Soft or steel cannula opinions please

My daughter (17) has just started on her first pump - the tandem x2. She has been using the autosoft 90 6mm but I wondered what are the advantages and disadvantages of plastic vs. steel cannula. She’s not had any problems with this set, but just wondering about her options.

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steel can’t kink. cannula-type sets can kink and I for one, can’t use them because of frequent kinking. I encourage everyone to at least try the steel sets. oh, and not only did i have issues (for years) with kinking but soreness, redness, swelling, and more scarring from the use of cannula sets. I almost quit pumping because of them.
one more thing: I don’t feel the steel sets, whereas cannula sets (I used several models) nearly always constantly irritated me.


I’ve only used the soft cannula since starting to pump many years ago. I’ve always had good luck and haven’t experienced any of the issues that Dave describes. Another one of those things that based on your experience with the soft you may or may not need try another type.

Good luck!!


I should have said I didn’t have much kinking for a number of years, but then it became a one or two times per week or so occurrence. When I wouldn’t get basal delivery for many hours at night, that because a critical problem for me. I called tech support which was no help. Someone on the old alt.newsgroups (not sure that’s the right name) told me about Sure-T’s so I called Medtronic back and they agreed to send samples. Sure enough, (pun intended) they worked great! I’m guessing that was roughly 20 or so years ago. To this day, I only get a “no delivery” alarm about once every 2 years and obviously it’s not nothing to do with kinking.


My story is very similar. I used the Silhouette for years, with fairly good success, but suddenly began having delivery issues, with no alarms. I exercise alot, and twisting my body, combined with tired belly sites, may account for the problem. It’s taken me a while to have success with the Sure-T, but I’ve finally found a way to insert it at a fairly straight 90° angle so that it functions as it should.

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I prefer the plastic (quicksets-90 now, angled silhouettes before) and have used for over 25 years. I got samples of steel sets from medtronics to try, but did not like them.

Check with your doctor or pump mfg for free samples.

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Sometimes I’ve had Sure-T’s with the needles not perpendicular to the patch, so while the guard is still on them, I’ll tweak them to be in proper alignment before inserting them. I’ve not ever had trouble getting the needle to go in straight so I’m wondering if it is your insertion technique more than anything. I place the tip against my skin, holding the set mostly by the tubing, and then tap it in with a flick of my finger. Simplest set in the world to insert; no cumbersome hardware needed.

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I found the soft semicircular wings difficult to use, while keeping the steel cannula at a 90° angle. My solution is to leave the paper on the adhesive, squeeze the 2 entire semicircles with my thumb and index finger, push the steel cannula into my skin, and the paper almost removes
itself from the adhesive. I use IV prep before inserting, and place paper tape over the set. If I have absorption problems, I can remove the set, and reposition it elsewhere. This procedure has been working well.

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I am wondering if steel sets create less scar tissue over time.

I think it really depends how a particular persons body will react to the specific material used. I have used the plastic for many years and have no scar tissue that causes problems. Then again there are others who have bad reactions to the plastic.


LESS. cannulas cause more tissue damage. they are about 2x as thick as a steel cannula and after about 15 years or more of using Sure-T’s my scar tissue from using cannulas prior to that have dissipated. chalk up one for Sure-T’s.

I’m so happy to hear this! I recently switched from Mio’s to Sure T and It’s made a difference with insulin absorption and I have the ability to relocate my site without opening a new set if uncomfortable.

The plastic cannulas didn’t kink that much for me, but when they did for me it was painful and caused highs that were not caught until it was too late.

Still learning. Very thankful for this thread and question!


I have used both kinds and they both have positives and negatives for different reasons. Soft sets I can put in more places, which is why I went back to using them currently as the only good areas I have left don’t work well with the steel ones, but they are always a little questionable since I can’t tell for sure until after 12 or so hours if it is going to be good or not. Same is kinda true for the steel sets, but at least I know that they are going in. The soft sets are more comfortable, as the steel ones tend to hurt if I bend or move in different ways or if they get pressed on. Both basically only last 1.5 - 2 days for me. I also highly prefer the single pad and connector format of the soft sets vs the separate infusion and connector pieces of the steel ones.

It blows my mind that more pumpers don’t opt for steel sets. Or at least try them. Much of the problem, I think, is that people have it in their heads, that a steel set “must” be uncomfortable. Maybe so, for some folks. For me, it is a rare set that I feel at all, and the cannula sets were much more problematic, tissue-damage wise, absorption-wise, and definitely comfort-wise, they are way down the spectrum from the comfort level that I get from Sure-T’s. I understand the term “to each his own”, but geez, if people that are having issues with cannulas, would just TRY a straight steel set, they would either find that it fixes they problem, or at least it would be one item they could check off a list of possible fixes.

After 20+ years on plastic cannula infusion sets I decided to try SS this past month; not because of the issues you mentioned (I generally didn’t experience them), but because insulin adsorption has slowed over the years and I was looking for a different dynamic at the infusion site. I had no basis to believe it would help, but so far it seems to have a positive impact. Here’s my two cents worth based on my experience so far.

Pluses -

  • No more pain with SS than plastic. I agree it’s a perception issue.
  • I like the ability to control insertion myself. I had having a spring-loaded device fire one into my skin. With the SS sets if I feel pain during insertion I can stop inserting or pull it out and move to another spot.
  • Adsorption seems better for me. That’s a bit subjective but with time I’ll have more (or less) confidence with that conclusion


  • I can’t get more than 2 days out of SS. I could almost always get 3 days out of my Autosoft 90’s
  • There seems to be more bleeding at the site when I pull it out. Doesn’t really make much of a difference other than I have to put pressure on the site for a longer period. I suspect my removal technique may have something to do with it. Maybe it will improve with time
  • I’m not a big fan of the 2-point anchor system. Just another loop of tubing to worry about pulling on. Again - no big deal.
  • Not available in 46” tubing length I’ve been using all these years. For me it makes placing the pump on the opposite side of my body (where my G6 sensor is attached) a bit more challenging. A specific issue for me, maybe not most people.

On balance I think SS is a plus and I’m going to stay with them.

As to your negatives, I can go longer than is recommended on a Sure-T, ie if I put enough insulin in the 3ml reservoir, I can go 5 days (I try to change every 3).

No bleeding, except once in a blue moon.

I LOVE the 2 point anchor. It serves as a strain-relief, so if my pump falls towards the floor, no harm; no foul.

I’m fine with 32" length.

Glad that you found some very important pluses! :slight_smile:

Did you notice how ultra-low profile the Sure-T set is?

The SS sets are definitely worth a try. I wish that they worked better for me as they did have some good advantages.