Silhouette infusion set troubleshooting

I’ve been using an insulin pump for at least a decade at this point. I’ve had minor issues with infusion sets, on and off, but nothing major. Last year, I switched to Medtronic, and have not had any luck with sets since.

I started on the Mio, since it was most simliar to the Cleo I was using with my Animas pump before that. Started having issues with insulin leaking out, infected sets, and various other problems, so I tried some of the other infusion sets. At the time, the one I liked best was the Sure-T, so I started using that one.

Since January, I have been trying to get in shape again. I’ve made a lot of progress, but got to the point where the Sure-T cannula length was too long for me-- I’d have the steel needle rubbing against my muscles when I ran or worked out, which is quite unpleasant. Hearing that the Silhouette is good for thin folks, I decided to give it a try. It is never painful. However, I’ve had a litany of issues with them. At first, I was using the sil-serter. I was trying to put them in relatively shallow, but kept ending up with kinked cannulas that would lead to high blood sugars. Also had other issues with the sil-serter, such is difficulty removing the set from the serter while the needle is in my body, and various other problems. Eventually, I went back to inserting them by hand.

Now, I’m having a lot of trouble (every 1.5 days, for about 2 weeks now) with a small amount of insulin leaking out near where the cannula connects to the plastic body of the set. It smells strongly of insulin, and is always followed by high blood sugars. When I take the sets out, they are almost never kinked. If they are, it’s only a slight kink that I would say happens occasionally over the 10 years I’ve been using infusion sets, with no significant issues.

Anyone have ideas for what my problem could be? Any alternatives to consider? I’m using a 670G, so I need an infusion set that’s compatible with the Medtronic tubing.

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Only Medtronic sets will connect to their pumps but this shouldn’t matter since it appears that all pump makers use the same supplier for their sets. When I had a Medtronic pump I used Silhouettes, since changing to a Tandem pump I use their version of the Silhouette called the Vari-soft. It is the exact same set with a different tubing connection.

It is possible that you have received a bad batch of sets. Another possibility is that you are experiencing absorption problems due to scaring. Do you think that the insulin you are seeing is being pushed out around the cannula.

Would there be a good way to check where exactly it’s being pushed out? It’s somehow ending up on the surface of the skin. It could be coming out through the cannula, but due to scaring cannot be absorbed quickly and so it makes it’s way back out, or it could be coming out of the cannula itself where it meets the body of the set.

I’ve had this same issue on my legs and abdomen. Inserting the set on my back is not easy to do by myself, especially in any region where there’s enough fat to be able to put a set in. Not that this rules out scarring. These are the two places I’ve used my whole life.

It’d be nice to have a way to test some of these different hypotheses.

You can try using sets from a different lot. Also enlist a little help and try a new site.

Site problems are a pain in the rear, I hope you work them out soon.

I used Sils and Comforts (Animas) for about 17 years. In the beginning they worked fine. I never used the Sil serter, just did free hand. But in the latter years they would literally work their way out of my skin. I was having 500 BG and always around the third or fourth day things would go up. But never knowing if it was the set or something I ate, I let it go too long. I went back to Cleos, and did just fine with them. Had to learn to do the tipping technique because I pulled out a bunch of sets when inserting them.( The sticky didnt stick.)
Now I am using Omnipod and having the best numbers. No more bad sets, no more 500’s and I had an awful lot of 500’s. I think the Sils can just end up hitting scar tissue and failing. That is what my CDE and I decided. For some reason the angle of the pod is not causing issues, and I feel better.