Insulin pump infusion sets: Which one is right for you?

Insulin pump therapy offers a variety of benefits that support a more flexible lifestyle, better insulin management, and fewer potential episodes of hypoglycemia for people living with type 1 diabetes (t1d). Whether you're an experienced pump user with changing lifestyle needs or new to insulin pump therapy, technological advancements in insulin pumps can make diabetes management easier.

However, there are many factors to consider when deciding which insulin pump infusion sets to use, including the different tubing, needle, and cannula length options, among others.

Here, we're examining the five main aspects of infusion sets to help get you started, which you can further discuss with your doctor to make the best choice for your lifestyle. If you need additional support, an insulin pump trainer can show you how to insert and change infusion sets. It's also important to note that not all infusion sets are compatible with all insulin pumps.

1. Soft flexible cannula or stainless steel needle

Choosing between a soft flexible cannula or a stainless steel needle can be guided by experience. Soft cannula sets are made of Teflon and are known for their comfortability, and they can also be worn for up to 72 hours. However, an occasional kinked or bent cannula can result in blocked or inconsistent delivery of insulin. If you're using soft cannulas, you can learn how to identify and troubleshoot kinks or blockages.

A stainless steel needle set, on the other hand, can give peace of mind to someone less confident using soft cannula, but they must be changed more frequently (every 48 hours). Those with skin allergies or sensitivities to Teflon may also opt for using a stainless steel needle.

2. Needle length and placement

The length of the needle is another consideration when choosing an insulin pump infusion set. Your doctor can advise on appropriate length based on your size, body mass index (BMI), skin thickness, and level of physical activity.

The cannula or needle lengths can vary from 4.5 millimeters to 19 millimeters depending on the depth of adipose or fatty tissue at the insertion site. While insulin pump infusion sets are usually placed on the arm, abdomen, thigh, and buttocks, the abdomen is frequently preferred due to ease of access and comfort.

3. Insertion choices and angles

It's important to factor in the options of manually inserting the cannula or needle or using a quick set insertion device. Manual insertion is typically done at an angle and may be preferred by people with low BMIs who are physically active. An insertion device is best for people with arthritis or difficulty using their hands. Inserting the infusion set into harder-to-reach areas, like the back of the arm, is easier using a spring-loaded device.

The manual insertion supports angles ranging from 10 to 45 degrees and longer lengths for the needle or cannula. Inserting the set at 90 degrees means the needle is inserted at a right angle directly into the skin.

There are a number of benefits to shorter and longer angle placement. If you're physically active, you may prefer angled placement with a longer cannula length to prevent movement. This means you can exercise knowing your infusion set is secure and without having to disconnect the insulin pump. If you're less active and more concerned about needle length, you may prefer a shorter needle inserted at 90 degrees.

4. Tubing length

Your preferred tubing length — usually 23, 32, or 43 inches — can vary depending on lifestyle and daily physical activity. Most individuals who use an insulin pump wear the pump on a belt loop or place it in the pocket of a shirt or pair of pants. Others wear the pump beneath their clothing and would therefore opt for a shorter length.

Users of insulin pump infusion sets often keep a variety of tubing lengths to accommodate for the distance between the insulin pump to the infusion site. Tubing distance is also relevant to the location — for example, you may want it to be accessible to a counter or a table where you can perform the daily routines of entering data, recharging the battery, or adding insulin.

5. Lifestyle

Elements of your lifestyle — such as whether you work full-time, are physically active, or are retired and enjoying leisure activities — can play an important role in choosing the right infusion pump set. Combining the use of an insulin pump with a CGM, for example, can offer even more options for managing t1d.

Since sustained physical activity can affect blood glucose levels, your doctor or a diabetes educator can give you more information on how to adjust insulin levels for the pump to avoid experiencing a low blood sugar event. Additionally, if you intend to disconnect the insulin set from the pump to shower, bathe, swim, or participate in other activities, it's important to be prepared to monitor blood sugar levels and inject insulin as needed.

By discussing your options with your doctor, you can identify the right infusion set to match your insulin pump. The right insulin pump infusion set can let you enjoy life without constant attention to blood sugar levels and managing insulin. Whether you're working or engaging in physical activity, you can confidently feel your best.

If you want to learn more about insulin pump therapy, check out this article that covers all the basics.