Medtronic Veo Insulin Not Affecting

[Diabelly]

Hi everyone,

I'm diabetic for a little over three years and live in israel.
I never consulted with others about my diabetes but now I need some help.
I need all the Veo's users' advice.

I got my Veo over a year ago but pretty soon I started noticing that many times after changing a site the
insulin I administer didn't affect at all. I then have to reinsert the cannula and check again my BG after an hour or so.
Every change turned out to be a long and scary process where I need to start it at morning so I won't reach night
with ineffective pump and high BG.

I always wait for the insulin to become completely warm and check thoroughly for air bubbles.
I insert the cannula at either the abdomen or the upper outer thighs,
I noticed that when inserting the cannula to the abdomen it's usually better than to the thighs but even there I still
had 50% of the time this same problem.
I met with a pump representative and he just showed me again how to change sites, and he told me not to worry
so much and that he has periods of several days where his sugar is very high (like above 250) and he can't get it down
and that it's normal.
The one thing I can think that could be a problem is that I have quite a lot of strech marks on my belly and that while
I was trying to insert between them and not on them I'm sure I didn't always succeed.

So, do any other of you Veo users have this problem? Please help me cause right now I'm back to shots
but I think many people out there are happy with their pumps...

Thank you all very much

 

[pumppimp]

Hi Diabelly,
I'm not a veo user but it sounds to me like it's not the pump but either the infusion set or the site you are putting it into.
Do you tend to use the same areas in your thighs and abdomen? after 3 years of using the same sites you are bound to have some scar tissue. Could you maybe try your bum, hips, upper arms for a while and see if that improves anything. Also do you bolus or prime your set cannula how much? I usually bolus for the insulin I've missed from having a shower etc and then the 1u which fills the cannula and then I usually put a temp basal on at 120% for an hour. For me this seems to negate any drastic rises when I change my set. Also have you gained weight or lost weight? is the length of your cannula right for you I lost some weight from going on my pump so also had to change the length of the cannula. They come in anything from 4-13mm. It would be worth changing if you've put on weight as well. Stretch marks aren't the best place to put a set in as the tissue can't absorb the insulin as well so try and avoid if possible.
Maybe worth trying some different types of sets as well.
Yes people can get really high and really low sugars from time to time. For me stress and hormonal changes and illness do all sorts to my levels. But I can usually bring them back down to normal once I know what's going on. If you can't bring you sugars down then something is usually wrong with the cannula, tubing, site. The pump itself is usually the last thing to go wrong generally it's human error first.
If you want to you can post up some more specifics to see if any of us can be of more help, good luck.
Laura

 

[Lucypieee]

Hi Diabellu,

I use a Veo and I have a problem with cannulas. Are you using the soft cannulas? If so, the issue is probably that the cannula is bending slightly or a lot as you insert it (if you check the cannula once removed, you may notice this).

This happens for me a lot on my abdomen sites (about 50% of the time), I've been recommended to use the steel cannulas on that area as they won't bend and you are far less likely to have an issue with inserting them.

Might be worth a try?

 

[Diabelly]

thanks for the replies!

I forgot to mention I only started using the pump about a year and three month ago but about 4 monthes ago I stopped using it. Recently I gave it another try and again very quickly despaired.

When I say the insulin isn't affecting I mean for example: I have 220 mg/dl, I administer 5 units and after an hour I have 250, and so I administer again like 6 units, check again after 30 mins or an hour and if then the BG stays the same I change the site again.

About using different sites, I did also use the lower back and the hips and the same problem often occured, I don't want to use the arms because I want the pump to sit in my pocket.

I am using the soft cannulas ,In all my time pumping I only saw once when I removed the
cannula that it didn't go in at all and it was completely bent.
Most of the time I can actualy see it getting out of my body and it doesn't look very bent.
The thing is, when injecting with a pen in pretty much the same places I never have a problem of the insulin not affecting.

I just looked at the length of the cannula and it is 9mm while the needles I use are 8mm so if the cannula does actually go al the way this shouldn't be a problem either.
Maybe I don't press the quick-serter hard enough when inserting? do you use force or just place it on the site?

I don't know what else to do or ask you

 

[Lucypieee]

Steel cannulas would solve the bent cannula issue. So it might be worth trying that.

If the actual insulin is an issue and obviously everything's in date, it would probably be worth speaking to your DSN / Doctor and looking at changing insulin, some people prefer Aprida for instance over Humalog or nova rapid.

 

[donnellysdogs]

Try steel cannulas

 

[iHs]

Hi

Im not a Veo user myself but I do use the Tenderlink set now and again which is the same type of set that I think you are using - the Silhouette (9mm). If you are using the Quickset... then change as that set has caused loads of pumpers problems although some are ok and some are just not......

When you insert the introducer needle how sideways are you inserting it? only the angle sometimes also affects the flow of insulin coming out. Also, when you remove the introducer remember to remove it completely holding it at the same angle that it went into the skin and remove it slowly rather than quickly until you get the knack ok. Once the introducer is removed, you can then carefully stick down the adhesive by removing the backing papers.

Some people also prime the set with more insulin to get it working ok instead of the recommended prime amount and that seems to help..

Also, some parts of the body don't absorb insulin as well as other parts so trying different areas might be worth having a go.

If the Silhouette is not good, try a steel needle set as that should help.

Also, remember to weigh yourself and use your bodyweight to help determine how much insulin you will need in the pump. It does sound as though your basal might not be correct and your correction factor might need to change...

Pumps are hard work at times... so good luck and all the best. If at first you don't succeed ......... :lol:

 

[Diabelly]

I am using and have always used the Quick-set infusion set by Medtronic, your saying this one caused many problems?
Which other good infusion sets should I try? If you could recommend one steel one and one soft one?
About the angle, I place the quick-serter on the site and press the white buttons, so I think it should be 90 degrees.

Thanks.

 

[pumppimp]

Hi Diabelly,
Phone up medtronic and get them to send you every type of set they have try them all out to see what works best for you. Try the ones with the plastic and steel canuals and the ones with the inserter device and the ones you put on manually. What works for some of us may not nesscecarily work for you but It's worth experimenting with. 90 is the right angle for the quick set yes. In my experience from being on different forums reading posts people seem to have more problems with the 90 degree sets that have an inserter compared to the 45 degree sets that are manually inserted. Not to say though that many people use them without any problems really easily.

 

[iHs]

Hi

Not sure if this will be of any help to you regarding the Quickset but...... from what I can remember the white adhesive dressing is fairly large and circular and it was thought that some of the edge of the adhesive glue was rubbing off in the inside funnel of the insertion device as the set was being fired in the body. What some people did was to use an alcohol swab or piece of cotton wool soaked in surgical spirit and then very carefully wipe around the inside funnel of the insertion device to remove any glue residue after inserting a Quckset (obviously let it dry before using it again). The other alternative was to carefully trim some of the circular adhesive away using a pair of sciissors so that the edges of the white circle didn't touch the funnel sides. This helped make the Quickset fire in correctly without the potential to stick to the sides of the funnel on the inserter.

There are other infusion sets that can be used with Medtronic and in the UK these are Silhouette, Mio and Sure-T. The Mio is a 90 degree Teflon cannula that fires in a bit like the Quickset but has the insertion device incorporated with the design of the set itself so doesn't need a separate device like the Quickset. The Mio is more or less like the Animas Inset II so you can see how it fires in by looking on youtube. The Sure-T is a 90 degree steel needle set so that might be better for you in the long run.

Unfortunately with Medtronic pumps, the infusion set tubes have a unique Medtronic connection and don't use Luer connections like Accu chek and Animas pumps. Animas UK do offer an adaptor for Medtronic pumps that enables a Luer tube to be connected to the Medtronic pump using the adaptor. Not sure though whether the adaptor is only available to users of pumps that are out of the 4year warranty period..... Another company based in USA is called Fifty50 and they sell infusion sets and tubes with Luer connections to fit Medtronic pumps using their adaptor.....

Hope all this is of some use to you....

 

[Diabelly]

I will try some other infusion sets.
I'm going to see my doctor this friday and will ask her for prescriptions for all available infusion sets.

I'll update if anything helped.
Thanks anyway...

 

[pumppimp]

Hi diabelly,
You should be able to get free samples from medtronic if you contact them. Saves you having to get a whole box full if you don't get on with them and then them being wasted. Good luck at your appointment.