# Where/how to put in cannulas when you don't have much fat?



## Nellybee9 (Feb 16, 2018)

Apologies if this is already a thread but I couldn't find anything.

Since I started doing a lot of climbing I've lost most of my sub-cut fat except for a wee pouch on my tummy and my bum. I can't use my bum because it just gets ripped out too easily. I occasionally use my hips but the absorption is really different. My nurse was talking about getting some insets that are a different angle but they haven't materialised yet so in the meantime does anyone have any tips?


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## trophywench (Feb 16, 2018)

Hi Nellybee - the angled ones can help some people so definitely worth a try.

A lot of us order our pump supplies direct from the pump company so were it me, I'd just ring Roche (my pump co) and ask them for a few angled ones to try.  They supply orders direct to our homes so no trekking off to hospital clinics or waiting round for things.  They just invoice the CCG in the normal manner for such things usually.


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## HOBIE (Feb 16, 2018)

Medtronic have different cannulas for different angles. at leased 3 types . Good luck Nellybee !


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## SB2015 (Feb 16, 2018)

Hi Nellybee

I recently tried out some different cannulas when I tried a switch of insulin.  My DSN sent me a few of each to try before I ordered from AacuChek as they would have to be in 10s.  Good job as I didn’t stick with the new insulin long enough to need anywhere that many.

As for possible sites, I have used the tops of my legs but did find that they sometimes it got hoiked out.  Bum had the same issues, so I am also back to abdomen.  I swap sides each time and have a good look to check that I am missing previous sites, and try to imagine walking across abdo on one of three (albeit very short) lines.


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## Ref (Feb 16, 2018)

I'm very slim since my surgery and use angled cannulas (Mio 30s) with my 640G.


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## Matt Cycle (Feb 17, 2018)

Hi Nelly

I don't think there's much you can do other than different cannulas.  Not sure which pump you're using but as others have said with the 640G there is both the Mio 30 and the Silhouette with angled cannulas for leaner bodies - try and chase it up with your DSN who may have some knocking about you could try.  There's not much on me either but when I got the pump in December we were automatically allocated standard Mios.  We were told we can't change it ourselves with Medtronic and the request has to be through the DSN.  Being new to it I haven't got anything to compare it with but I may speak to the DSN to see about trying one of the other cannulas.


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## everydayupsanddowns (Feb 17, 2018)

+1 for angled cannulas - I use silhouettes from Medtronic. 

I had real problems with blocked/failed cannulas at 90-degrees. The long ones really hurt, and the short ones seemed to fail at least once a month. 

Since using angled (several years now) I think I could count the cannulas I’ve swapped for potential absorption issues on one hand. 

For sites I have used back and sides for years. Above the hips and below the rib cage. I start at the front and move round towards the spine in 2-3 ‘rows’ then swap to the other side.


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## daducky88 (Mar 21, 2018)

[QUOTE="Nellybee9, post: 795203, member: 21166"
I've lost most of my sub-cut fat except for a wee pouch on my tummy and my bum.[/QUOTE]

I,m pretty far less on the legs and arms and found that the top of the thighs was really painful to use a 640g cannula.  So I just rotate spare tyre, upper outer 1/4 bum, outerish low back (level with mini spare tyre on front) on the LHS the body, then the same on the RHS.  So it's 12-18 days recovery time per region.  So far it's ok, I,ve been doing this a few years now.


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## Nellybee9 (Mar 21, 2018)

Sorry I haven't responded to anyone yet but thank you all for the advice! I have an Animas vibe and currently use the inset II. I haven't heard from my DSN about them but I asked animas last time I was on the phone to them and they're sending me a few inset30s to try. Will let you know how it goes!


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## trophywench (Mar 21, 2018)

Sounds good - be interesting to know how you get on with them.


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## heasandford (Mar 22, 2018)

I agree, let us know how you get on! 
I have the same issues, no spare flesh, how do people with CGMs as well manage? I have now started to use my bottom, and put tape over the cannula to stop it ripping out, but it's difficult to see them properly! And I agree, completely different absorption, much slower, nightmare to adjust after using tummy. Thinking of trying thighs? 
My reason for not using the angled cannulas is that I can't put them in, I am a wimp and rely on the insertion thingie that fires it in (Accuchek Combo pump)
Best of luck!


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## Nellybee9 (Apr 16, 2018)

heasandford said:


> My reason for not using the angled cannulas is that I can't put them in, I am a wimp and rely on the insertion thingie that fires it in (Accuchek Combo pump)
> Best of luck!



I know what you mean, I used to have a port for injections that you did yourself and it was tricky! The angled cannulas I've been sent now are automatic and really easy to use  can you mix and match with your pump?


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## Nellybee9 (Apr 16, 2018)

Also so far I like the inset30s. Still using my tummy for now but I can use the edge of my fat more easily so it's a start. Easy to put in and only hurt the once


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## trophywench (Apr 16, 2018)

He can LOL - trouble is the Roche angled cannulas do have to be inserted manually, only the 90 degree ones do you use the spring loaded inserter to insert.  It's a re-usable inserter, each cannula has to be first loaded into that.

13mm has always seemed a bit ruddy long to me - first time I saw them it reminded me far too much of the huge long needles we had to use on the glass syringes.  No thank you! - and they were only 12mm .....


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## Ref (Apr 18, 2018)

heasandford said:


> I agree, let us know how you get on!
> I have the same issues, no spare flesh, how do people with CGMs as well manage? I have now started to use my bottom, and put tape over the cannula to stop it ripping out, but it's difficult to see them properly! And I agree, completely different absorption, much slower, nightmare to adjust after using tummy. Thinking of trying thighs?
> My reason for not using the angled cannulas is that I can't put them in, I am a wimp and rely on the insertion thingie that fires it in (Accuchek Combo pump)
> Best of luck!


Be careful using thighs.  I tried that and the slightest bit of walking made me hypo.  I changed back to my abdomen within 12 hours due to the number and severity.


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## everydayupsanddowns (Apr 18, 2018)

Ref said:


> Be careful using thighs.  I tried that and the slightest bit of walking made me hypo.  I changed back to my abdomen within 12 hours due to the number and severity.



I tried thighs a couple of times (worried about overusing my regular rotating sites). I found them much more ‘stabby’ than sides/back so stopped using them. 

I used thighs quite often on MDI and didn’t have absorption-speed problems, but I’m not keen for infusion sites either.


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