Cartridge low alarm - help please

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PattiEvans

PattiEvans

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Type 1
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Hi

The pump (AccuChek combo) has just warned me that there's only 20u left. I was going to change sets in the morning and there's plenty there to get me through the night as I only take just over 15u in a 24 hour period and I'm not planning on bolussing for anything before tomorrow. Will the pump keep warning me through the night? In which case I'd rather change sets now, but I needed a fresh vial this time and it was in the 'fridge which means I have to leave it to warm up and that would put the change right before bed and I know you aren't supposed to do that. Can anyone advise please?
 
I would leave it till the morning Patti. But the Veo wouldn't 'low res' alarm again for a long while
 
Hi Patti, we have the Combo too. It won't do anything else until the cartridge is completely empty so you are safe to wait until the morning.
 
Aaaaagh, hope it doesn't alarm in the night and disrupt your sleep. I'm afraid I don't know about the combo, does it say anything about this in the manual? If I were you I'd be tempted to change it now and fill from the cartridge in your insulin pen (assuming you have one?). This is a bit fiddly since the reservoir doesn't fit squarely onto pen cartridges like it does on vials, but I have successfully done this a few times when I've forgotten to get the new vial out of the fridge in time.
 
Sally thanks.... ISTR a convo on another forum where someone said it only went off once so that's what I thought.

Redkite... the manual is very non-specific, just tells you how to silence the warning. I've tried the online manual but it is hanging and won't load. I have pen cartridges but they're in the fridge too, on the premise I used to inject straight from the fridge if necessary.

I have rung Accu-Chek and someone is supposed to ring me back any minute.
 
We have been down as low as 7 units with no further alarms so you can sleep peacefully! The manual is rather frightening, isn't it!! 🙂
 
Pattidevans said:
I have pen cartridges but they're in the fridge too, on the premise I used to inject straight from the fridge if necessary.
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Oh! That idea's a non-starter then. 🙂. I do try and remember to get a new vial out of the fridge on the day the old vial is used up (ie. 2 days before it will actually be needed), because otherwise I would never remember on the actual set-change day - and also by Sod's law if the vial was in the fridge we would probably have a cannula problem that day! :D
 
Accuchek rang me back (from the USA as the UK lot are in bed) and told me that the alarm won't go off again until the cartridge is empty, so I can safely go to bed and change sets in the morning. Thanks to all who responded to me and particularly for responding so quickly 🙂

The manual is rather frightening, isn't it!!
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It's big, that's for sure! Odd that there's so little info on the subject in the "war and peace" manual, or the interactive DVD manual.
 
Redkite, I meant to get a new vial out when I changed the last set, but they last 6 days for me, so I thought it a little premature, then forgot it entirely!
 
😱 All OK - I woke with 9u still in the cartridge
 
Always take the vial straight out of the fridge & have never had any prob. I use Medtronic veo & cant comment on other pumps but if you are getting bubbles just flick with finger & push them out with syringe ?? Hope you got sorted
 
I once forgot to get a vial out of the fridge in advance, and not knowing what else to do I just warmed it up in my hands for a few minutes. Probably not what you are supposed to do, but it seemed to work OK - there was perhaps a little more air in the cartridge than I usually get, but not much and it came out easily enough when I primed the tube. We didn't get any problems afterwards.

Patti - glad all is well and you were able to sleep soundly!
 
I didn't mean that I made it "warm", only that I took the fridge chill off it lol...
We got away with it that time but probably not something to make a habit of! I do normally get a new cartridge out of the fridge a few hours in advance so that it can get up to room temperature slowly 🙂
 
A vial normally takes 3/5 hits of being in & out of fridge. If you are warming even with hands what is the point. I will say again I have NEVER had problems with bubble that I cant just flick with finger & push ot with syringe. I would Not warm & cause the insulin to be useless. I would rather flick the bubble out. What do they do in the hosp ???? Warm all the bottles ????? 🙄
 
HOBIE said:
A vial normally takes 3/5 hits of being in & out of fridge. If you are warming even with hands what is the point. I will say again I have NEVER had problems with bubble that I cant just flick with finger & push ot with syringe. I would Not warm & cause the insulin to be useless. I would rather flick the bubble out. What do they do in the hosp ???? Warm all the bottles ????? 🙄
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Hobie, I think you are going a bit over the top 😉

It is standard practice to use room temperature insulin.
What Sally did was quite correct.
If you think about it the insulin in your pump is at room or body temperature after being in the pump for 20 mins or more and I don't know how often you change your cartridge but mine is done every 6 days. I'm one of the many pumpers that does not carry a portable fridge around with me to keep my pump or insulin nice and cool :D
 
Hi Hobie, I am sorry if I have upset you with that comment, I will try to explain.
At the time I was quite inexperienced and thought that you weren't supposed to put insulin in the pump straight from the fridge. I thought that holding it in my hands for a few minutes to take a bit of the chill off would not be too drastic. I was able to get all the bubbles out without difficulty as I have already said, and the insulin was not damaged as it worked perfectly and we had no problems afterwards. As per my DSNs instructions I always keep the in use vial at room temperature anyway so did not put it back in the fridge afterwards, and we had no problems with the rest of the vial.

I have already said that I knew this is not the best idea, and perhaps I was lucky to get away with it; but I was inexperienced and at the time couldn't think of anything better to do. That's all part of learning isn't it, mistakes will be made sometimes and you learn from them. I thought I had made it clear that I normally allow new cartridges to get to room temperature slowly, I only did this once and even though it worked I don't intend to do it again. I don't think I've suggested that it's a good idea that other people should try either, but if it reads that way then I'm sorry.

I hope that has explained where I'm coming from, I didn't mean to cause any offence. But if we got everything right all the time then we wouldn't need this forum!
 
Sally, please rest assured you are not wrong. HOBIE is in the wrong.
What you did was correct.
 
Well, I don't know about pumps, but I always warm the cartridges in my hands after getting them out of the fridge and before using them. Body temperature isn't going to render the insulin spoiled and I've never had a problem 🙂
 
Unbelievably I had the exactly same thing last night for the first time, but didn't go on here - should have done! But like you, plenty of insulin overnight and no more alarms.

I keep one vial out of the fridge all the time so it is always at room temperature to fill a cartridge. I work on the basis that I used to have all my pens at room temperature so why not? It lasts less than 30 days, I put a date on to check and it's a glass container. I then usually make up a cartridge the night before I change it, I know that adds half a day extra to its life but I assume there is plenty of safety life built in. I haven't ever felt that insulin-failure has been one of my problems - I have enough variation, but not due to that!
 
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