When Should I Change an Infusion Set?
I have used an insulin pump for 15 of the 19 years I have had diabetes. How can I know when to change my infusion set? Because infusion sets are so expensive, I usually wait until I have two unexpected highs or about two to three days’ use before I change the site. Dorothy Quandt, Willoughby Hills, Ohio
Janis McWilliams, RN, MSN, CDE, BC-ADM, responds:
Congratulations on being an “insulin pumper” for 15 years!
What to Know
It is difficult to maintain good glucose control when you are treating high glucoses instead of preventing them. In general, manufacturers of insulin pump infusion sets recommend changing them every 24 to 48 hours for a metal needle or every 48 to 72 hours for a soft cannula. It is best to follow these guidelines to maintain good control and minimize infection risk. After inserting a new infusion set at a new site and filling the catheter with insulin as directed to avoid any interruption in flow, check your blood glucose one to three hours later to be sure it is working properly. Never change your site at bedtime as you won’t be awake later to check that insulin is being delivered.
If you are following these recommendations and still have high glucoses toward the end of the infusion set’s life, note whether this happens at certain sites. You may have areas that have some scar tissue or lipohypertrophy (excess fat in the infusion area). Consider resting these sites for a while, and you may need to retire them. Be sure to always rotate your sites at least 2 inches from the previous one and avoid areas where you have not been getting good absorption.
If you are still not getting the recommended use from each set, consult a health care professional knowledgeable about pump therapy for suggestions, including a different type of infusion set. You can also call the customer service number of the company that makes your insulin pump. Pump makers often employ clinical specialists who can suggest ways to improve your pump therapy.
An insulin pump is a great way to manage the day-to-day challenges of intensive insulin therapy. You and other longtime pumpers might benefit from a tune-up by a pump specialist to help keep your blood glucose levels in your target range.