- Locations for Inserting Glucose Sensors
- Locations for Inserting Infusion Sets
- Why Regular Site Rotation is Critical
- Abdominal Rotation Methods
- Infusion Set Management Tips for Achieving Balance and Control
- Infusion Site Troubleshooting Tips
Locations for Inserting Glucose Sensors
Proper site selection is important for optimal glucose sensor performance and to prevent bleeding at the site. Here are some tips on choosing a site:
Choose a place on your body at least:
- 2 inches from your navel
- 2 inches from your insulin pump infusion site
- 3 inches from any manual insulin injection site
For best glucose sensor performance, avoid:
- Sites where clothing may rub or constrict (for example your beltline)
- Sites where your body naturally bends a great deal
- Sites that are scarred or have hardened tissue or stretch marks
Note: Clinical trials for glucose sensors were performed on sensors inserted in the abdominal area.
Locations for Inserting Infusion Sets
The abdomen is the most commonly used site for infusion sets.
Experiment to find the most comfortable site location(s) for you. The important thing is to remember to avoid inserting the infusion set into bony areas, under belt lines (near your waist) or in other areas where clothing might cause irritation. If you are using Personal Continuous Glucose Monitoring (CGM) with your insulin pump, your glucose sensor and infusion set sites should be at least two inches apart.
The U.S. Center for Disease Control and Prevention (CDC) recommend changing your infusion set every 2 to 3 days.1
In addition, insulin looses its strength over time2, especially with heat and agitation. As this happens, insulin becomes less effective, and controlling your glucose levels becomes more difficult. Therefore it is critical to change your insulin reservoir every 2 to 3 days as well.
Why Regular Site Rotation is Critical
If you rotate your infusion site every time you change your infusion set and reservoir, you'll help promote healing and ensure the future availability of many healthy and viable infusion sites.
Abdominal Rotation Methods
Using a simple visual scheme will help rotate your infusion sites in an easy, organized way. Here are simple diagrams of two commonly used methods. In both cases, avoid the 2" area surrounding your belly button and make sure the new site is at least 1" away from the previous site.
Visualize an imaginary clock drawn around your belly button. Rotate infusion sites by starting at the 12 o'clock position and then rotating the site clockwise to 3 o'clock, 6 o'clock, and so on.
Imagine an "M" or "W" pattern approximately 4" long on either side of your belly button. Start at the end of one letter and proceed through the letter, rotating the infusion set at each intersection.
Infusion Set Management Tips for Achieving Balance and Control
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Infusion Set Management Tips for Achieving Balance and
Control
(File size: 169 kB) Download time on a 56k modem: 26 seconds
Infusion Site Troubleshooting Tips
If you experience a high blood glucose (BG) that does not come down with a correction bolus, check your infusion set site.
Is the site red, irritated or painful? If the answer is yes, then rotate and change the infusion site, infusion set, reservoir and insulin.
For tips beyond your infusion site, click here.
If you determine that your infusion site, infusion set, pump and insulin are OK, continue to follow the protocol for treating a high BG and contact your healthcare provider.
- 1
- Centers for Disease Control and Prevention (CDC). Guidelines for the Prevention of Intravascular Catheter-Related Infections. MMWR. 2002;51(No. RR-10):9-10.
- 2
- NovoLog® Prescribing Information. Princeton, NJ: Novo Nordisk Inc.; Mar. 14, 2008.
Medtronic Diabetes Infusion Sets
We offer a variety of infusion sets for various body types and sizes. Most MiniMed Paradigm® infusion sets can be inserted using a Serter® auto-insertion device for reliable, fast, easy and virtually painless insertion.
Information on each type of Sertable® infusion set is available here.
| MiniMed Paradigm Infusion Sets | |
|---|---|
| Quick-set® infusion set (10/box) | |
| The Quick-set infusion set, the most popular infusion set, is inserted under the skin at a 90° angle. The Quick-set offers "at-site" disconnect and built-in adhesive (no over-taping is needed). It works with the optional Quick-serter® inserter device (sold separately) to provide optimal insertion every time. | |
| MMT–396 | 9 mm Soft Cannula, 43" tubing |
| MMT–397 | 9 mm Soft Cannula, 23" tubing |
| MMT–398 | 6 mm Soft Cannula, 43" tubing |
| MMT–399 | 6 mm Soft Cannula, 23" tubing |
| MMT–395 | Quick-serter Insertion Device (1 each) |
| Silhouette® infusion set (10/box) | |
| The Silhouette infusion set offers comfort and flexibility for active pumpers. With a variable-angle (35°) cannula, the Silhouette infusion set lets you choose your insertion depth and is generally good for extra lean adults or children who have less depth to their body fat in which to place the cannula. It works with the optional Sil-serter® insertion device (sold separately). | |
| MMT–377 | 17 mm Soft Cannula, 43" tubing |
| MMT–378 | 17 mm Soft Cannula, 23" tubing |
| MMT–382 | 13 mm Soft Cannula, 43" tubing |
| MMT–381 | 13 mm Soft Cannula, 23" tubing |
| MMT–385 | Sil-serter Insertion Device (1 each) |
| Sure-T® infusion set (10/box) | |
| The Sure-T infusion set features a 90° angle insertion with a 6mm fine steel needle. Additional site adhesive prevents needle dislodging. Security and simplicity for first-time insulin pump users or those with allergies to soft cannulas. | |
| MMT–840 | 6mm Stainless Steel Needle, 23" tubing |
Infusion Sets from Other Manufacturers
We cannot guaranty or warrant the performance of our insulin pumps with reservoirs and infusions sets not sold under the Medtronic brand.- General Suggestions
- Antiperspirant
- Infusion Set-Basic Method
- Infusion Set-Sandwich Method
- Glucose Sensor
- Tape Tips and Other Infusion Site Information
Tape Tips
General Suggestions
- Keep the site clean–shaven.
- Try exfoliating (removing dead surface skin cells) with a facial scrub, brush or loofah (or simply a washcloth) followed by an alcohol swab, then soap and water.
- Stretch skin taut before using bonding agent or tape.
- After you apply the tape, go back around the edge of the tape with your finger to seal the edges to your skin.
- Use sticky medical cloth tape over the infusion set or sensor when you have to be absolutely sure the site doesn’t come loose—for instance, when you compete in athletic events. Athletic tape (for example: PowerFlex) can also work well - the kind used for taping ankles,etc.
- Avoid wearing seams or waistbands over the site because they may rub and loosen the tape.
- Avoid using lotions where you intend on applying tape as the tape won’t stick well to your site.
Antiperspirant
Some people find that using an antiperspirant on their site prior to insertion helps the tape stick better.
- Purchase a solid or spray antiperspirant deodorant for site use only (no gels or creams). Sprays really work best - otherwise sticking can be an issue.
- Apply to chosen infusion or sensor site and allow it to soak in for 10-15 minutes.
- Cleanse site to remove residue from skin.
- Follow insertion directions as usual.
- Cleanse a solid stick with an alcohol wipe after each use.
The antiperspirant formulas target a specific gland in the epidermis of the skin that 'turns-off' the production of moisture. This will allow the infusion set or sensor to stick better with minimal need for extra tape or sticky substances that might increase the risk of skin reactions.
Infusion Set - Basic Method
Several products are available that may help you secure your site.
Medtronic Diabetes carries IV Prep™, which you can use on your skin as an antiseptic skin preparation; Mastisol® adhesive and its remover, Detachol® — which many insulin pump wearers swear by for keeping infusion sets in place when nothing else works. Here are some tips to keep in mind if you have a difficult time keeping your infusion set in place:
- Change the site when you are showering: Before you shower, remove your old infusion set. Clean off the old adhesive with an adhesive remover such as Uni–Solve™ or Detachol (for removing Mastisol). In the shower, wash off the solvent with soap.
- Let skin dry THOROUGHLY before applying either the infusion set or the adhesive.
- Apply a tacky prep wipe (for example IV Prep) in a large area around the site and fan it, allowing it to become tacky. (You can also try a stronger adhesive, such as Mastisol. However, be sure to have Detachol solvent available for removal.)
- Touch as little of the adhesive as possible on the infusion set so as to avoid getting skin oils on it.
- On days you know you will be very active, sweating or swimming, cover the site with additional adhesive tape.
- To prepare an adhesive overtape for the Silhouette® or Quick–set® infusion sets, fold the tape in half with only a slight crease. Cut out a half–moon that’s half the size of the plastic "bump" on the infusion set. When you unfold it, it will be just the right size. If the tape peels off, you can replace it to last until the next site change.
- You can try using additional tape on the corners to prevent them from peeling up and lifting the entire infusion site out.
- Check regularly to make sure the tubing is not pulling on the site and adding stress on the adhesive.
- When all else fails, change the site!
Infusion Set - Sandwich Method
The sandwich method should be used with infusion sets only to help your infusion set stay in place. You cannot use the Sandwich Method with sensors because the sensor electrode is sensitive and could become damaged if inserted through anything other than dry skin prepped with alcohol.
- Prep the skin and allow the prep to dry.
- Apply a clear adhesive dressing (for example: Tegaderm or Polyskin) directly to the skin. NOTE: Check the instructions on the adhesive dressing that you choose to confirm that the manufacturer does not state that the adhesive properties decrease when another tape is placed over or under it as that is exactly what you will be doing with this method.
- Insert the infusion set through the clear adhesive dressing (follow the instructions for inserting infusion sets) - In this way the adhesive on the infusion set will be sticking to the clear adhesive dressing instead of sticking directly to your skin.
- *Optional* Apply a second clear adhesive dressing on top of the infusion set. Remember you will need to cut a hole in the second clear adhesive dressing so that you can easily disconnect and reconnect at your quick release
Glucose Sensor
It is highly recommended that you cover the transmitter and sensor with a transparent dressing to secure the system in place and ensure that the sensor remains fully inserted underneath the skin. Seasonal climates, skin lotions/creams, trapped moisture, or different clothing may affect your sensor tape adhesion or the way your body reacts to it. Here are some tips you may want to try:
Important Notes:
- Do not use the "sandwich method"commonly used with infusion sets.
- Do not use skin prep or barrier wipes where the glucose sensor goes into the skin.
Inserting the glucose sensor through any barrier may damage the glucose sensor.
- If too much tape is applied, it may weigh down the transmitter and cause it to fall off.
- Cut a piece of IV-3000® in half and place it crossways so that it covers the glucose sensor and the part of the MiniLink® transmitter closest to the sensor connection. This secures the glucose sensor and MiniLink transmitter while allowing them to air dry.
- Try another type of tape from your local pharmacy or a simple Band-Aid® over the MiniLink transmitter.
- While the sensor and transmitter are safe to be worn in a hot tub, be careful as the adhesive may weaken.
- After inserting the glucose sensor and prior to removing the paper backing, lift back the white tape tab and paint the area underneath with a liquid skin barrier like Nexcare™ Skin Crack Care. Hold back the white glucose sensor tape for about 10 seconds before removing the white tape and pressing down.
Tape Tips and Other Infusion Site Information
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Tape Tips and Other Infusion Site Information
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Preps and Tapes
Several types of products are available to help with adhesion and skin irritation problems:
- Preps and Wipes — These are brushed onto clean skin at the chosen site. For many of these products, once they dry, they provide a barrier layer between the skin and your tape (or adhesive product). Do not use skin prep or barrier wipes where the glucose sensor goes into the skin, as inserting the glucose sensor through any barrier may damage the glucose sensor.
- Tapes and Adhesives — These are used to help hold an infusion set or MiniLink® transmitter in place on your body.
- Adhesive Removers — People with sensitive skin sometimes find that the adhesive residue causes skin reactions after removal. Adhesive dissolvers can help with this issue.
Medtronic Diabetes carries a wide selection of preps, wipes, adhesive tapes and related products. You may also find a selection at your local pharmacy, or through mail order supply houses.
Product names listed with hotlinks are available through Medtronic Diabetes or by calling 1.800.646.4633 and selecting option 2.
We appreciate www.insulin–pumpers.org for providing the basis for this guide. This Guide was developed for the convenience of our customers. Any listing in this Guide does not constitute an endorsement of the manufacturer or the product quality. Medtronic Diabetes is not responsible for the completeness or accuracy of product information. Availability may vary by country and region. Please check with the manufacturer listed or consult your pharmacist.
| Preps and Wipes | |
|---|---|
| AllKare® Protective Barrier Wipes | |
| Provides a barrier film layer on skin used under tapes, skin barriers, and adhesives to help protect against irritation and adhesive build–up. Available in wipes. | ConvaTec 800.422.8811 www.convatec.com |
| Antiperspirant Deodorant | |
Use a solid or spray antiperspirant deodorant for site use only (no gels or creams). Steps include:
The antiperspirant formulas target a specific gland in the epidermis of the skin that "turns–off" the production of moisture. This will allow the infusion set or sensor to stick better with minimal need for extra tape or sticky substances that might increase the risk of skin reactions. |
Various. Available at pharmacies and retailers. |
| Bard® Protective Barrier Film | |
| A liquid that dries to form a breathable film that liquids can’t penetrate. Protects against abrasion and friction. Available in wipes. | C. R. Bard, Inc. 800.526.4455 www.bardmedical.com |
| Cavilon™ Durable Barrier Cream | |
| A concentrated, therapeutic cream that provides durable, long–lasting protection. Resists wash off and therefore requires less frequent applications. | 3M 866.777.0819 www.3m.com |
| IV Prep™ | |
"Prep the site" with IV Prep for antiseptic cleansing to reduce irritation and to make the tape stick better. NOTE: IV Prep should not be used to prep a glucose sensor insertion site. |
Smith & Nephew, Inc. 800.876.1261 www.smith-nephew.com |
| Nexcare™ Skin Crack Care | |
| Seals and promotes healing of painful, dry skin cracks on fingers, feet and elbows. Long–lasting waterproof formula contains Vitamins C and E and TeaTree oil. | 3M 866.777.0819 www.3m.com |
| No Sting Barrier Film | |
| Helps to protect skin from irritants. Unique non–sting formula can be used on intact or damaged skin. Available as a spray or wipes. | 3M 866.777.0819 www.3m.com |
| Perma–Type Surgical Cement | |
| Contains natural latex rubber that helps create a strong, yet gentle, waterproof bond between skin and appliance. Similar to the discontinued Skin Bond product made by Smith & Nephew. | The Perma–Type Company, Inc. 860.747.9999 www.perma-type.com |
| Skin–Prep® | |
| Effective protection between tape and skin. Recommended for tape and film adhesion. Non–irritating. Available in a spray, wipes or swabs. | Smith & Nephew, Inc. 800.876.1261 www.smith-nephew.com |
| Skin–Tac™ | |
| This latex–free, hypo–allergenic wipe aids in the adhesion between skin and adhesive tape. | Torbot Group / Mason Labs 800.545.4254 www.torbot.com |
| Tincture of Benzoin | |
| Keeps tape sticky in wet or hot conditions. Available in spray or liquid. If you purchase the liquid, use a Q–tip to apply a small amount as needed. | Various. Call your local pharmacy or medical supply house. May require special order. |
| Tape and Adhesive Products | |
|---|---|
| DuoDERM® Dressing | |
| Semipermeable, modern hydrocolloid dressings for the management of light wounds. | ConvaTec 800.422.8811 www.convatec.com |
| Hollister 7730 | |
| Silicone adhesive that does not include natural rubber latex. Allows skin to breathe. Can be used on sensitive skin. Available as a spray. | Hollister, Inc. 800.323.4060 www.hollister.com |
| Hypafix™ Tape | |
| Non–woven fabric made from white polyester material and coated with hypoallergenic adhesive on quick–release backing paper. This product does not contain latex or natural rubber components. | Smith & Nephew, Inc. 800.876.1261 www.smith-nephew.com |
| Hy–Tape® | |
| A latex–free tape with zinc oxide that is waterproof and washable. Adheres to wet, oily, or hairy skin. | Hy–Tape® International 800.248.0101 www.hytape.com |
| IV3000™ | |
| Clear, transparent tape dressing for covering infusion sets or sensor sites. This product is now latex–free. | Smith & Nephew, Inc. 800.876.1261 www.smith-nephew.com |
| Mastisol® | |
| Clear, latex–free, non–irritating liquid adhesive. Available as pads and liquid. | Ferndale Laboratories, Inc. 888.548.0900 www.ferndalelabs.com |
| Micropore™ Surgical Tape | |
| An economical, general purpose, breathable latex–free paper surgical tape. Available in various sizes. | 3M 866.777.0819 www.3m.com |
| Nexcare™ Durapore™ Durable Cloth Tape | |
| Strong, durable, and multi–purpose, silk tape with excellent adhesion. Tears easily for application, is permeable, hypoallergenic, and comfortable. Available at many drugstores. | 3M 866.777.0819 www.3m.com |
| OpSite™ | |
| Transparent waterproof dressing. This product does not contain latex or natural rubber components. | Smith & Nephew, Inc. 800.876.1261 www.smith-nephew.com |
| Paper Tape | |
| Economical, for general use. | Various. Available at pharmacies. |
| Polyskin™ II Transparent Dressing | |
| Transparent latex–free dressings made of a thin polymer film coated with a hypoallergenic adhesive. A simple, effective delivery system allows one–handed application. | Covidien 800.962.9888 www.kendallhealthcare.com |
| Tegaderm™ I.V. Transparent Film Dressing 1610 | |
| Latex–free, transparent, water–resistant wound dressing. | 3M 866.777.0819 www.3m.com |
| Toupee Glue | |
| Comes in liquid form and can be applied with a Q–Tip after the sensor or infusion set is inserted. | Various. Available at pharmacies. |
| Transpore™ Surgical Tape | |
| Latex–free, clear, porous, plastic hypoallergenic surgical tape. Available in various sizes. | 3M 866.777.0819 www.3m.com |
| Adhesive Removers | |
|---|---|
| AllKare® Adhesive Remover | |
| Gently removes all adhesives including skin barriers, tapes and hydrocolloid dressings. Available in wipes. | ConvaTec 800.422.8811 www.convatec.com |
| Bard® Protective Barrier Film Remover | |
| Convenient disposable wipes that effectively remove barrier films and adhesives. | C. R. Bard, Inc. 800.526.4455 www.bardmedical.com |
| De–solv–it® | |
| Citrus–based solvent. Available at various retailers. | Orange Sol Group 800.877.7771 www.orange-sol.com |
| Dermasol | |
| Surgical solvent for the removal of surgical cement from the skin. "Easy" on the skin — fast drying. | The Perma–Type Company, Inc. 860.747.9999 www.perma-type.com |
| Detachol® | |
| Non–irritating, alcohol free, and hypoallergenic liquid used to remove left over adhesive material from sensitive patient’s skin. | Ferndale Laboratories, Inc. 888.548.0900 www.ferndalelabs.com |
| Goo Gone® | |
| Citrus–based solvent. Available at various retailers. | Magic American 800.321.6330 www.googone.com |
| Nail Polish Remover | |
| Solvent, can remove adhesives from skin. | Various manufacturers, retailers. |
| Tac Away® Adhesive Remover | |
| For complete, effective removal of adhesive residue. Non–Acetone. | Torbot Group / Mason Labs 800.545.4254 www.torbot.com |
| Uni–Solve™ | |
| Designed to ease tape and adhesive dressing removal | Smith & Nephew, Inc. 800.876.1261 www.smith-nephew.com |
Products listed are registered trademarks of their respective owners.