Cannual sealing off

[bambee3]

hi has anyone had the experience of cannulas sealing themselves off or the body doing it? Since Thursday last week I have had my cannulas sealing off after a couple of hours. I am on the new Medtronic 640g with silhouette soft cannulas or I have also been trying the Minimed Mio 30 (these are the ones that have been sealing off) I have been inserting at the correct angle (with the delivery system of the Minimed) but less than three hours later its sealed off. I have used 7 over the course of the weekend and ended up with an average of 27 mmol and used nearly 400ius of insulin to try and get myself back on an even keel. I have went back to the silhouette soft cannula and have not sealed off (yet). I am calling Medtronic later today to report it, I was wondering if any other pump users had experienced this as well. I am understandably a bit tired and grumpy after a weekend of fighting high sugars that wasn't my own doing.

Any advise greatly received. Take care everyone.

Hi Johnpol,
I also use the Medtronic 640g pump. Previously used the Minimed mio. I had times with both pumps were my levels were increasing despite having insulin on board, also after giving bolus for highs. My DNE advised me that it looked like I was not absorbing the insulin, known as pooling. The only remedy was to change sites. I was advised that when this happens esp after giving boluses for high big levels and they are not coming down to manually correct the high with an injection and to be more vigilant for a few hours as the your body may finally release (dumping) all the insulin it has stored. I also found using a longer cannula helped as well, I use the Medtronic mio 9mm, 80cm (32”) Pooling Insulin can also lead to leakage of your insulin as the site fills with unabsorbed insulin. During these times I also noticed my pump did not alarm with no flow etc because technically the line was not always blocked as the insulin was leaking.
Hope this helps

 

[kitedoc]

I had problems with plastic cannulas of infusion sets used with Animas and Tandem pump (leaking or slow delivery) and after lots of questioning of people like reps, my DNE and endo came to the conclusion that over 45 years of MDI and 5 of pumping that scar tissue has built up and either bends the plastic cannula or the cannula tip becomes embedded in scar tissue (who remembers where their cannula was 6 years ago)? I have had better luck with 90 degree steel cannulas and varying the length between 6 and 8 mm plus trying to find absolutely new sites.
I am however concerned that longer term use of my pump will reduce the amount of unscarred subcutaneous tissue and that MDI will be needed again.

 

[Mr Whippy]

I have had problems with insulin "tunnelling" using various types of soft teflon sets - most of the time I find that I can get around the problem by giving my bolus doses (well certainly anything more than 5 units) as extended 15 min boluses (15 mins is the minimum extended bolus dose time on my Accu-Check pump). Giving the dose slowly gives it more time to soak in without leakage - giving it all in one shot, especially if it's a large dose builds more pressure and therefore it's more likely to leak out down the sides of the needle / cannula.

My control has improved since I started giving all my bolus doses over 15 mins instead of in one shot.

Dave.

 

[eventhorizon]

I have had problems with insulin "tunnelling" using various types of soft teflon sets - most of the time I find that I can get around the problem by giving my bolus doses (well certainly anything more than 5 units) as extended 15 min boluses (15 mins is the minimum extended bolus dose time on my Accu-Check pump). Giving the dose slowly gives it more time to soak in without leakage - giving it all in one shot, especially if it's a large dose builds more pressure and therefore it's more likely to leak out down the sides of the needle / cannula.

My control has improved since I started giving all my bolus doses over 15 mins instead of in one shot.

Dave.

I shall be trying this.

 

[johnpol]

Thanks everyone for the replies/advice given over this issue, I have been ok of late as have been alternating between the silhouette and minimed Mio sets and seem to have only had two sealing off/ leaking (but also with some bleeding as I hit a capillary) so fingers crossed I can have a settled period with stable sugars and no need for correction doses with the pens.

 

[johnpol]

I have had problems with insulin "tunnelling" using various types of soft teflon sets - most of the time I find that I can get around the problem by giving my bolus doses (well certainly anything more than 5 units) as extended 15 min boluses (15 mins is the minimum extended bolus dose time on my Accu-Check pump). Giving the dose slowly gives it more time to soak in without leakage - giving it all in one shot, especially if it's a large dose builds more pressure and therefore it's more likely to leak out down the sides of the needle / cannula.

My control has improved since I started giving all my bolus doses over 15 mins instead of in one shot.

Dave.

I deliver my insulin by my pump over 30mins split into 2 doses as the pump allows for this it makes the likelihood of leakage smaller, but going forward I will maybe put the dose in over a longer period to allow for better absorbtion

 

[Chrissy232]

Hi I've been experiencing a similar problem with the Minimed Mio.
I've noticed literally in the last month or so that my cannula seems to seal off after only a couple of hours after changing it, suggesting that it is blocked even though there are absolutely no bubbles when I attach the insulin to the tubing, not even champagne bubbles. I thought it was just something I was doing wrong as I've only been on pump for just under 2 years but it seems to be every time I do it now. Luckily I've worked out how to sort it out without having to change the set each time otherwise I'd always run out but it is extremely annoying to say the least.
I'm wondering if there has been a bad batch of infusion sets.

 

[Ann48]

Hi I've been experiencing a similar problem with the Minimed Mio.
I've noticed literally in the last month or so that my cannula seems to seal off after only a couple of hours after changing it, suggesting that it is blocked even though there are absolutely no bubbles when I attach the insulin to the tubing, not even champagne bubbles. I thought it was just something I was doing wrong as I've only been on pump for just under 2 years but it seems to be every time I do it now. Luckily I've worked out how to sort it out without having to change the set each time otherwise I'd always run out but it is extremely annoying to say the least.
I'm wondering if there has been a bad batch of infusion sets.

 

[Ann48]

Chrissy, can you advise how you’ve worked out a solution.

 

[johnpol]

Medtronic are saying that I have had a bad batch of sets, but the new box that was sent as a replacement is now sealing off again, and when I go to change the cannula it is bent at the tip by about 40 degrees I'm assuming that this is the issue as on all the other sets they are straight when it comes out of the body. I will be speaking to Medtronic as well as my nurse today as my levels are all over the place and I'm using my pens a lot more to correct (which is all the time now) I will let you all know what they say regarding the Cannulas.

 

[johnpol]

Just to update everyone on my cannula issues, I have been extremely unwell with high readings for the last few weeks and have now gone onto the MIO 6mm cannula, I think they are the 90 degree ones and so far so good BS's now back in single figures and the symptoms that I have been displaying are now going away. its amazing to think how reliant I have become on the pump and for it to work in the way it should. I wold like to thank everyone for their advice and help with my issue.

 

[Ann48]

Hi, I’m still having problems with cannulas, Last Friday I used 3 Mios, each one failed. Two appeared to go in ok, the third one I took off when my BG reached 25.9, it was completely bent backwards. I’m really unsure if it’s me. I’ve been pumping for 6 years and previously used the quicksets,which I’ve now gone back to. I’m waiting Medtronic to send Sure T’s to try. The worrying thing, I corrected 2 units via the pen when my BG was 25.9 as I had a lot of active insulin, then experienced my BG dropping like a stone. So I guess the insulin was pooling.