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Re: [IP] Re: Help with infusion

At 07:20 AM 6/9/98 -0400, Judy C. wrote:

>Megan woke up three times to pee in the night last night. Tested at 4 am
bg of
>527!! Changed the set-again after only a day. Blood all over the
tape-inject 2
>units of Humalog-surprisingly enough-no ketones.
>We are using the Rapids which is an 8mm needle that stays in place with IV300
>tape under the set and over the set. Most of the time she bleeds and you can
>see blood in the tubing after only 1 day. Could not tolerate Silouettes-
>cannula would crimp after a day or two. Megan is very skinny. Same problem
>with the sofsets.


Soundslike the set is consistently too deep. The 8mm Rapid is the shortest
one available now, but Disetronic is supposed to have a 6mm Rapid out "very
soon". The 6mm flavor is designed to be more easily used by thin pumpers.
One of the reasons I've never tried the Rapid is I'm sure the 8mm flavor is
too long for me (also a bit on the lean side). The 8mm needle is similar in
length to the MiniMed SofSet, and I could never use them. They scratched
constantly against the muscle layer and drove me nuts ;-(

Since Megan seems to consistently show blood in the tubing after one day,
it suggests very strongly that this length / type of set is not appropriate
for the locations you are using. If she shows blood even when using
different sites, this is even more reason to suspect the design of the set

I forget, but what was it that Megan didn't like about the Silhouettes?
Since they can be inserted at different angles, using different depths,
they can be adapted to a bunch of different needs. Some users find they
only need to be inserted about 3/4 of the total length to be effective.

I don't have a ruler or a spare cannula, so I can't measure it. I'm curious
to know what the length of the cannula is on the Silhouettes / Comforts /
Tenders. Using 3/4 of the total available cannula length will probably
result in less than 8mm in the sub Q layer, especially since it goes in at
an angle.

Another possibility, though a remote one, is the Humalog itself irritating
Megan's tissue, somehow causing bleeding into the tubing. I have heard
scattered reports from users that they experienced more incidents of blood
in tubing when on Humalog than they did with Velosulin. I noticed this over
time, but not with the frequency Megan is experiencing.

>Also-Mini-med IS developing an infusion set for leaner people but they
told me
>it would take 12-15 months to put it out on the market. If anyone wopuld like
>to get on the band wagon to speed it up-if possible? Please call Alan
>at Mini-Med. He is the product manager for the infusion sets!
I wonder how this fits with Bill VanAntwerp's  (MiniMed Chief Scientist, on
this list) comments that MM is well aware of "issues with tissues" -
specifically problems with Humalog pumpers and premature site failure.
Could the sets for leaner people also be designed to work better with Humalog?

Being the skeptic that I am, I wonder if the 12 - 15 month "development"
time frame for the infusion sets coincides with Eli Lilly's research /
testing / validation / certification of Humalog in pumps. This seems a very
long time to develop and market an infusion set.

Bob - who really wishes that the vendors who listen and learn from our list
would also post to our list to share their knowledge and findings ;-|

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