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Re: [IP] Am I Too Shallow?

Wayne wrote:

>Barb, I too have noticed a similar thing when I insert at too shallow an
>angle.  This also promotes "tunneling," i.e.,  the movement of insulin back
>around the cannula.  Deeper should not be a problem as long as you don't

I've never heard that "tunneling" is caused from an insertion angle that's
too shallow. Nothing I've heard or read mentions depth or angle of
insertion as a causative factor.

Insertion angles that are too shallow can contribute to poor insulin
absorption, since the cannula / needle ends up in the dermal layer. It's
sometimes a fine line between too shallow, just right and too deep. Maybe
we need something like one of those high tech fish finders to show us where
things are "perfect for insertion".

I understand tunneling to be caused by the tissue hardening around the
cannula. The factor I've seen cited most often is the length of time the
cannula remains in place. A crude comparison might be made to the way that
skin hardens around a foreign object such as a splinter.

I had a situation the other day very similar to the one which Barb
referenced in her original message. The tissue was slightly pink near the
end of the cannula. The pink extended away from the base of the set, with
the color concentrated immediately adjacent to the cannula. In this case, I
had a strong sense that the set was too shallow, but I let the experiment
run on.

After one day, the pink color subsided. BGs were good. Toward the end of
the second day, the BGs got a little "squirrely" - some random readings
with no clear cause. The pink color did not re appear. I eventually changed
the set, since a bolus didn't bring down an unexpected high.

I noticed the cannula was very shallow when removed (you can check this if
you remove it carefully). There was no evidence of insulin seeping from the
site, even after an extended period of time. I'd expect seepage with tunneling.

BGs promptly came back down with a new set in a new site.

Bob Burnett

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