My son's pump site fails after one day, Can switching from Humalog to Apidra help?

Does anyone have their small child on Apidra? I heard it can extend the number of days your site works for.

Any other tips?

It has been 5 months since starting the pump and it seems to really matter where I stick his site in. Bottom won't absorb any more insulin, back of the leg is almost used up . Going to the front of the leg now.

I am tired.

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Replies to This Discussion

Hi Melissa, we just switched from NovaRapid to Humalog, have your tried NovaRapid?? We are getting less time out of sites with Humalog, but he is sensitive to NovaRapid, so we switched. It is worth a try.
my 6 year old uses novorapid in his pump and we are able to get 3 days. Have you considered trying a different infusion set? We had tried the orbit micro (steel set) and it didn't even last for 24 hours. but with the quicksets we get 3 days. maybe a different type of set will suit him better?
I was on Orbit Micros for and you are right. I got one day out of it. I have tried Cleos, Rapid D and now I am on Inset IIs.

Quicksets don't come with the Animas ping. I am pretty sure it has to do with how much insulin his body can take in a certain spot.
lol, i also tried the cleo. that one fell off after 3 hours, just didn't stick and i didn't think it was worth trying the other sample. the quicket is the 90* insertion 6mm, animas would have an equivalent. we also tried the silhouettes (angled insertion) but Ezekiel didn't like them. the quicksets are mostly good, but sometimes they don't want to reconnect properly after disconnecting and this has caused us to lose a few sites (which is why we were trying different ones). if we use anything other than minimed sets, we need to use a luer lock resevoir, which one company makes to fit the paradigm pump.
we were told at our pump training that young children usually only get 2 days from a set then their numbers will go up so we were told just to change every 2 days. once (early on) I forgot and his numbers were fine so we have always done 3 days with no problem. however when i asked why this was they said then THINK it might be something to do with the body trying to heal itself where the site is and starting to heal over the cannuala (or something like that).
it probably couldn't hurt to try the novorapid. I have heard (but don't really know) that apidra isn't approved/recommended for children in canada (I think that is what i had heard i am not too familiar with apidra)
I agree, the Cleo did not stick. I used "coloplast" (skin prep) to make it stick but then when it was time to take it off, it ripped his arm hair off. Not even "remove" would dislodge it.

My poor poor 4 yr old. What a lot to have to go through.

I am pretty sure I have solved the kinking problem of the Inset IIs by putting it in the freezer for 10-30 min before insertion. Well, I am going to poke him right now and if his numbers are awful after correcting an hour ago, I guess I will change his site.
The Animas equivelent of the Quickset is the Inset II, which is available in both 6mm and 9mm and with varying tube lengths.

Perhaps a teflon cannula instead of the stainless steel one in the Orbit Micro might make a difference?
We are currently using the Inset II 90 degree 6mm teflon cannula equivalent to the quicksets. We are getting a full day and a half out of it.
We have used 20 of them. (4 weeks or so). I am really tired of not having consistent numbers. Does everyone have two programs in the pump for day one and day two of the site?
The first day all of his basals are 40% lower than the second day and somewhere after a few correction boluses, we finally change the site during the second day.
Have you considered trying an angled set? Personally I've had much better luck with the Inset 30's than I have the Inset II's. At present I'm having great success with the Inset 30 13mm set.

13mm sounds like a lot, but in actuality its not that deep that it goes because of the angle of insertion. I also find that with the angled set it doesn't move around as much, and I'm less likely to push it deeper into the skin.

During my trials with the Inset II 6mm I found myself accidentally pressing it further into the skin which ended up make it very uncomfortable, and needing to change my sites more frequently. They always ended up itchy and red - no longer the case with the angled sets.
Hmm.

I am noticing that the Inset II are lasting longer on the front of the leg than the back. Perhaps it is being wiggled too much?

I tried a inset I on Payton once. It went in at 45 degrees, it was the very first set he had in him. My hand was shaking. Payton was screaming. Not good. I never went back. Perhaps it is time to try again.

The only drawback to it is trying to get the angle right when my kid is skin and bones. Chubby bottom and thats it. There is no real estate and I hear that for every two angles sets, you can get three 90s in, in the same space. Well, I guess the only thing that matters is site failure at this point.

I have one or two 30s. Maybe I will try it before I switch insulins.

Uggh
If I recall correctly, the Inset I didn't have the serter did it? I find that for the angled sets the serter helps out a lot. If you have an Inset 30 there, when you open it you'll see that it was two "feet" - just make sure these are flush with the skin and it takes care of the angle of insertion.

As far as real estate goes, as long as you're leaving about 2" in between each needle mark you're safe. Remember with the angled sets you can change the angle in which the needle goes into the skin - so you can always try to point it towards a meatier area if needed. The other thing I try to do is line the tubing up with the direction of where the pump is going to be - that way it minimizes the amount of stress put on the site itself.

What you're saying with the legs could very well be a factor in how long the infusion sets are lasting. On the back of the leg there is usually a fair amount of movement and the more you move a set, the more irritated it becomes.

What about the back of his arms, or lower back? Typically I've seen these sites work well on young children. (By lower back, I mean the "love handles" area.)

Best of luck! Hope my two cents helps you out a bit. :)
I WISH my kid had love handles. I can't wait for him to get some fat. The child is a perpetual motion machine and there is 0 fat on his back or stomach.

Arms will work. Last time I tried them was OCT and he had weird little insulin blisters under the Orbit Micros. I think it was just the Set though, or those recalled Triad wipes, who knows.

Well, the front of the leg lasted for 30 hours then he started going high. It is very predictable, I think I have figured out two different basal rates for the two days.

I think it will work. I will try the arms again too before I switch insulins.

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