New to Group
Hi!
I just joined this group — nice to see there’s a place to go with
questions about pumps — there are so many things that the doctor
can’t help with.
I have had type 1 diabetes since 1990, and I have had a Minimed pump
since 1991. I now have a 507. I’m having a new problem recently
that I wonder if anyone else has had:
I have thickened areas under my skin on my abdomen where I inject,
and it appears to be from repeated injections of the canula set over
the last 10 years. Recently, every time I change my sof-set, my
sugar is very high — 300 - 400, and then it will come down and
everything is fine. If there were a blockage or leak, etc. I would
think my sugars would go — and stay — high. But this is only for
the first couple of hours and seems to be an absorption problem,
maybe from the lumps I’m injecting into?? I have started taking a
large bolus after each new sofset, and that is helping some. I met a
nutritionist soon after I was diagnosed who had worn a pump for nine
years and had to go to shots because she was having absorption
problems. Hopefully, I won’t have to go off of the pump for awhile.
Has anyone had similar problems?
Thanks!
Katherine
July 29th, 2006 at 3:48 pm
<< have had type 1 diabetes since 1990, and I have had a Minimed pump
since 1991. I now have a 507. I’m having a new problem recently
that I wonder if anyone else has had:
I have thickened areas under my skin on my abdomen where I inject,
and it appears to be from repeated injections of the canula set over
the last 10 years. Recently, every time I change my sof-set, my
sugar is very high — 300 - 400, and then it will come down and
everything is fine. If there were a blockage or leak, etc. I would
think my sugars would go — and stay — high. But this is only for
the first couple of hours and seems to be an absorption problem,
maybe from the lumps I’m injecting into?? I have started taking a
large bolus after each new sofset, and that is helping some. I met a
nutritionist soon after I was diagnosed who had worn a pump for nine
years and had to go to shots because she was having absorption
problems. Hopefully, I won’t have to go off of the pump for awhile.
Has anyone had similar problems?
>>
Hi Katherine: Welcome!
There are lots of other sites you can use for pumping. And a number of
different infusion sets that you might want to explore. How long do you
leave your set in? should rotate sites at least every 3 days otherwise you
can develop what you are experiencing. Good skin care, extremely important.
And good aseptic technique. Don’t pet the cat when changing your site.
There’s a slack that the piston in the pump has to take up before it’s really
pumping. Your bolusing when you change your site is definitely a good idea.
The other thing in learning what your insulin sensitivity factor is….how
many mg/dL of glucose will be brought down by how many units of insulin …..
You should be working more closely with your pump trainer/CDE and
Nutritionist.
Invest in John Walsh’s Pumping Insulin. It’s our "Bible of insulin pumping"
and an excellent resource.
If you have pockets of blood pooling behind your site when you are ready to
change it, it’s a good idea to let it bleed out…otherwise another source of
infection and trauma to the tissue…..hope this all helps….Joan :))))
July 30th, 2006 at 4:44 am
Ive been on the pump about 1 1/2 yrs. I do have a problem sometimes w/high
BGs after a set change. But I had worse problems on shots. Ive been
diabetic for 33yrs and had those lumps alot! I could not use those spots
after awhile because the same thing would happen. My BGs would go high if I
continued to use those places. Since I was taking 3-4 shots/day I was
running out of places. Ive heard others say there are other places you can
put your set in. I havent had to do that yet. Hopefully I wont have to for
awhile. I dont know if this helps at all. Chrissy
July 30th, 2006 at 1:45 pm
Hi Katherine,
Welcome to the group. I have been type 1 since age 8 (1968) and pumping
since Jan 1997. I have on occasion experienced what you describe. The
thickening under the skin is scar tissue and if I go unusually high and the
boluses don’t bring it down, I switch the site. This just happened to me
last week. I usually need around 45 to 50 units a day and this particular
day I ended up with a total of 110 units and BG’s of 400! I finally clued
in after several hours of bolusing 10 units an hour and then waiting for
the bg’s to come down that it just wasn’t working. When I switched sites,
it helped. Do you rotate around alot? Some people use other sites besides
the stomach. Maybe that would work for you for awhile. Also, how long do
you leave it in? I find that the longer I leave it in, the more scar
tissue forms. I’m sure you’ll get lots of advice from the experts on this
list. I gain so much from them. Well, I hope you’ll work it out so you
can stay on the pump. Good luck and glad to meet you. –Jeana in Alaska Ü
July 30th, 2006 at 8:23 pm
I gave up on softsets many years ago; I found them unreliable.
But, have you determined that you are taking out the backlash after changing the
set?
The rule I was taught was to use 0.8 units to take up the backlash. I had
found from experimentation that it usually takes up to 4 units to do this. So,
I no longer just put the number in and wait. I put in about 4 units, and wait
until I see a bubble of insulin form on the tip of the needle (I use the bent
needle). Then I KNOW that the backlash has been removed!
Works.
David
July 31st, 2006 at 2:08 pm
I didn’t have good luck with the softsets either. I think the needle was
just too short to get through the flab of my stomach. I also was very
allergic to the adhesive. I now use the Minimed Silhouettes. I like the
longer needle and I can put it straight down and it works great. Better
absorption than the other sets. (I tried all of them) Another mistake I
made when first starting was lubricating the plunger. I forgot to pull the
plunger out a couple of times before filling and I think it would kind of
stick and not deliver the insulin the way it should. Have done much better
since I now get the reservoir lubricated. Just a couple more thoughts I
had… Jeana Ü
July 31st, 2006 at 9:22 pm
> I now use the Minimed Silhouettes. I like the
> longer needle and I can put it straight down and it works great.
Jeana,
I also use the Silhouette but I was taught to put it in at an angle. I cant
imagine putting that long needle in straight down! I dont even like doing it
the way I was taught. But I do like the Silhoutte. Dont have to mess w/all
the tape etc. Chrissy
August 1st, 2006 at 6:23 am
Yes, you are supposed to put it in at an angle, but I have alot of flab to
go through and going straight in works so much better for me. It isn’t any
worse than giving a shot. Just a huge needle. I tell myself, "One, two,
three, jab!!" and then push! LOL Ü -Jeana Ü
—– Original Message —–
> Jeana,
> I also use the Silhouette but I was taught to put it in at an angle. I
cant
> imagine putting that long needle in straight down! I dont even like
doing it
> the way I was taught. But I do like the Silhouette. Dont have to mess
w/all
> the tape etc. Chrissy
>
August 2nd, 2006 at 12:14 am
Maybe there was something on the Quick Set that was discussed here earlier that
I’ve forgotten about…
but I tried some of the samples when MiniMed sent me the 508. My trainer, a
non-diabetic, said she had just tried if for a few days
and recommended it highly. I ordered it and found it to be just great. There
really is no tape mess at all, it inserts very easily and with
virtually no pain. The 9mm insert does the trick for me, and I’m of average
weight.
August 3rd, 2006 at 6:16 am
You are brave!!! Chrissy
August 3rd, 2006 at 2:24 pm
How does the Quick Set work? I know nothing about it. Do you need something
special to insert it? I have a 507c….is it compatable w/that? Thanks.
Chrissy
August 9th, 2006 at 3:23 pm
> The rule I was taught was to use 0.8 units to take up the backlash. I had
> found from experimentation that it usually takes up to 4 units to do this.
>
maybe the 0.8 was meant as the prime AFTER you remove the needle…..
August 15th, 2006 at 2:09 am
No, the initial bolus after insertion was specified separately, at 0.8 units.
I find that the backlash value can vary from as little as 0.8 to as much as 4.0.
This makes sense, since every time you replace the syringe, there will be a
different value of backlash remaining to take up….
David
August 17th, 2006 at 6:49 am
> No, the initial bolus after insertion was specified separately, at 0.8
units.
>
> I find that the backlash value can vary from as little as 0.8 to as much as
4.0. This makes sense, since every time you replace the syringe, there will
be a different value of backlash remaining to take up….
> David
Is this *backlash value* the same as the *slack* between the arms that press
against the top of the reservoir and needs to be *tightened* by that prime of
*up to* 10 units. The only way to get it seated correctly is to run the prime
until a decent-sized drip comes out. Then after insertion and withdrawing the
introducer needle, depending on the canula used, that prime goes INSIDE the
body to fill the emptiness left by the withdrawal. That last prime that goes
inside the body is what threw me off for about 6 years until I joined the ‘net
and learned otherwise.
Jan (~_^)
August 19th, 2006 at 3:41 am
You got it…slack and backlash are different names for the same thing.
David
August 20th, 2006 at 8:56 am
After reading these messages I am completely confused. I was taught
the I prime with 5 units then insert and away I go until I need to
bolus. It sounds like from what I read that you are priming and then
our giving yourself a prime of so many units and not having the
meter record it as a bolus. Do I have this figured out right?
Mary
pumping since Feb 2001
August 20th, 2006 at 8:55 pm
Hi Mary,
I prime 5 like you said (before inserting into me!) then I prime 1u inside of
me. It takes up the slack of the cannula that is inserted. Im sure others
will answer this too. Chrissy
August 21st, 2006 at 12:34 pm
It seems that this depends on what meter you are using. The earlier ones do not
record backlash or initial infusion events.
The important points are:
1. Take up the backlash. Do this by watching until a good bubble appears at
the end of the needle. This could be from 0.8 to 4 units. But, watch until
it happens!
2. Then, after placing the set into the site, infuse about 0.8 to fill the
cavity.
Then, enjoy yourself.
David
August 23rd, 2006 at 1:00 am
Mary,
How are your BG readings for the next several hours after a site change? I ran
in the 300’s for a few hours for six years because no one had instructed me to
prime 0.5u INSIDE me after withdrawing the introducer needle. I had used
straight (metal) needle infusion sets for 10 years and that wasn’t necessary
when seeing the drip at the end - the insulin was there and ready to go. Then
I got on here and found out after withdrawing that needle, the canula was
*empty* and had to be filled *inside* me to take up that emptiness. With the
silhouettes 9mm canula, 0.8 needs to be primed, and the 0.6 mm canula there
needs to be 0.3u.
How long do your batteries last? If not long enough, are you priming the
tubing with the pump motor or by *hand*? When setting up your changeout, push
the priming insulin for the tubing through by hand and don’t waste the battery
power to do it. Then after putting the filled reservoir/cartridge with tubing
in the pump, there will be a tad of slack when placing the driver arms against
the reservoir. That needs to be primed with the pump to take up that slack to
make sure it is seated correctly and you see insulin coming out. Now you are
ready to insert the set. When you are done and taped down and the into needle
is withdrawn, THIS is when you need to do that prime INSIDE you. Your manual
should have the amounts listed correctly. The *how to* on using the Prime
feature is also in the manual.
Which pump are you using? Hope this helps. Let us know.
BTW, my hugsband says a backlash is when gears have a gap and there is a
backward action as a result. There is no backward action in the reservoir
against the driver arms, therefore it is slack. (~_^)
August 23rd, 2006 at 9:07 am
On my previous post I forgot to say I use the Sof-Sets and those need 0.5u
prime inside me. You can call your pump company’s 800# and ask how much prime
to fill the empty canula for the particular set you use. It’s not good to
under/over bolus.
Jan (~_^)
August 23rd, 2006 at 7:36 pm
Katherine,
some of the confusion might be the dual use of the term ‘prime’. It
is being used as
1) priming of the pump: the preparation of the infusion set prior to
insertion…as in first you fill the tubing with insulin manually
(until you get insulin out of the needle); then you prime the meter
by setting a bolus or prime (depending on the meter) to take up the
backlash/slack - this is required to properly activate the motor.
This is when the amount varies, and can be done by watching for a new
and complete drop of insulin at the needle. I think mini-med
generally recommends trying 5.0 units as a starting point, but it may
take more or less.
2) the priming of the site. this is done after insertion on any
infusion set that removes a needle, leaving an empty canula. In some
cases it may be recommend even with a needle set to ‘prep’ the area
for insulin absorption. For the minimed soft-set the recommendation
is 0.5 units. This can be programmed as a bolus or a prime (I choose
to use prime so it doesn’t show in my totaly daily use amount). This
is the one that varies according to the type of infusion set you use,
and the lenght of the canula. For individuals who have immediate
lows after a new site is started this is generally reduced.
Both ‘primes’ are essential for proper start up of a new site.
If you ever do an ‘emergency’ resevoir shift without a new site (I’ve
done this when in a major time/location crunch or short on supplies)
then you would disconnect your tubing at the quick release or
equivalent location, and prime the pump, but skip the site prime. Of
course this isn’t a good general practice because the longer the site
is used the greater the chances of loss of absorbtion and/or
infection. But as in life there are always those unplanned events!
Suzanna
August 25th, 2006 at 1:42 pm
Mary,
I do the same as Chrissy to take up the space where the inserter needle was.
Gail
August 28th, 2006 at 2:09 am
Priming: I was taught to hold the prime button until 5 drops come out
of the connector and all bubbles are cleared, then I bolus 1u to fill
the canula after connection. I am getting the impression that the
folks posting don’t have the luxury of a prime button??
August 28th, 2006 at 7:10 pm
Yeah - we do have a prime button but why waste the battery power to do it when
you can shove it by hand. The prime then can be done after the
reservoir/cartridge is placed in the pump and prime until 5 drops come out.
The 42" tubing holds 20 units of insulin - that’s a lot of battery power
unnecessarily consumed. On my 507C for the prime I push the down arrow for 10
units and stop it when I see enough come out. The amount to fill the canula
inside your person after the intoducer needle is withdrawn is done with the
prime button, too. (~_^)
August 30th, 2006 at 7:10 pm
I see your point regarding batteries. However, I have not experienced
any problems with battery usage by using the pump to prime. I use the
Animas R-1000-A, which uses the typical #357 battery. I have been on
the pump for 2-3 months and have only changed the batteries once.
Maybe the MiniMed and Disetronics use more battery power?? I do know
that the batteries was one of the deciding points in choosing the
Animas over the Disetronics. (Availability mainly) I have also been
using the 24" infusion set, mainly, but do also use the 43". My
original order for supplies contained both lengths. I was leaning
towards the 24" sets, but both have their benefits.
September 1st, 2006 at 4:28 am
<< After reading these messages I am completely confused. I was taught
the I prime with 5 units then insert and away I go until I need to
bolus. It sounds like from what I read that you are priming and then
our giving yourself a prime of so many units and not having the
meter record it as a bolus. Do I have this figured out right?
Mary
pumping since Feb 2001 >>
Hi Mary: the best way to explain is that you should saturate the new site
with insulin to compensate for the interruption in pumping and absorption.
Some of us are more sensitive to insulin than others, and some sites are more
sensitive to insulin absorption than others. Each of us varies, and there is
no set minimum amount to bolus. Just remember less is better until you have
it all fine tuned…Joan:)
September 2nd, 2006 at 4:50 am
You changed once in 2-3 months - I don’t change at all for 2-3 months. Mine
takes two 357’s that I get at our supermarket @ $1.47 Eveready/Energier zinc
oxide.
> Maybe the MiniMed and Disetronics use more battery power??
I have a MM 507C - a backlight is on it but I rarely use it - which would also
consume power. I think we all come up with tips and tricks to make it go more
smoothly. (~_^)
September 3rd, 2006 at 12:35 pm
Very true regarding tips and tricks!! I use the same batteries, but 4
instead of 2.
September 3rd, 2006 at 9:28 pm
> Very true regarding tips and tricks!! I use the same batteries, but 4
> instead of 2.
Are you saying then, you are using 8 batteries compared to my 2? (2-3 months
you’ve used 8 - I’ve used 2) hmmmmm…. To each his own.
September 4th, 2006 at 12:58 pm
I have used a total of 8 since starting. I did also have some
problems with the original pump and had to prime several times, so I
think the batteries were drained unnecessarily. See ya!!
September 4th, 2006 at 5:57 pm
No, I don’t have the ‘luxury’ of a prime button! I have a Minimed 507, soon
to be a 508; then I will have that luxury. Is it really a luxury? Sounds
like a frill to promote the new model. Marginally useful, good selling point.
I guess if you keep close tabs on your daily dosage, that would be useful, but I
can estimate it just as well.
David
September 5th, 2006 at 2:05 am
Jan,
I think you are using the term ‘prime’ when you really are talking about
backlash in your example. Prime (to me) means filling the tubing from the
syringe before installing it in the pump. Backlash means taking out the
mechanical slack in the pump after installation.
David
September 5th, 2006 at 10:12 am
Jan,
You say you have TWO batteries; don’t you mean THREE?
With my 507 I seldom get much more than 6 weeks battery life, but I do use the
backlight frequently. Very handy in movie theatres, dark restaurants, and
walking on the beach at night.
David
October 4th, 2006 at 4:17 pm
You need the "Quick-serter" which is just a gizmo that auto-inserts the cannula.
You can choos a 9mm or 6mm size along with tubing
at 43" or 23" . Call you MiniMed rep or maybe they have this on their web site.
I found out about it when I first ordered my supplies.
October 6th, 2006 at 8:55 am
I’m new with any pump, but my 508 is great.
You can manually (without using up batteries) press the injector of
the reservoir or the PRIME button to fill the tubing after the
reservoir is in the pump and before inserting into your, say,
stomach, so that it doesn’t count in your DAILY BOLUS.
I must also "prime" to get those LEAD SCREWS that pump the insulin
into me set up properly. You can call it backlash or anything
you want. Each company may have its own definition/determination.
Minimed says to use the PRIME screen, so some of us say
"prime’.
As mentioned before by someone, the lead screws have to be in
position and pumping insulin out of the needle before insertion is
made.
The manual suggests 5U. However, if even one decent drop of insulin
shows at the needle, on the 508 you can simply press a button
2times to stop that influx, insert and get going.
I hope that helps even people who have another make to understand
what (my) 508 does regarding PRIME. There are so many pumps
out there, it is really important that each person either read or
reread their manual, or get in touch with their manufacturer. I
believe
all are available on a 24 hour hotline. There is probably a
technical help line, too. MiniMed has one.
Audra
MiniMed 508 since April 26/01