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Constant issues with Accu-Chek infusion sets

Discussion in 'Insulin Pump Forum' started by ChrisLinington, Jan 1, 2019.

  1. ChrisLinington

    ChrisLinington · Member

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    Hi everyone,

    I have been Type 1 Diabetic for 25+ years and have been using the Accu-Chek Insight pump for almost 2 years now. Before this I was using pens.

    This is my first ever post on a diabetes forum because I am having serious issues when changing my infusion set. I would say that 50% of the cannulas that I use do not allow insulin through and I sometimes have to change the set up to 3 times before I get one that works and starts to lower my BG.

    I have done a google search for known issues but can’t find too much info.

    Does anyone else find this issue? Am I just doing something really stupid?

    I am starting to consider ditching my pump because it is so unreliable and I am getting worried every time that I need to change it. It’s not right that my BG spikes half of the time that I change it because it simply does not do its job.

    Any help or tips would be greatly appreciated! Or even just to know that I’m not the only one!

    Thanks
     
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  2. Jollymon

    Jollymon Type 1 · Well-Known Member

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    I have a prescription so that I can change my infusion set daily. My body does not like them either.

    Some days I find a spot and have not problems. If no problems, I leave it alone. However if I do have issues like pain, or bleeding, or swelling, or it just doesn’t seem to be working, then use this mantra- “when in doubt, change it out”:

    I’m lean and very thin skinned. I found 90 degree cannulas kinked all the time. So I use and angled set that I push in by hand. The angled set freaks people out, but it’s something that I have to do.
     
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    #2 Jollymon, Jan 1, 2019 at 2:03 PM
    Last edited: Jan 1, 2019
  3. NicoleC1971

    NicoleC1971 Type 1 · Well-Known Member

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    Sorry you are struggling with this; its annoying to dose yourself but not know that it hasn't worked until you get that hard to bring down spike...
    Did not have your issue but I did find their help desk useful once I got through to a nurse via their help line though seeing a pump specialist nurse would be even better as she can advise if alternative infusion sets would improve matters, I use the same pump and am aware that just as pen users can get lumps so can pump users to which the solution is to move the pump insertion sites every 3 days to avoid the build up of fatty tissue caused by insulin, just under the skin.
     
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  4. ChrisLinington

    ChrisLinington · Member

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    Thanks both for your responses. I do move the site around every 3 days. Definitely going to look into those angled cannulas!
     
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  5. Jollymon

    Jollymon Type 1 · Well-Known Member

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    I wish I could cite a good YouTube video on how to push an angled set in by hand. I’ve just done it for so long that I don’t need one. When I was told this might be a solution for me I was completely intimidated by them. 90 degree cannulas we’re so easy. When I couldn’t make them last, I was ready to shelve my pump and walk away from it.

    I was fortunate enough that a local nurse from the hospital here went through the same issue, and she showed my how to deal with them. I was so thankful for her experience.

    Pinch up the skin to make a “tent”, shove the inserter into the front of that “tent”, lay it down, and then tape it down and pull out the inserter needle. All cannulas just need to get through the skin layer. All of them. A 90 cannula goes straight in; an angle set goes through the skin on a hypotenuse angle.
     
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  6. ChrisLinington

    ChrisLinington · Member

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    Which pump do you use Jollymon?

    I think the angled cannulas are only available for the Accu-Chek Combo and not the Insight which I use. Am I wrong?
     
  7. Jollymon

    Jollymon Type 1 · Well-Known Member

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    I think they are called tenderlink on the uk website. Then, I think your connection is called a “luer lock”. Any luer lock infusion set can work if that’s true. As another source, call Accu-Chek, tell them what you’re experiencing, and have them tell you what they can do. And then have them send samples.

    I’d text Scottie Johnson, who loved his Accu-chek pump, but I’m sure he’s probably sleeping.
     
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    #7 Jollymon, Jan 1, 2019 at 8:42 PM
    Last edited: Jan 1, 2019
  8. ChrisLinington

    ChrisLinington · Member

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    Thanks so much, Jollymon. I’ll get in touch with Accu-Chek and see what they can do :)
     
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  9. aphex2k

    aphex2k Type 1 · Well-Known Member

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    I never had any issues with Accu-chek cannula in three years

    I do have issues with the Medtronic Mio infusun sets which seem to work "loose" and pop out, or not go in correctly when I use the 6mm. I prefer the Medtronic Sure T (also at 6mm) which appear to be less rage-inducing!
     
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  10. tim2000s

    tim2000s Type 1 · Expert
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    @ChrisLinington - I've found that I can't use the Flexlink+ Sets with on the combo, which are the same as the Insight Flex sets on the Insight. I just found that for some reason they don't allow insulin to pass in correctly, where the Flexlink sets always worked fine. My best guess us that they are 27G rather than 22G (i.e. narrower) and as a result, somehow get "squashed" in my body.
     
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  11. ChrisLinington

    ChrisLinington · Member

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    Thanks everyone!

    Have just sent a message to Accu-Chek to see what they infusion set they would recommend that I use. I'll let you all know what they have to say :p
     
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  12. Deanc883

    Deanc883 Type 1 · Member

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    I use the insight but never had the same issue as you.
    When starting on a pump I was told to change cannula every three days. In the last month or so I had to change the cannula after two days due to very high bG’s.
    Not had any problems since.
    I’m thin but found it best to place the cannula in the back of my arm in the fatty part, near the tricep area. I alternate in each arm for three weeks then go back to stomach area for three weeks.
     
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  13. ChrisLinington

    ChrisLinington · Member

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    That's interesting! I knew it was possible to put the cannula in the arm but had never really considered it because I wasn't sure where I would 'wear' the pump. I always put my cannula in my stomach and put my pump in my trousers pocket or in a SPI belt around my waist overnight.

    Where do you 'wear' your pump when the cannula is in your arm? Do you have longer tubing and run that into your trouser pocket?
     
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  14. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Like @aphex2k, I use metal cannulas now. I find the 6 mm 90 degree plastic type tend to bend too easily causing delivery problems. The other thing I was told by the pump rep (I use a Tandem pump) was that scar tissue can build up and this will influence the degree of infusion. I am currently using sites or areas I have not used before and at times will vary from a 6 mm to 8 mm steel cannula.
    Mind you have have been injecting insulin for 52 years, 7 of those on a pump, so I guess there is "a bit" of scar tissue there!!
     
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  15. Chas C

    Chas C Type 1 · Well-Known Member

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    Hi @ChrisLinigton

    I've seen the issue you mention but not to the same extent as you. I use 6mm flexlink with an Insight.

    I've been IDD for 48 years, in my pen/syringe days when much younger I did not rotate sites at all or change needles enough which cause scarring, resulting in my legs not being able to be used now for maybe 20 years or more. Its so much easier with a pump to manage rotation as you can see where your last cannula was/is inserted so for me the pump is easier.

    I do find if a site has bruised I need to leave it for a month or two for it to recover.

    I use my waist, sides and arms now.

    If I have an issue with absorption - then like you I just change the cannula.

    I would try longer or different cannula's, I would not leave my pump now and go back to pens (unless my pump was broken), I would try different insertion area's and avoid those causing issues (if possible). Do you have a CGM to monitor your BG's, as this would show you quickly that a site is not working well ?.

    Sorry to hear your having issues but do hope you find a way to resolve them.
     
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  16. ChrisLinington

    ChrisLinington · Member

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    Thanks @kitedoc and @Chas C, I definitely think that I need to rotate my sights some more. I have been using my pump now for almost 2 years and have always put my cannula in my stomach area. I do move it around each time but probably not enough. When I was using pens for 23+ years I would often get lumps. I don't mean to keep using the same spots but it's just habit I guess!

    I think I'll try moving it out further to the sides etc and maybe even try one in my arm.
     
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  17. ChrisLinington

    ChrisLinington · Member

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    Oh, and I do have a CGM as I have a Freestyle Libre. However, I only buy a sensor every so often... I have been thinking of buying some more.
     
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  18. Chas C

    Chas C Type 1 · Well-Known Member

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    @ChrisLinington I use CGM 24/7 for number of years now, I have to self fund though.

    On the site rotation I start just below my ribs then work round and down go as far down as I can comfortably go (avoiding trouser waist band/belt). So start one side then work around my waist to the other, I can get about 12 into a row one after the other (so around a month), then go back to start side and drop down one cannula width and start again. Can get about 4 to 5 rows. Also use my arms where I can get maybe 10 on one side and perhaps 4 or 5 on the one with the CGM.

    I see you had the same pen issues as me - its so hard to rotate these 4-8 times a day. In my early teenager days I had reuse-able stainless steel needles and no sharpener either, these damaged my legs.

    Hope the rotation works for you.
     
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  19. ChrisLinington

    ChrisLinington · Member

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    Whoa, thanks for that very detailed reply @Chas C! I'm going to follow your advice and try out some of these rotation sights! :)
     
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  20. Deanc883

    Deanc883 Type 1 · Member

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    I have a running belt that I wear under clothing. It is elasticated and has 3 pockets.
    I use a 70mm tube. Sometimes I use the plastic clip that attaches to my trouser belt.
     
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