Which infusion set?


#1

I have Tandem T2 pump. Started using the steel needle. No real problems Except pain at injection site about every other change. I inject only in abdominal, habit. I am wondering if any of you have found the cannula to be a better option. I am not athletic other than daily walks, a bit broad around the middle.
Any one using different injectors with the Tandem pump care to share?
Mark[date=2018-12-12 time=00:00:00 timezone=“America/Los_Angeles” format=“LL” timezones=“Europe/Paris|America/Los_Angeles”]


#2

I use the Autosoft 30. A spring sends it in at an angle and it has a soft cannula. I’ve never used a steel cannula so I’m afraid I can’t help you much with a fair comparison.

Insertion is generally pretty close to painless. I do find that the site is not very good for the first 12-24 hours, meaning that it seems like less insulin is absorbed and it’s absorbed more slowly. My doctor tells me that this is because there is a little bit of trauma caused by the insertion which leads to some inflammation. I have to remember to increase my basal for a while after I change sites. On the second and third days the site works pretty well and then of course you have to start all over again.

Not working well almost a third of the time is, admittedly, a pretty big drawback. I used to use manually inserted sets (that is, not spring-loaded) and my impression is they were better in this respect. But putting those sets in hurt a lot of the time. So, I’ve traded off a bad day of absorption (that I can sort of work around with higher basal and correction boluses) for less pain.

I don’t know if the steel needle is more effective in getting past that initial stage of poor insulin absorption, but the Autosoft 30 might be worth trying if you want to reduce the pain of insertion. (Sometimes I seem to hit a nerve, but that’s the exception not the rule.)


#3

I’m not a t:slim user but am still using my Animas. I’ve been using steel sets since 2011. The length is important - I can’t use the 9 mm sets because they hurt and bleed, but the 6 mm sets are fine.

One thing I love about the steel sets is that, if they’re in a painful location, I can just move them. Last night I inserted into a location that began hurting immediately, and I knew that even if the site absorbed well, it would make sleeping and moving uncomfortable. So I took it out and moved the whole thing to a completely new location. I have a method of using two layers of Hypafix (one cut so that it can go underneath the plastic bit on the infusion set) that go over the infusion set and two pieces of Flexifix (cut so they can go around the connection hub) that fit around the anchor piece, and they hold the moved set in place better than the original adhesive.

I have also used Insets and Comforts, both of which are available (under different brand names) for the t:slim. I’d check out a variety of infusion sets to see what works best and is most comfortable for you. For me, plastic sets do not work at all.


#4

YES. ⇈ I used cannula sets for years until the frequent (VERY frequent) “no delivery” issues nearly caused me to quit pumping. Enter the Sure-T, and I was back on track with my Medtronic pumping!! I always cover them with an IV3000 and if I need to move one, I just put another IV3000 over the moved set.


#5

Jennifer, thanks. Why don’t the plastic sets work for you?.
Mark


#6

Tnyc, thanks for the info. There is no pain on insertion with the steel. The pain is afterwards, especially if touching or lying on.
Mark


#7

Is no delivery due to canula obvious? The Tandum pump doesn’t seem to know. I forgot to remove steel needle cover once and the needle just bent over. No delivery. I didn’t know for a while, several hours. My BG some times doesn’t come down, even with insulin delivery. Never had that happen before the pump. Must have something to due with the injector or site selection. In that regard, MDI were always successful.
I must admit however that my 1st A1c since pump is lower than any in past 4 yrs. I am stoked, even with the mechanics problems with the pump and sensors.
Mark


#8

In my case, it’s because I seem to be allergic to the Teflon in plastic infuson sets. I can’t wear them for more than 24 hours without them becoming extremely irritated and ceasing to absorb insulin properly.


#9

I have tried all the nylon cannula sets Tandem offers, and finally settled on the steel sets. In my abdomen, arms, and thighs, I had repeated kinked cannula with the nylon sets. They were painless to Install, but the failure rate was too high for me. With steel sets I can always move them. When I’m being a cheap ba****d, I move the steel.portion of the set 2.to.3 times before changing it out completely over a. 10ish day period. I reuse reservoirs too.


#10

El_Ver, Thanks for your input. How were you alerted to cannula failure?

Mark


#11

Jen, I see. Thanks.

Mark


#12

High blood sugars, occasionally being able to smell insulin, occasionally the site felt moist and I had high blood sugars. When I would pull the set off the cannula would be kinked 90°


#13

Thanks for that info.

Mark


#14

I had the same experience, 1/2 dozen times or more. Pump never gave occluded warning but sugars spiked. It’s been steel ever since.


#15

I began with steel sets when I first went on a pump. When I switched pumps to Medtronic, I decided to try the cannula style. It was like night and day to me. I do have occasional problems where the cannula doesn’t go in right, and more often where the tape folds on itself when using the inserter tool, which is a fault of Medtronics for not having a more reliable device. The steel one used to hurt whenever I would catch the plastic head holding the cannula on something, like my clothing being take off… A nylon cannula does not dig into the skin and cause pain when it gets twisted or pulled.

I never had a no delivery issue that wasn’t for a good reason, so I can’t address that one. And only a few inclusions in 10 years.


#16

Davyboy, thanks for your experience. I sometimes make life decisions as if I were playing poker. What are the odds, based on what I know, or have been told? I have decided to stay with steel and try to find injection sites that work.

Happy New Year!!!

Mark


#17

This is why I put a square of Hypafix tape over the infusion set. It holds those two plastic tabs used to insert the set flat against the skin and prevents them from being tugged on.