Choosing an infusion set can be just as demanding and time consuming as selecting your insulin pump. The right set can mean the difference between 72 hours of carefree pumping and hours of frustrating high blood glucose levels and numerous “needle sticks.”
Many people never select their sets at all. Instead, not knowing they have a choice, they accept whichever set is included in the package when their pump is first shipped to them. Although all the sets perform the same function—delivering insulin into the fatty tissue below the skin—crucial differences can make one set preferable over another for different patients.
Before you automatically accept the set in the box, consider the following:
Type of needle
There are two basic options: steel needle or plastic cannula. Although steel may not sound as comfortable as plastic, these needles do have certain advantages over Teflon caterers. They are small, easy to insert and do not require an insertion device. They also don’t bend or kink, which makes them an option for people who have a history of repeated kinked or bent catheters. Their ability to hold firm despite being jostled makes them a good choice for muscular, active people.
Plastic catheters give you the option of 90 degree or angled insertion may produce less tissue trauma to the surrounding tissue when they enter the skin, are the catheters of choice for people with nickel allergies, and are widely available. Since many plastic catheter options come with an inserter, they work well for patents who are not comfortable viewing the needle
Angle of Insertion
Steel needles can only be inserted from a 90 degree angle but plastic catheters can be placed at either 90 degrees or 30-45 degrees. Using a plastic catheter angled infusion set usually ensures a firmer attachment than the plastic 90 degree sets and, like the steel sets, are appropriate for leaner more active patients. Patients in their third trimester of pregnancy (when the skin covering the abdomen is taut) or those with recurrent skin infections are also good candidates for angled sets. The insertion angle along with the extra length of the cannula in angled sets increases the likelihood they will stay attached.
The benefit of the straight sets, both steel and plastic, is their ease of use. Since most of the 90 degree plastic sets come with inserters, these sets are perfect for those who are needle phobic or have problems with manual dexterity.
Straight sets come with 6, 8, 9 and 10 mm cannulas. 30 degree to 45 degree angled sets come in 13 and 17 mm cannulas. Most patients do well with the short versions although patients requiring large boluses or basal rates, or those with lipohypertrophy (a lump under the skin causes by the accumulation of fat from repeated insulin injections) may find the longer lengths more suitable.
It may take a number of tries to find the best set for you, so don’t get discouraged if the first one isn’t the perfect match. Working with a diabetes educator can help you find the one that is right for you.