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Any tips to avoid "tunneling"

Discussion in 'Parents of Children with Type 1' started by LJM, Nov 23, 2010.

  1. LJM

    LJM Approved members

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    OK, we just had our third tummy site with tunneling. That is, insulin coming back out around the cannula on a bolus. Should I tape the tubing down or is there something else?

    Or is this just one of those---things we have to "deal" with.:mad:

    Unfortunately this happened on way to Harry Potter---when I had no extra sets or insulin to give a shot--and the one time I got tickets in advance. Not sure if I will be out the tix or not. Not a good diabetes day...grrrrrrr.
     
  2. Nancy in VA

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    We have never had that happen. Are you sure you are inserting the set at the right angle? Maybe you need to try a different set
     
  3. GaPeach

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    My daughter (12yo) uses the Inset 30's also. The angle is pre-set for the most part by the inserter.

    Was this a "larger than usual" bolus? My DD says that if she boluses over 5u, it "explodes" out the edges. Smaller boluses do not leak. We usually just monitor BG closer for the next couple of hours and make a small correction if necessary.
     
  4. BrendaK

    BrendaK Neonatal Diabetes Registry

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    What's tunneling? We've used the Inset 30's for years and I haven't heard of this.
     
  5. mmgirls

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    "tunneling" is the body working at geting the foreign object out.

    Pumping insulin says it happens with straight in teflon sets most, so angled sets or metal sets may reduse this from happening.

    I thing it also says an area with less movement will have this happen less.

    I beleive this was one of our problems after 4yrs of teflon sets, now that we are on steel sets it does not happen as much,
     
  6. TheFormerLantusFiend

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    I don't pump but this is what I'd do if I did- mess with the rate that the bolus is delivered. If it only happens on a bolus and not basal, I'd assume that you want a more gradual, slow, bolus so that her body has slightly more time to absorb the insulin.
    I might try a faster one just for the force of it.

    I know when I inject, sometimes I have ones where I can just tell, the insulin is going to come back up as soon as I take the needle out, and it does. It drives me nuts but since it's a shot I usually just take it out and do the shot somewhere else.
     
  7. LJM

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    It is where the opening around the cannula has formed tissue around it usually after a site gets quite a bit of movement. It makes the tissue around the cannula large enough for insulin to leak back on a bolus. The site was only 2 days old and not red or otherwise irritated.

    Yes, it was an 8 unit bolus==got a teen here that is a rather small bolus for a meal:cwds:

    Happens usually only after a site go pulled on a bit--I suspect that is what happened. They don't happen often but are our only cause of site failures with the Inset 30s--which we have used with good success for 2 years. I was hoping someone had a magic solution. Or wondering if we were doing something wrong to cause it.

    I just get mad when D interferes with life (or my lack of pre planning causes it to interfere with life---more accurately).
     
  8. TheFormerLantusFiend

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    Maybe you need tips to prevent a site getting pulled on then. What are you doing now to stop sites being pulled on?
     
  9. LJM

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    You know that is a real good idea. We have the pump set to deliver the bolus slowly as he had originally complained of some discomfort on delivery--but that was when he started pumping 2 years ago. Maybe now that he is getting so many more units at a time===we should speed up the force of the delivery? Or slow it down more (I think we are at our lowest pump setting) but we could break up the bolus into 2 smaller ones. Good thoughts all, thanks.
     
  10. LJM

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    We usually use Tegaderm and at times tape a loop in the tubing---but we usually only do that during sports seasons. Carter has been out of commission for the last 3 months with surgery on his knee so we kind of got out of the habit of securing the site. Now that he is finishing physical therapy and will be back at sports, I will watch them more carefully. I did look at Pumping with Insulin which has a short blurb on tunneling and it is recc. to put a loop in the tubing and tape it down so there is less pull on the tubing and less irritation of the tissue.
     

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