4 tips for infusion set and sensor site rotations

sensor rotation

When I started the MiniMed 530G with Enlite, I committed to wearing the Enlite sensor all the time. When I wore the Sof-sensor, I took occasional sensor breaks, but now with Enlite, I didn’t want to continue that same habit. 

I quickly found it was important to use my “real estate” wisely when it came to wearing two sites 24/7. Here are some tips I have learned along the way that might help you with infusion set and sensor site rotations. I call it the “S.P.O.T. method”.

(S) Site Location

The stomach is a very common place to wear an infusion set and one of the main areas that I have used for years. I initially started wearing my sensor and my infusion set in my stomach (making sure they were an inch away from another), but I found it to be too much space taken up on my skin with not a lot of flexibility to rotate. So after talking with my doctor, we decided to dedicate my stomach to sensors only (at least for now). For my infusion sites, I rotate between my thighs, arms, and back/love handles. Saving my stomach for my sensor allows ample time for my sites to heal and skin to remain healthy during the six day sensor wear. 

Before I insert a sensor or infusion set, I think about all the locations I can insert them, often choosing a site based on the answer to these questions:

  1. Where did I insert last? (Choose a different spot) 
  2. What types of activities am I planning on for the next 3 days? (Activities like working out might change placement) 
  3. What kinds of clothes will I be wearing for those activities? (Beach day or formal events mean different outfits so I choose a different spot) 
  4. Are any of the following true for the selected spot: a skin fold, scar tissue or overused site, too close to the belt line? (Don’t use those areas for sensor or infusion set insertions!)

    Infusion Site Rotation

    Infusion Set Site Rotation

     

    Sensor Site Rotation

    Sensor Site Rotation

(P) Pump Placement

When I started rotating my sensor sites and infusion sets, I occasionally lost communication between my pump and sensor. Tempted to always insert my sensor and infusion set on the same side of my body so that my pump could be clipped within a closer range, I got creative. Now, I stick with my rotation schedules and don’t wear my sensor and infusion set on the same side all of the time. Instead, I clip my pump on the same side of my body my sensor is placed, not my infusion set. Sometimes my infusion set will be on my right thigh and my sensor will be on the left side of my stomach, so I simply pull the tubing over, and clip my pump on my left side (This is where my mid-to longer infusion set tubing length comes in handy). This removes one more barrier when planning my insertion sites.

(O) Orientation

I was trained to have my sensor inserted horizontally on my stomach, but recently discovered that it can also be worn vertically with the transmitter on top of the sensor, too. By changing the insertion orientation, the sensor is at a different angle, using a slightly different area of the skin. I now swap my sensors from one side to another each time I change my site, and I change the orientation. 

You can do this with your infusion sets, too. Do you prefer tubing pointing up, down, or sideways? I have found that by finding the right way to insert, depending on body locations, it can make the insertion more comfortable while allowing for more site options.

(T) Track

Keep track of your insertion sites, and come up with a method or tool that can help remind you. When I first started on the pump, I manually wrote notes in my log book for where I wore my sites. ( I’ ve also heard of people who mark this down on their calendar or use reminders on their phone. ) But after a few years I became used to the practice of rotating so no longer needed to manually write it down. I just made a decision to be thoughtful of choosing my sites, and I mentally am able to recall where I should do my next sensor or infusion set insertion based on my last few spots. 

For infusion set site rotation, Medtronic recommends the “clock” or “M/W Rotation” methods on your abdomen.

Clock method

Clock Rotation

 

M/W Rotation

MW Rotation

Since I no longer wear my infusion set on my stomach, I rotate by choosing a different body part/side of my body when inserting a site. For example, if I wear my infusion set on my right arm today, then in 3 days I will use my left arm. I use the “M/W Rotation” as a guide for my sensors, but I always make sure that there is are at least two inches between my sensor and belly button (it’s the same rule for infusion sets if you wear them here too.) 

Sometimes it just takes a little thought and trying different things to find exactly what works best for you. What helps you with site rotation? Let me know in the comments below!

IMPORTANT SAFETY INFORMATION

- Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems. 

- Successful operation of the insulin infusion pumps and/or continuous glucose monitoring systems requires adequate vision and hearing to recognize alerts and alarms.

Medtronic Diabetes Insulin Infusion Pumps

- Insulin pump therapy is not recommended for individuals who are unable or unwilling to perform a minimum of four blood glucose tests per day. 

- Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately.

Medtronic Diabetes Continuous Glucose Monitoring (CGM) Systems

- The information provided by CGM systems is intended to supplement, not replace, blood glucose information obtained using a home glucose meter. A confirmatory fingerstick is required prior to treatment. 

- Insertion of a glucose sensor may cause bleeding or irritation at the insertion site. Consult a physician immediately if you experience significant pain or if you suspect that the site is infected. 

Please visit MedtronicDiabetes.com/isi for complete safety information.

 

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Submitted by Travis (not verified) on

In reply to by Commenter (not verified)

This is probably the most helpful set of pump tips I've come across. Thank you for sharing.

Submitted by naomi.kingery@… on

In reply to by Travis (not verified)

Travis, I’m so glad you found these tips helpful! We’re committed to providing content that’s helpful to our customers and community, so keep checking back or you can also subscribe to new blog posts here: http://feedburner.google.com/fb/a/mailverify?uri=loop-blog.

Thanks for the site insights. I've been a pumper for 20 years and just started using the CGM. I'm having trouble finding sensor sites I can reach where there is no or limited scar tissue. Can scar tissue be somehow partially restored.

Also I have just gone on to medicare and will likely not be able to afford sensors. It will solve the site problem but would like to find a way to afford the sensors. Thoughts?

Hi Douglas. Your healthcare team would be the best team to discuss your sites and scar tissue. They may have additional suggestions to help.
Medicare currently doesn't cover our CGM we are working with them for broader access. In the meantime, we do offer financial support options. If you'd like to learn more, please give our team a call at 800.646.4633 option #4.

Submitted by Shelly Hicks (not verified) on

In reply to by Commenter (not verified)

Thank you for these tips Naomi Kingery, I try to use them myself and with me being very thin i find it hard to use the love handle areas. I rotate my infusion sites and sensor sites every three days and if i use like my right leg, then i will change it to my left leg, then to my left arm then right arm and then belly, then i start all over again with the legs and so on.

Submitted by naomi.kingery@… on

In reply to by Shelly Hicks (not verified)

Shelley, thanks so much! I’m glad that you’ve found a method that works for you, since we’re all unique in our own ways!

Submitted by David Richards (not verified) on

In reply to by Commenter (not verified)

Do you have trouble with the sites on your thighs rubbing? I used to give shots to the top if my thighs all the time, but I've been able to keep my sensor and set on my stomach since I started. Site rotation does become a problem if I don't take a break and I still have trouble with the sensor tape coming loose during exercise.

Submitted by naomi.kingery@… on

In reply to by David Richards (not verified)

David, I personally haven’t experienced this, and I’m sorry to hear you’re having issues with your sensor tape during exercise. You may find these sensor taping tips helpful: http://www.medtronicdiabetes.com/customer-support/insertion-site-manage…. I’ll have someone from my team connect with you to try and help. Let me know if you have any other questions.

Submitted by Lisa (not verified) on

In reply to by naomi.kingery@…

I have trouble keeping the sensor tape on . It tends to want to come off before mt seven days are up.

Submitted by Nicole (not verified) on

In reply to by Lisa (not verified)

Sorry to hear this, Lisa. Our technical support team has additional tips to help with your sensor tape and can be reached at 800.646.4633 option #1. You may also find our tape tips article here: http://bit.ly/2tRkq4Y helpful.

Submitted by Linda Greenfield (not verified) on

In reply to by Commenter (not verified)

I just read the link about site selection. The suggestion is to use thighs and back areas. I wear shorts or pants. They rub against the set if on my thighs. I cannot see or reach to use my back or hip areas. Suggestions?

Submitted by naomi.kingery@… on

In reply to by Linda Greenfield (not verified)

Hi Linda. Your thighs and lower back areas are a couple areas to wear your infusion set. You can also place it in your tummy, upper butt, and behind your arms. You may find this site helpful, too: http://www.medtronicdiabetes.com/customer-support/insertion-site-manage…. I recommend speaking with your healthcare team on the best infusion site location for you.

Submitted by darlene kero (not verified) on

In reply to by Commenter (not verified)

I was diagnosed with type 1 diabetes in 2005 at the age 0f 57. I was started on pump therapy shortly after. I use the Sure-T infusion set. There has been times I experience pain when I do the insertion. I find it very difficult to do other areas , and living by myself, I have no one to help me. The few times I have tried other areas on my own, I have found it very painful. I am getting very frustrated, and thinking about going back to the pen. Do you have any ideas????

Submitted by naomi.kingery@… on

In reply to by darlene kero (not verified)

Darlene, I’m sorry to hear you’re experiencing pain when inserting your infusion set. If you experience pain for a period of time after the infusion set has been in place, this may indicate that you are in or near muscle tissue, and the set should be changed. I’ll have a member of my team reach out to try and help.

Submitted by Lauren (not verified) on

In reply to by naomi.kingery@…

I’m 14 and my Stomach where I put my infusion sets are starting to hurt but I am very scared to put it somewhere else because I feel like you’ll hurt worse what should I do?

Submitted by Nicole (not verified) on

In reply to by Lauren (not verified)

Lauren, while everyone is different, your sites shouldn't be hurting. We've had great feedback from those using other sites, such as their arms or thighs. Your doctor or trainer would be happy to help and can answer any questions you have about different sites that might work better for you. If you need help connecting with a trainer in your area, you can email us at dhelp@medtronic.com and we can help.

Submitted by Dixie Kristoff (not verified) on

In reply to by Commenter (not verified)

I just changed my site from my stomach.Itook it out and blood started squirting out in a stream! I hurried up got a wad of tissues and pressed it on the site. It finally stopped.Iput gause and tape over it,to make sure it wouldn't start up. Any idea why this happened.I always try to change my site every 2 to 3 days.

Submitted by naomi.kingery@… on

In reply to by Dixie Kristoff (not verified)

Dixie, I’m sorry to hear about this. I will have a member of my team connect with you to discuss this in more detail and to try and help.

Submitted by Brian McLaughlin (not verified) on

In reply to by Commenter (not verified)

When you use your arm for infusion set insertion where do you run the tubing? Where do you put your pump?

Submitted by naomi.kingery@… on

In reply to by Brian McLaughlin (not verified)

That’s a great question, Brian. Everyone wears their pump in their own way that works best for them. One way to wear your infusion set on the back of your arm is to run your tubing through the inside of your shirt, and have your pump clipped to your waistband or in your pocket. Hope this helps!

Great writing it is such a cool and nice idea thanks for sharing your post . I like your post very much. Thanks for your post.

Submitted by Kim King (not verified) on

In reply to by Commenter (not verified)

My son Nathan, who's 17, just got started with the Medtronic pump and infusion set silouette. He's a skinny kid and he's having problems with the insertion. He says it bothers him to insert it in the abdomen area, and prefers his leg, but whenever it's inserted in his leg, it leaks. Does this insertion set just not work for him? Any suggestions? We are back to shots.
Kim King

Submitted by naomi.kingery@… on

In reply to by Kim King (not verified)

Kim, I’m sorry to hear your son is having trouble with his infusion set and site. We do offer 4 types of infusion sets with 20 different configurations to match specific needs. I recommend connecting with your son’s healthcare team to determine which infusion set and infusion set site works best for him. I’ll also have a member of my team reach out to you to try and help. In the meantime, you may find this article on the different types of infusion sets helpful: http://www.loop-blog.com/which-infusion-set-is-right-for-you/

Submitted by Gert Pottichen (not verified) on

In reply to by Commenter (not verified)

I have a terrible problem with itching at the sensor site and the infusion set sites. I always change my sights / sensor after my morning shower so the area is nice and clean. Sometimes the itching is so intense I just pull everything out and start all over again. however the sensors are so expensive it gets to be cost-prohibitive. Last week for instance Within 24-hours I went through three different infusion sites. Currently I am wearing the sensor on my abdomen and I needed to peel the tape almost completely off because of the itching. When I called the company all they do is send me an instruction booklet on taping methods.

Submitted by Karrie Hawbaker (not verified) on

In reply to by Gert Pottichen (not verified)

Gert, I have asked that someone from our Advanced Troubleshooting team reach out to see if they might be of more assistance.

Submitted by Diana L Larimore (not verified) on

In reply to by Commenter (not verified)

I'm having trouble with my insert sites. I do rotate them faithfully but here lately they will clog and insulin will not go into the site. I'm getting frustrated with this and like one of the comments above am tempted to go back to injections. I have a clotting disorder so I don't know if that has anything to do with it or not. any suggestions?

Submitted by Karrie Hawbaker (not verified) on

In reply to by Diana L Larimore (not verified)

Diana, I’m sorry to hear you’re having trouble. Our 24-Hour HelpLine Team would love to help. They can be reached at 800-646-4633 and then press Option 1 to get their help immediately.

Submitted by Shelia Adamson (not verified) on

In reply to by Commenter (not verified)

Everything you said is very helpful but I have one question can I sleep on the side that my pump and infusion set and sensor is on?
Thanks

Submitted by Naomi Ruperto (not verified) on

In reply to by Shelia Adamson (not verified)

Sheila, we don't recommend adding additional pressure on your sites, but please sleep as you normally do. If you have any questions you can reach our 24-Hour HelpLine at 800.646.4633 option #1.

Submitted by Shelia Adamson (not verified) on

In reply to by Commenter (not verified)

Thanks
Naomi Ruperto
Have a great day

as I was having problems with the infusion the guild lines I received on the way to help the problems has helped me understand why I was having this problems and as I start to use some of them hope it will make life a lot better thanks for the heads up !!

Submitted by Krista Clark (not verified) on

In reply to by Commenter (not verified)

What's the best way to clean the sticky substance from the tape off of the sensor? I've tried alcohol but it doesn't take it off.

Submitted by Karrie Hawbaker (not verified) on

In reply to by Krista Clark (not verified)

Krista, we've found hand sanitizer works the best. Just make to connect the transmitter to the tester to form a water-tight seal to prevent any liquid from getting inside.

Submitted by Barbara Jewell… (not verified) on

In reply to by Commenter (not verified)

My great-niece just turned 12 years old and I was thinking about how cruel other kids can be about things they notice about someone else.
She has Juvenile Diabetes and has a pump. Her grandma always has her wear her pump in it’s case near the front of her stomach. The other part, I can’t remember the name of it at the moment, that actually administers the insulin isn’t far away and is also at the front of her stomach area. It is very noticeable since it makes a large bump under her shirt right on the front of her belly. My great-niece is already socially-awkward so I don’t want kids bullying her because of the bump. Does her medical equipment for diabetes have to be placed directly on the front of her belly just above her belly button?

Submitted by Karrie Hawbaker (not verified) on

In reply to by Barbara Jewell… (not verified)

Thanks for reaching out, Barbara. There are several approved locations for infusion set insertion (the piece that administers the insulin). You can learn more here: http://bit.ly/1gXAPnq

Great article, thanks. I have found it very helpful to write the date on the infusion set (on the tape) so I remember when it was inserted.

I’m just getting my first CGM and have very little real estate for my pump sites due to 14 abdominal surgeries. I don’t have a lot of excess fat on my extremities and I’m not sure I can use both on my stomach due to scar tissue. I’m going live tomorrow with my CGM and initially thought I could wear it on my upper buttock or maybe the back of my arm. Any recommendations?

Submitted by Nicole (not verified) on

In reply to by Paula Hatcher (not verified)

Hi there, Paula. Our Guardian Sensor 3 sensors are approved to be worn in both the abdomen and the back of the upper arm. In addition, your infusion sets can be worn in several locations. Check out our website here: http://bit.ly/NNGWDe

Submitted by Josette West (not verified) on

In reply to by Commenter (not verified)

Hi I’m new to all of this sensors and infusions it was great that I came to see this I always used my stomach for both right side and left side I didn’t realize that I could use the back of my arm but I do have a question if I put my infusion in my arm how would I disconnect to shower therefore that is why I have been using my stomach not to sure about my thighs I will give it a try again thank u for sharing

Submitted by Karrie Hawbaker (not verified) on

In reply to by Josette West (not verified)

Josette, I'm sorry for the delay in replying. As long as you are able to reach your infusion set site, you can still disconnect using the quick release; Some customers find using a mirror helpful both when inserting and disconnecting. If you have any other questions or would like to discuss this in more detail, please give our 24-Hour Technical Support team a call at 800.646.4633, option 1.

I try to use my arm doesn't always stay in. Do I need additional tape possibly? Is there a spot on arm that may be better than another spot. Any suggestions would be wonderful.

Great question, Michelle. Guardian Sensor 3 sensors have been approved for use in both the upper arm and belly areas, depending on your preference and additional tape is typically not required. I recommend reaching out to our 24-Technical Support team at 800.646.4633, option 1 to discuss this in more detail.

Submitted by Pam Comorski (not verified) on

In reply to by Commenter (not verified)

Was a pumper since 1996. 58 year old female . I just quit the pump last night. My problems where for last four years of bad sites not getting good delivery . I have had major surgery of my bowels due to a botched endometriosis surgery in 2001 where they burned through my intestines so I have a lot of scar tissue in my abdomen. but still remained on my pump. My A 1 c has been 9.4 last two times .Ive tried my pump on arms ,legs they always rip off .I'm also allergic to the glue on the silhouettes always have to use a barrier swab cause bad burns to my skin this has started in last ten years ,so placing my silhouettes out of site is a problem because I'm unable to see where I put the barrier.So I always use my abdomen the most.My hips have stretch marks (never been over weight 128 Lbs) . So they have never worked there ether. So I told my Dr. I'm done with it give it all a rest. Not sure if going to Pen needles will work but now I can use my calves and can reach my buttocks , no barrier needed / Readings were still 200-300 today sucks all way around

Submitted by Karrie Hawbaker (not verified) on

In reply to by Pam Comorski (not verified)

Pam, I'm sorry to hear this, but I am glad to hear you have found a solution that works for you. You might find our blog post on "lumps and bumps" helpful, you can find it here http://bit.ly/1BAqUhN. If anything changes or if we can do anything for you in the future, please let us know.

Submitted by Roger Tolley (not verified) on

In reply to by Commenter (not verified)

Can the enlite sensor be worn in the arm? I have trouble getting the sensor to stay in when I wear it in my abdomen in the summer because I sweat a lot. I use skintac in addition to the clear slotted tape things that comes with the sensors and also XXXXXXX tape because it breathes really well. Usually get three days before it comes loose and comes out of my abdomen. I’m gonna go back to using mastisol adhesive because I believe it does last longer. Wintertime I don’t have any problem it will stay intact the full six days.

Submitted by Nicole (not verified) on

In reply to by Roger Tolley (not verified)

Hi, Roger. The Enlite sensor is not approved for use in the arm. I encourage you to speak with your healthcare team about your concerns, as they can make the best recommendations, based on your individual needs.

Submitted by Roger Tolley (not verified) on

In reply to by Nicole (not verified)

Thanks a lot for looking into this for me. I would like to know if the guardian gcm sensor is compatible for use with the 630G pump. Your response will be greatly appreciated

Submitted by Nicole (not verified) on

In reply to by Roger Tolley (not verified)

Hi, Roger. Yes, our Guardian Link 3 and Guardian Sensor 3 sensors are both approved for use with our MiniMed 630G system.

Submitted by Jennifer Biggs (not verified) on

In reply to by Commenter (not verified)

So why is the sensor recommended to only go in the abdomen area, but the infusion sets are recommended for multiple areas. I think the opposite would be better. With the amount of times you have to disconnect and reconnect your sites for showers etc., it is a pain to do that in some of those locations especially if they are behind. Plus trying to deal with your tubing in some of those areas is not easy. The sensor on the other hand is inserted and can be left in for up to 7 days (depending on the senor) with very little interaction. Just wondering if the CGM results are not as accurate if they are not in the abdomen area?


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