Infusion Sets: What’s New? What’s Not So New?
By: Barbara Bradley
Often, the more options we have, the more difficult it is to choose. Or, the more options available, the greater the chance to experiment.
Individuals who are exploring the option of insulin pump therapy have questions about the types of infusion sets available. Some new pumpers might need to experiment with several infusion sets before they find the one that meets their needs. Veteran pumpers might want to use one preferred infusion set for usual daily activities and different set for alternative circumstances. One set for an abdominal site might be satisfactory, but another set for an alternative site (hip, thigh, arm) might be needed.
Site location, insulin absorption, wardrobe, exercise, time of year, time of month, height, weight, age, gender and pregnancy are a few other variable that could influence your choice of infusion set. Catheter/needle length and tubing length is an additional factor to consider when choosing the “perfect” set for your lifestyle. The method of catheter/needle placement under your skin and the method of securing the set to your skin may also need to be evaluated.
You may also want a set that can be disconnected without removing the catheter/needle.
The sets most frequently used are plastic catheter sets that can be easily disconnected from the tubing for bathing, swimming, sports, intimacy, changing clothes, or whatever. Most pumpers use this type of set. Bent needle sets, which can also be disconnected, are a good choice for people who have tissue reactions to catheters, or who have a problem with catheters bending in certain body locations. There are some “old-timers” who started out with needle sets on day one, and prefer not to change.
What size catheter/needle length do you need?
It depends on whether you can “pinch an inch” or have very little to pinch. Does it matter to you if the insertion is straight in, at a 90 degree angle, or do you need less of an angle? If you have a normal subcutaneous fat layer under the skin surface, then a 90 degree insertion may be what you prefer. Thinner people may need to use a set that is inserted at 45 degrees or less. A pregnant mother may need to switch from a catheter set to a needle set by the seventh or eighth month. A child will need a shorter insertion catheter/needle than a 150-pound adult.
What length of tubing should you choose?
That also depends. Do you need a set of 24 or 42 inches? Your decision will be based on personal preference to meet your needs. If you are petite, or short stature, do you really want that 42-inch tubing? If you are 6′ 5″, do you want a 24-inch tubing?
There are some amusing stories about tubing lengths that some pump veterans are eager to share. I am tempted to paraphrase a camp song here: “…Does your ‘tubing’ hang low? Does it wobble to and fro? Can you tie it in a knot? Can you tie it in a bow?” Does it wrap around your sleeping body and get tangled in your toes? Is it long enough to slither down your leg when you want to wear the pump hidden at your ankle?
You will want to secure the infusion set to your skin after you have inserted it. Who would want it to fall out? There is also a tape method to suit your needs. The Comfort/ Tender/ Silhouette and Contact/Rapid sets have adhesive as part of the insertion set, and, usually do not require additional tape. For extra security, you might want to “sandwich” your set by first placing tape on your skin and then inserting the infusion set through the tape.
MiniMed Sof-sets, and other needle sets, will need a securing tape placed over the insertion site. There are a variety of transparent tape brands available, as well as adhesives and skin barriers, should one form of tape prove not to be the right type for you. Pump manufacturers, your pump trainer, or medical equipment supplies frequently provide samples with which to experiment. There is a tape method for your personal needs.
There are two new types of infusion sets: MiniMed’s Sof-set Micro QR 6 mm. catheter, available since fall 1999, and Disetronic’s 6 mm. Rapid needle set, available since January 1999. The Sof-set Micro QR has a disconnection feature, but the Rapid, however, does not have this feature available in the United States.
For help with your decision about tubing sets, ask your pump trainer to demonstrate the options. Whichever brand of pump you choose, the pump manufacturers usually provide samples to “play” with while you are in the training phase of getting ready to pump. The chart included in this article provides a summary of available sets to assist you in your decision.
Whatever you decide to use, it should be the right decision for you. Don’t choose a set because your pumper buddy says it is the only one he or she would use. Everyone is different and has unique personal needs. The one you choose is the right one for you. And, if it turns out not to be the right one for you, change to one that is.