T-Slim or T-Flex and Occlusion Alert

I’ve been using a T:Flex for about 2 months now with Novolog. In the last week, I’ve received 2 occlusion alarms. Last night after I cleared the alarm and changed my infusion site, my BG was over 400 and it has been a bear to get it down today. Wondering if anyone else has had this issue?

I only use MM pumps but if your concern is that Novolog is involved in that issue, it shouldn’t be. I’ve used Novolog for years, as well as Humalog. If you are using a cannula-type set, I URGE you to switch to a steel needle type. Unomedical makes sets for luer-lock systems, as well as making them for MM, which are called Sure-T’s, which I use exclusively. They ARE comfortable. Many people have it in their head that steel needle sets might be uncomfortable. It really depends on the person., I can’t stand cannula sets, which I wore for far too many years before being turned on to Sure-T’s. They stopped my no-delivery issues.

I use cannula type sets. I think I’ve had 2 occlusions in the past year, and it was all due to the tubing. I first try changing out just the tubing, and inspect the tubing for little white spots or spaces that could be due to kinking, folding, or some other damage, like the tubing getting into my clip.

(knock on wood) in the past 4 years since I switched to Accu-chek Ultraflex sets, I have had no kinked cannulas, which usually didn’t set off an occlusion alarm for me anyway, just high bgs.

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I seem to have occlusions almost exclusively during sleep time. I was told this could be because of a combination of lying on the infusion site, immobility and a build-up of insulin around the cannula. The advice was to try just gently massaging the infusion location and seeing if that clears it. That has worked for me. Worth trying before having to haul yourself out of bed in the dark and going through a site change, anyway!

@phoenixbound, re Sure-T’s: now that I’m back on my Minimed I should definitely give those a try. Been having a lot of irritation by the 3rd day on standard sets. Canulas, if not the spawn of Satan, are at the very least the spawn of some lesser demon. Asmodeus, I suspect, or Belphegor.

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agreed! I used them for many years and their usage nearly caused me to stop pumping. Only because I was told to try Sure-T’s did I continue to pump. MM didn’t even offer that model to me as a solution when I repeatedly called about no-delivery issues. When I called them later on, after hearing about Sure-T’s, they offered to send samples. They should have done that without me having to learn about Sure-T’s from another source.

I used the steel sets from Roche for a while but didn’t like the “pigtail” connections. Do these connect right at the infusion set? If they do, I would be interested to try them.

there is a pigtail. I actually like it as it provides “pull-out” protection between the pump and the set but to each his own

I’ve always used the sets with plastic cannulas but it’s sounding like I should try the metal ones. Honestly, just the idea of metal scared me, that it would be incredibly uncomfortable.

common misconception. i thought the same thing but the steel needle is both short and thin. THINNER THAN A CANNULA. I used to feel cannulas quite often. The Sure-T’s are pretty much unnoticeable. Only painful if I hit a nerve or an infection develops at the site which happens rarely and use to happen more to me with cannulas.

I’ve had the T:Slim for a couple of months now. I had read about others getting occlusion alarms with the pump and was a little nervous about it. I chose the contact detach sets (steel needle, 6mm) and have never had a problem with it. Plus, they are very comfortable, I can’t feel them and the only time I’ve accidentally ripped one out was when I pulled up my panties and they got caught on the tubing between the site and the anchor while the site was on my thigh.

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MissMargie, That’s what I have been trying to tell people: steel-needle sets ARE comfortable, despite all the natural aversion to needles. You couldn’t pay me to use cannula sets again. :slight_smile:

I will tell you what, though, accidentally ripping one of those suckers out is quite painful!!

An added bonus, though, is that if you do rip it out, you can shove it right back in and tape it down till you have time to deal with it.

Nice to know i’m not the only one experiencing problems with occlusion alarms. I’ve been using the tslim for a couple years and have had constant alams regardless of the infusion set. First used the quickset, then the inset 30 and finally the contact detatch which I was sure would solve the problem. Yet I continue to have occlusions! I tested the pump and tubing by detaching and requesting a 5 unit bolus. The pump is delivering insulin so the site has to be the problem. After 18 years of pumping it looks like I have to give it up. Any suggestions?

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I suggest you experiment with other infusion sets as well as new sites you haven’t used before. I am currently having very good consistent absorption using my back above my belt to the left and right of my spine. Around the back from the “love handles.”

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Thanks for the suggestion Terry. I have actually rotated my sites and it doesn’t seem to matter. Some time ago Tandem replaced my original pump due to occlusion alarms and I was ok for awhile. I can’t help but think it’s the pump and if they won’t replace it I’ll be on injections.

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It could be that Tandem has their pressure sensors (for occlusion alerts) set to too low a threshold. I remember reading about this issue, I think with another pump, and that was the case. It could have been the discontinued Snap pump.

What is your total daily dose of insulin, basal + bolus?

I did have a few occlusion alerts with the Snap pump, but it was able to recover from those without much of a problem most of the time – when it wasn’t, have to change out the set and was usually satisfied that the occlusion was real. using the Vibe now, and have only had two occlusions so far. One that resulted in an alert (and had to change out the set), the other did NOT trigger an alert, and my BG sky-rocketed! Then again, I also had a couple occlusions when using the Omnipod – and there, there IS no fix other than changing the whole thing out.

I use Apidra, which I believe is more prone to crystalization and, therefore, to occlusions. Don’t know what would happen if I were using Novolog.

Several years ago I tried the Omnipod for five months. I really wanted to make that system work. I finally quit due to many occlusions and the howling alarms. It was disturbing my BGs about once per week. I finally left the Omnipod and would be hard pressed to go back. I’ve used many different pumps over many years and that was by far the most incompatible system for me. Yet, I read so many good stories about happy Omnipod users, so I’m left with the conclusion that it was something about me that spoiled the magic.

I’ve been at this for a very long time…53 years and in fact run the Type 1 Diabetes Lounge www.type1diabeteslounge.org. I only take average 23 units when the pump is functioning.

I was wondering if very low flow rates might be contributing to the occlusions. Seems like 23 units/day should keep things moving along.

About four years ago I had a rash of occlusion problems. I wasn’t getting most of the alarms (except for my Omnipod fiasco) but my absorption was impaired.

With 53 years of insulin delivery, it seems that some of your sites are tired. Do you have any “real estate” that is unused?