Trying a new infusion set site location

infusion set site locations

I look forward to my endocrinologist appointments because it's an opportunity for me to get the most out of my diabetes management. Take my last appointment, for example, where we discussed trying an infusion set in a new place for the very first time. While discussing this, my doctor recommended testing my blood glucose more frequently to make sure that I know whether or not the insulin absorption is the same for my new infusion set site location compared to my previous site locations. 

For some background, in almost 11 years on a MiniMedTM insulin pump, I've used four different infusion sets with a variation of tubing lengths. I've always practiced the habit of rotating and alternating infusion sets. Today I might wear my site on the right side of my belly, but in two days I'd plan to move it to the left side or down to my thigh. But the one approved location that I've never worn used is the back of my arm. How would it feel? What do you do with the tubing? It never seemed to make sense to me. 

So when my doctor and I discussed using the back of my arm for the first time it made me a little nervous. But after all of these years my site rotations are that much more important and it's time to find new areas of skin, so I went home to try it with my Mio infusion set. I stood in front of the mirror, twisted around, and placed the serter on my skin. I then took a deep breath and whispered a word of encouragement to myself before I inserted it. "Phew, that wasn't so bad." (Note: this is one of the site locations where it actually might be a good idea to get help from a loved one depending on your flexibility and dexterity.) 

Although this transition hasn't been perfect, now I've worn it in my arm eight times and each time it's gotten easier as I continue to learn what works best for me. Through this experience with a brand new site location, here are some things that I've noticed.

  • The insertion feels different and is almost as comfortable as when I insert on my stomach but I think in time I will get used to it. One time, the insertion was noticeably uncomfortable, so I pulled it out and tried another one because I thought I may have hit some muscle or inserted it incorrectly so that's something that I am now more aware of.
     
  • Since I'm right handed I find that it's much easier when I wear it on my left arm. It is a little more awkward to disconnect the site, so that's something I've been practicing.
     
  • The tubing length really matters in this case since the tubing now has to reach from my arm, around my shoulder, and down to my pocket where I typically clip my pump. I own boxes of infusions sets with different tubing lengths so I make sure to use the longest option (for my set its 32") when I choose the back of my arm as a site.
     
  • Since the set isn't in my line of sight it can be harder to tell if the cannula gets bent with an insertion, the edges of the adhesive are peeling up, or if there happens to be blood at the site, so I know it's important to take glances in a mirror to make sure everything looks ok. But I think my favorite part about this new site location outweighs this as it gives the rest of my body some time to heal.
     
  • I also don't mind that my pink infusion set now peeks out of my short sleeves!

No matter how long it's been since you were first trained on a pump, it's important to know that there are options. If you find that an infusion set that has worked for you but your body is going through changes, then talk to your doctor about trying a different cannula length or type of infusion set. If the tubing you use today doesn't work in a specific season of your life with a sports uniform or prom dress because it's too short or long, then talk to the Supply Order Team about trying a box of another length in your next shipment. Like me, you might be pleased when you push yourself to try something new! So tell me, what infusion set do you wear and where do you wear it? 

Editors note: See image above for the best body areas for infusion set insertion or in your user guide. Visit our website to learn more about infusion set site locations.

 

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. For more information, please visit MedtronicDiabetes.com/isi.

 

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Submitted by June S. (not verified) on

In reply to by Commenter (not verified)

From what I can tell, I am out of options - except for the Silhouette, which I insert manually (since I'm slender.) I have tried the Sure-T in my arm, and had a terrible time with it - my BG's rose precipitously after every insertion. I believe I may have an allergy to stainless steel under the skin. Medtronic - have you ever thought of creating a Sure-T-like infusion set made out of plastic? I'd love to be able to wear an infusion set in my arm, and there's no way I could ever manually insert a Silhouette there by myself!

Submitted by naomi.kingery@… on

In reply to by June S. (not verified)

Hi June, I’m sorry to hear you’ve had problems trying different infusion sets. I’ll have a team member reach out to you directly to see if see if there is any way we can help and answer any other questions you may have.

Submitted by Sara Tilleskjor (not verified) on

In reply to by Commenter (not verified)

Hi Stevie. Yes, Naomi discusses using the Mio. The Mio infusion set is an all-in-one design that combines the infusion set and insertion device into one unit. Please let me know if you'd like me to connect you with someone from my team to find out more information. You may also find this link helpful: http://www.medtronicdiabetes.com/treatment-and-products/infusion-sets.

LP, I am sorry to hear you're experiencing issues keeping your infusion set attached. I will connect you with someone from my team to try and help.

Tim, happy to hear that you are enjoying the Mio and it is working well for you!

Hi Peg and Brittney. We recommend changing your infusion set every 2 to 3 days to keep your sites healthy and allow for proper insulin absorption. You can learn more here about the approved locations: http://www.medtronicdiabetes.com/customer-support/insertion-site-manage…. For the Enlite sensor, which is approved for use with the MiniMed 530G, we recommend the tummy area for sensor site location. I encourage you to speak with your healthcare team to determine the sites that will work best for you. If you are interested in discussing this further, please let me know and I will have a member of my team contact you.

Cassie, I am sorry to hear you are having issues with your infusion sets staying on. I could imagine this is frustrating. There are a variety of environmental factors such as seasonal climates, skin lotions, or different clothing that may affect the tape adhesion or the way your body reacts to it. You may find this link on key taping methods helpful: http://www.medtronicdiabetes.com/customer-support/insertion-site-manage…. Please let me know if there's anything else I can help you with, or if you'd like me to connect you with someone from my team to try and help.

Submitted by Kerri (not verified) on

In reply to by Commenter (not verified)

When I refill my sets how do I get different size lines? Also I wanted to know about the all in one infusion set and how to get that, thank you.

Submitted by naomi.kingery@… on

In reply to by Kerri (not verified)

Kerri - Thanks for the question. I'll have some from my team contact you to discuss options with you.

Submitted by Gina (not verified) on

In reply to by Commenter (not verified)

I have lost about 35 pounds in the past six months. I am having a problem getting my infusion set cannula to work properly. The tip end sometimes bends and keeps the insulin from flowing. I don't know if it's because there is less fat to insert into or what.. It usually takes two or three tries to get a good insertion. Any suggestions??

Submitted by Jennifer (not verified) on

In reply to by Commenter (not verified)

I have had problems with the Sure T infusion set this summer. I just started using it earlier this year, but have noticed that my blood sugars run higher when I use this infusion set. Where I live, the summers are quite hot (normal daytime temperature is 95-100 degrees). The month of August is particularly awful. From my experience, the Sure T may not be a good choice for warm weather climates because of it's design. There is a 3-4 inch length of tubing between the metal needle and the connection point where it hooks into the main tubing, which is also stuck to my body with adhesive. Even if I use a pump "cooler" when I am outside, this 3-4 inch length of tubing is stuck to my body and there is no easy way to keep it cool. The insulin is exposed to the 95-100 degree weather and seems to be rendered useless, which results in a lot of high blood sugars unless I change out the entire set with new insulin. If I want good blood sugars wearing the Sure T in hot weather, I would have to change the set every single day. It's been a very frustrating summer. Has anyone else had this problem?

Submitted by naomi.kingery@… on

In reply to by Jennifer (not verified)

Jennifer, thanks so much for the feedback. I'd like to connect you with someone from my team to try to offer you some suggestions as I'm sorry that you've experienced these issues during warmer weather with your infusion sets. Someone will reach out soon!

Submitted by NORA FRANCO (not verified) on

In reply to by Commenter (not verified)

gracias por sus informes por esa ayuda constante , por preocuparce por todos los que sufren la diabetes .
bendiciones

Submitted by carolyn klingensmith (not verified) on

In reply to by Commenter (not verified)

I usually insert my cannula in my back.. I lift people all day and found that the cannula pulled out at times and sometimes hurt when holding people close while lifting. . anybody else out there use their back as an insertion site ???

Submitted by naomi.kingery@… on

In reply to by carolyn klingensmith (not verified)

Hi Carolyn, I’m sorry to hear you have this problem. I’ll have someone from our HelpLine Team reach out to you to see if there is anything we can do to help. In the meantime, you can find more information on insertion site management here - http://www.medtronicdiabetes.com/customer-support/insertion-site-manage…

Submitted by stevie (not verified) on

In reply to by Commenter (not verified)

I would also like to know about the all in one sets. Is that Mio? Thanks!

Submitted by Tim (not verified) on

In reply to by Commenter (not verified)

Love the MIO all in one! I've been using mio for about 2 years, I got away from the standard inserter because of the cannula bending...with mio you get a fresh serter with every change..never had one crimp again! These sets are also very comfortable and absolutely painless...

Submitted by peg (not verified) on

In reply to by Commenter (not verified)

I am using the new 530 pump with the gym. The book says to only use sites on your stomach. Can I use alternative sites with the new system?

Submitted by Brittney (not verified) on

In reply to by Commenter (not verified)

I usually use my stomach but after I had my son I get bad sites much more frequently. I would like to look into using my thighs but they are very muscular and I'm not sure how that would work.

Submitted by Cassie Olerie (not verified) on

In reply to by Commenter (not verified)

I'm having issues with the infusion sets coming off. I waste so many because they don't stay attached. It's frustrating and expensive. I've started using paper tape to keep them attached. I'm not sure what to do about it.

Submitted by keith mcglaughlin (not verified) on

In reply to by Cassie Olerie (not verified)

i use the 3M T3gaderm Film 1624W it is 2 1/8 by 2 1/4 inches it keeps the infusion set in place i move computer equipment daily and have no issues since i started using the film it evens holds when I sweat in hot weather.

Submitted by naomi.kingery@… on

In reply to by keith mcglaughlin (not verified)

Thanks for sharing your tips with us, Keith. I’m glad you’ve found what works for you!

Submitted by LP (not verified) on

In reply to by Commenter (not verified)

Having trouble keeping Silhoutte attached also. What is this MIO? Having trouble with Mini-Med. Having high BG a lot then having extreme lows. Type-1 diabetic for 42 yrs and having lots of problems! Please help!

Submitted by Brian (not verified) on

In reply to by Commenter (not verified)

Even with the needle left in place do you find it uncomfortable while bending and twisting? I currently use the sure-t and only placed it in my abdominal cavity since I am a slender guy I feel that is the most comfortable even though it is painful at times on insertion. The reason for my question is that being active do you find it uncomfortable other then your abdominal cavity?

Submitted by naomi.kingery@… on

In reply to by Brian (not verified)

Hi Brian. I recommend working with your healthcare team to determine an infusion set site that will work best for you. We do offer 4 types of infusion sets with over 20 different configurations to match your specific needs. Based on lifestyle changes, your body type, and fluctuations in individual needs, your healthcare team might recommend looking into other infusion sets. Please let me know if you’d like to talk to someone to find out more, and I’ll have a member of my team reach out to you.

Submitted by Dee Meloche (not verified) on

In reply to by Commenter (not verified)

How was your sensitivity with using your arm? I am looking for a spot that will make my insulin work better.

Submitted by Jennifer (not verified) on

In reply to by Commenter (not verified)

Hello, I have been having issues with finding infusion sites. I have used my arms and it was working really well. I have tried the love handles, stomach, legs, nothing seems to be working at all. Then when I think I got it and it starts to work. Then all of a sudden it stops. I have stoped using the pump for a little bit and used pens. They worked at first then stoped. So now I am back to my pump. It just seems like a battle with everything. Is there something I can do to make this pump to work for me?

Submitted by Nicole (not verified) on

In reply to by Jennifer (not verified)

I'm sorry to hear this, Jennifer. You may find this article helpful regarding your sites: https://bit.ly/2yuiqnE Of course, our 24-Hour Technical Support team is always here to help with tips and can be reached at 800.646.4633 option #1.

hello,i am out of options on where to put it my tummy is swollen so i got told not to put it on there and i keep pulling it of on my arms and legs im unsure where else i can put it.also my bloods are high a lot as the insulin is working slower as i put it in the same place.please can i have some advice.

Poppy, infusion sets can be inserted in several locations. In addition to your abdomen, you can use the back of your arms, your thighs, and lower back. Check out our website here http://bit.ly/2KHKjfa for more information.

I've been using the Quick Set infusion sets since I began wearing a pump in 2017. Initially, all was well. Then I began to notice occasional bent cannulas when I removed a set. These coincided wth stretches when my blood glucose levels responded sluggishly to insulin boluses, or required more insulin to budge. Because this wasn't a regular occurance, I didn't make the connection immediately. I thought maybe I was coming down with a bug, or had eaten more carbs than I realized. Maybe my desk job was keeping me from getting enough exercise. Or the steroids I took when my asthma flared were to blame. I scrutinized my insertion technique and re-read the User Guide. I began adding extra tape to secure the sets. But, the problem has continued and become more frequent. I just removed my fourth infusion set with a bent cannula in a row.
Yes, I have talked with Medtronic Customer Support numerous times. But I stopped calling them because I just don't have the time (or patience) for the lengthy calls. I'm sure there is a script that the agent must follow- What exactly were my blood sugar readings and when did they occur. Was the cannula bent once, or twice like a "Z." What is my weight. Would I please check to see if I kept the packaging with the lot #? Would I mind being placed on a brief hold? Replacement infusion sets were sent out and I returned the bent ones. I requested and was sent a new inserter.
Today, browsing through this Loop blog, I finally read other mentions of bent cannulas. So it's not just me! Nowhere have I been able to find written information addressing this problem. Can anyone out there who has knowledge about this help??

Hi, Christy. We are sorry that this has been your experience. You already mentioned contacting our Customer Support team, but have you had the opportunity to try out other infusion set options? If not, we would recommend talking to your healthcare provider about other options that might work better for you. Thanks!


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