Pain with T-Slim

My son started using T-Slim 3 weeks back and continuously report pain while inserting as well whenever Bolus is given. he was happy with shots and not at all interested in
T-Slim due to pain. any advice? it’s very heartbreaking to see him cry every time when we attach T-Slim and his pain continues for few hours.
Thanks for the support.

If he’a really unhappy I understand Tandem gives you 30 days to try it out so you should contact them right away if he’s that unhappy. Unfortunately that doesn’t give you time to try others out but if you think it could make a difference there are infusion sets that insert at various angles - I usually use the Autosoft 30 (30 degree angle) but switch to the Autosoft 90 from time to time - perhaps a switch would work. There’s also a steel set which some users say is more comfortable than it sounds but I’ve never tried it.
So sorry to hear he’s having these troubles.
One more thing - is he using the same insulin as before? Some have what I will describe as an allergic reaction to certain formulations - they cause burning or stinging.

@abhijitekre , @wadawabbit

Abhijit,

Your post is sad. Dorie has given you good information. Contact the Tandem Clinical support line. Work with your Endo, the pump team, and the local Tandem clinical specialist.

The pain you are reporting is concerning. I have discomfort from a pump site about once every six months and pain with a bolus about every 3 months. This needs action, NOW.

It may help others to know the age of your child, body build, and site set causing this discomfort.

Hope this helps.

I only have one thing to add @abhijitekre all pump literature should show you where to place the pump infusion set. If he has pain please try to use another site. Here is a video from Tandem. https://support.tandemdiabetes.com/hc/en-us/articles/360039440333-Infusion-set-tips-and-best-practices-video- I cannot use my abdomen (no matter what they say) due to pain for example.

You can also try different infusion sets. I use the shortest 90 degree sets, for example.

Good luck :four_leaf_clover:

Good point about the length. There are weight guidelines that usually are a good guide to the cannula length to use, but you might see if a different one works better.

Thanks all for the response. he is 12 years old, ~52 Kgs/115 Lbs, 5’2’’ tall. he is not thin. he prefers only thigh and doesn’t like abdomen at all for Tslim. we are using 6 mm, auto soft 90 set. we want to continue with it for few more weeks as it helps him in school etc. are there any recommendations for canula size and infusion sets for his age and body structure?

Here’s a link to Tandem’s user guide, and a screenshot from page 42 with an image of site choices. I sometimes use upper thigh with no problem but since the muscles are used so much I can see how it could cause some degree of pain. FWIW on my thigh or arm I always place the set going up and down, whereas on my abdomen I place it going sideways. I don’t know if changing direction might help but it could be worth a try.
You could contact his trainer and see if they can give you some samples and recommendations (I wish pumps came with a “sample pack” when you first start!). They can also advise you is the locations are current - TBH I believe this guide is from 2012 and don’t know if this have changed.

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Idoe sot inset perpendicular to the skin and of so, s 6mm the shortest cannula? I use Varisoft 13mm, which goes in at a 45 degree angle. I think the pain is from the cannula hitting muscle fascia. The angle might help decrease depth.

I also insert in my flank (think love handle area just above waistline).

@ken28dec I’m pretty sure 6mm is the shortest but a trainer or your supply company could verify the options. Hopefully inserting at a different angle (direction) helps! Let us know what inserting when you try it out. The new direction might feel awkward add first, and you might tilt the applicator as you try it out (I’ve done that and it caused clogs). Be sure to just keep the applicator flat against the skin. I hope that works for you!

The likely issue is site selection and type of infusion set, choosing the type of infusion set and trying different options are something that tandem rep along with your endos diabetes educators should handle, there are other choices for angled insertion canula the “VariSoft Infusion Set” for tandem has different angle choices.

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