I’m all set up on my Loop and am having problems with constant bent cannulas resulting in consistently high BG for 48 hours.
I have been on Omnipods for about 10 years now and have had little to no experience with tethered pumps. I spent the last 2 days on my new (old) Medtronic 723 with abysmal results. Day one I replaced the cannula twice only to find that both were kinked and not delivering any insulin (isn’t the pump supposed to detect occlusions). I replaced the second bent one with a new one today, this time a Quick Set rather than a Mio and a few hours later after a steady increase in glucose values, I tore it out only to find a third bent cannula.
A few observations here:
I’m skinny and using 9mm cannulas, are they too long? Should I try a new area?
I normally wear my pods on the back of my upper arms, whereas I’m applying the Medtronic cannulas to my abdomen and lower back. Is it possible I could have absorption issues in those areas?
I have no experience with these infusion sets (9mm Mio’s and 9mm Quick-Sets [manual insertion]) and probably don’t have the technique down, are there any tips?
I have tested the pump for a few days not connected to me or loop and it appears to work fine.
(I’m not sure that this is the right thread to start with but I couldn’t find one that was more appropriate and didn’t want to start a new one.)
@sanfran I am no expert, but my skinny D-friends use 30-45 degree sets like the comfort short and the Inset 30 with short cannulas. Their explanation is that they do not have enough body fat to place a vertical cannula into, so they use an angled set. I personally have no experience with these sets. Hope it helps.
The problem is QuickSets and Mios. 9mm is way too long, I used 6 when I tried them and still found they kink. Use an angled set such as the Silhouette or Mio 30. OmniPods are angled which is why they worked better for you.
@sanfran I am using an Omnipod now, but I was using a Vibe for 3 years. I am pretty thin and I used 6mm cannulas on my side and back with no problem. I didn’t have one bad site in 3 years. I think that the 9mm cannulas are too long for you.
I found that the cannulas tended to bend more when I placed them on my abdomen. When I placed them on my legs or arms, this rarely happened. I don’t remember what length cannulas I used, but they were quickset. You might want to try different locations to see which ones work better for you.
Also, make sure that you lock the set into the inserter before you press down on the button. For some reason, the pump educator told us to just set it inside the inserter, pull back, then press down on the buttons to insert it. It is possible to actually secure the set inside the inserter, and you will have better results if you do.
When you say manual insertion, are you saying that you’re not using an inserter? It is absolutely required to use an inserter with the Quicksets. You cannot insert the set fast enough without doing so. That may be the crux of the problem here.
Here is a video showing insertion with an inserter: https://www.youtube.com/watch?v=Fi5beQrLi-k
I’m probably using the wrong word for the little gadget, but you’ll see what I mean.
Are you using the QuickSets and Mios? I’ve heard from many people that absorption with these is iffy.
We have our son on the metal needles; we rarely have problems with bent needles and absorption problems. So you might try out the Sure-Ts-- they are more comfortable for him as well.
@TiaG, I’ve tried both Quick-Sets and Mio’s but they’re likely too long for my body type. I’m now going to try and get hold of some Sure-T’s and Silhouettes.
The blue one is the older model (MMT-395), and the green one is the new version (MMT-305QS). You can use either one with quicksets. There are small differences that Medtronic thinks make the new one better, but I actually prefer the old blue one. You can search for “Quick-serter” and find, for instance, that adwdiabetes.com sells the green one for $29. I’ve had no problems with that vendor.
It actually is possible to insert a quickset without the inserter. Face the palm of your hand towards you, make a Vulcan salute, squeeze the blue tab of the set between your middle finger and ring finger so that the needle faces you and the set is flat against your palm, then rotate your hand to point the needle at the desired spot from about 6" away, and quickly SLAP! the needle in. Hold the set in while withdrawing the blue tab / needle.
It is much easier to use the inserter, but in a pinch you can get by without one.
I’d recommend 6mm rather than 9mm. With the 6mm I’ve only had 2 bent cannulas (out of a few hundreds) and both were the result of pulling the set partially out and then pushing it back in while removing the inserter needle.
With a bent cannula the pump should detect the back pressure and alarm “no delivery” for the occlusion, but it takes several units of insulin to build up enough pressure to trigger the alarm. At a low basal rate, you can go hours without insulin delivery before the pump detects it, especially if you are using a long tube.
I use 6mm quicksets on my sides and back, but my BMI is 25 so I do have enough of a fat layer. Absorption issues don’t cause bent cannulas. Insertion into bone or connective tissue can cause bent cannulas.
If you don’t have a 1/4" fat layer where you want to insert a set, you would do better with the angled-insertion set (the Silhouette.) That one doesn’t need an inserter.
I want to thank everybody for being so useful to me with their information on infusion sets. Yesterday I was able to get 3 Sure-T 6mm sets from @TiaG who is local and I am truly grateful for her generosity. I have now had the set running on my Looped Medtronic 723 for a day and I have to say, it’s truly amazing and incredibly comfortable. A few more people have been kind enough to send me various other options which I will try soon and I have managed to get my doctor to write me a prescription for future sets.
Thank you to everybody on the forum who contributed to this thread and helped me solve my issue in record time!
Seems you may have solved your problem. I too dealt with too many kinked canulas until I moved to 6mm from 9mm. Huge difference even in areas where I’m well padded. Best of luck.
i am super skinny and use the Medtronic 13mm cannula Sillouette Paradgm set. i pinch up what little flesh i have and push it in manually on a 25 degree angle. i have only rarely had bent cannulas. (i dont have enough meat on my bones to do it on any other angle) i could probably use a shorter cannula, but this one works well for me and i have relatively no scaring issues, but i rotate a lot, and i use the same location sites that you mentioned you use yourself.
also, when using this angle, it doesnt hurt as much as it use to on the 45 degree angle.
