Insulin pumps

[Inka]

Interesting @Pattidevans I didn’t realise some came in big packs. I always insert mine by hand so don’t need an inserter. One less thing to carry!

Perhaps “fail” is the wrong word? None of my cannulas have broken or blocked, although one or two have become filled with blood so I changed them. It’s more about ‘bad’ sites for me. In those cases, I’d say the cannula had ‘failed’ - ie failed to work properly rather than suffered some internal failure. That’s what I meant by them being ‘the weakest link’. My Dana sets are fabulous but still a bad site can mess things up. If only there was a way to ensure insulin delivery 100%. Pumps will never be perfect for that reason. This only became really apparent to me after some years.

 

[Lily123]

Interesting @Pattidevans I didn’t realise some came in big packs. I always insert mine by hand so don’t need an inserter. One less thing to carry!

Perhaps “fail” is the wrong word? None of my cannulas have broken or blocked, although one or two have become filled with blood so I changed them. It’s more about ‘bad’ sites for me. In those cases, I’d say the cannula had ‘failed’ - ie failed to work properly rather than suffered some internal failure. That’s what I meant by them being ‘the weakest link’. My Dana sets are fabulous but still a bad site can mess things up. If only there was a way to ensure insulin delivery 100%. Pumps will never be perfect for that reason. This only became really apparent to me after some years.

Maybe the way cannulas can go wrong varies depending on the make of the pump?

 

[PattiEvans]

Inka, the combo cannulas I use come in blister packs 7.3cm x 7.3cm x 5cm high.

I agree though, it could be all sorts... I have once taken off a cannula to find the filament bent at 45% half way down it's length. On the other hand a bad site can be a slow fail.... once a cannula fell off in the night (I was in a very hot climate and no aircon, so I guess sweat had something to do with that) and also sometimes insulin goes off. It can be a bit of a guessing game at times. Of course insulin going off can happen with injections as well.

Maybe the way cannulas can go wrong varies depending on the make of the pump?

I don't think you can say that Lily. Most pumps have more than one type of cannula and what suits one person may not suit another though.

 

[Lily123]

Inka, the combo cannulas I use come in blister packs 7.3cm x 7.3cm x 5cm high.

I agree though, it could be all sorts... I have once taken off a cannula to find the filament bent at 45% half way down it's length. On the other hand a bad site can be a slow fail.... once a cannula fell off in the night (I was in a very hot climate and no aircon, so I guess sweat had something to do with that) and also sometimes insulin goes off. It can be a bit of a guessing game at times. Of course insulin going off can happen with injections as well.

I don't think you can say that Lily. Most pumps have more than one type of cannula and what suits one person may not suit another though.

Sorry I have done my research on pumps but not done my research that much on cannulas

 

[Inka]

Maybe the way cannulas can go wrong varies depending on the make of the pump?

No, they’re all very similar, just some are better quality than others. The ones with my Dana pump are excellent.

The fault really is the way cannulas interact with the body. It also depends on a person’s body composition. There are different cannula lengths, different insert angles (some straight in, some angled), some are Teflon, some are steel - but they all have the potentially to ‘fail’ and cause high blood sugar.

I hate having high blood sugar so I try to replace dodgy cannulas earlier rather than later. I’ve used a pump for 18 years. As I said, the weak point is the cannulas as perfect delivery can’t be guaranteed. Therefore the cleverest, smartest, nicest pump still has the potential for a silly little bit of Teflon or steel to mess things up. That’s why they’re ‘the weakest link’ and it’s what will be a big problem when looping becomes more available. The Dana cannulas are the best I’ve had, but even then they’re not infallible. If someone could invent a way to infuse the insulin that was perfect, then that would be amazing because it would make a big difference.

To be clear, cannulas don’t usually ‘fail’ by breaking or malfunctioning. They fail at the intersection with the body.

 

[Inka]

Sorry I have done my research on pumps but not done my research that much on cannulas

The cannulas are critical. Everyone goes on about all the great features of pumps blah blah, but it’s all pointless if the cannulas are poor quality or you have a poor choice of cannula types. Look closely at the range of cannulas for each pump, and Google for issues with them too.

I use different cannula types for different body areas, and that’s not uncommon.

 

[Lily123]

No, they’re all very similar, just some are better quality than others. The ones with my Dana pump are excellent.

The fault really is the way cannulas interact with the body. It also depends on a person’s body composition. There are different cannula lengths, different insert angles (some straight in, some angled), some are Teflon, some are steel - but they all have the potentially to ‘fail’ and cause high blood sugar.

I hate having high blood sugar so I try to replace dodgy cannulas earlier rather than later. I’ve used a pump for 18 years. As I said, the weak point in the cannulas as perfect delivery can’t be guaranteed. Therefore the cleverest, smartest, nicest pump still has the potential for a silly little bit of Teflon or steel to mess things up. That’s why they’re ‘the weakest link’ and it’s what will be a big problem when looping becomes more available. The Dana cannulas are the best I’ve had, but even then they’re not infallible. If someone could invent a way to infuse the insulin that was perfect, then that would be amazing because it would make a big difference.

To be clear, cannulas don’t usually ‘fail’ by breaking or malfunctioning. They fail at the intersection with the body.

So they go wrong through the insulin getting blocked or something like that?

 

[Lily123]

The cannulas are critical. Everyone goes on about all the great features of pumps blah blah, but it’s all pointless if the cannulas are poor quality or you have a poor choice of cannula types. Look closely at the range of cannulas for each pump, and Google for issues with them too.

I use different cannula types for different body areas, and that’s not uncommon.

I will go and research cannulas. Although my parents asked about a pump when I was recently diagnosed and they said I had to good control for a pump but it won’t hurt to ask as it’s been 6 years

 

[Inka]

So they go wrong through the insulin getting blocked or something like that?

They don’t work properly. Occasionally they get blocked, but often it’s to do with the body area they’re in. Absorption might be poor, or the area might get inflamed, etc. You can see that when you randomly get high sugar. Because you have no long-acting basal insulin with a pump, any mess up in the insulin delivery can cause blood sugar to rise quickly. Sometimes the cannula can get slightly bent or kinked and that interferes with delivery too.

 

[Inka]

I will go and research cannulas. Although my parents asked about a pump when I was recently diagnosed and they said I had to good control for a pump but it won’t hurt to ask as it’s been 6 years

It’s always worth re-examining things over the years 🙂 Managing Type 1 is an ongoing process. Things can change, our preferences can change. It’s good to stop and see if you need or want changes🙂

 

[Lily123]

They don’t work properly. Occasionally they get blocked, but often it’s to do with the body area they’re in. Absorption might be poor, or the area might get inflamed, etc. You can see that when you randomly get high sugar. Because you have no long-acting basal insulin with a pump, any mess up in the insulin delivery can cause blood sugar to rise quickly. Sometimes the cannula can get slightly bent or kinked and that interferes with delivery too.

So if you over use the area the cannula is in and that body area could become lumpy and stop the insulin working properly? Like with MDI?

 

[Lily123]

They don’t work properly. Occasionally they get blocked, but often it’s to do with the body area they’re in. Absorption might be poor, or the area might get inflamed, etc. You can see that when you randomly get high sugar. Because you have no long-acting basal insulin with a pump, any mess up in the insulin delivery can cause blood sugar to rise quickly. Sometimes the cannula can get slightly bent or kinked and that interferes with delivery too.

What does the degree bit mean? (Sorry but kinda confused)

 

[Inka]

So if you over use the area the cannula is in and that body area could become lumpy and stop the insulin working properly? Like with MDI?

Similar - sometimes the area has simply become overused (remember the pump cannula sits in the same place for 3 days infusing insulin) but sometimes the way the fat is distributed under the skin causes poor absorption even in an area that’s not been used a lot. As an example, I can hardly use my tummy for cannulas because of the composition of the skin/fat there. The absorption varies a lot and quite randomly too, which is stressful. However, if I use an insulin pen to bolus, I can inject in my tummy and the insulin will work.

It seems some areas are more fussy with cannulas. It can also depend on where your muscles are underneath. I like using my thigh for cannulas and it’s my best place, but others can hardly use their thighs at all, yet they can inject in them.

 

[Inka]

What does the degree bit mean? (Sorry but kinda confused)

No need to apologise 🙂 Which bit did you mean?

 

[Pumper_Sue]

Maybe the way cannulas can go wrong varies depending on the make of the pump?

Very much so, I used to have an Animas pump and a Cozmo before that and never any problems. Medtronic is a different matter though, putting it politely their consumables leave a lot to be desired.

 

[Lily123]

No need to apologise 🙂 Which bit did you mean?

Where it says - 90-degree soft cannula. I’m on the Tandem website looking at the Tslim if thats any help

 

[Pumper_Sue]

So they go wrong through the insulin getting blocked or something like that?

Sometimes they just kink on insertion hence no insulin gets through or sometimes they will come out/off if the stick comes unstuck.

 

[Inka]

Where it says - 90-degree soft cannula. I’m on the Tandem website looking at the Tslim if thats any help

Ah - it means the cannula goes straight in (ie at 90 degrees to your skin). I guess the ‘soft’ bit means it’s Teflon (plastic) rather than steel like a pen needle.

Some cannulas are angled not straight in, and they go in at 30 degrees or 45% degrees.

 

[Lily123]

Ah - it means the cannula goes straight in (ie at 90 degrees to your skin). I guess the ‘soft’ bit means it’s Teflon (plastic) rather than steel like a pen needle.

Some cannulas are angled not straight in, and they go in at 30 degrees or 45% degrees.

Ah, that makes sense

 

[Lily123]

Sometimes they just kink on insertion hence no insulin gets through or sometimes they will come out/off if the stick comes unstuck.

Thanks - the amount of things that could go wrong had started to put me off a bit but then again the positives outweigh the negatives.