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Re: [IPk] Re: Question for Teresa



Hi Teresa,
another thing that can help prevent highs after infusion set change is
always to change the set shortly before a meal when you will give a
bolus which essentially seems to help start the new infusion set
working nicely - no scientific basis that I know of, but many people
find it helps. Also are you using a large enough bolus to prime the
new infusion set?
Nanette

On 29 June 2011 10:40, Melissa Ford <email @ redacted> wrote:
> Hi Teresa
>
> Can you clarify what you mean by "new insertion" versus "set change"?
> Do FlexLink sets come packaged so that you're meant to use each length
> of tubing twice, ie one length of tubing per 2 cannula changes?
>
> Re the highs after a new cannula, that's pretty common. A lot of
> people (myself included) find that leaving the old set in place on the
> body for a few hours (no tubing attached to it) after changing the
> cannula seems to help. The insulin sitting in the old cannula seems to
> help smoothe the transition to the new cannula.
>
> Of course if the reason for the set change is irritation or bleeding
> (etc) at the old site, it's best to remove the old set rather than let
> it sit. If the blood glucose is very high at the time of the set
> change, you may wish to deliver the correction bolus by injection,
> then change the set right after the bolus to get the glucose down
> quickly. If you give a bolus by injection in this way, it's a good
> idea to deliver the same amount by pump whilst the pump is NOT
> connected to the infusion set so you have a record of the bolus in the
> pump history.
>
> Does that make sense?
>
> Melissa
>
>
> On Wednesday, June 29, 2011,  <email @ redacted> wrote:
>  > Thank you so much for the advice. Can you tell me if you fill the cannula
> after
 >> each new insertion or just set change as agter a new cannula is fitted we
get
>> high numbers for a few hors with the correction not working the first time.
>>
>> Cheers
>>
>> Teresa
>>
>>> ----- Original Message -----
>>> From: Melissa Ford
>>> Sent: 29/06/11 06:51 AM
>>> To: email @ redacted
>>> Subject: [IPk] Re: Question for Teresa
>>>
>>> Hi Iain
>>>
>>> It depends on the person - people have different thresholds for pain
>>> and some people will feel the withdrawal of the needle more than
>>> others. It can be more painful for children because they tend to
>>> squirm around, which creates vibration and thus stimulates nerve
>>> endings in the subcutaneous tissue as the needle is being pulled out.
>>> Even if the child is very still, another person doing the set change
>>> may unconsciously introduce vibration whilst withdrawing the needle.
>>>
>>> If you're happy with your sets, keep doing what you're doing. Just
>>> ensure you're rotating your sets around enough so you're not
>>> developing scar tissue. If you feel nothing at all (i.e. it's as if
>>> the tissue below the skin is numb) when you insert a set, you may have
>>> hit on an area of damaged/scarred tissue. Continually putting sets
>>> into damaged tissue can lead to trouble with absorption and,
>>> therefore, unpredictable blood glucose levels (just what we try to
>>> avoid with a pump).
>>>
>>> Melissa
>>> Type 1 18+ years; MiniMed pumper 7.5 years; Animas pumper 6.5 years;
>>> currently writing up a paper on infusion site management for diabetes
>>> care professionals (freelance gig)
>>>
>>> On Wednesday, June 29, 2011, Iain Jenkins <email @ redacted> wrote:
>>> > Hi Melissa,
>>> >
>  >> > What are the problems regarding introducer withdrawal - I don't have
> issues
>>>  > with medtronic quicksets and silhouettes, maybe some other types that I
>>> should
>>> > be wary of?
>>> >
>>> > With every good wish,
>>> >
>>> > Iain.
>>> > T1 Essex, UK.
>>> > minimed 515 pump
>>> > Current A1C February 2011 5.7.
>>> >
>>> > Help diabetics to reach their full potential through athletic endeavours:
>>> > http://www.insulindependence.org
>>> >
>>> > --- On Tue, 28/6/11, Melissa Ford <email @ redacted> wrote:
>>> > The big benefit, they say, is
>>> > set changes are a lot easier without having to withdraw the introducer
>>> > needle (the worst part of a set change for many of us, even adults).
>>> >
>>> > All best
>>> >
>>> > Melissa
>>> > .
>>> .
>> .
> .
.
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