Infusion pain / sites

[clarky99]

I am in the process of obtaining a pump and I have a few question regarding infusion sites.
I have been a diabetic for 25 years and have been successful with a MDI regimen (A1C - 6.8), but I think I owe it to myself to atleast try a pump out to see if I fing it any better. And considering I live in the great province of Ontario where pumps and supplies are covered by the government I would be foolish not to give it a try.

My questions are;

Even after 25 years of injections I have still never gotten used to the pain of needles. I often find injections quite painful. For those experienced pumpers out there, do you find inserting and infusion set to be significantly more painful than a standard injection?

I am fairly lean and would like to stay that way. I have not had any issue with my injections sites up to this point. It sounds like pumpers have more issues with injection sites. Do you notice an accumulation of fat or scar tissue around your typical infusion sites? More so than with MDI?

I am very active and am concerned about pulling out my infusion sets. I really just need someoen to put my mind at ease about it. I am concerned about playing hockey and wearing the pump / infusion set under my gear, as well as showing with the set.

Thanks in advance for any input.

[Joeprep4820]

I have become leaner since starting on pump therapy. The infusion needles hurt a bit but you rotate the sites and infuse every 3 days or so, so not bad. I usually go kidney area, side belly, front belly, then legs on each side. I have not seen any problems with sites coming out unless the tube gets caught on something. The pump actually allows you to administer less insulin so you might become even leaner.

[lark 27]

I'm not all that lean with a 28 BMI, so I can't give much expert advice there, but I've seen it posted by the skinny folks that they've had success with infusion sets still. I would say that in some ways the actual insertion coupled with the removal of the needle is a bit more painful, but I'd still say pretty minimal. Psychologically I never really had issues with injections, but one thing that helps many people with the insertions is the use of insertion devices. It is psychologically easier to press buttons that release the spring-loaded device to insert your infusion set than to just insert it by hand.

[Gordonm]

I had the same concerns as you about the pump. I was on MDI for 32 years before the pump and was doing well on them. I am also quite lean and very active. The issues you are talking about are not a problem at all. Every once in a while one will give a little pain upon insertion but for the most part I never even feel them in me. As far as scar tissue for me it is less with the infusion sets than it was on MDI. I use my abdomen for the most part and have very little if any scar tissue. After 3 years of pumping I have never ripped a set out. I have had one or two come out due to the tape not staying stuck after a few days but if yo ucatch it early enough you can tape it down before it comes out.

The pump has been the best thing going in my mind. I was extremly skeptical on the pump. Now I wonder why I waited so long to do it. Once you have the basals and IC ratios down it is a breeze.

[telizas]

I had the same concerns, especially with scar tissue. I scar very, very easily. I get scar tissue when I look at a sharp object. I have just finished my first box of infusion sets and no big raised areas of scar tissue so far. I've been trying to rotate sites as much as possible.

I actually think the infusion sets hurt less. Especially with the inserters, you can't see the needle going into your body and its much, much quicker than you could ever do it. It feels like a rubber band snap against your skin, at its worst.

There *are* sets out there that don't use inserters, but I haven't tried these yet. I'm kind of leery about them, but they are nice to have on hand in an emergency. :)

[SCC]

I am suprised to day I think they hurt less also. I use the shorter silhouettes and the insertion needle LOOKS huge, but they must do a great job manufacturing them, because they honestly don't hurt. And - you only change they every three days or so. I did well on MDI for 41 years, and like Gordonm, wonder why in the world I waited so long.

I'm pretty active and fairly lean, no issues with the sites, and I've yanked two out - catching tubing on doorknobs when I was just learning about pump logistics.

I gained about 4 pounds after I started because I was astounded at how easy and fun it was to eat and push buttons instead of inject :) They are gone now....

Go for it! You can always drop back to MDI since you are OK with that. Give yourself some time when you first start to get used to it, fine tune things etc. Then enjoy it. I can't imagine having to do MDI again and haul insulin and syringes everywhere and take shots so often.

[SharpTail]

Clarky99....I can't tell you anything about the pain of the insertion of the infusion sets, but you have a great opportunity to try the pump with no expense out you pocket. Like you I've dealt with diabetes for 28 years and for a long time never thought I would want to pump insulin. I started warming to the idea and realized the cost was somewhat prohibitive. Now with the Ontario government paying for it, right away I enrolled in the Assistive Device Program and now have a pump sitting here and waiting for the training (and haven't paid a cent). I can't wait to get started. I say go for it! Pat

[yanki01]

now have a pump sitting here and waiting for the training (and haven't paid a cent).
lucky....

:(

[clarky99]

Thanks everyone for the replies, I appreciate it.
You've helped to somewhat ease my concerns about infusions sites and pain, but I guess I won't really know until I try it.

Thanks again.

[Subby]

Even after 25 years of injections I have still never gotten used to the pain of needles. I often find injections quite painful. For those experienced pumpers out there, do you find inserting and infusion set to be significantly more painful than a standard injection?

It is a bit variable, depending on the set type and site, but in general I find it is either painless or just a little bit painful - pretty much the same as I have always found injections. They are, more substantial than modern injections. A bit more intimidating. The upside to that is only 1 every 3 days... and that's a big upside.

It might be likely you need to experiment more with sets than injections, that's for sure. If you are lucky the 90 degree sets like the quickset will work - I say lucky because they are a cinch to put in, and if they stick, are likely to stick well.


I am fairly lean and would like to stay that way. I have not had any issue with my injections sites up to this point. It sounds like pumpers have more issues with injection sites. Do you notice an accumulation of fat or scar tissue around your typical infusion sites? More so than with MDI?

After a year, I'd say it seems about the same. What I find is that I get lumpy from previous sets, but it goes down after a few weeks, I put it down to some kind of reaction to having a lot of insulin at the site. Whether there is residue "scarring" I'm not sure yet.


I am very active and am concerned about pulling out my infusion sets. I really just need someoen to put my mind at ease about it. I am concerned about playing hockey and wearing the pump / infusion set under my gear, as well as showing with the set.

Thanks in advance for any input.

After you wear a pump for a while, you just get used to the dangling physicality of it. They are usually attached very securely at the body end. I would predict you have no problems working out a way to stash it into a hockey outfit, and you would not notice it.

Your A1c is good but how great would it be to see it come even further down, and I found that the BG benefits were not just shown in A1c but in more stable BGs as well. I say go for it, too. You can always go back, or even alternate between MDI and pumping, if you like. Mixing it up is always an option.

[balcy24]

It might be likely you need to experiment more with sets than injections, that's for sure.

I have been on a MM 722 pump now for 3 days now so I have lots of questions. :)

The upside is my insurance covered the pump and supplies 100 percent. They are also going to cover the CGMS 100% once I get used to the pump (according to the Medtronic rep). My CDE said she likes to wait about a month before adding the CGMS as it is a lot to learn at one time (I agree). The downside is so far I have had no choice on what infusion sets that they sent.

When I got the pump I got 4 boxes of resevoirs and only 1 box of Silhouette infusion sets. The CDE said to re-order when I got into the last box of supplies which is now. The problem is I don't know how to do that when the insurance is covering the cost. I ordered the Quick Set inserter when I spoke to the Medtronic rep (which is the only thing the insurance doesn't cover) so getting the Silhouettes surprised me and the CDE. How do I order the Quick Sets?

I was able to do my first resevoir/infusion set change last night and the Silhouette hurt a lot more than the first time at the doctor's office. I thought maybe the angle was too shallow but my BS has been really good so far.

Another question has to do with changing the infusion set when doing an insulin refill. Apparently, I am near the limit of U100 insulin (Apidra). The CDE said I may have to double bolus at times because of the 25U pump limit. My basal rate is 2.25U/hr and my ratio is 1U per 4 gr of carbs with an insulin sensitivity of 13. Bottom line is I go through 300U in just over 2 days. Do I always have to change the infusion set or can I disconnect the tubing and change just the resevoir?

I went on the pump because my sugar was a roller coaster. I went to bed one night last week at 335, took my normal 85U of Lantus and was at 39 some four hours later.

Later,
Dave

[butterflykisses]

I have been on a MM 722 pump now for 3 days now so I have lots of questions. :)

The upside is my insurance covered the pump and supplies 100 percent. They are also going to cover the CGMS 100% once I get used to the pump (according to the Medtronic rep). My CDE said she likes to wait about a month before adding the CGMS as it is a lot to learn at one time (I agree). The downside is so far I have had no choice on what infusion sets that they sent.

When I got the pump I got 4 boxes of resevoirs and only 1 box of Silhouette infusion sets. The CDE said to re-order when I got into the last box of supplies which is now. The problem is I don't know how to do that when the insurance is covering the cost. I ordered the Quick Set inserter when I spoke to the Medtronic rep (which is the only thing the insurance doesn't cover) so getting the Silhouettes surprised me and the CDE. How do I order the Quick Sets?

I was able to do my first resevoir/infusion set change last night and the Silhouette hurt a lot more than the first time at the doctor's office. I thought maybe the angle was too shallow but my BS has been really good so far.

Another question has to do with changing the infusion set when doing an insulin refill. Apparently, I am near the limit of U100 insulin (Apidra). The CDE said I may have to double bolus at times because of the 25U pump limit. My basal rate is 2.25U/hr and my ratio is 1U per 4 gr of carbs with an insulin sensitivity of 13. Bottom line is I go through 300U in just over 2 days. Do I always have to change the infusion set or can I disconnect the tubing and change just the resevoir?

I went on the pump because my sugar was a roller coaster. I went to bed one night last week at 335, took my normal 85U of Lantus and was at 39 some four hours later.

Later,
Dave

Minimed just went through a Quickset recall and I think they're still catching up with the demand, replacing the recalled sets. I read some where that they were not taking new orders for Quicksets, so that might be the problem.

You should be able to call Minimed and find if you can order from them or if you have to go through somewhere else. Right now it might be hard to try other infusion sets because of the recall. Unfortunately, because of the proprietary system, you don't have many options. They do make converters that will allow you to use the luer lock system. Animas has them. I think Orbit 90's makes one too. The problem might be your insurance paying, and I'm not sure how using these converters would affect your warranty??? If you can get the Sure T's I think you'd like them. They go straight in, and I think the 90 degree sets are a lot less painful to insert...usually don't feel them at all. good luck! Minimed will get caught up at some point and the control with a pump is much better.

Oh...I wouldn't change my set out when I changed my reservoir, really no need.

[SCC]

I am in a similar situation and called Minimed - the overnight shipped a box of Silhouettes.

[zakksmom]

I am in the process of obtaining a pump and I have a few question regarding infusion sites.
I have been a diabetic for 25 years and have been successful with a MDI regimen (A1C - 6.8), but I think I owe it to myself to atleast try a pump out to see if I fing it any better. And considering I live in the great province of Ontario where pumps and supplies are covered by the government I would be foolish not to give it a try.

My questions are;

Even after 25 years of injections I have still never gotten used to the pain of needles. I often find injections quite painful. For those experienced pumpers out there, do you find inserting and infusion set to be significantly more painful than a standard injection?

I am fairly lean and would like to stay that way. I have not had any issue with my injections sites up to this point. It sounds like pumpers have more issues with injection sites. Do you notice an accumulation of fat or scar tissue around your typical infusion sites? More so than with MDI?

I am very active and am concerned about pulling out my infusion sets. I really just need someoen to put my mind at ease about it. I am concerned about playing hockey and wearing the pump / infusion set under my gear, as well as showing with the set.

Thanks in advance for any input.
My husband is Canadian- our son was just diagnosed with T1 we were wondering if pumps and the monthly supplies were covered in Canada- do you know if there are caps on the supplies or the pump? We have ins here in the states but can honestly go bankrupt with the out of pocket that we are subject to.. we may end up moving back to Canada just for the health ins.. any responses would be greatly appreciated.