All About Insulin Infusion Sets for Diabetes

Insulin pumps are an extremely common tool for diabetes management, and although most people are aware that they have choices of pump brands, they don't always realize that they also have options when it comes to their infusion sets (the small adhesive unit that connects the pump to your body).

Knowing your options can allow you to choose supplies that work best for your body type and your lifestyle.

Read on to learn more.

An infusion set connects the insulin pump device to your body. It's a small adhesive that houses a tiny needle that punctures your skin to place a cannula (tiny plastic tube) under your skin in the subcutaneous fat to deliver insulin.

Infusion sets can be inserted manually, but most have a separate inserter device that houses the adhesive patch, cannula, and tubing, which connects to your insulin pump. Once the infusion set is inserted, you remove the needle, and the cannula and connection site are left behind.

The Food and Drug Administration (FDA) currently requires existing infusion sets to be changed every 2 to 3 days to avoid insulin buildup or site infection. One company has recently gotten FDA approval for the first-ever 7-day wear infusion set, but as of fall 2021, that product is not yet launched.

Experts recommend alternating where you wear the sets to avoid scar tissue and insulin buildup. Places for your site include your abdomen, buttocks, arms, and thighs. However, most doctors recommend stomach placement as it has the fastest insulin absorption rate. They also warn users to be careful of placing a set where clothes may irritate it, such as your belt line, or where your body bends, as these places can often lead to the set prematurely falling off. To intentionally disconnect the pump tubing, most sets require you to squeeze and turn the sides to "click" out of the set.

Like most other diabetes supplies, infusion sets require a prescription, so be sure to talk with your doctor about your choice of infusion set.

There are two main types you can choose from:

Angled. Most of these infusion sets are inserted at a 30-degree angle and can be used with different needle and cannula lengths. Although most are inserted at 30-degrees, both Tandem and Medtronic also offer one set option that allows users to determine which angle they would like to insert at. Some people with active lifestyles or athletes have reported that angled sets work better for their lifestyle and are less prone to being ripped out or experiencing crimping when compared with "straight" sets.
Straight. These infusion sets are inserted at a 90-degree angle and have different cannula lengths you can purchase. I have used a pump for 10+ years and have always used straight sets, as I have found them to be less painful and easier to insert.

Note that it is possible for infusion sets to fail, due to "crimped" cannulas or bad locations on your body. If you are noticing higher blood sugars, change your set as soon as possible and consider taking an insulin shot via syringe to ensure insulin delivery. Also, the site where you place the infusion set can become infected, so be sure to pay attention if the site feels painful or if the skin around the area is red or discolored. If so, change out the set immediately and contact a medical professional for possible antibiotics to treat the infection.

Generally, insulin sets look very similar. But besides angled or straight, there are some important features to consider when picking the right set for you.

Needle gauge. Infusion set needles generally range from 25 to 29 gauge in diameter. Remember that the lower the gauge number, the shorter the needle. These are very tiny needles.

Cannula length. Infusion set cannulas come in lengths from 6 to 17 millimeters (mm), but most common lengths are at the lower end. Medtronic Diabetes, a leading insulin pump and infusion set provider, suggests using a 6 mm cannula length if you have low or average body mass index (BMI); if you tend towards higher BMI, they suggest using the 9 mm cannula length.

Tubing length. Infusion set tubing is available in a variety of lengths, typically 23, 32, and 43 inches. Your choice will depend on factors related to your height, preferred location of pump wear, daily activities, and other preferences.

Medtronic suggests that if you wear your insulin pump close to your infusion site, 18″ or 23″ tubing is recommended. If not, then 32″ or 43″ tubing may be the best fit.

Insertion device. There are different versions of the disposable plastic piece that's designed to insert the set. Some are made specifically to be usable with just one hand, for example.

Connector type. Most pumps these days use a luer lock male-female plastic connector, to protect against accidental exposure of the introducer needle and possible leakage.

The cost of an infusion set can vary from $90 to $140 out of pocket, but with insurance, they're usually lumped in with other insulin pump supplies for a low monthly copay.

Most sets are available to purchase directly from the manufacturer, or from online diabetes supply sites and even from Amazon. If you go through insurance, you may be required to use a third-party medical distribution company like Edgepark, OneMed, or Medco Supply.

Here are details on a few of the leading infusion set brands:

MiniMed Mio Paradigm

Sold by: Medtronic
Type: Straight, can be used with any Medtronic pump
Needle gauge: 27
Type of cannula: Teflon
Insertion: This set has an all-in-one insertion design that does not require a separate serter. This infusion set can be inserted with one hand (left or right) and uses a spring-loaded design to insert the cannula into your body. Once you have inserted your infusion set, the insertion device can be thrown away and has a needle cover for easy disposal.
Unique features: The easy one-handed insertion makes this an appealing option for many pumpers. In addition to selecting your needle size and tubing length, you can choose from a box of blue, pink, or clear Mio infusion sets.
Other options: Tandem offers their own version of this infusion set called the Tandem AutoSoft 90.

MiniMed Mio Advance

Sold by: Medtronic
Type: Straight, can be used with any Medtronic pump
Needle gauge: 27
Type of cannula: Teflon
Insertion: This infusion comes with a pre-loaded insertion device with automatic needle retraction. Like other inserters, you just peel away the adhesive at the bottom, place the insertion device where you would like to insert your infusion set, and firmly press the button on the top of the device. Then, you carefully pull the insertion device away from your body and safely dispose of it.
Unique features: This device uses a hidden needle, which may be a great option for children and people who are afraid of needles.

MiniMed Quick-set

Sold by: Medtronic
Type: Straight, can be used with any Medtronic pump
Needle gauge: 27
Type of cannula: Teflon
Insertion: Uses the MiniMed Quick-serter, a gray and green plastic device, to insert the cannula under your skin with the click of a button.
Unique features: One of the most popular infusion sets, it's available in various tubing and cannula lengths.

MiniMed Silhouette

Sold by: Medtronic
Type: Can be inserted at a variety of angles, can be used with any Medtronic pump
Needle gauge: 27
Type of cannula: Teflon
Insertion: Uses the black plastic Sil-serter insertion device, that Medtronic says "provides consistent insertion depth every time for optimal insulin absorption and better access to awkward, hard-to-reach infusion sites."
Unique features: Because it offers a choice of insertion angle, this set may offer good flexibility and comfort for people who are lean or who live an active lifestyle.
Other options: Tandem offers their own version of this infusion set called the Tandem Varisoft.

MiniMed Sure-T

Sold by: Medtronic
Type: Straight, can be used with any Medtronic pump
Needle gauge: 29
Type of cannula: Steel
Insertion: This set uses manual insertion, so no need for any additional devices; it is designed to allow for quick and easy insertion.
Unique features: Designed with a kink-free steel needle, the thinnest available in the MiniMed portfolio, along with an extra disconnection site 10 centimeters away from the infusion site to provide extra security against clogging and dislodging. Medtronic says the MiniMed Sure-T is particularly suited for infants and children, pregnant women, or people allergic to Teflon.
Other options: Tandem offers their own version of this infusion set called the Tandem TrueSteel.

MiniMed Mio 30

Sold by: Medtronic
Type: Angled, 30 degrees, can be used with any Medtronic pump
Needle gauge: 27
Type of cannula: Teflon
Insertion: Uses an all-in-one design, combining the automatic spring insertion device with the infusion set. You just place the site over your body, squeeze the buttons on the side, and then pull the needle out and dispose of the inserter piece.
Unique features: The first angled infusion set with an integrated insertion device, the Mio also has a transparent window so you can view the point of insertion.
Other options: Tandem offers their own version of this infusion set called the Tandem AutoSoft 30.

Cleo 90

Sold by: Smiths Medical
Type: Straight, works with any pump that has a luer lock fitting
Needle gauge: 25
Type of cannula: Teflon
Insertion: It's an all-in-one set with a canister that serves as both the inserter and needle retractor, which reduces accidental needle stick injuries. No need to see or touch the needle at all.
Unique features: Unlike other sets, you can control the speed of insertion.

There are a number of parameters to consider when choosing an infusion set for your insulin pump. You can consult with your doctor, but at the end of the day, you have to figure out for yourself which set works best for your body and lifestyle — which may require some trial and error.

Most insulin pump companies will allow you to return these products and exchange them for something else within 7 to 10 days of receiving your order if you do not like them.

Happy pumping!

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