Choosing the right infusion set is one of those decisions that can make or break your pump experience. Even as someone who came from a tubeless system, sitting down with Gary Scheiner—diabetes educator, clinician, and author of Think Like a Pancreas—opened my eyes to how many different infusion set designs exist and why they matter. Whether you’re on a tubed pump like Medtronic, Tandem or Beta Bionics’ iLet, understanding these choices can help you pick a set that works with your body, your skin, and your daily routine.

Gary broke everything down into simple categories that made the whole landscape way more understandable. Infusion sets generally vary by cannula type, insertion angle, and insertion method—and each variable affects comfort, absorption reliability, and how well the site holds up over time.

One of the biggest distinctions is between steel cannulas and flexible (Teflon) cannulas. Steel sets insert a tiny metal needle under the skin that stays in place as the active cannula. It sounds intense, but they’re actually super consistent, less likely to kink, and often preferred by people who have experienced unexplained highs due to cannula bending. Flexible cannulas, on the other hand, sit much softer under the skin and tend to feel more natural—great for people who want comfort above all. But they can sometimes bend during insertion or with movement, which is something to consider if you’re active.

Then there’s the question of angled vs. 90-degree insertion. A 90-degree set goes straight in, which makes placement easy and predictable. Angled sets go in at about 30 degrees and are ideal for leaner individuals, athletes, or anyone who needs more stability when moving around. Gary explained that angled sets can also work better for people whose tissue tends to pinch or fold during straight insertion. It’s all about finding the angle that gives your cannula the best chance of staying secure.

Another deciding factor is whether the set uses manual insertion or an auto-inserter. Auto-inserters are great for people who want quick, consistent insertions—no hesitation, no slow push, no second-guessing. Manual sets give more control, especially if you want to be gentle with sensitive areas or place the set at a very specific angle. Gary emphasized that neither method is “better,” but one may suit your personality and comfort level more.

One of the most interesting parts of the conversation was looking at the future of infusion sets. Companies are working on improved adhesives, longer-wear cannulas, and designs that reduce inflammation. We’re already starting to see this progress in the real world, with options like Medtronic’s 7-day extended infusion set now available, and other manufacturers—such as Tandem—working toward their own longer-wear infusion sets expected in the coming years. Even though the tech looks simple on the surface, there’s a lot of innovation happening behind the scenes to make sets more reliable and more comfortable.

Choosing the right set really depends on your skin type, your daily activity, your comfort preferences, and what gives you the fewest site failures. Talking with Gary reminded me how individualized these choices are, and how trying multiple options can help people find what actually works for them—not just what came in the box.

If you want to dig deeper and see all the sets Gary walked me through, check out the full video below or listen to the conversation at the top of the page.

Disclaimer: Diabetech content is not medical advice—it’s for educational purposes only. Always consult with a physician before making changes to your healthcare.