Diabetes Self-Management Blog

As longtime readers of my blog might know, I’ve written before about intermittent difficulties with infusion sites. For example, last fall I talked about difficulties keeping the infusion site attached to my person and recently I wrote about mobile infusion set site changing. Insulin pumps: you gotta love ‘em, but you also know — if you’re an insulin pump wearer — that there’s always the potentiality for issues related to insulin pumping.

Today, then, I choose to write about a very specific issue of insulin pumping and infusion site adhesion. In fact, the narrow scope of this entry might also be product-specific. If that’s the case and I’ve alienated you, I’m sorry. I’ve never used any site applicator besides the Cleo cartridges, so I don’t know if other applicators work in a similar way. Therefore, if you pump insulin and haven’t yet discovered my process — because I may just be daft; most people may have learned this trick a long time ago — or if you’re looking to attempt it yourself, you may have to modify it.

At any rate, here’s my revelation: After nearly three years of insulin pumping, I discovered a couple of weeks ago that when changing infusion sites, the one thing I’d been missing was The Twist.

Cleo applicator

You see, during the site-change process, I always have difficulty getting the adhesive tape to pull itself away from the applicator proper. What this means is that as I try to remove the applicator (see both of the purple plastic objects in the pictures provided in this entry: that whole thing is the applicator), I had been tipping it forward or back against my body as I tried to get it to dislodge and leave behind the tape/cannula button (the infusion site). More times than not what I ended up doing was pulling the newly stuck to me infusion site away from my skin, as well. That’s not good.

Why was it bad to pull the adhesive tape back? Well, that tape is mostly a one-time-best-time type of stuff. When/if I restick, it’s pretty likely the tape will want to pull away again, more easily each time, and thus have a less effective adhesion to my body. Those lesser sticks leave a more likely chance I’ll lose that site sooner, be it through rubbing it off simply by day-to-day living, having it tugged off by the infusion set tubing, sweating it off while working out, or by some bizarre happening (door/drawer knobs!).

Cleo applicator explained

So what is The Twist?

It’s pretty simple. After depressing the applicator against my skin and then holding it there with mild pressure for about ten seconds (to get much better stick-to-it while the adhesive does its thing), rather than the tipping process I’d been using, I now give it a gentle yet firm clockwise or counterclockwise twist (or some combination of both) as I pull the purple applicator, ever so gently, away from my body with an ever-so-slight tipping motion.

Be gentle!

What happens during this process is that rather than using only the little bit of adhesion force against my skin from a small percentage of the adhesive-tape from applicator, instead I’m using the entirety of the adhesive force against my skin to help dislodge it, and with that combined adhesive force, the tape doesn’t seem to want to pull away from my body.

The applicator seems to more easily let go of its grip on the infusion site.

And that’s all I’ve ever wanted.



  1. i use a medtronic minimed pump so im not familiar with this pump but why cant you OR why cant you remove the adhesive cover before plunging the device into your skin?

    the minimed version also has two adhesive tabs on the side of its insertion site that i always remove before i insert the site and it’s much easier.

    Posted by mandy |
  2. Thank you for your great tip Eric. I found I had this same problem when attempting to insert some sample Cleo90s onto my reluctant 10 year old’s abdomen. She’s going to appreciate my new insertion-without-unsticking-the-cannula technique when we start using the Cleo full-time next week!

    Posted by Karen |
  3. I have a minimed Paradigm pump and use “Quick sets”. I use an IV prep pad, much like an alcohol pad, on my skin and wait until it is “tacky”, and then inject the infusion set. It will hold for days, and not come loose until you peel it off. Not a problem with showers, sweating, etc. Insurance will pay for them, and they are “definitely” worth it.


    Posted by Jeny-Lynn |
  4. My son uses the minimed quick set. We also use the IV prep, which makes your skin tacky. The site sticks without a problem. If it comes off from sweating, you could use a quick swipe of anti-perspirant on your skin prior to applying your site. That will reduce sweat; thus, reduce the chances it will come off when sweating. If the site sticks to the inserter after you insert the site, try cleaning the inside of the inserter with unisolve. It will get rid of any tacky residue on the inserter which might be causing the site to stick to the inserter after insertion.

    Posted by Laurie |
  5. I also use the Paradigm pump from mini-med. I also use the “quick-serter to inject the fusion set. I have used the IV prep pads. They are terrific!! Would recommend them in a heartbeat.

    The quick swipe with anti-perspirant goes on after the site is cleaned, before insertion?
    I’ll have to try that.

    Posted by shinaye |

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