I just took out my first steel cannula and it bled. The blood came while pulling the cannula out and didn´t stop when I wiped it off like a finger prick would. It didn´t hurt but it kept bleeding like a normal small wound vould have done.
Does this mean the insulin flow has been hindered all the time since I put in the cannula or can this happen any time during the two days I´ve had it in?
And does the bleeding mean that I only get some % of the insulin I think I´m getting or am I still getting the insulin in full?
If my BG is ok, I don't worry about bleeding too much, unless it's really pouring out. I had a few times I had to lie on the floor putting pressure on it for like 10-15 minutes but, fortunately, that hasn't happened for a while.
Thanks. Blood sugar was high every time I ate and I was kind of insulin resistant after eating, but it could be anything. Just got back to a pump less than 48 hours ago so nothing is figured out yet. My I:C ratio which used be 1:10 +/- during the day is now 1:5 give and take. And when BG has reached 140 mg/dl it´s almost impossible to get down. Everything is just weird. Better not get upset about it. It will level out, just need some time. And patience.
I'm sort of dismissive of insulin resistance but the 140 and unresponsive might make me consider pulling a site. Another thing I do is if the site is sore or irritated, I increase the basal figuring that there may be some absorption problems. When it starts to drop, I figure it's going and go back to normal. This is, of course, easier to keep an eye on with a CGM but could be done with a few BG tests too.
I do have an CGM on my new pump (Animas Vibe) and it´s great. I guess I use the term "insulin resistant" whenever my BG seems unresponsive to insulin for whatever reason. It was discomfort on the infusion site but I had heard there would be with steel cannulas so I didn´t pay attention to it. Guess that was my first lesson.
Good advice turning up the basal until BG starts to drop, but I thought the temp. bad flow was something I would avoid using steel over teflon. I thought using steel cannulas was they always work, and if they don´t you´ve hit a blood vessel and need to change site. Hope it was just bad luck with first infusion set.
I've used a steel needle too, for many years now. Site-wise I have noticed that nerves and blood vessels seem to go together. When I am inserting my set, if I gently touch the needle tip here and there in the area I want to use, then choose the spot with the least pricking sensation, my set lasts the longest and I rarely get bleeders.
Thanks for advice, earthling. I´ll try the technique you describe the next time.
What sites do you use for steel cannulas?
You're so welcome! I use the 6mm cannula of the Contact-D type. And I mostly use my abdomen (got some padding there!)but occasionally my butt/hip area. To make sure I rotate evenly I made a picture of my abdomen, ran it through our copier. Each month I put dots and the date on the spots I use so I can make sure I don't re-use them for a month. Sounds kind of OCD, but it helps reduce scar tissue build up.
I agree that blood vessels and nerves seem to go together. I've seen your advice before about testing potential infusion sites by touch. I've adopted your technique with good results. I didn't often hit blood vessels before and when I did I didn't notice a strong correlation with insulin absorption problems.
One thing I did learn, from someone on this site, is to use pressure from one fingertip on an infusion site bleeder when withdrawing an infusion set. I've blood-stained some clothes in the past, frantically looking for some tissue to soak up the blood. The finger-tip technique for bleeders works well.
Thanks again. I use the same sets. Maybe I should make a bodymap too to make sure I don´t use the same spot? Is one month before reusing the same spot the time required for not building up scar tissue? I´ve never thought about this before, hence the question. I just rotate without thinking too much.
Thanks, Terry. I´ll use this newly adopted technique in about an hour for the first time. My second site feels good so far, and I used me abdomen this time.
Which sites do you use?
I primarily use my abdomen. I had a trend of poor site absorption about a year ago. I changed infusion sets from the Inset 30 to primarily the Inset 6mm but also some Contact Detach (steel cannula) 6mm and 8mm. The Contact Detach work well but I have to change at 48 hours due to site soreness.
I started using a loofa sponge on my abdomen when I shower and that seems to have restored my abdomen sites. I'm not disciplined about a systematic site rotation but I always probe prospective sites with my fingers and can feel recently used ones. I avoid reusing those sites too soon.
I experimented with using my side/back between the rib cage and hip and had good results there but I prefer the abdomen since I can see it well and its been giving consistent absorption.
When I get a bleeder like this I usually will note poorer absorption of my insulin. The biggest issues is bolusing and the larger the bolus the worse it is. It is really frustrating. I usually leave the infusion set in for a day before I am too frustrated and pull it. I new set and predictable results from insulin is much better in my opinion.
Interesting that larger boluses makes it worse when you have an infusin set that doesn´t work. I haven´t noticed that but will keep it in mind when I start "rage bolusing" the next time.
This is an excellent tip and one which I will try at my next set change. I've had my share of sites that didn't give very good absorption...maybe I should have been listening to the 'message' my skin was sending when I try putting it in a spot where the nerves are really tender.
It works, Mayumi. And with a steel cannula you can take it out if it hurts and try another spot with the same cannula. At least this is what I´ve read here at tudiabetes and I did it myself with the set I´m using at the moment. If anyone has opposing information on this, please post it here.