A Typical infusion set is made up of the pump connector, a length of tubing and the needle or cannula. Different sets suit different people and it is important to experiment when you first get your pump, to find out what works for you. If you are having problems with unexplained high sugars when using your insulin pump and you are confident your control should be better, the chances are that it is due to problems with the infusion set. Tiny blockages can build up in the needle or cannula that the pump can't detect. Changing the infusion set regularly (typically every 24 to 72 hours dependent on the type) is vital for good performance.

KEY INFUSION SET CHOICES
If you are still considering which pump to buy, you should carefully consider the cost of the infusion set, as over time, this cost will overtake the initial cost of the pump.
Here are some of the key points to think about:

• Connection Most pumps use a universal "Luer Lock", which means a greater choice is available. Some (notably the Minimed Paradigm range) use a proprietary lock, which restricts the choice. Some companies are producing adaptors, but check the costs.

• Needle or Cannula Needles are good for people with little body fat or who are allergic to cannulas. Needles need changing daily or every other day. A Cannula is a soft fine tube that is pushed down a steel inserter needle which is then withdrawn. Cannulas are more popular, as they are more comfortable for most people. A cannula based infusion set will last up to three days.

• Insertion angle Straight forward 90 degree needle offers the simplest and most repeatable insertion. This type is good for those less keen on needles and like a fast insertion. Angled sets are available with 30 to 45 deg angles. These offer a greater variety of insertion depths and favor slower insertion.

• Needle / Cannula Depth In order to accommodate different amounts of fatty tissue, different insertion depths are available. Typically 2 or 3 needle depths are available and your Doctor can advise you.

• Tubing length A length of tubing connects the needle / cannula to the connector at the pump. Allow yourself plenty.

INFUSION SITE SELECTION
As with manual injections with an insulin pen, where you set up your infusion set is important. The best areas are at the front and sides of the stomach, acceptable sites are on the outside of the thighs and tops and bottoms of your upper arms. You should also rotate your site position, some use a clock face method - imagine a small clock face in an area, first use the 12 o'clock position, then 3, 6 and 9. More sophisticated methods are available, but use whatever you can remember easiest. Its a good idea to write a memo, so you remember where in your rotation you are, on the infusion set itself.

SITE USE
Follow these simple steps to ensure trouble free site preparation and infusion set insertion:

• Always start with clean hands, preferably use an anti-bacterial soap

• Make sure no body hair will interfere with the set, shave as necessary

• Clean the area thoroughly and allow to dry naturally

• Keep the needle / cannula sterile - do not allow it to touch anything non sterile

• Infusion set insertion is often better if you are standing rather than sitting

• Make the skin taut and follow any specific manufacturers instructions for the final insertion

• Check your blood glucose levels about two hours after a new infusion set is inserted