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  • Introduction

    As you know, an insulin pump is a small mechanical device that delivers insulin according to pre-set programming. So far, you have seen how the Accu-Chek Combo insulin delivery system works in mimicking insulin secretion of the pancreas and how it can be adapted to respond to your changing insulin needs.

    The insulin pump delivers insulin from an insulin reservoir placed in the pump through the tubing of an infusion set to a cannula placed in the subcutaneous tissue.

    There are a number of different things to consider when choosing infusion sets and infusion sites (a site is the exact place/spot on the body the cannula will be inserted into e.g a place/spot on the buttocks or abdomen). In this lesson you will learn how to connect the infusion set to the insulin pump and to your body in the Standard Training Module.

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  • Goals

    At the end of this lesson, you will know:

    • What is an infusion set
    • How infusion sets differ from each other
    • The benefits of an insertion device
    • Where to insert the infusion set on your body
    • Where and how to wear the insulin pump
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    Features of the system
  • What is an infusion set?

    The infusion set connects the insulin pump to your body. It consists of a soft tube called the “transfer set” A and a “head set” (cannula) B. There is also a protective cover that can be connected to the head set when you are disconnected from the insulin pump. The cover prevents contamination of the head set while being disconnected. The abdomen is most suitable for infusing insulin.
    The recommended sites are 1 :

    • Abdomen
    • Outer hips

    Other sites 2 that can also be used are:

    • Buttocks
    • The upper part of the outer thighs
    • The outer part of the upper arms

    Under the guidance of your Healthcare team, choose (and disinfect) an infusion site away from your waistline, bones, any scar tissue, belly button / navel / umbilical area and recently used infusion sites. Rotate your infusion site regularly. Insulin is delivered from a cartridge in the pump, through the infusion set, and into your subcutaneous tissue.

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    Features of the system
  • Types of infusion sets

    There are different types of infusion sets available for the Accu-Chek Combo insulin delivery system. Infusion sets can have either a steel or soft cannula.

    Accu-Chek FlexLink Accu-Chek TenderLink Accu-Chek Rapid-D Link
    Cannula Fine silicon-coated
    soft cannula
    Fine silicon-coated
    soft cannula
    Ultra fine steel cannula (0.36mm)
    90° Insertion
    Angled Insertion
    Cannula length 6, 8, 10mm 13, 17mm 6, 8, 10, 12mm
    Tube length 30, 60, 80, 110cm 30, 60, 80, 110cm 20, 50, 70, 100cm
    Disconnection (head set) (head set) (At the D-Link connection)
    Audible click
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    Features of the system
  • How do infusion sets differ?

    There are several different types of infusion sets available to give pump users the choice to customize what works best for them.

    Infusion sets vary in cannula length, cannula entry angle and in the length of tube connecting the cannula to the insulin pump. For example, a person with little body fat may choose to use a set with a short cannula that enters the skin at a shallow angle (20 - 45°). A person with more body fat may find that a longer cannula entering at a right angle (90°) to the skin works best.

    You may have to try a few infusion sets to find the one that’s right for you.

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    Features of the system
  • Steel or soft cannula?

    Some people prefer soft cannulas 1 to steel ones 2 because they find them more comfortable to wear. They do not feel the cannula when bending, twisting or exercising. A soft cannula can stay in place for 48 - 72 hours. Steel cannulas are a little smaller. They tend to be used by people who find soft cannulas more difficult to insert. You can keep a steel cannula in place for 24 - 48 hours.

    Regardless of the type of infusion set you choose, you need to ensure that you replace the infusion set within the agreed limits. If you leave it in place too long, insulin absorption might be unpredictable or the infusion site may become infected which can cause occlusions and scarring.

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    Features of the system
  • Disconnectable?

    Disconnectable infusion sets allow the insulin pump to be taken off, without having to insert a new head set/cannula. This is useful when playing sports or during intimate moments.

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    Features of the system
  • What is an insertion device?

    Some pump users prefer to use an automatic insertion device to insert their 90 degree angled Teflon® infusion sets like the Accu-Chek LinkAssist automatic insertion device to insert the cannula easily. The device has a single release button and allows for virtually pain-free insertion. The ergonomic design enables the Accu-Chek LinkAssist automatic insertion device to be used with only one hand if needed.

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    Features of the system
  • Where to insert the infusion set

    The recommended infusion sites 1 are:

    • Abdomen
    • Outer hips

    Other sites 2 that can also be used are:

    • Buttocks
    • The upper part of the outer thighs
    • The outer part of the upper arms
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    Features of the system
  • Infusion site rotation

    The sites on the body where the infusion set is placed need to be rotated at each new cannula placement / insertion. This is to avoid hardening of the skin due to insulin (lipohypertrophy). Many insulin pump users prefer the front and side of the abdomen as infusion sites because these areas are easy to access. However, different regions of the body should be used in accordance to your healthcare professional's advice.

    The figure shows you a number of ways you can rotate where you place your infusion set. As a rule of thumb, choose an infusion site at least 2.5 cm (1 inch) away from your navel / belly button / umbilical region and 5 cm (2 inches) away from the previous infusion site.

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    Features of the system
  • Where to wear the pump

    Once the infusion set has been inserted, you can wear the insulin pump in a number of places as shown.

    When sleeping, you can:

    • Attach the insulin pump to your sleep clothes
    • Place it next to you on the mattress
    • Place it under your pillow
    • Place it on your nightstand
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    Features of the system
  • Quiz

    Check the correct words for blanks in the following sentence

    The infusion set connects the pump to your body. It consists of a _________ and _________ which is placed in the abdomen or other recommended area.

  • Quiz

    What is lipohypertrophy?

  • Quiz

    When you use an infusion set with a soft cannula, what is the longest period of time you can wait before it must be changed?

  • Congratulations!

    You have completed the Beyond the pump section.

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    Features of the system

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