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Leaving old cannula in place, was Re: [IP] There is a first time for everything

Kathie wrote:

>In a message dated 1/29/00 8:46:06 PM Eastern Standard Time,
>email @ redacted writes:
> > You should leave the old set in place for
> >  2 hrs on H
> >  4 hrs on R
> >  to allow time for any infused insulin to be absorbed before removing
> >  the set. This prevents leakage or tissue damage from affecting the
> >  absorbtion of already infused insulin.
>I am very confused.  When I do I set change, I put the pump in suspend and
>disconnect at the site, while showering I remove what's attached to me and
>then proceed with IV prep , etc., etc.  The whole process takes me 15
>minutes.  I have always removed the old set first.

As do I .....

There seem to be a couple different approaches to set changes:

1)  Those who change sets just prior to a meal, such as breakfast, then 
bolus. This helps ensure there is no tissue blocking the end of the new 
cannula (or metal needle), the new site gets a bit of a "prime", etc. This 
is the way I was taught several years ago, and it has worked for me without 
fail. My "post infusion set change" BGs don't climb or wander erratically.

Important note is that this technique works for me with any type of 
infusion set - Classics (bent needle), Rapids (straight metal needle), 
Tenders (soft cannula).

2)  Those pumpers who change sets *after* a meal (and the meal bolus). A 
common scenario might be a pumper waking, bolusing and eating breakfast, 
showering then changing the infusion site. In these cases, it makes sense 
that there will be some insulin "leakage" (sometimes attributed to the 
"tunneling effect", resulting when the cannula is removed).

Of course, if you are changing sites due to problems with the old site, it 
doesn't make sense to leave the old cannula in place for any period of 
time. After all, it was causing problems to begin with, so it's probably 
best to remove it.

Not to appear critical, but the approach suggested by Michael is not the 
*best* way. It's another way ......... :-)

As always, YMMV

Bob Burnett

mailto:email @ redacted

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