# Cannula locations



## HarrisonMSlough (Apr 25, 2020)

I currently use an Accu Chek Insight pump. I insert the cannula into the abdomen. I mainly change this not going above the line of my belly button (not going above the height of the belly button). I didn't realise that you could actually go above the belly button. Just wondering whether this is painful at all. I use the plastic needles.


----------



## trophywench (Apr 25, 2020)

Anywhere you have enough flesh and observe thereafter that you have good insulin absorption from wherever you put the cannula, is 100% fine.


----------



## SB2015 (Apr 25, 2020)

Welcome to the forum @HarrisonMSlough 

Like you I had thought that I had to stay below the belly button level.  I was surprised when I saw a diagram with the belly button as the centre of a target.  I then started working a little higher but below the rib cage.  I do find that I am more sensitive higher up and I have a lot less padding there, so sometimes end up taking the cannula out, if the initial ouch does not settle, but if I don’t go too high it does work and gives the lower abdomen a bit of a rest.

I also move round to the sides a bit, but I like to be able to disconnect without assistance so don’t go too far, and often forget to orientate the cannula towards the front, which then becomes a bit of a difficult task reconnecting.


----------



## HarrisonMSlough (Apr 25, 2020)

SB2015 said:


> Welcome to the forum @HarrisonMSlough
> 
> Like you I had thought that I had to stay below the belly button level.  I was surprised when I saw a diagram with the belly button as the centre of a target.  I then started working a little higher but below the rib cage.  I do find that I am more sensitive higher up and I have a lot less padding there, so sometimes end up taking the cannula out, if the initial ouch does not settle, but if I don’t go too high it does work and gives the lower abdomen a bit of a rest.
> 
> I also move round to the sides a bit, but I like to be able to disconnect without assistance so don’t go too far, and often forget to orientate the cannula towards the front, which then becomes a bit of a difficult task reconnecting.


Thanks for your help. How high up did you go for the first time?


----------



## SB2015 (Apr 25, 2020)

I worked my way up and found it got less comfortable once getting just under the ribs.  It did give me an extra line of sites to use.


----------



## HarrisonMSlough (Apr 25, 2020)

Okay. Thanks for your help


----------



## Pumper_Sue (Apr 25, 2020)

HarrisonMSlough said:


> I currently use an Accu Chek Insight pump. I insert the cannula into the abdomen. I mainly change this not going above the line of my belly button (not going above the height of the belly button). I didn't realise that you could actually go above the belly button. Just wondering whether this is painful at all. I use the plastic needles.


Hello and welcome to the form.
I've always used my belly starting from under my ribs and working my way across and down each side with no issues.


----------



## trophywench (Apr 25, 2020)

99% of all cannulas are 'plastic' once you remove the introducer needle anyway (some sort of Teflon)  Do you mean the angled 13mm ones you have to insert by hand? cos if so, you need to be able to reach em better than I now can the ones in my bum that I have to rely on my husband to insert and 'deal with' for me.  (You can see now why I'm so keen on him not getting 'the current lurgy' can't you?   )


----------



## everydayupsanddowns (Apr 26, 2020)

I generally use sides and back (between hip-line and ribs), but as @trophywench suggests, the most important thing seems to be the amount of ‘flesh’ in any area.

I know people who regularly use thighs and arms, but I’ve not found those areas to be very comfortable when I’ve tried them.


----------



## trophywench (Apr 26, 2020)

My outer thighs no longer have enough flesh to be of use (lipohypertrophy and marked hollows when still on MDI)  but if I use the front of them, with just a teeny weeny bias towards 'inner' side, it's still good.  Some of my belly doesn't absorb well these days either, but that's the opposite effect of lipo where the flesh beneath has gone fibrous.  Hence I now have 3 sites each side of my navel, 3 each leg and 3 each bum cheek.  Cannula needs changing every 2 days (clinic and I decided that early on, so as to try and avoid even more iffy areas) so that no one spot gets used more than once a month.

I'm very short waisted and practically live in trousers so though I've tried, it's very uncomfortable for me to have a cannula above the waist.  There's a limit to how many cannulas I'm prepared to waste by having to rip them off !  Not exactly a cheap commodity are they!


----------



## owl61uk (Aug 23, 2020)

Sorry to bring back on oldish thread but my excuse is i am new on here

Been using the Minimed 640 for around 18 months and generally things are getting better. I do however find that, on occasions when I insert a new canula, my BG tends to rise and stay fairly high, above 10 for a number of hours. Maybe 4/5 hours later things settle down, and for next few days before I change again, BG seem to be fairly well controlled.

I do rotate my sites around my stomach so no lumpy bits as such and there is, ahem, sufficient skin area for cannula to go

Anyone experience similar issues ?


----------



## Kaylz (Aug 23, 2020)

Not sure if its been spoken about on this forum and I'm not a pumper but I've seen numerous pumpers deliver some insulin via pen when doing a set change as they go high when doing so, you could try a forum search xx


----------



## Pumper_Sue (Aug 23, 2020)

owl61uk said:


> Sorry to bring back on oldish thread but my excuse is i am new on here
> 
> Been using the Minimed 640 for around 18 months and generally things are getting better. I do however find that, on occasions when I insert a new canula, my BG tends to rise and stay fairly high, above 10 for a number of hours. Maybe 4/5 hours later things settle down, and for next few days before I change again, BG seem to be fairly well controlled.
> 
> ...


Are you doing a set change before meals or a bolus for a snack? This is the best way to avoid any spikes in blood sugars. Also leave the old cannula in for an hour, so any insulin in the old cannula is absorbed. 


Kaylz said:


> Not sure if its been spoken about on this forum and I'm not a pumper but I've seen numerous pumpers deliver some insulin via pen when doing a set change as they go high when doing so, you could try a forum search xx


I think you have misread the posts as the bolus via pen is given if bloods are running high and not coming down as in illness or a failed cannula.  It is not a good idea to give insulin via a pen or syringe at set changes, the pumper needs to find out why they have the problem and fix it.


----------



## SB2015 (Aug 23, 2020)

Just a thought.  Do you prime your new cannula.  I am on a Combo (the predecessor to Insight) 
With a new cannula I need 1unit of insulin to prime it.  I don’t always remember and then I see a rise and check back to make sure I primed.

Thanks @Pumper_Sue for the tip about leaving in the old cannula.  I have never had that suggested.


----------



## Kaylz (Aug 24, 2020)

Pumper_Sue said:


> I think you have misread the posts as the bolus via pen is given if bloods are running high and not coming down as in illness or a failed cannula.  It is not a good idea to give insulin via a pen or syringe at set changes, the pumper needs to find out why they have the problem and fix it.


Thanks Sue but no I did not misread it, it may not be a good idea but people often do something they maybe shouldn't no matter how wrong you may think it is, I have seen a few people doing it as its what they have found to work, so yes it may not be the right thing but you can't stop them


----------



## Pumper_Sue (Aug 24, 2020)

Kaylz said:


> Thanks Sue but no I did not misread it, it may not be a good idea but people often do something they maybe shouldn't no matter how wrong you may think it is, I have seen a few people doing it as its what they have found to work, so yes it may not be the right thing but you can't stop them


Well if they are doing it, then there is no point in them having a pump is there? The pump has been designed to deliver the correct amount to fill the cannula (as long as you the user set it up correctly) Injecting extra means you have insulin unaccounted for in any calculations the pump makes for correction of highs or meal boluses. If there is a problem then use the pump to bolus not a pen or syringe.


----------



## everydayupsanddowns (Aug 30, 2020)

I am another pump user that always makes sure a set change happens just before a meal, so that a decent sized dose goes through the new cannula and creates a ‘pocket’ under the skin from which the insulin will be absorbed. If a meal isn’t due I would have a snack so that at least a unit or two needs to be delivered.

It also helps to check the absorption of the new site, as BG would rise rapidly in response to the carbs if it wasn’t gonna work out.


----------



## trophywench (Aug 31, 2020)

I've never done that Mike, just change em whatever time it happens to be convenient every 2 days.


----------



## Sally71 (Aug 31, 2020)

We were told to always do it before a meal, so that the meal bolus will flush the cannula out and if it hasn’t inserted very well you’ll find out sooner rather than waiting however many hours worth of basal it takes to trigger an occlusion alert.  These days however we prefer to waste as little insulin as possible so do it when the cartridge is as low as we can get it.  So tonight that was just before bed, she had 6 units left which won’t last the night.  She did need a correction though so that served instead of a meal bolus!


----------



## everydayupsanddowns (Aug 31, 2020)

trophywench said:


> I've never done that Mike, just change em whatever time it happens to be convenient every 2 days.



It’s worked for me, and certainly helped in my early years when I was on Quicksets which failed far too often. 

I can’t remember whether it was a PWD suggestion, or something my DSN said during training


----------



## trophywench (Aug 31, 2020)

Not a thing I've had happen all that often, thankfully.


----------

