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Question:

From Mississauga, Ontario, Canada:

I have been using a Deltec Cozmo insulin pump for about two weeks and things aren't going as I had planned. I have used the 6 mm Comfort short needle and also the one that you have to insert at a 45 degree angle. Every other day, I have to change my infusion set because it keeps coming out. I'm not doing anything that is causing the needle to come out; it just comes out by itself. I'm starting to run out of sets because I have to change them every other day. I use a body wash on my skin and have tried the sets only on my stomach. I called my doctor who told me that I should use a tape called Tegaderm that is made to stick on skin. My doctor told me to put the Tegaderm on first and then put in the needle. The needle was in my stomach for a about a day then it came out. How can I get my infusion sets to stay in longer?

A second problem I am having is with blockages. A few days ago, I had checked my blood glucose and it was 32.2 mmol/L [580 mg/dl]. I checked the tubing to see if it was working fine and there was a little blood at the end of the tube. I had changed the tubing and then I was getting my insulin, but would you know how the blood might have gone in the tube? In the future, how I can prevent it?

Answer:

There are two issues here: first, the infusion set should not be falling off. Most times, we find it is that the pumper is using a soap or body wash that has a moisturizing component that is making the adhesive come loose. Try a non-moisturizing soap and most of the time things get better right away.

The high blood sugars may have been caused by the blood. The rule of thumb is that if you see blood in the tube to change the infusion set and the tubing. This should only be happening occasionally. New and old pumpers alike should be inspecting the tubing and infusion set on a regular basis.

The pump is the most physiologic way to replace insulin. You cannot put it on and assume it is working. Regular blood sugar monitoring (at least six times a day) is the best way to prevent high blood sugars due to infusion set (most common) or pump issues.

NB

[Editor's comment: To help the sets stick, some people use a product call Mastisol, which you apply to the skin and allow to dry before inserting the Comfort. Some pumpers have applied antiperspirant, not deodorant, to the skin. This, too, helps the set stick. BH]

DTQ-20070725235039
Original posting 29 Jul 2007
Posted to Insulin Pumps

  
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Last Updated: Tuesday April 06, 2010 15:10:12
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