Pumping Advice
Lately I've been having major issues with my Medtronic Minimed pump. It seems that more times than not, the cannula that goes into my stomach will bend or kink resulting in me not getting the insulin I need. Before, the rare event would cause my pump to give me a "No Delivery" warning, so I would know to change my infusion set right away. Now, it doesn't give me a warning, so I go about my day, eating what I normally eat, only to start feeling sick a couple hours later because of a blood sugar of 350+.
I'm getting very frustrated for many reasons:
1. The pump is supposed to be convenient and supposed to give you better control of your blood sugar. Since my cannulas are kinking and my pump is not giving me a warning, my blood sugar control is worse now than it was before going on the pump. It's also become an inconvenience since I get so sick from high blood sugars that I've been having to leave work early, waste tubes, call Medtronic, etc...
2. I work very hard to eat healthy and eat the right foods for my blood sugar control, but when this happens, I feel like there's no point in trying so hard when my pump and it's supplies malfunction and I have high blood sugars anyway.
3. These supplies are not cheap! I've wasted so many in the past month because of this problem...
On Friday, I had to change my infusion set 4 times because of it bending and kinking and spent all night and early morning fighting highs. I've called Medtronic and according to them, I'm doing everything right in the way I insert it, so I don't know what else to do.
I'm looking for advice, options... anything. Would you suggest a different pump? Should I go back to giving myself shots? What would you do? Have you had a similar experience? HELP!!
I'm getting very frustrated for many reasons:
1. The pump is supposed to be convenient and supposed to give you better control of your blood sugar. Since my cannulas are kinking and my pump is not giving me a warning, my blood sugar control is worse now than it was before going on the pump. It's also become an inconvenience since I get so sick from high blood sugars that I've been having to leave work early, waste tubes, call Medtronic, etc...
2. I work very hard to eat healthy and eat the right foods for my blood sugar control, but when this happens, I feel like there's no point in trying so hard when my pump and it's supplies malfunction and I have high blood sugars anyway.
3. These supplies are not cheap! I've wasted so many in the past month because of this problem...
On Friday, I had to change my infusion set 4 times because of it bending and kinking and spent all night and early morning fighting highs. I've called Medtronic and according to them, I'm doing everything right in the way I insert it, so I don't know what else to do.
I'm looking for advice, options... anything. Would you suggest a different pump? Should I go back to giving myself shots? What would you do? Have you had a similar experience? HELP!!
Replies to This Discussion
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Permalink Reply by Scott E on -
I, too, think that scar tissue could be the issue. Do you feel hard spots on your abdomen, or wherever you use the infusion sets (I know I do!). Where, and how often, do you rotate sites? I find that when the site starts to become a bit irritating, the insulin doesn't absorb as well. I don't get No Delivery alarms (rarely do) because the insulin is getting into my body, it's just pooling up in the same spot.
The other question I have is whether or not you use an insertion device. Sometimes the spring on those things can weaken, and the infusion set doesn't go in all the way. I've heard more about that with the CGM sensors, but I see no reason it wouldn't affect the infusion sets as well.
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Permalink Reply by Amanda on -
i had the same problem when i started the pump and i was told that i didn't have enough fat on top of my muscle in my stomach area and that the cannula was kinking because it was hitting muscle. i was told to try my love handle area and that made a HUGE difference...it doesn't hurt and i haven't had a single problem since then!!
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Permalink Reply by Terry on -
I agree with others that your problems may stem from more than one source. Scar tissue may interrupt insulin absorption even if the cannula is not bent. I had a problem with the 90 degree teflon cannulas bending just below the skin. I switched to an infusion set that inserts at a 30 degree angle and most of that problem went away. I realize that a 30 degree teflon cannula set may not be available for the MM pump -- I use an Animas. It sounds like one solution worth checking out is the metal cannula sets. That would definitely rule out the bent cannula source of your problem.
It took me a long time to go through all the troubleshooting to figure out what would work for me. I know it's frustrating, especially since you look after your diabetic regimen so carefully. I still think trying to stay on the pump long term is your best option going forward. The pump's ability to deliver a customized basal profile cannot be duplicated with a long acting insulin like Lantus or Levemir.
Good luck and don't get too discouraged. It's worth the effort to get this problem solved!
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Permalink Reply by Korrie on -
I also have trouble w/quicksets. I like them as I have tried all the other sets MM has available. I use 6mm (began w/9, switched about 8 mo to 1 yr ago to the 6mm). I have learned NOT to apply skin prep/skin tac before I insert. (I use to, but seems to cause more bent cannulas now than before inserting through the skin tac). So I clean site, make sure area dry, insert, then use the skin tac pad to soak the tape of the quickset AFTER I have primed and unclipped. Make sure it drys before reclipping all back together.
I do not use my stomach for insulin delivery, only area I can use easily for CGMS. That being said, do you rotate to legs and buttocks? If not, scar tissue sure could begin to be a problem. If you do rotate to different body locations and only have trouble with belly insertions, I would tend to hazard a guess it could be scar tissue. You might want to try other sites to see if you have similar problems.
Also I will try to do a site change when I can bolus a "large" amount of insulin in immediately - either because I eat or because I am having to correct a high. Especially if I bolus and eat after a site change, I can determine within usually 2 to 3 hours if the site is good or bad - and correct immediately, hopefully preventing sugars getting above the 250 threshold.
Oh - something else I will do - with the quickset, after insertion and a "large" (like 1 to 1.5 units give or take) bolus, I wait for bolus to clear, give it about 30 sec or so, unclip and take a tissue (like a kleenex) and press it on top of the quickset. If the tissue absorbs a lot of insulin, it's probably a bad site as it kinked and the insulin is just going out around where the tubing connects to the site instead of in the cannula - so check sugars but expect a problem! If there is just a "spot" of insulin on the tissue it's probably ok. No insulin on the tissue is best of course!
Good luck, I hope you can find a solution. Make sure you continue to report the problem ones to MM and request replacements. You are right - they are expensive!
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Permalink Reply by Laura S. on
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I tossed all the 90 degree sets, and went to angled sets.
Problem was solved instantly, though I nearly gave the stupid pump back because of this issue.
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Permalink Reply by MyBustedPancreas on -
A few things come to mind.
Have you tried different infusion sets? Medtronic makes several and this issue might be specific to the kind of set you're using.
What sites are you using? Are you rotating? I've heard that if an area is overused for both shots and pumping, it can become hard and calloused, thereby increasing the risk of kinking.
If I were you, I'd go back to shots in the meantime, until you can get this figured out.
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Permalink Reply by lizard on -
Thank you, everyone, for your responses! I didn't really realize that there were different infusion set options like angled ones and metal ones. I've been in contact with my doctor, and I'm going to try a couple different infusion sets to see if I can find something that works.
Thank you again!! :)
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Yep, that is the way to go.
If a dear friend and CDE hadnt shown me alternatives I would have thrown the pump out the window! Best wishes!
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Permalink Reply by Donna K on -
I have experienced difficulties with kinked canulas and high sugars as well and have reported this to Minimed on three occasions. I also have never received the "no delivery" error message and only thanks to my multiple testing as well as my CGM have I been able to detect the high sugars. I have had to change settings 3-4 times to clear the problem as well - not cost efficient for certain. Minimed replaced my inserter in my last call to report the problem and have sent me samples of other infusion sets with longer canulas. Using these alternate sets did not elminate the problem. I get very apprehensive every time I complete a set change hoping I will not experience the problem once again. Minimed also offered an explanation of scar tissue to me as well and suggested new sites for the sets as well as alternating araes. From what I am reading hear this is a common complaint - hopefully to be addressed very serious by Minimed. An incident of high sugars not detected could cause very serious complications!
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But for the most part, sets are made for different pump companies and they just call them by a different name.
So it isnt necessarily a MM issue, it's either an infusion set issue or the wrong set for a certain body type.
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Permalink Reply by Claudia Labate on -
Hi Lizard,
I have those problems mentionated too. No delivery warnings, cetoacidoses because of a misswarning, and i get really upset quem it happens.
What i did is too change the cateter with more frequency (2 days or 3), I use the minilink (so I can be more aware of it by night for example), i studied more about the application (believe me, orientarion in my country is very inefficient) and one thing that I though, after reading your message, was if your changing locations. If you put the cateter only on your stomach the skin would be less healthy to receive and best absorve insulin.
Hope everything is going well with you!
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Permalink Reply by Debbie on -
this used to happen to me, I switched to the sure-T infusion set as it doesn't have a cannula, it has a small needle that stays in you and it doesn't bend. I'm very lean and the cannula used to bend when it hit muscle. there is also the silhouette, goes in at an angle for those that are somewhat lean.
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