The problem with extending inset time is not to get more money out of us. Our bodies see the cannula as an invader, resulting in inflammation. This caused the port on the end to begin clogging and the inflamed tissue doesn’t absorb as well.
Last year Tandem acquired Capillary Biomedical who was working on ways to decrease inflammation and improve insulin flow and absorption. I believe this set is approved for testing by the FDA. This is never easy or cheap to get FDA approval to release to us.
This video is nearly an hour but it really explains the problems with sets and possible ways to extend life.
With the T-Slim and auto soft 30s you don’t have to change the site and the cartridge at the same time. I always change the site after 3 days because of the issues you raise.
The reason for the extended use is my insulin use dropped and at 3 days there was a lot left in the cartridge. I made the decision to not change as the insulin was working well. I don’t know when I’ll be able to use this site if ever.
I encountered this during a hospital stay. But I believe my problem was they would rather me be 100 too high than 1 too low. Didn’t seem that they were applying any corrections when I was already high. After signing some forms they provided, I was allowed to resume using my T-slim and saw much improvement. But they still required me to use insulin from a vial they provided instead of insulin I had.
I’ve never had a problem with Humalog in Tandem cartridges and I’ve even refilled a cartridge a time or two. My insulin requirements are pretty high so I was only getting about 2.7 days per cartridge with U-100 and was having issues at night because I couldn’t program a high enough basal rate. I switched to U-200 to solve the overnight issue and I’m now getting 5+ days per cartridge.
I use the left side of my abdomen for infusion sets and rotate through around 10-12 locations so it takes around 60 days before I’m back in the same vicinity again. I use the right side of my abdomen for G7 sensors with 4-6 locations so 40-60 days before I’m back to the same location again.
@Luis3 – The picture of the inflamed 5-day infusion site is reminiscent of the symptoms I developed with Novolog insulin. I had been using Novolog for some time yet I developed a sensitivity to it, even after 1-2 days. I haven’t used Novolog for many years and my allergy to it is noted in my medical record.
I know the point you were trying to make was about extending pump sites beyond three days can have damaging consequences to the tissue. Yet I realize that our individual reactions are often related on spectrum.
I’ve been a long-term pumper at 37 years and remain skeptical that beyond 72-hour cannula placement could work for me. I’d like to enjoy longer infusion site sessions but they’re not worth the dermal damage. I can only hope that this personal reality can give way to technical break-throughs.
I’ve been using the Tandem pump for about a year & a half now. From the beginning I filled my cartridge with 300 units and kept using it until it either gave me the low insulin alarm (set for 10 units) or if I noticed the insulin wasn’t as effective. That didn’t happen often, usually it was fine. I don’t use a lot of insulin so even with all of the waste (filling the tubing and the fact that the pump says it’s empty even when there’s a good 25+ units in there) it lasts me more than a week. I do change the infusion set every 3 days. I just reconnect my already filled tubing to the new cannula and do a cannula fill.
I think in the literature that comes with the Humalog vials it says that it’s approved for use in a pump for 7 days. I’m not a fan of the Tandem cartridges but I prefer the pump/algorithm over Medtronic. With Medtronic I never had an issue with insulin becoming less effective even if I was on day 12 of the reservoir!
Thank you for sharing, Liz. I love all the ideas I have gotten from experienced users here. My training was today so I finally am wearing my Tandem. The instructor went through putting the set in. Although I was dreading the process, it didn’t seem as formidable as I had imagined, but there are a lot of steps involved. If your way would save some insulin, I’d be interested in trying but first I’m going to get used to following the protocol that I was taught today. There is a lot to learn but I’m feeling more optimistic now.
Whenever I tried a new infusion set it would take me forever to change it. Once I got the hang of it I could do it with my eyes closed. I found the way the trainer showed me to fill the Tandem cartridge was a pain, so I do it my own way now.
My end wrote my prescription to change every 2 days so I definitely get enough supplies. I actually called Tandem and asked them to put a hold on my cartridge prescription because I have so many. Getting 5 boxes of sets has been great because the Autosoft XC (and 90) isn’t the greatest. I’ve had some where the tape folded over itself going in so it was only half stuck to my skin. I had a couple where the tape was folded on itself right out of the package. I’ve had some that bled upon insertions and some that just didn’t seem to be working. Having extra has given me peace of mind.
I’m using the Softsets also. The one the trainer helped me insert went in like a dream. If I have trouble with future sets, I’ll have to call Tandem. Hopefully they will send replacements for defective sets because my endo prescribed a change every three days so I won’t have any extra. One thing I will have to remember at my next appointment with my endo is to have him increase the number of Humalog vials in my prescription to account for more usage with Tandem. One thing I hate about this pump is all the waste, but I hear it’s better than Medtronic so I’ll put up with it.
@Terry4 Did you switch to Humalog following the sudden reactions to Novolog? I had the same issue with Humalog after using it for 30 years. I’ve switched to NovoRapid (what we call Novolog in Canada) and have been fine since.
My only complaint is that both Humalog and NovoRapid have an onset time of at least 60 minutes, which makes eating a PITA. Fiasp worked well for 6 months, then became like injecting water. Lyumjev and Afrezza aren’t available in Canada.
@Jimi63, after the pump-site reactions to Novolog, I switched to Apidra. I use Apidra to this day; it works well for me.
I eat a carb-limited diet and find synchronizing insulin with my meals relatively easy. I only use 25 units per day and my meal boluses are usually 2-4 units. The CGM helps. Do you use a CGM?
@Terry4 Yes Terry, I’ve used a CGM for nearly 10 years. Perhaps you don’t remember me, I used to be a regular on this site (when we used to compare flat lines).
Jim
Jim – I remember comparing and commenting about CGM lines with people. Sorry that my memory has failed me. Pleased we have crossed paths once more. - Terry
