Two set failures (Vibe Inset II)

[Spiker]

As sets go, although I sometimes use the inset Ii, the best set for insertion and reliability is the inset 30. The steel needle Contact D is also good.

To be fair, with the steels and the Inset 30 there is absolutely no doubt that it's penetrating the skin, unlike with the Inset II where the whack of the impact on the skin leaves it uncertain whether it was a puncture or just an impact.
However even with the Inset 30s I have managed to put them in at such a shallow angle that they don't infuse properly (basically inserted parallel to the skin and between the skin layers, causing blister pockets of insulin) or insert them at too broad an angle and get a blood bath.

 

[Spiker]

Yes I use the inset 30 and used the cleo90 before that. I can not get on with the steel needles though.

The steel needles actually work really well for me, apart from the fact that they leave big bleeding holes.

 

[Spiker]

Re...Inset 2s are you pulling the white plastic spring back until it firmly locks only there have been some sets where it becomes hard to get the spring to lock ok and if the spring is only partly locked, the introducer wont fire correctly and the teflon cannula might bend slightly at the end which will cause high bg but not an occlusion. If you suspect that some of the sets have dodgy springs, inform Animas and insist on replacements.

No, I'm getting a firm lock and a good springy whack when it goes in. And I'm holding them perpendicular right on the skin for insertion. I thought I had the Inset 2 process down pat, but lately I've noticed a lot of them leaking and so I'm starting to wonder if the times I thought I was ill it was just another leaky infusion set. It's at the point now where whenever there is an unexpected high result I put my fingertips around the canula patch during the correction bolus to feel if it's leaking. And maybe one time in four, there is a clear insulin leak from the patch. :-(

 

[MushyPeaBrain]

@Spiker something is going on with the Inset IIs as I had similar issues a while back. I complained to Animas but they don;t seem bothered. I now have to keep several different batches of Insets in stock as I can't trust the first set from a new batch right off. I have also complained about how much harder they are to **** back. When I reported this to Animas they sent me a replacement batch but suggested I get my hand mobility checked out. Although not as bad as the previous batch I still have trouble every time cocking the sets. This is after 4.5 years pumping with no issues until their new design! Just to be certain I got my doctor to check my hand movement and no issues. My husband also finds them hard to **** and has to pull back so hard he feels like he'll break the set!

When a set fails for me I can normally tell before I get over 13. However if I was over 13 I would put a couple of units through pen and the remaining correction through new set to test that. I have to ignore IOB as it's wrong due to previous failure.

Where you putting both sets in same site? After a set failure the site is often sore underneath the skin and so my DSN has always told me to move onto next site as chances are if you reuse it will fail again. Just a thought!

 

[Spiker]

I dont bother too much anymore using the bolus wizard on the Vibe. I use the Expert instead and then whatever the bolus amounts to, I just use Normal on the Vibe and enter the amount and away it goes. I dont bother with Diasend either

Is the Expert able to upload the carb data from its bolus calculator to Diasend? I rely on Diasend to have all my BG, carb, and insulin data in one place.

I am strongly considering getting a good bolus calculating meter like the Expert. Not least because dose calculation, IOB tracking and dose logging (with upload to Diasend) are some of the features I really like about the pump. So if I come off the pump I want to get those features from a meter instead. Then the only thing I will be missing from the pump - apart from the constant aggravation - would be the much more accurate basal profile matching.

 

[iHs]

To be fair, with the steels and the Inset 30 there is absolutely no doubt that it's penetrating the skin, unlike with the Inset II where the whack of the impact on the skin leaves it uncertain whether it was a puncture or just an impact.
However even with the Inset 30s I have managed to put them in at such a shallow angle that they don't infuse properly (basically inserted parallel to the skin and between the skin layers, causing blister pockets of insulin) or insert them at too broad an angle and get a blood bath.

You are meant to insert the 30 at a 30 degree angle. Lay the 2 feet on the end of the housing flat against the skin and then release the spring.

 

[Spiker]

Where you putting both sets in same site? After a set failure the site is often sore underneath the skin and so my DSN has always told me to move onto next site as chances are if you reuse it will fail again.

Yeah I always move the site. I use the technique I was taught of putting the new canula down next to the old one, moving right to left and then when I get to the edge I start moving back the other way.

 

[Spiker]

You are meant to insert the 30 at a 30 degree angle. Lay the 2 feet on the end of the housing flat against the skin and then release the spring.

I know, and I know the technique - in fact I think it was you who taught me that technique. I just find it difficult to achieve that accuracy. I am out by +/- 20 degrees or more every time. And frankly the giant needle on the Inset 30 freaks me out.

 

[Spiker]

When a set fails for me I can normally tell before I get over 13. However if I was over 13 I would put a couple of units through pen and the remaining correction through new set to test that. I have to ignore IOB as it's wrong due to previous failure.

Good advice, I will try that next time. Thanks.

 

[Spiker]

Well unless you can get yr hospital to set up another account with Accu chek to supply their Luer connecting tubes and sets, you are stuck with Animas or back to pens again and just use the Vibe as a cgm

Do you think the Accuchek infusion sets are better? It's worth giving it a try I guess.

 

[noblehead]

Problem with correcting with a pen is you lose the opportunity to use the correction to confirm that the new infusion set is working.

Take on board your point, but if your bg is in the high 30's you don't want to be hanging around to see if the new set works, with bg levels that high its imperative that you get some insulin inside your body.

Anyway, hope you get the problem sorted soon Spikes.

 

[Spiker]

@Spiker something is going on with the Inset IIs as I had similar issues a while back. I complained to Animas but they don;t seem bothered. I now have to keep several different batches of Insets in stock as I can't trust the first set from a new batch right off. I have also complained about how much harder they are to **** back. When I reported this to Animas they sent me a replacement batch but suggested I get my hand mobility checked out. Although not as bad as the previous batch I still have trouble every time cocking the sets. This is after 4.5 years pumping with no issues until their new design! Just to be certain I got my doctor to check my hand movement and no issues. My husband also finds them hard to **** and has to pull back so hard he feels like he'll break the set!

When a set fails for me I can normally tell before I get over 13. However if I was over 13 I would put a couple of units through pen and the remaining correction through new set to test that. I have to ignore IOB as it's wrong due to previous failure.

Where you putting both sets in same site? After a set failure the site is often sore underneath the skin and so my DSN has always told me to move onto next site as chances are if you reuse it will fail again. Just a thought!

OK as others are having issues I will give them a call and add my voice to the protest.
Honestly I didn't even notice they had changed the design, though I remember reading about it on here.

 

[iHs]

No, I'm getting a firm lock and a good springy whack when it goes in. And I'm holding them perpendicular right on the skin for insertion. I thought I had the Inset 2 process down pat, but lately I've noticed a lot of them leaking and so I'm starting to wonder if the times I thought I was ill it was just another leaky infusion set. It's at the point now where whenever there is an unexpected high result I put my fingertips around the canula patch during the correction bolus to feel if it's leaking. And maybe one time in four, there is a clear insulin leak from the patch. :-(

Have a look at the introducer needle after the spring has been cocked into position and using a magnifying glass, look to see if some of the cannula
is showing. If it is, then the set will fire in and the cannula will be crooked.

 

[iHs]

OK as others are having issues I will give them a call and add my voice to the protest.
Honestly I didn't even notice they had changed the design, though I remember reading about it on here.

The design hasnt changed but the moulds that the manufacturer is using need to be examined for accuracy issues. The design is complex....

 

[CarbsRok]

Apart from the fact that the Vibe just discards any record of the IOB on a battery change or reservoir change(?).

There must be a fault with your vibe if the IOB disappears when you do a cartridge change, mine certainly does not. As to the battery change simple solution is to change when no IOB or look in bolus history as it quite clearly states last bolus given so just work it out from that.
The IOB and battery change is pain in the rear end but there are ways around it.

 

[CarbsRok]

I have probably had between 20 to 30 set failures in 13 months of pumping. :-(

If this is the case, I would be looking at a refresher course to find out what is going wrong and why. You are talking about 3 months worth of cannulas and in my book that is totally unacceptable.

 

[iHs]

Do you think the Accuchek infusion sets are better? It's worth giving it a try I guess.

I found the Flexlink set very simple to insert even though it had a seperate spring inserter. The Rapid D is also good but the Tenderlink no. The Inset 30 takes some beating.

 

[masonbason63]

I have probably had between 20 to 30 set failures in 13 months of pumping. :-(

Blimey that's ridiculous I've had 2 failures in 15 yrs using the Accuchek Tenderlink and I reckon probably some of the blame was my own fault for connecting it to me and the pump without paying proper attention to the job in hand

 

[Spiker]

As to the battery change simple solution is to change when no IOB or look in bolus history as it quite clearly states last bolus given so just work it out from that.

It would be nice if you could manually enter an IOB after a battery change.
Or for that matter, since, as you point out, the pump actually has the necessary data, it could recalculate it itself.

 

[Spiker]

Blimey that's ridiculous I've had 2 failures in 15 yrs using the Accuchek Tenderlink and I reckon probably some of the blame was my own fault for connecting it to me and the pump without paying proper attention to the job in hand

Maybe I have leaky skin.
In the last one, the canula was bent at a 90 degree angle parallel to the skin, and outside the skin. So maybe my skin is too hard?
I had this problem in the first couple of months of using the pump but I thought I'd got it sorted. Guess not.
It's bloody depressing. :-(