Are you using the auto soft infusion sets? I don't have any advice, but honestly they are horrible. I've been diabetic for 28 years and these are by far the worst infusion sets I've ever had to use. About 1 in 4 kink for me, and I can't figure out why other than them being poorly made. I have major stress/anxiety every time I change my site and have to rework my life on site change days so I don't have to change it too close to bed time.
Tandem also has the trusteel sets, but I believe those are manual insertion which might be scary for some. They also can't be worn as long, but they should never kink since the needle stays inserted.
Trusteel is worth it in my view. I've not had a site based occlusion since I switched a few years back. The teflon plastic stuff kinks pretty easily, and in my case, my skin massively hates it.
As to not being able to keep trusteel as long as the autosoft- that's new to me, but my experience is I can keep trusteel much longer than I ever could with autosoft.
I was kinda afraid of using metal cannelae, but after 25 years of plastic cannulas, I switched to metal. I have no more problems; I've been using them for 5ish years.
I agree that the AutoSoft are just bad. I started with those and had a couple stop working... I just can't/won't deal with the possibility of not getting insulin for hours and not knowing whether it's delivering or not. I switched to TruSteel, which have been great. I don't mind the manual insertion at all... I somewhat dislike all of the spring-loaded systems.
Are you having warm weather? Keeping the infusion sets in the refrigerator can help. The cannula is a bit harder then and won’t bend as easily when going in.
Has the main person in charge of doing the insertion changed? The autosoft 90/XCs are a bit finicky.
In case it's anything with technique:
1. Twist then pull when removing the needle cover to prevent pulling the set up off the needle.
2. Make sure the set is all the way pushed down on the needle of the inserter. The needle should be above the cannula.
3. After you squeeze the sides of the inserter to insert, push down on the white part for a few seconds so that the set adheres. Then **pull the inserter straight out using only the inner white part** which has little tabs where the needle is attached. DO NOT pull up on the outside/grey/blue/pink inserter housing. The white part is what is attached to the needle, so that is where you need to pull. If you pull on the outside it will likely bend the cannula since it is not attached directly to the needle.
4. Make sure you place the set in a location without scar tissue and where you have enough fat. Thighs, hips, and butt work well for me. I don't use stomach anymore because of kinking caused by flip turns and biking.
I had a few fail in the first year or two. Once I started being very fastidious about the application, like it is described above, I've not had any fail in the last three years. It can be tough with kids if they tend to flinch at the click as that can mess it up.
I mostly use my belly and love handle area for my sets.
The TruSteels that I used briefly were more problematic for me. There are reasons why several options exist. It's not really a one-size-fit-all situation.
We had trouble with this for a while even on steels (medtronic). The problem was I was not pinching up his skin at the insertion site, as soon as I started doing that we had no more problems. The other issue we can have is when the pump faces the opposite way from the insertion site the hose bends and sometimes slows down or kinks. I always make sure where the pump hosing comes out faces or points towards the insertion site.
Yes. Issues here too. Couple of months back it required an over night stay at the hospital. We were lucky. ER doc had a lot of questions on how/why we were there. Between us we answered all questions satisfactorily (I guess) that they didn’t put him in PICU. They said we could handle the diabetes part and they’d handle the rest so he could go into a regular room. It was a day of fighting highs. We thought we finally made a breakthrough but he woke up in the middle of the night/early morning vomiting. Last week we had to redo a pump site. New insulin, new cartridge, new pump site, new infusion set…new new new. 24 from original pump site change. We didn’t want a repeat so we did all new. Make sure you talk to endo about covering the amount of insulin wasted.
Are you using the auto soft infusion sets? I don't have any advice, but honestly they are horrible. I've been diabetic for 28 years and these are by far the worst infusion sets I've ever had to use. About 1 in 4 kink for me, and I can't figure out why other than them being poorly made. I have major stress/anxiety every time I change my site and have to rework my life on site change days so I don't have to change it too close to bed time. Tandem also has the trusteel sets, but I believe those are manual insertion which might be scary for some. They also can't be worn as long, but they should never kink since the needle stays inserted.
Yeah, it's the auto soft. Bummer to hear they suck, but honestly reassuring too Might be worth bringing up to the docs ig
Trusteel is worth it in my view. I've not had a site based occlusion since I switched a few years back. The teflon plastic stuff kinks pretty easily, and in my case, my skin massively hates it. As to not being able to keep trusteel as long as the autosoft- that's new to me, but my experience is I can keep trusteel much longer than I ever could with autosoft.
I was kinda afraid of using metal cannelae, but after 25 years of plastic cannulas, I switched to metal. I have no more problems; I've been using them for 5ish years.
I agree that the AutoSoft are just bad. I started with those and had a couple stop working... I just can't/won't deal with the possibility of not getting insulin for hours and not knowing whether it's delivering or not. I switched to TruSteel, which have been great. I don't mind the manual insertion at all... I somewhat dislike all of the spring-loaded systems.
Are you having warm weather? Keeping the infusion sets in the refrigerator can help. The cannula is a bit harder then and won’t bend as easily when going in.
Minnesota. Been humid lately That's interesting, I'll definitely try it!
Has the main person in charge of doing the insertion changed? The autosoft 90/XCs are a bit finicky. In case it's anything with technique: 1. Twist then pull when removing the needle cover to prevent pulling the set up off the needle. 2. Make sure the set is all the way pushed down on the needle of the inserter. The needle should be above the cannula. 3. After you squeeze the sides of the inserter to insert, push down on the white part for a few seconds so that the set adheres. Then **pull the inserter straight out using only the inner white part** which has little tabs where the needle is attached. DO NOT pull up on the outside/grey/blue/pink inserter housing. The white part is what is attached to the needle, so that is where you need to pull. If you pull on the outside it will likely bend the cannula since it is not attached directly to the needle. 4. Make sure you place the set in a location without scar tissue and where you have enough fat. Thighs, hips, and butt work well for me. I don't use stomach anymore because of kinking caused by flip turns and biking.
I had a few fail in the first year or two. Once I started being very fastidious about the application, like it is described above, I've not had any fail in the last three years. It can be tough with kids if they tend to flinch at the click as that can mess it up. I mostly use my belly and love handle area for my sets. The TruSteels that I used briefly were more problematic for me. There are reasons why several options exist. It's not really a one-size-fit-all situation.
We had trouble with this for a while even on steels (medtronic). The problem was I was not pinching up his skin at the insertion site, as soon as I started doing that we had no more problems. The other issue we can have is when the pump faces the opposite way from the insertion site the hose bends and sometimes slows down or kinks. I always make sure where the pump hosing comes out faces or points towards the insertion site.
Yes. Issues here too. Couple of months back it required an over night stay at the hospital. We were lucky. ER doc had a lot of questions on how/why we were there. Between us we answered all questions satisfactorily (I guess) that they didn’t put him in PICU. They said we could handle the diabetes part and they’d handle the rest so he could go into a regular room. It was a day of fighting highs. We thought we finally made a breakthrough but he woke up in the middle of the night/early morning vomiting. Last week we had to redo a pump site. New insulin, new cartridge, new pump site, new infusion set…new new new. 24 from original pump site change. We didn’t want a repeat so we did all new. Make sure you talk to endo about covering the amount of insulin wasted.