Lately I’ve been having major issues with my Medtronic Minimed pump. It seems that more times than not, the cannula that goes into my stomach will bend or kink resulting in me not getting the insulin I need. Before, the rare event would cause my pump to give me a “No Delivery” warning, so I would know to change my infusion set right away. Now, it doesn’t give me a warning, so I go about my day, eating what I normally eat, only to start feeling sick a couple hours later because of a blood sugar of 350+.
I’m getting very frustrated for many reasons:
The pump is supposed to be convenient and supposed to give you better control of your blood sugar. Since my cannulas are kinking and my pump is not giving me a warning, my blood sugar control is worse now than it was before going on the pump. It’s also become an inconvenience since I get so sick from high blood sugars that I’ve been having to leave work early, waste tubes, call Medtronic, etc…
I work very hard to eat healthy and eat the right foods for my blood sugar control, but when this happens, I feel like there’s no point in trying so hard when my pump and it’s supplies malfunction and I have high blood sugars anyway.
These supplies are not cheap! I’ve wasted so many in the past month because of this problem…
On Friday, I had to change my infusion set 4 times because of it bending and kinking and spent all night and early morning fighting highs. I’ve called Medtronic and according to them, I’m doing everything right in the way I insert it, so I don’t know what else to do.
I’m looking for advice, options… anything. Would you suggest a different pump? Should I go back to giving myself shots? What would you do? Have you had a similar experience? HELP!!
I had the exact same problems and after about 4 months, I decided to go back to shots. I tried every type of infusion set Medtronic has to offer and couldn’t get anything that would work consistently. Going back to shots felt like a huge relief and my control got much better. I figured that I can always go back on the pump if I miss it. I know most people never want to go back to shots once they get a pump, but that is what worked for me and I’m very happy with my decision. I don’t see any harm in going on a pump vacation to help you decide which method works best for you.
What infusion set are you using? Is it a teflon catheter? If so, you might want to try the Sure-T infusion set. It has a metal catheter, Lots of people here, who’ve had trouble with teflon sets have seen big improvements when they switch to the Sure-T.
Hi. Have you ever tried a Sure-T? It’s a slim metal needle that doesn’t bend. I like it because if it begins to hurt for some reason, you can just pull the needle out and move it close by; just use a little cloth tape to hold it down after you’ve moved it. Sometimes Medtronics will send samples; once when I was having a lot of trouble, my pharmacy gave me some samples. I can only use any needle or cannula in the same spot for 2 days before it starts to fill with blood – by moving the Sure-T needle, I can get another 12 hours from the same infulsion set. Must be frustrating for you, best luck.
I have had similar experiences with the cannula bending and no alarms from the pump. I seem to get some insulin through the kink, but the major problems arose when I bolused. A bolus seam to have “absorption issues” (slower than expected insulin activation) that I could not figure out until I pulled out the set and saw the kinked cannula. If you are using the 9 mm cannula then you may want to try the 6 mm one and see if that helps?
My other thought would be scar tissue. You may want to try other sites (leg, back, butt) to see if the problem corrects itself.
I just tried the 6mm cannula, with the first one I put in kinking and the second one I tried giving me a No Delivery warning, but when I pulled it out, it wasn’t bent. So I’m not sure if the 6mm will work for me. I’ve only had Diabetes for just under 5 years and been on the pump for just under 4. Would I have that much scar tissue already?
As far as the metal ones go… can you feel them when they are in? What happens if something hits you in that spot accidentally? I’m just imagining it going in deeper and causing a lot of pain… Is it pretty much the same set up, just a metal cannula?
I can empathize with you. I switched from the 43" to the 23" because of that very reason: kinking, knotting, etc. Having a shorter tube actually made it easier to manage.
What caused your pump to suddenly stop giving you a “no delivery” warning? That is a bigger issue.
I recommend you test more often while you are experiencing this problem. I am required by my doctor to test 6-8 times/day. That means an occasional middle of the night test. I only do those when I happen to wake up. I don’t set an alarm to do so, because inadequate or interrupted sleep can raise my blood sugar all on its own.
Also, once or twice a day I detach the cannula (not pull off, just ‘unscrew’ it) straighten it out manually, and reconnect it. (Kinda like straightening a Slinky!)
Are you a very active person?
I think it’s all in when I take my pump off my bra, test, then return it. When I handle it, I unconsciously turn it, making it a little bit curlier. So try uncurling it once in a while, and see if that helps.
I have the same problem from time to time. Since I am rather thin and exercise with heave weights, the problem is compounded. It there is a simple answer, I’d like it too. I’ve NEVER received a “no delivery” alarm?
If I use a hard needle, they tend to do damage when I lift weights.
Not only are supplies expensive, Medicare will only supply “just enough” for one every three days.
It sounds like you’re using the Quickset. Are you being very careful to position the inserter with the ENTIRE circumference firmly contacting your skin? If the inserter is slightly cocked, it will bend the cannula when the triggers are released. I have trouble occasionally when I get in a hurry and forget to check positioning.
Actually, I use the 6mm Quickest and I am very pleased …
Hi lizard. No, I don’t feel the Sure-T needle either going in or after it’s in. I think that at night I sometimes dislodge it a bit, because sometimes when I wake up, I do feel it. That’s when I change it’s location. I think it’s most unlikely that it would be pushed in deeper, as it has the adhesive, etc. on the top, just like the quick-set. I like to use cloth tape over the adhesive making it as secure as possible – when I move it of course, but also when I first insert it. If I think it’s in a place that my dogs might dislodge it (unlikely as that is!), I put a band-aid over it as well.
I started with Quicksets but very quickly switched to Silhouettes, mostly due to No Delivery Alarms. Ask if you can try a few of the 13mm ones. They look long and scary, but I’m pretty thin, so inserting them at an angle gives me more places where I can use them.
My CDE always says that you can’t rely on the No Delivery alarm to know if you are getting enough insulin. Since it is set off by increased pressure in the tubing, if the insulin is making its way into the canula, it won’t go off. Some times the kinks will be just enough to ensure that its getting into your canula and making its way into your body, but just not enough that it is enough to cover all of your needs.
I, too, think that scar tissue could be the issue. Do you feel hard spots on your abdomen, or wherever you use the infusion sets (I know I do!). Where, and how often, do you rotate sites? I find that when the site starts to become a bit irritating, the insulin doesn’t absorb as well. I don’t get No Delivery alarms (rarely do) because the insulin is getting into my body, it’s just pooling up in the same spot.
The other question I have is whether or not you use an insertion device. Sometimes the spring on those things can weaken, and the infusion set doesn’t go in all the way. I’ve heard more about that with the CGM sensors, but I see no reason it wouldn’t affect the infusion sets as well.
i had the same problem when i started the pump and i was told that i didn’t have enough fat on top of my muscle in my stomach area and that the cannula was kinking because it was hitting muscle. i was told to try my love handle area and that made a HUGE difference…it doesn’t hurt and i haven’t had a single problem since then!!
I agree with others that your problems may stem from more than one source. Scar tissue may interrupt insulin absorption even if the cannula is not bent. I had a problem with the 90 degree teflon cannulas bending just below the skin. I switched to an infusion set that inserts at a 30 degree angle and most of that problem went away. I realize that a 30 degree teflon cannula set may not be available for the MM pump – I use an Animas. It sounds like one solution worth checking out is the metal cannula sets. That would definitely rule out the bent cannula source of your problem.
It took me a long time to go through all the troubleshooting to figure out what would work for me. I know it’s frustrating, especially since you look after your diabetic regimen so carefully. I still think trying to stay on the pump long term is your best option going forward. The pump’s ability to deliver a customized basal profile cannot be duplicated with a long acting insulin like Lantus or Levemir.
Good luck and don’t get too discouraged. It’s worth the effort to get this problem solved!
I also have trouble w/quicksets. I like them as I have tried all the other sets MM has available. I use 6mm (began w/9, switched about 8 mo to 1 yr ago to the 6mm). I have learned NOT to apply skin prep/skin tac before I insert. (I use to, but seems to cause more bent cannulas now than before inserting through the skin tac). So I clean site, make sure area dry, insert, then use the skin tac pad to soak the tape of the quickset AFTER I have primed and unclipped. Make sure it drys before reclipping all back together.
I do not use my stomach for insulin delivery, only area I can use easily for CGMS. That being said, do you rotate to legs and buttocks? If not, scar tissue sure could begin to be a problem. If you do rotate to different body locations and only have trouble with belly insertions, I would tend to hazard a guess it could be scar tissue. You might want to try other sites to see if you have similar problems.
Also I will try to do a site change when I can bolus a “large” amount of insulin in immediately - either because I eat or because I am having to correct a high. Especially if I bolus and eat after a site change, I can determine within usually 2 to 3 hours if the site is good or bad - and correct immediately, hopefully preventing sugars getting above the 250 threshold.
Oh - something else I will do - with the quickset, after insertion and a “large” (like 1 to 1.5 units give or take) bolus, I wait for bolus to clear, give it about 30 sec or so, unclip and take a tissue (like a kleenex) and press it on top of the quickset. If the tissue absorbs a lot of insulin, it’s probably a bad site as it kinked and the insulin is just going out around where the tubing connects to the site instead of in the cannula - so check sugars but expect a problem! If there is just a “spot” of insulin on the tissue it’s probably ok. No insulin on the tissue is best of course!
Good luck, I hope you can find a solution. Make sure you continue to report the problem ones to MM and request replacements. You are right - they are expensive!
I tossed all the 90 degree sets, and went to angled sets.
Problem was solved instantly, though I nearly gave the stupid pump back because of this issue.
Have you tried different infusion sets? Medtronic makes several and this issue might be specific to the kind of set you’re using.
What sites are you using? Are you rotating? I’ve heard that if an area is overused for both shots and pumping, it can become hard and calloused, thereby increasing the risk of kinking.
If I were you, I’d go back to shots in the meantime, until you can get this figured out.
Thank you, everyone, for your responses! I didn’t really realize that there were different infusion set options like angled ones and metal ones. I’ve been in contact with my doctor, and I’m going to try a couple different infusion sets to see if I can find something that works.
