Infusion set leaking every day?

[cpitchford]

I moved onto an Insight pump just over a year ago and I've not had a consistently good experience with the insight flex cannula. So far I've tried 6, 8 and now I'm on 10mm cannula kits and, the last two weeks the 10mm sets have been leaking 24-36 hours after fitting.

Since last Thursday, they've been leaking every day and I'm not sure what's changed or why its happening.

I've change boxes, in case it was a bad batch
I've reduced the delivery speed to the slowest on the pump
I've swapped sides (every time I fit a new cannula) and changed height (always on my stomach / 1-4" from belly button, side to side)
I always use the link assist to fit the cannula and I always stand to fit them

The problem I'm facing is partial dosages. Today, for example, I had pasta at work for lunch. I have to keep checking my cannula sticker every couple of seconds to see if it starts to get damp (or if I notice the smell of insulin) Then its a rush to stop the pump (why no pause feature?) then I've no idea how much of a dose I've been given.

To err on the side of caution and assume most of the dose will mean I jump to 24 gradually over the next hour. Then I'll require a large correction bolus... and then there's a good chance it'll leak (or rather the correction dose will take, but the next bolus hours later will leak)

To assume a complete lost dose means I'll go low and I have to test throughout the next few hours to ensure I don't end up hypo. Today, I re-took the full dose and ended up 1.8 a few hours later so maybe this time most got through.

I've only been using the pump for 12 months but its not been as bad as it has this last two weeks. I was told to change it every 3 days (and I have set an alarm on the pump to record this... also, why is there no "record cannula change" on the pump/meter?) but looking back over the year I've used 146 cannulas which makes it about 1 changed every 2.6 days

I'm wondering if anyone has any suggestions for changes I could try? This leakiness is pushing me towards moving back to pens (or pens for bolus dosages / pump for basal), its just too unreliable

I've followed youtube clips for fitting cannula and can find no difference in my technique.

I'm reluctant to move to legs / back as I can't reach the cannula sticker through my shirt to test for leaks (I can reach between button holes to feel for dampness if its on my front but it means a trip to the loo otherwise I guess) but I'm willing to try if people have found that more reliable.

 

[iHs]

Hi

Hopefully some Insight users will post but in the meantime have you asked Accuchek to send you another Link Assist only it might be the spring mechanism in the device that is not firing correctly? Also, are you sure that the tube clip to the set is attached firmly? Lastly, if you cannot get to the bottom of what is causing the leakage, send an email to Accuchek head office stating the problem and cc your DSN. That way a rep will respond and meet with you and yr DSN and go over yr technique and try to work out what is going wrong. It might be yr technique but it might also be that you might need to use a 30 degree angle Tenderlink set or maybe a steel needle set.

 

[philchap1]

Hi, been on the insight since August,8mm cannulas and apart from a few problems with absorption ( in a muscle ) haven't had any leaks, change cannula every 3 days, Accu Chek have a 24 hour helpline give them a call and see if they can help, all the best.

 

[Gaz-M]

Hi I've only been using the insight for just over 3 weeks no not had a leak, as for stopping the pump when you restart it (from what I've read) it delivers the insulin that you should have had, so basically it is in pause mode.

I would call them and request another link assist plus,

 

[cpitchford]

Hi I've only been using the insight for just over 3 weeks no not had a leak, as for stopping the pump when you restart it (from what I've read) it delivers the insulin that you should have had, so basically it is in pause mode.

I would call them and request another link assist plus,

I have two link assist units. I keep one in my desk drawer at work with a 5 spare cannulas and I've been using both, this one I ordered after I got the pump. The other is the one that came with the pump. I use them both depending on where I am.

Stopping the pump cancels the bolus. it tells you what (it thinks, depending on leakages) it has given you and what it was supposed to deliver.. You need a bit of maths to figure out how much was left. If it stops because it detects a fault or the cart runs out, then it does pause and resume afterwards... but you can't ask the pump to pause itself.. only stop/cancel

It's definitely not a leak at the clip. Some times the leak takes a while to appear (as it soaks through the sticker) and sometimes (rarely) it will be pink/red.

I have in the early days slipped trying to disconnect the hose and twisted the cannula between my thumb/forefinger in a pinching action. That really screws it up and it leaks almost immediately.. hurts too.. However, I always make sure I pinch with one hand and use the forefinger nail on the back of the cannula to keep it firmly in place when connecting/disconnecting the hose.

Thanks to everyone for your replies. I'll give accu-chek a call. I really like the flex design but maybe I might be better on a different type.

Someone suggested it might be the colder weather, being out in the cold. That's an interesting idea.

I'll report back!

 

[CarbsRok]

It sounds to me as if the cannulas not being inserted correctly or something is kinking the tubing. No idea what your body build is but 10mm is quite a size for a 90 degree cannula. Have a very careful look at the end of the cannula and see if it has a pinched together look about it.