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The Good, The Bad and The Ugly

Posted Jun 05 2009 5:06pm

   I'm an infusion set freak. I love to try new sets, and I'll put them anywhere possible. Including a very uncommon site that is not often mentioned in Polite Company. But since none of us qualify as Polite Company, well, errrrrr, just click the link and spare me from having to figuratively bare myself (again) to the world wide web. And no, there are no pictures.

   Okay, train of thought derailed, many casualties. Moving on...

   Thanks to Rick Lynch and Applied Diabetes Research, I can try every single infusion set available. Thinset_reservoirs_2 In Canada. (Which, thanks to Health Canada and it's myriad of restrictions and hoop-and-poodle act, isn't a whole lot.) But I digress (again). The ingeniously crafted ThinSet Reservoirs transform my Paradigm 515 (soon to be the REAL Time 522 system!!) from a proprietary connection to a luer lock, allowing me to connect any standard luer infusion set to my Paradigm Insulin Pump.

   To date I've only had the opportunity to try three luer lock infusion sets:

  1. ADR's ThinSet Infusion Set: This one is, by far, one of m y favourites. In fact, I like it more Thinset_infusion_set_3   than Minimed's Quickset. The ThinSet is the lowest profile, at-site disconnect set that I've seen. It barely makes a bump even under the tightest, whitest t-shirt. It is a 90 degree, 6 or 9 mm, non-metal cannula. The tape is superb, and I have yet to have any of the corners lift even after three days of wear and tear. It has a see-through window at the connect site, so it is easy to see if you've hit a gusher or not. The self-sealing disconnect on the hub of the set means that there is no need for any sort of cap, even when swimming. And the best part of the ThinSet Infusion Sets? Their price. They are a good $40 cheaper than any of the other teflon cannula sets that I've used, and comparable with Minimed's Polyfin (bent needle) sets.
  2. The Accu-check (formerly Disetronic) Rapid-D Infusion Set: I've been waiting on the edge of Rapidd my seat to try this one. Only to end up flat on my face. The Rapid-D infusion set is a steel cannula needle set  (meaning there is no teflon cannula; the needle stays in for the duration of the set) with its own adhesive and a 90 degree insertion. It has an off-site disconnect, as seen in the picture. I'm a long-time user of the Polyfin sets, so the option of a 90 degree steel needle set was pretty darn exciting. And then I got some samples. I asked for samples of the 6mm needle with 43" tubing. I got the 8mm with 23". OK, fine, I told myself. Just insert them in the (few) areas that are padded enough for 8mm. Should be good to go, right? Wrong. Big, bad, ugly wrong. And if the pain wasn't enough to dissuade me from using these sets, then the tape was. A day after inserting these sets, the tape was bunching and lifting dangerously. Not just the edges, the whole thing. Resulting in my having to resort to medical tape in the first aid kit at work. And then having to cover the site with my Op-Site dressing thereafter. Oh, and I didn't just give up at one. Nope, I tried three of them, in three different areas, three different times. Ouch ouch ouch. Granted, the 6mm would definitely be a better choice for me, but the tape and the price of these sets pretty much decided me. A box of these bad boys is over $200. And you don't even get full sets; the tubing is reused for three sets. So what, I would like to know, is this company charging us for?? Crappy tape and a box of 15 needles with only 5 transfer sets (tubing). Right. Not worth it, IMNSHO. Oh, and yeah, my insurance covers these suckers at 100%. But I, quite frankly, am not willing to give this company any money that is associated with me for these crap-ass sets. I am not a cash cow, Disetronic. But thanks for trying.
  3. Accu-check Ultraflex: I received a few samples of this set along with the Rapid-D's. Another flop. Basically, see above. Bad, bad, bad tape. The hub-tubing connection is tight and akward, and even my small fingers found attaching and detaching cumbersome. Long story short: don't like 'em. Won't be using 'em again. It's so bad it doesn't even rate a picture!

**NOTEWORTHY** Minimed's Sure-T infusion set: A 90 degree, 6 mm steel needle set that was initially manufactured for new and young pumpers. It has a proprietary connection and uses the Paradigm reservoirs. The Sure-T sets have a 4", off-site disconnect with its own adhesive patch to prevent stress on the main Suret_1 site and possible dislodging of the needle. It comes only in 23" tubing and 6mm straight needles; longer tubing and needles are not available. I have been using these sets for a few weeks and I LOVE them. The Sure-T has the same connection as the Silhouette sets so I am able to connect the 43" tubing from my Sil's, making sleeping much easier. Personally, I do not like the second adhesive patch, so I just yank it off of the plastic connector and let the tubing roam as it will. The adhesive at the main site is kick-ass; it is so wonderfully tacky that I have yet to require a safety loop even with excessive tugs and twitches (if you have a Border Collie puppy who likes to jump up, you'll know what I mean). I particularily love to use the Sure-T sets (with the Silhouette 43" tubing, of course) in my arms, as manual insertion is simple and quick...no introducer needle to try to remove with one hand. As far as I'm concerned Minimed has a winner in this set...and it'll be even better if they ever decide to package it with 43" tubing.

   Next on my list of To-Try's are the Simple Choice infusion sets and the Cleo 90, if the distributing companies of these products ever return my phone calls and multiple emails. And, though it is not yet available for public consumption in Canada, the insets will remain at the top of the list.

   Until then, I'll ponder the meaning behind the name of Minimed's Sure-T's. Sure-teriffic's? Sure-tremendous? Sure-trombone?

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