to. I love the Sure T and now they come in different lengths of needles and tubing lengths. You may try different Sure T needle lengths and different areas on you body to see if they won’t start working for you better. I sure hope so. I know how helpful the pump is.

#6

You might want to try a different insulin… I had site failures really quickly when I returned to pumping, and switching insulin (from Novolog to Apidra - I had switched from Humalog to Novolog 7 years earlier for the same reason) fixed that for me.

#7

David often has similar problems. His sites seldom last more than 24 hours. Occassionally when he removes a site you can distinctly see a small kink in the end of the cannula where one must assume that it has bumped into tissue hard enough to bend it. A couple things have helped. He stays away from his thighs as a site choice at present (to little fat) and so dropped quicksets altogether. He uses the 13mm silhouette around his abdomen and the 17mm on the pockets of his but. Another thing that he finds he needs to use 100% of the time is IV prep instead of alcohol pads to prep the site.

He used to tend to tuck his excess tubing into his jeans and tighten his belt, now he leaves the tubing loose and that has put an end to the no delivery messages. He knows that when he is heading toward 24 hours that he needs to watch his BGs more closely, because exactly like you, when the site fails, his BG rises rapidly. Some people have sensitivities to “tape” or the sticky stuff that keeps the site in place and David is definitely one of those people so the IV prep is essential as it provides a skin barrier between his skin and the glue that makes the site stick to ones skin.

Cheryl

#8

Hello,
I have had issues with the various insets and have discovered a couple of things.
I need to change usually by day two. For insurance purposes, the manufacturer states the cartridges need changing every two days, so I’ve used this information to get coverage for more frequent changes. Also the fact that my body seems to reject by day two.
Anyway, I’m using the annimas inset 30. They go in at an angle and seem to work better for me. I’m not skinny, so these are not usually given to somewhat of my weight in the beginning.
If I see redness, feel a bump at the site or see any sign of blood then I know my site has gone bad.
I also have noticed that sometimes it’s a bubble in the cartridge that causes flow problems for me. For some reason air bubbles pop up and cause flow problems even with taking the best care in removing them when filling the cartridge.
I run into site problems about once per week which can be really frustrating.
I injected for 17 years and am now on the Animas Ping. I think too, flow problems can be caused by years of injections as shared by others here.
I have found that changing more often helps, also putting it into my thigh can be beneficial.
I too am new to pumping and my bg’s are still a rollercoaster, but I am hanging in there.
I don’t remember what I started with for insets, they were short with the little round injector thing. I just know they didn’t work for me at all as the cannula would either not go in or it would bend causing delivery problems.
I just know too that when I get a bad inset, it can take me hours to a day to get the blood sugars down. I like these inset 30’s too because there is a peek window so I can at least see if it has gone in . Also when I first started out, I was getting red, sore, itchy reactions and the site would become infected if I left it in the full three days.
Best of luck and know you’re not alone.

#9

tried that!- sure ts worse

#10

tried them everywhere uncluding places with no possibility of scar tissue

#11

i heard humalog tends to crystalize in the infusion sets more than the others- im on humalog. problem is ive had no delivery alarms only 5% or less of the times. ill look into it thanx

#12

tried it with and without iv prep/ alcohol swabs- didnt fix it- i got no delivery alarms maybe 5% of the times they didnt work

#13

as for your air bubble in your reservouir (sp?) problem- it could be the temurature change- cold insulin heats up in your pump and makes air bubbles. my pump trainer told me to leave my insulin bottle out of the fridge 3 or 4 hours before i fill my reservouir

#14

Thanks everyone for your ideas etc-
good news!.. i MIGHT have figured out what the problem is- the only common denominators throughout all the problems were the pump and my insulin.
i knew that my humalog worked great when i injected it but i was worried it was crystalizing in my infusion set.

as for the pump- i ran the self tests over and over on the pump through this whole ordeal and i came up with nothing. the pump hadnt give me any alarms (except for a couple “no delivery alarms” which maybe covered 1% of the times my infusion sets didnt work) so i assumed it wasnt the pump.

so i decided to call medtronics and they sent me a new pump- i started pumping with a new infusion set yesterday afternoon and so far so good!
MM asked me to send them my old pump for testing and in a couple months they will give me a printout of how the testing went.
please pray that this new pump fixes the problems! i am so grateful that i am feeling better already

i hope that my sharing this ordeal helps someone else who is going through the same thing

#15

Good news! Glad you are feeling better. How is Tarzan? My little Jane…xo

#16

I was allergic to the cannulas with the silhouettes. Didnt have the Sure Ts when I was pumping 3 years ago (that I know of). I have scars across both sides of my stomach. Looks like transluscent lizard scales from where my infusion sets were.

Same issues as you, but in addition to insulin resistance to short acting Humalog. Tried all the troubleshooting, got No Delivery alarms on a consistent basis. I ended up using my MM warranty and got a new pump overnighted. It worked fine for a while, but eventually the same thing happened. Went into Dka when my BG skyrocketed for no reason and with no alarm. Blood would back up into the tubing.

I had no resolution. I had to come off the pump.

:frowning: Good luck!

#17

Heather- I hope this works for you! Please keep a close eye on your BG throughout this. I, too, used my MM warranty to get a new pump (after doing ALL the troubleshooting for a month!) and it worked fine for a little while. But, eventually, I ended up getting the same issues all over again.

I hope it works out for you. Truly.

#18

well hopefully that wont happen- havent had the blood back up in the tubing in awhile. how long did the new one work for?

#19

Did this help? My son switched to Medtronic 722 back in September. He started experiencing high blood sugars and large ketones for no reason. We have tried the Quicksets, Silhouettes, and finally the Sure T’s. We still had the same problems so they sent us a different recertified pump (we took advantage of the trade in deal with his Cozmo). Put the new settings in and started with a new site, new insulin, etc. Worked for less then 24 hours and had high blood sugars with large ketones as well! I am just curious, was yours a recertified pump or a brand new one? He is currently on shots b/c he was missing so much school/class time and falling behind. The company was of no help. I am scared to try him back on the pump. We’ve been pumpers for 4 years before going on the Medtronic so it’s not a newby situation.

#20

Heather-

reading all your posts made me think that its not probably the infusion sets, you have tried maybe all of them from minimed(at least), thats what i was thinking first, maybe the pump itself is defective, or the insulin crystallization too… but im glad minimed decided to send you a new pump, i wish they sent you sooner than having to go through all those trial and errors not to mention the high BGs youve had…

anyways, im glad its getting better now…i hope this time works… i know how does it feel getting frustrated, feeling youve done everything right and still not getting the results we hoped for… been there, done that… when i started pumping 2 years ago, after 20 something years on injection, i thought pumping wasnt for me… my BGs were crazy, its on the extreme sides, too low if not high… but then friends from here keep me goin… so im glad i didnt give up… Being on pump made a difference in my life, especially on my A1Cs, before i couldnt keep it down to 7 or below, but now, i have it to 6.3…i did have one done last friday and i will have my endo appointment this thursday,so we’ll see…

anyways, i hope everything works out for you…

good luck.