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[IPp] Our experience on infusion sets

There have been several questions in the past few days from new pumper parents
or about to be's regarding type of infusion set, especially related to
bent/obstructed cannulas - and the lack of fatty real estate on lean kids.  The
concern over the risk of very high bg's & ketones on the pump as compared to on
shots is a very real risk - you MUST have a plan to address this, such as
giving a small insulin shot to start dropping those bg's/addressing ketones. 
If we're having site problems & aren't sure the new one will work, we give a
shot first.

My son Luke, 7, has been pumping 14 months - and I think he's gotten leaner
each month as he grows.  We started on Sof-Sets - but the cannula would pull
out at the drop of a hat but the outer tape would just secure it enough that we
wouldn't know it until time to check & Luke had bg's of 500, ketones, etc.  So
I personally never recommend these - some folks love 'em & I say use what works
- YMMV.  Our mileage on SofSets stinks.

We used QuickSets for about 1 year.  We still love 'em - but the 90-degree
angle cannula bends so quickly & so readily if put into a muscular area such as
on Luke's tummy.  We've been restricting the areas on which we can use them
more & more over the past 6 months, and are currently at only the lower
back/love handles (which is only good for about 1 site/month).  The inserter is
much less intimidating to Luke, it's more comfortable, it sticks really really
really well to his skin, and he loves the disconnect.  

In the past couple of months we've been using Silhouettes w/ the inserter - I
wasn't very good at manual insertion (too slow I think).  These are working
great & work very reliably in areas where QuickSets bend, all around his tummy
"fat" - what little there is.  I'm thinking these are going to be our long-term
set.  Just this week Luke got to the point where we can do a Sil changeout in
<5 min. - and he doesn't use Emla.  For him, waiting an hour just gets him more
& more nervous - it's best to get the insulin reservoir ready & go on Luke.  
The Sils stick just as well as QuickSets do, thankfully.

We've just used the MiniMed sets so I can't comment on any comparable
Disetronic or Animas sets but have no reason to think they would be very
different for us in similar styles.

Hope that helps any of the deciders.  Try to get some training if possible w/
the new sets from your pump trainer - it's really frustrating to be at home in
the evening with a scared child & not know well enough how to insert a set - or
how to disconnect it (like our first day on QuickSet).
Shelly V, mom to Luke, 7, dx'd 10/99, pumping 3/01 - MM508 + Novolog + Sils now

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