I confess that I am not a total rule follower with my Tandem pump. But I think that some of the “not In the manual” things I do make my pumping experience better. Today I will share two Tandem infusion set hacks with you.
If you don’t use TruSteel or VariSoft infusion sets, you might want to quit reading now.
Pain with TruSteel Sets
Within the last year I have become a convert to metal infusion sets and with Tandem that is TruSteel. I find that insulin absorbs immediately after insertion unlike other infusion sets where I had to bolus or use a temp basal to prevent post-insertion highs. And I don’t get site failures. Except…. Sometimes TruSteels just hurt because it really is just like sticking a thumbtack into your body.
When discussions about pain come up in the Tandem t:slim Pump group on Facebook, many people say that these sets never hurt and lots of parents report that their children use them pain free. So am I a wimp? I guess so because I occasionally get lots of pain and pull sets prematurely or limit the locations where I use them. And for me a painful site gets inflamed quickly.
Last week in a Facebook discussion when I shared my wish that Tandem would make a metal set with a really short needle, my online friend “Lauren” suggested putting a small piece of gauze underneath the set to seemingly make the needle shorter. Wow! I always think I know all of the diabetes hacks, but that was something I had never thought of. At the same time I am lazy and couldn’t imagine cutting up tiny pieces of gauze. Brainstorm. How about a small round Bandaid that has a built-in gauze pad in the middle?
I am on my 4th TruSteel with a triple layer of products and the results are incredibly good. I have no idea what the exact thickness of the Bandaid is, but it is enough that I have had zero pain even with rolling over and sleeping with a set on my hip. I never could do that before. Every location I have used has been pain free and the procedure is quite easy. Stick a round Bandaid on the intended site, insert the TruSteel needle through the central gauze pad, and then put a small rectangle of Opsite Flexifix or Tegaderm on top. (I have always used over-tape on the needle site because it prevents me from accidentally ripping off the set by catching my thumb in the tubing.)
Although I still think that Tandem should have a TruSteel set with a 4mm needle, this hack is currently a great work-around for me.
Using Animas and Medtronic sets with Tandem
The following hack only relates to TruSteel and VariSoft sets. It is possible that something similar can be done with other Tandem sets but I have never used those sets.
Interim Blurb: I’ll preface the discussion by reminding you that tubing for insulin pumps has two ends. One end connects to the pump reservoir and is unique for each brand of pump. Tandem tubing will not connect to Medtronic or Animas reservoirs. Nor will Medtronic or Animas tubing connect to Tandem cartridges.
BUT…. The other end of the tubing that connects to the infusion site on your body is the same for Tandem, Medtronic, and Animas. And not only is it the same for each pump brand, it is the same for TruSteel and VariSoft sets and the Medtronic/Animas equivalents of those sets. So if I use Tandem tubing attached to my Tandem pump cartridge, I can hook the other end of the tubing onto a TruSteel, VariSoft, Medtronic Silhouette, Medtronic Sure-T, Animas Comfort, or Animas Contact Detach set.
Why is this important?
Many of us struggle to get a sufficient number of infusion sets and that has been my experience on Medicare. But I have a diabetes friend who at one point had lots of extra Medtronic Silhouette sets that he wanted to get rid of. I was happy to help him out.
Interim Blurb: I use my pump cartridges and tubing for longer than my infusion sets and often change them independently of each other. I have done this throughout my entire pumping career with Medtronic, Animas, and now Tandem. My old lady skin and tissue require changing infusion sites every two days but it would be expensive and time consuming to change my cartridge and tubing that frequently. Some people consider that heresy but it has always worked well for me.
So how do I use my friend’s Silhouette sets? When I start a new cartridge on my t:slim, I use a Tandem infusion set (VariSoft or TruSteel) and the Tandem tubing that comes with that set. Two days later when I change my infusion set, I have the flexibility to use a VariSoft, a TruSteel, a Medtronic Silhouette or Sure-T, or an Animas Comfort or Contact Detach. And WHY is that? Because the end of the tubing that connects to the pump site on my body is identical for these six types of sets. The blue circles in the illustration below show that the site connectors on Tandem, Medtronic, and Animas are identical.
You may wonder why I keep mentioning Animas since these pumps and supplies are no longer sold in the US. But there are still people occasionally posting on social media that they have Animas supplies to donate. I was the beneficiary of a huge number of boxes of Animas Contact infusion sets that a local woman wanted to dispose of. I explained that she could use them with her daughter’s Medtronic pump with a tubing substitution but she wasn’t interested. These extra infusion sets are providing me with years of protection from Medicare rationing of supplies.
Another reason to understand how infusion sets can be substituted from brand to brand is that if you’re out of town and forget to bring extra Tandem infusion sets, maybe there is someone locally with a Medtronic Silhouette or Sure-T or even some Animas sets.
Interim Blurb: When you change infusion sets more often than cartridges and tubing, you end up accumulating lots of extra tubing. I save most of it because it gives me flexibility. I still have my Animas Vibe pump and could use Tandem or Medtronic sets with it because I have baggies full of Animas tubing. Similarly if I switch to Medtronic in the future, I could use Tandem or Animas sets because I have lots of Medtronic tubing.
I think that this hack will be confusing for many people. But if you understand what I am saying and use either VariSoft or TruSteel sets, you may find it helpful.
Now back to reading the Tandem user manual because I will be starting Basal IQ in a few weeks….
Thank you but the font you use is very difficult to read.
I’m sorry you had problems with the font, I do think that the font used for the title is funky but the rest of it seems fairly traditional. And maybe the sections with italics were difficult for you. I have to admit that I am either too lazy or too terrified to change the theme of my blog. But thanks for reading.
Laddie – As always a great read with wonderful “data”. I keep bookmarking these so I can have at hand when I can finally swap my MedT 630G for the Tandem X2, but that is still one-year away.
I have “one-off” infusion sets as I’m using the Med-T QuickSet Paradigm and thus doesn’t have the “common” connector for the infusion set side. Sigh!!
BTW – I had no problems with your font and I don’t have the best eyes in the world. 🙂
Thanks, Nolan. I always appreciate your comments.
Laddie, I have never used a steel set, in my case the Quickset is my preferred infusion set. But if I were to try the steel set I am sure I would read this easy to understand instructions.
Thanks for the excellent, Macgyver-esque insulin pump hacks. I’ve been trying to amass a buffer zone of extra supplies to coast through what may not be a smooth transition into Medicare. (In 15 days!) I’d been thinking about reusing pump syringes for more than one infusion set change. And your article gives me hope that it might be feasible.
Thanks for these great ideas! I also use the tslim and find steel sets work best. I do move them, often making them last 6 days with new sticky stuff and tape each time. I love your idea of the little bandaid – I’m going to try that! I do get sites that are either really painful, or not great absorption, and wonder if this will help with both of those… Question – do you put the bandaid sticky side down or up? I guess either side is sterile out of the wrapper…
I have been putting the sticky side down. When I pull off the set, sometimes the Bandaid comes with it, Other times I have to pull off the Bandaid separately.
Thanks for the hacks! The bandaid idea is sheer brilliance (feel free to tell “Lauren” I said so). I also occasionally have owwch sites. Those sweet munchkins – even the slim ones – have more of the juicy subQ fat than we do.
Most often my owwch site results from piercing a capillary and I can almost tell upon insertion. That’s anything I love about the steel cannulas – our ability to move the placement without wasting the set. When I do that, I add more goo to the part that sticks to me and of course a bit of Tegaderm. Small price to pay…
I do these things too. Nice to learn I’m not alone. I fill my Tandem X2 cartridge and tubing once a week, change my set every other day. The bandaid is a GREAT idea! I’ve used Dr. Scholl’s callous protectors over my Sure-T sets to prevent pressure pain, but can’t find them locally anymore. “Top Care” ones don’t stick well enough. I’ll try the bandaid! Thanks.