Is there a trick to reconnecting infusion set after a bath?

Hello, first post.

My daughter has Type 1, she's 5, and has just gone on the MiniMed.  So far the numbers are great, and almost everything about it is easy.  She loves that she doesn't need shots anymore.


Anyway, is there a trick for reconnecting the infusion set after a bath?  We are using the Medtronic Quick-Set.

From reading the book, it seems there is supposed to be some sort of fixed prime in there, but the reading of it is very vague. 

After taking a bath, and reconnecting, her numbers just keep going up.  She's getting "some" insulin, just not enough, and eventually we have to change the set.  Now she's only bathing every 3 days.

It's really a nightmare and anyone with any info on how to change this out properly, the instruction is greatly appreciated.  With summer coming up, she does a lot of swimming, and I hope I won't have to change out the set almost daily.





To do a fixed prime, hit act and go to the "Prime" menu, the first option should say "fixed prime."  It doesn't really matter what dose it's set at for this step, because you just want to make sure insulin is coming out of the tubing - it SHOULD NOT be attached to her yet.  Once there is insulin coming out, you can twist the tubing part back onto the infusion set and it should be good to go.

Does she use a cap to cover her infusion set?  That could make a difference, if her set is getting clogged with gunk during the shower.  It doesn't seem that likely or that it would be as consistent as you described, but best to keep up good habits.

What you described sounds more like she needs that insulin that she's missing during the bath, and is going high because of that.  Skipping a fixed prime, while not the best practice in the world, shouldn't make a very big difference.  I almost never do a fixed prime before I reconnect (I get lazy..), and I don't use a cap anymore (again, I'm lazy and I don't notice a difference), but I have never had a problem after a bath or shower.  Not saying that  I recommend this, just trying to share my experience to provide perspective.

If she's going high because she was disconnected and not getting her basal insulin, you should figure out how long she bathes for and do a quick "correction" to match that missed insulin either before or after the bath.   Another thing to watch out for - make sure she doesn't have any boluses or square wave boluses still being delivered before she disconnects.

Hope this helps.  I've used quicksets for the last eight years and they work fairly well for me.

That's strange.  I've used Quicksets the whole time I've been on the pump - about 5 years - and have never had a problem with the insulin coming out after reconnecting. 

As far as I understand, there is the manual prime in which you are not connected to the pump (you do it while you are changing the set), and the fixed prime, which you do while the pump is attached to you, after it has been inserted.  I've set my fixed prime amount for .3 units, but you should set it based on your daughter's insulin needs.  I've never done a fixed prime except for right after the set is inserted. 

You should talk to Medtronic about the problem if it still persists.  They are very helpful with customer service.  Best of luck!

Thanks for the replies!

So neither of you do a fixed prime or anything when putting the set back on?


Hypothetical...You are going swimming.

You then spin the set off, put the set cover on.  After you swim, you spin the cover off, and spin the set back on?  That's it?


I am guessing this is operator error if that is as simple as it really is and doesn't adversely affect your BG levels later that night and into the next day.


If that is the case, is there a "trick" to it?  Besides lining it up correctly.  Do you have to push down very hard or something?  That may be our problem, because my daughter winces when you push down on the set, so we try to do it too gently maybe. 


I just don't know.


Thanks so very much for your continued help!


That's all I do, correct.  As long as it "clicks" back into place and feels like it's hooked on - if you tug a little it doesn't want to come off - then the set itself should be good.  If you still don't feel confident with that, I'd try calling customer service.  They're always really nice and very helpful. 


For you, I would advise doing a fixed prime before you reconnect to make sure the insulin is all ready to come out of the tubing - sometimes when she's disconnected the tubing can leak a little of it's insulin out if it got shook around or something.  I'm going to guess my insulin dose is significantly larger than your daughter's, so it would be less of an issue for me than for her.  It's still not going to make a huge difference if she misses a 0.2 units because the insulin isn't at the very edge of the tubing when you reconnect, but it's a good habit to have to make sure there's insulin coming out before you reconnect.  I just get lazy.

I'm going on two years with the minimed, and I don't fixed prime it...ever and I always throw away (or find randomly through my home and car) those little covers for the sight.  I haven't notived any strange sugar behavior after disonncting and reconnecting either.  I would try the insulin compensation and then test her sugar.

Hi Augster,

I second the comments here - you definitely don't want to be doing another fixed prime after reconnecting. The fixed prime should be done when you put in a new set, but after that the insulin is already in the canula, and doesn't go away. I have been on the minimed for almost 4 years, and I have never done any sort of priming after reconnecting. I also have NEVER (not even once) used the plastic 'cap' that comes with the infusion set to cover it while disconnected (this includes shower/workout/beach/pool/etc) . The area where the needle pierces the set is a rubber gasket, and it does not allow water, junk, etc to enter into it.

If you are seeing this happen consistently, I would call Medtronic directly (1-800-minimed) and discuss it with them. You shouldn't have to change the set after a bath or swimming, and ABSOLUTELY shouldn't have to change it daily. The only catch I have had is when I spend an extended time in the water, the adhesive just dissolves and the site falls out. There are adhesive patches that Medtronic can include in your pump supplies to put over the site that offer additional adhesion if you need (I think they are from 3M?) Their customer service is great and can help you with anything that may just be wrong with the pump's insulin delivery.

Good Luck!!

If the bath is in the AM shortly after waking this is a typical time for an increase in BG. There is no reason for the prime when disconnecting and reconnecting the pump with QuickSets. The only missing insulin is the amount that appears at the ring where the infusion line attaches, which I would guess is minimal if at all.

If you are removing the pump for a long time you can pre-basal to cover the no pump missing insulin. You need to be careful about the exact amount, since it has to match the per hour amount of insulin infused when connected.

It is possible that you are damaging the site during the bath, with hot water, but not likely. Remember that if there is a lack of insulin, resulting in a rise in BG, it may take a few hours to get the BG under control win the missing insulin.