Prime,prime,prime, ...

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SB2015

SB2015

Well-Known Member
Relationship to Diabetes
Type 1
Duh!!!
Gardening all morning double digging in clay soil, and wondering why on earth my levels were above 10 in spite of all the hard work. After corrections and changing the set I checked my meter and found I had not primed after changing the cannula this morning. I just don’t learn. It was OH who suggested that I check thatlittle detail.

With no priming, which takes 1 unit and my basal rate so low that means two hours without any basal insulin. I need a wayof remembering, and old age hasn’t even set in yet!!
 
I’ve sat looking at my pump after doing a set change, wondering why the insulin isn’t appearing in the tube when priming, only to discover the new cartridge still sitting on the bedside table.
 
Haha! Brilliant both of you. Great to know that all of us can make those head-slapping errors.

Do you find that you need to push a bolus through the new site to get it to start working properly? I always try to change just before a meal, but on occasions where that hasn’t been possible, and I’ve not had a snack (20g or so of carbs which is my fall-back strategy) I seem to find my BGs rise as if the basal on its own isn’t enough to start a site going. Someone had a theory about the surface area of a pocked of insulin around the cannula which kinda made sense to me - but I’m not sure if others find the same?
 
We were advised to always change before a meal for that reason, on occasion however things have not worked out that way and we've done it before bed. Seems to work ok, daughter's basal is at its highest at that time though which might help (2.65 u/h or thereabouts at the moment!)
 
I was told that a new cannula needs 1 unit of insuin to fill up the top of it. I was also told to do it before a meal but it just doesn’t always work like that, as Sally said. Now on my third hypo as I had been correcting the highs and have obviously overdone it.

I would love to think that that was lesson learnt, but I am realistic enough
to know I will no doubt do the same again a while in the future.
 
Yes, the cannula prime is to fill the length of tubing under the skin (after the tubing connection) isn’t it. Different tubing types have different fill amounts on Medtronic, with angled cannulas needing more as the longer angled cannula takes more to fill.

I still seem to need an actual bolus to kickstart the site though. Generally happens automatically with the meal of course. But on other occasions I just HAVE to resort to biscuits. Which is a tragedy, obviously.
 
I like your logic, and can think of a few different things that could qualify for the kickstart!!
 
The Roche cannulas (the Teflon ones not the steel) the Right angled ones use 0.7u and the angled ones take 1.0u.

I've never noticed what you have, Mike - could you not just ass 0.1u to the 'prime' amount to give yourself a shove in the right direction?
 
trophywench said:
I've never noticed what you have, Mike - could you not just ass 0.1u to the 'prime' amount to give yourself a shove in the right direction?
Click to expand...

I use Silhouettes. The official prime amount is 0.7u but I’ve always used 0.9u as when I used the straight cannulas I needed a little more than the recommended.

The cannula fill works fine, but my experience is that filling the cannula alone is not all of the issue. If I change infusion set and then only leave basal insulin infusing it seems less reliable BG wise than if I make sure I push at least a unit or two through the fresh set at the beginning. My feeling is that an initial meal/snack bolus helps the basal insulin to absorb reliably. Basal alone is a fresh set seems to struggle.
 
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trophywench said:
The Roche cannulas (the Teflon ones not the steel) the Right angled ones use 0.7u and the angled ones take 1.0u.

I've never noticed what you have, Mike - could you not just ass 0.1u to the 'prime' amount to give yourself a shove in the right direction?
Click to expand...
I’m interested that you say the right angled cannulas need only 0.7 units to prime. I checked this recently and the booklet that comes in the box of cannulas I get says 1 unit, however I have occasionally wondered if 1u was too much. Where did you find the 0.7 figure, Jen?
 
Yes we were told 1 unit by the Roche rep and that seems to work, we use Flexlink 6.
 
In my head since 2009 since it was exactly what the DSN told the 4 of us starting pumping that day.

I freely admit, I've never read one of those books - straight in the recycling bin!
 
trophywench said:
The Roche cannulas (the Teflon ones not the steel) the Right angled ones use 0.7u and the angled ones take 1.0u. I've never noticed what you have, Mike - could you not just ass 0.1u to the 'prime' amount to give yourself a shove in the right direction?
Click to expand...

I checked with Accu-Chek today, as I was surprised when TW said that it was 0.7 for right angles needles and 1 for for angled ones. Just to avoid confusion that is true for Insight cannulas. For Combo it is 1 unit prime for both angled and right angled ones. It is to do with the differences in the head of the cannulas on the different sets for the Insight. Hope that makes sense.
 
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