Two Set Questions (Inset 30)

I thought I was getting past the learning curve on set insertion (I’m currently alternating between the 6mmstraight, 9mmstraight and the angled (inset 30).

I’ve had several problems the last couple days with the inset 30. I’d been using my hips which seemed to work well, but I wondered if it was time to rotate as there aren’t that many different spaces there, so I’ve gone back to my leg. I had a couple problems I couldn’t identify but I had two I wondered about.

Just now I inserted the inset 30 in my thigh (which I’ve used without problem). I immediately noticed a bit of blood in the canula. Not filling the canula, but oddly in the middle of the part that shows through the window. My guess was that the insulin can’t pass through blood and so I removed it. But I wanted to make sure this is the case so I don’t waste sets if it happens again and it’s ok. I would think the blood would displace part of the amount used to fill the canula and the rest would get below the skin, but I would think that was too small an amount to matter. i just wondered if I could have left it there.

The second question is I’ve noticed that sometimes the canula seems to enter the skin a short distance into the window area and sometimes it enters much further along, like the full length of the window area and I can even feel it a little past the window. Does that matter? (I’m guessing not).

It is not uncommon to nick a blood vessel at time you insert the cannula . . . and you are right to change the site when you are able to see such, as the blood can clot and obstruct flow of insulin.

Your note that the tip of the cannula is very close to the window on the Inset 30 is also of importance, as the cannula can pull out very easily when it is so close to the area of insertion, insulin could leak out, and it may not be in far enough to allow good absorption. When you insert the set be sure that the “C” shaped platform around the needle is pressed firmly against your skin . . . enough so you see skin pouching up in the space that is inside the “C” shaped platform . . . and be sure to press and hold your finger over the window while you pull the insertion devise out, and when you pull the needle be sure to use one clean smooth stroke, to prevent nicking of the inner cannula . . . as that can contribute to kinking at the tip of the cannula.

The Unomedical website has some nice visual guides for insertion of all the sets . . . and it is often helpful to go back and read the components of each step in detail . . . as it is easy to miss a step that are very important to the use of each set. To find the visual guide go to , select the product tab, select your infusion set, then look for “visual guide” towards the end of their description, and click on the language you want to use.

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Thanks, Leilani. I knew the blood meant I should change it again, but wasn’t sure about the depth of the canula thing. I see what you mean about how it could pull out. That might explain how sometimes it seems it’s fine for a day or so and then I have bg problems. I looked at the picture. I’m doing everything right, but may not be as smooth as I could be in my movements. Hand/eye coordination is not my strong suit! Practice, practice.

I was just stareing at my set and realize I was totally confused again! (Big surprise). I had asked about how much of the cannula was showing as it sometimes was a very small amount - just a little ways into the window area, and sometimes it took up the whole width of the window. You said that if it was close enough to the area of insertion, it might not be in deep enough and insulin can leak out, which is what I was thinking too. But when I think about it if just a little bit of the canula is showing, then the rest is under the skin, where if a longer length of canula is showing, very little is under the skin. So wouldn’t it be the opposite? The less canula visible above the skin the better? I hope I explained this right. I’m totally confused!

I believe you are thinking about that right. The less that is showing the more that is under the skin.

The one other suggestion I would have especially since you are sometimes seeing differing lengths of the cannula showing is try to be as consistent as possible about how those prongs (the ones that are holding the set above the skin before you actually release the set to go into you) are sitting on your skin. I always try to visualize at what angle the set is going to go in and make any slight adjustments right before I release the “spring”. Actually I was having such problems feeling the bolus when using Inset 30’s I decided to abandon them (plus trying to get the angle right is tricky) but can see when you are using the thighs how I would want to go in at more of an angle as I don’t have much fat in the thigh’s. Good luck!

BTW- I can almost always get at least a day and usually 2 out of a bloody infusion set. The problem is I have to test so much to see when it is going bad I do not know what method may be more cost effective but do not particullarly relish ripping a set out I just put in and having to turn right around and put another in. I had three mishaps in a row one time. I decided for at least a day I was going to go back to shots that time.

Thanks, Moss Dog. I hate when my perception of something all of a sudden turns all the way around; makes me dizzy!

I just try and keep the “feet” flat and pressed against my skin. I’ll watch and see what little variations do to how it ends up under the skin. At least now I’m clear which “position” I want to aim for! What do you mean by “feeling the bolus”? The only thing I am aware of feeling is the vibration of the pump when it boluses. You can actually feel insulin flowing in??

I most likely have more fat on my thighs than you do! I’m still in the process of collecting data between the 6mm and 9mmstraight and the inset 30 to see which I have less problems with. I do like having the little window to look through. The only thing I’m certain of is I like the 43 inch better. I just wish they came in another color!

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Yes actually feeling the insulin go in (even though I turned the speed to slow). I guess for me when the cannula is so close to the skin it makes it so I can feel (and it dosen’t feel good!) the insulin going in.
I agree on the 43" tubing. Every time I use the 23" it just drives me crazy. Does seem as if we are in the minority though. My rep says in his whole territory he is only aware of one other person who uses the 43". I guess few enough people choose them there is not as much need for all the cool color variations.

Hmmm. No, I don’t think I’ve ever felt that! Yes, my trainer told me she only had one person who ever used the 43 and he was a 6’5" man. So I guess Animas figured 6’5" men don’t care for pink infusion sets! The 43 inch makes it so much easier to get dressed and in general makes me feel less tethered. I still have a box of 23" to go through and then I’ll just order 43s.

When you remove the cannula, if you hold it up you can see the angle of insertion by gauging the angle between the cannula & the sticky tape. So you can begin to note if a deeper or shallower insertion angle gives you better results. This is partly why I keep on using the Comfort Shorts instead of the Inset30 even though it is a manual insertion, I feel I have more control over the angle of insertion, but I know most people prefer the automatic inserters, when I started pumping 4 years ago the Inset30s were not yet available so I got used to them.

As to blood in the cannula, I’ve had a couple of times where the blood has disappeared & not returned after bolusing, this was when blood appeared after a day or 2 of use, the time I had blood after insertion I removed it at once & it bled profusely so I obviously nicked a blood vessel.

hey Zoe! i had to have an Animas rep stop by my house today and give me a straight inset,she said many people have trouble with the inset 30,like i have been having,
i have a gigantic bruise from it on my stomach…

Thanks, Annabella, I’ll check that out when I remove the next set. I’m anxious to accumulate as much data as I can to see which sets and which techniques give me more time problem free form sets.

II’m looking forward to when I get to the place the women in my Type 1 group said where they only have set problems about 5% of the time! I felt I had gotten there for a week or so but now I’m having another spate of problems.

didn’t feel adventurous enough to try bolusing “through” the blood. This one wasn’t a gusher actually, just a drop of blood when I removed it. I had a gusher once before with no warning.

You are correct that the less cannula you see or feel under the window the better. By point of insertion I mean the point where the cannula actually pierces the skin . . . which should be very close to the hard plastic hub that you snap the infusion set into. You should see very little, if any, of the cannula through the window, and you should not be able to feel a hump where the cannula lies underneath the skin or dressing.

The insertion devise is so very light that it is easy to tilt the devise so the feet no longer press against your skin, as you push the circles to release the set . . . which can cause the needle to graze along the surface of the skin before it goes under. . . leaving very little of the cannula under the skin.

I had a difficult time with the set when I first started using it because I was trying to angle the cannula parallel to the skin (similar to the way I put in the Comfort set) rather than allowing it to go in at a steeper angle. . . It took me several weeks to figure out what I was doing wrong, but now that I know how to use it, I actually love the set.

Thanks for the clarification, Leilani, I had originally misunderstood your post, but when I looked and thought about it some more I figured out I was thinking backwards! I’m going to be even more conscious of keeping the feet pressed down and see if that helps.

Yikes! No fun! I actually have all three - the straight 6mm, the straight 9mm and the slanted. So far I just seem to have different problems with the different sets. And then I had like a week and a half where every set worked fine. I should write down which one works more often so I can decide on a favorite. That’s great that she stopped by your house and brought you the straight set instead of having to wait for the order. I hope it works better for you!