Preventing Tunneling in Insulin Pump Infusion Sets: Tips for Active Individuals

Tunneling occurs when insulin leaks along the path of the infusion set cannula under the skin, leading to inconsistent insulin absorption. This issue is particularly common with Teflon infusion sets and often affects golfers, tennis players, and other active individuals. The only warning sign of tunneling may be unexpectedly high blood sugar levels, and in some cases, insulin may leak onto the skin surface after a large bolus.

What Causes Tunneling?

Tunneling is more likely with Teflon infusion sets due to their inert nature. When an infusion set remains in place for several days, the surrounding tissue can “heal” and harden. Any movement or bumping of the set can loosen contact between the Teflon and tissue, creating a path for insulin to escape to the skin surface.

How to Prevent Tunneling with Infusion Sets

  1. Choose the Right Infusion Set:

    • Infusion sets with a flexible cotton base and a lower profile are less likely to be bumped or moved.
    • Metal sets like the 90-degree Rapids are also a great alternative. These sets are small, comfortable, and less prone to tunneling.

  2. Secure the Infusion Set Properly

    • Use a “plastic sandwich” technique:
      •  Apply a piece of IV3000 or similar adhesive material under the infusion set.
      • Place a second piece of adhesive over the top of the set to reduce catching and movement.

  3. Rotate Infusion Sites Regularly

    • Avoid scar tissue, lipohypertrophy, or irritated skin.
    • Allow sites to heal fully before reusing them.

  4. Maintain Good Site Management

    • Keep the skin clean, dry, and free of lotions before insertion.
    • Avoid areas prone to frequent movement or pressure.
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Key Takeaway

For active individuals, preventing tunneling in insulin pump infusion sets involves choosing the right set, securing it well, and maintaining proper site management. These steps can reduce the risk of unexpected high blood sugar levels and ensure consistent insulin delivery.

Read Pumping Insulin, now in its 7th edition, for easy steps to succeed with your insulin pump.

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