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Infusions sets: General "stickiness"

Discussion in 'Adults with Type 1' started by GChick, Nov 29, 2013.

  1. GChick

    GChick Approved members

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    If the hope is for infusions sets to last a full three days, is it assumed that you will need something other than the "sticker" bit of the infusions set to help 'em stay stuck? Or is that a problem that only some people have all of the time, or everyone has some of the time, but everyone doesn't have all of the time?

    If it is almost always required (or even if not), what are some names of "stuff" for me to try? Does anything come with the pump supplies for that, or is that just something you gotta source on your own?
     
  2. Megnyc

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    I have no issues getting 3 days out of a set without adding anything. I don't really sweat though and my skin has never been oily. During the summer I spend a ton of time in the water and don't have any issues.

    In terms of adding stickiness I like mastisol, skin-tac (I would start with this), and opsite tape. The mastisol is the best but some people do develop a pretty severe allergy to it. I prefer the skin tac in the bottle so I can just dab a tiny bit on my skin (I use it for CGM sites). The wipes are really convenient for travel though. Opsite tape is nice to patch up the edges if they start to come up.

    I hope that helps. Let me know if you have any questions!
     
  3. kiwikid

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    We always used Skin Tac and had great adhesion. Now we don't use anything and still have great adhesion.... If we were going to have a 'wet' week of swimming etc I would go back to using Skin Tac.
    I think the most important thing is to try and see how they stick to 'your' skin and work from there..
     
  4. TheLegoRef

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    We've found good luck with the IV3000 Infusion Set tape http://my.medtronicdiabetes.com/tapes--prep-wipes/infusion-set-iv3000/transparent-dressing-1

    We've just started using Skin Tac, and it's been working well. With that, we don't need to use the IV3000. http://my.medtronicdiabetes.com/tapes--prep-wipes/skin-tac-wipes/skin-tac-wipes

    We used to have trouble with sites lasting two days, or constantly getting ripped off. He scratched one off with his hand less than two hours after it was put on when he had forgotten the IV3000 tape. :rolleyes:
     
  5. GChick

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    Skin Tac it is then!

    Ok, so I'll probably try to use it for my first few site changes etc... just so I am able to try things out for the longest possible time without the need to keep changing sites etc....

    Then I'll try a few times without it and see if it is needed for anything other than when I know I will be swimming etc. Hope it is not needed much.
     
  6. Amy C.

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    I thought my son needed something to help the sites stick and we used IV prep for years. When I couldn't get any for a period of time, we discovered it wasn't needed.
     
  7. GChick

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    its possible they changed to formula as the years progressed.

    Either way, all of this is very encouraging 'cus reading through some posts it wanted to "look" like there was always trouble with them sticking to some degree.... but I'm sure it's more a matter of when people need help/have trouble with something those posts will ring the loudest than the ones where everything is just honky dory.
     
  8. RomeoEcho

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    I have problems sometimes. But for the most part, it's predictable. If a set gets wet (sweat or water) in the first ~six hours, it's going to be a problem child. If I'm likely to sweat or shower or swim, I'll try to do a set change at night so that I have the most likely dry hours for the adhesive to fully bond. (I use steel sets so I don't worry about doing them at night, you might fee differently if you're going to use teflon) All the toughest adhesives and tapes out there don't work for me if I can't keep it dry enough to bond. After the first twelve hours, they'll usually much longer than I should leave them on.
     
  9. GChick

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    Ah... very good to know about the +/- 6 hrs dry thing, that may not have occurred to me as quick as it should.

    Oh, and what do you mean about teflon vs steel sets at night? What does inserting at night vs day do to make one more worrisome/problematic than the other? (I'm just gonna be using whatever they send at first and see how it goes... my assumption is that that will be teflon). Especially with the whole "wet" thing, my plan was/is to insert at night.
     
  10. sincity2003

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    I would see if you can get samples before buying. We spent $100 on different adhesives, only to find my DS is allergic to all but the OpSite Flexifix.
     
  11. MomofSweetOne

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    We were told to change sets in the morning so that we would know if there were problems before nighttime hours. In reality, though, diabetes don't work on a set change schedule, at least in our world. I've never worried about bedtime set changes because we have the CGM that would alarm us if her BG were rising. I know someone whose daughter woke up at 675 with ketones one morning because of a bad site. That is why bedtime changes are recommended.

    My daughter recently switched to steel sets rather than teflon because we were having so many problems with Mios kinking and she didn't want to go back to Silhouettes. Steel cannulas don't kink, so inserting them at bedtime isn't a concern. I'd ordered sample Sure-Ts one day when I was beyond frustrated with kinks, but my daughter wasn't interested...until one day when we'd been through highs from bad sites 4 days in a row. She asked to try the Sure-T and has stayed with it. She says the thought of a steel cannula is awful, but that they don't hurt unless bumped.
     
  12. firstport

    firstport New Member

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    Teflon VS Metal Cannulas

    Hi GChick,
    Teflon can bend/kink, and leave the pumper with very high BGLs in just a couple of short hours. :eek: It is therefore recommended by DE's not to do set changes at night before bed (but I would add, "...if using "soft" teflon cannulas..."), as you may find yourself in ketoacidosis by the time you wake up in the morning. They recommend therefore to do your set changes in the morning if on teflon and check your Blood Glucose level 2 hours after a set change.

    If you feel pain on insertion with a soft cannula, it can also be that the intro needle has penetrated the skin but the teflon cannula may be just indenting the skin (not penetrating) :( - as that is what often happened to me. Then, after the intro needle is removed, if more pain is experienced, then it is probably the teflon cannula kinking or sticking into your skin, as the teflon is not strong enough to keep the skin indented without the rigid intro needle present, so it simply kinks when the intro needle is removed if the teflon hasn't penetrated the skin.

    The metal cannula of the Sure-T however, does not bend or kink as it is rigid metal and under skin all the time, so is therefore much safer if you need to do a set change before bed. The metal cannula is also a finer needle gauge, so less likely to hurt as much on insertion (if at all) :) and the Sure-T cannula sticky pad lies flat (low profile) - compared to the Quickset which is raised and bulky. (If the Sure-T doesn't go in straight away, I give the cannula top a flick with my finger to make it penetrate). Sure-T's can only be inserted manually, but the cannula has butterfly wings on the outside that can be folded back so you can pinch it to hold it when inserting. I prefer to simply hold the tubing so the cannula is at 90deg to skin, and then tap it to penetrate the skin and to stick it down.

    The Sure-T has a separate (2nd) sticky patch where you connect/disconnect from the pump, so you aren't playing with the cannula site when disconnecting like you have to with the Quickset. And, if you accidentally drop the pump and it jerks and dangles from you, you are definitely going to wish you had a Sure-T connected at the time and not a Quickset, otherwise the cannula will take the bulk of the jarring action and may kink as a result, leading to more hurt and possibly, high BGLs. The Sure-T on the other hand would hang the pump from the 2nd sticky pad (that doesn't have a cannula under it), so the cannula on the Sure-T would remain unaffected by a dropped & hanging pump.

    I've changed from Quicksets to using Sure-T sets, because cannula kinks were a fairly common event for me on teflon. Each time I would go high BG, and I just don't want the complications that come from high and erratic sugar levels. (Eg: Eye damage they say is done not only from high BG, but even more so from rapid changes in blood sugar apparently). If I were you, I would definitely keep Sure-T in mind and look into it. :D

    If you are looking at a Medtronic Insulin Pump, the following site has pictures of the different Infusion sets...
    http://www.medtronicdiabetes.com/treatment-and-products/infusion-sets

    I think I still prefer the QuickSet if going swimming though, as it seems (whether actual or not) to have a better water proof capping mechanism for keeping water out. But best get that confirmed with Medtronic before making any decisions either way.

    One thing that is a bummer for the Sure-T is that they recommend only 2 days use, as opposed to the Quickset's 3 day recommendation. This is because a metal cannula gets rejected by the body quicker than a teflon cannula.

    PS: I personally stick to the 2 days per site recommendation for metal cannula, but I re-use the cannula immediately a 2nd time in a separate site to get 4 days from it. To do this, I alcohol swab both the cannula and centre of the cannula pad and the new site, then do a small prime till I see droplets form at the cannula tip, flick the drops off without touching the cannula, then insert it at the new site. The sticky pad won't stick as well the second time, so I supplement with the use of "3M Hypoallergenic Soft Cloth Tape on Liner No. 2764" 10cm x 10m roll, and just cut in half to patches to a size of 5cm x 5cm. I put these on top of the cannula pad to ensure it stays in place. 2 days later I peel these back off the cannula pad before removing the cannula. (I can't recommend the re-use of cannulas to others, but just mention that I do re-use).

    Hope that helps?
     
  13. GChick

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    I see. Makes good sense on the surface.

    However I would imagine that anything over 250 for too long would send me to the bathroom so soon after going to bed or often enough that I'd know something was up and test (I do NOT like having to get up to pee at night so do what I can to avoid it... sometimes unsuccessfully, but still). Also, I'd imagine that as long as I do it an hour or more before going to bed that'd hopefully give me enough time to see if there were any problems (that'd occur during insertion anyway.)


    Hmmm for general use it sounds like steel sets would probably be my best bet... cept for the fact that I may possibly be kicked/punched etc at the site during a Karate class etc. I'll probably wait to try them unless I start having problems with the teflon.

    Thanks for the info.
     
    Last edited: Dec 10, 2013
  14. GChick

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    I don't believe my meter even goes above 599!

    Having said all that, I'm also a lil worried that I might have a slightly "nonchalant" attitude towards ketones. I don't believe I have tested for ketones since before meters were commonly used here and we just tested urine (not exactly the best way to control sugars btw)) and my parents had to test my pee for sugar anyway, so testing for ketones wasn't all that much of an extra step. I forget how old I was when we got a blood sugar meter?

    In 31 years, I have never been to the hospital/doctor for a high/ketones (other than diagnosis)... hope that doesn't change with the pump.
     
    Last edited: Dec 10, 2013
  15. MomofSweetOne

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    How often and how long are your karate classes? With the steel sets needing changed every two days, you could possibly schedule your set changes for when you're at karate & just be set-free during classes. If my daughter is wearing the Medtronic when going swimming, she boluses 1/2 of her basal for the next hour and then disconnects her pump. You could do similar but completely remove the site. If you weren't able to go back on the site in an hour or so, then you could dose basal by syringe until you do. There's lots of ways to make pumps fit into your lifestyle.:)
     
  16. GChick

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    yknow... I never thought of that! Karate classes are generally Tuesday nights, Thursday nights and Saturday mornings (or at least they will be starting this January... schedule change). While it would not be a perfect system at all... scheduling site changes for those days as much as possible might be a good way to go anyway. Then I wouldnt even have to worry about the adhesive losing it's "oomph" due to sweat etc. If I were trying steel sets, I might try to sneak in that third day occasionally... but some times wouldn't even have to (in a perfect world... which it never is). Also... just FYI, Karate classes are generally an hour and a half long.

    I still think I will wait to try steel sets until I get my first box of "whatever they send me" (which I believe will be "Comfort") and see how that goes. But glad to at least know about other options ~before~ I already have a problem.
     
    Last edited: Dec 10, 2013
  17. GChick

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    Thanks for all the information. I actually decided on going with the t:slim. While I'm not sure if they make the Sure-T with the luer lock connection, what I have found on the tandem site is the "Contact Detach" infusion set which seems very similar to the description that you gave for the Sure-T. So I might give that a try sometime.

    [Edit: just looked around on the internet and indeed the Sure-T and the Contact Detach are the same thing with different names for different brands.]
     
    Last edited: Dec 10, 2013
  18. obtainedmist

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    Our daughter just uses Skin Prep, not for the stickiness but for the barrier between the adhesive on the set (insets) and the skin. When we ran out briefly, she just used the set w/ nothing at all...it stuck almost too well! haha!
     
  19. kiwikid

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    We easily get 4 days (and often more) out of a steel needle set and after 8 years have no skin problems at all. If we had to change every 2 days I don't think my daughter would want to pump..
     

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