Yet another question

[brett]

Sorry, coming across something all the time lol. I'm sure I read to change the insulin cartridge every 10 days. Is that right? I would estimate that if it was full it would last maybe 20 days maybe less depending how greedy id been. If that is correct could I fill l the insulin cartridge half way only and keep the rest of the vial in the refrigerator to be used next time. Using accu chek combo

 

[everydayupsanddowns]

I only ever half fill my cartridges as Medtronic ones are only supposed to be used for 3 days. The 'in use' vial should stay out of the fridge so that it is at room temp (helps prevent bubbles forming in the cart). Vials can stay out of the fridge for 28 days by which time you'll prob have used all the insulin.

Medtronic also say that once the cart is filled it should be used straight away - so not prefilled and stored for use later. Not sure about Roche guidelines tho.

 

[m1dnc]

I was told to change it every 6 days, so I fill it with enough to last 6 days plus a bit for over-indulgence. That way you change the full infusion set with tubing at the same time as the reservoir change, with just a cannula change at three days. A nice simple routine. Put another way, I change the reservoir and full infusion set when the reservoir is empty, and the cannula when it is half empty. At my age, simple routines are highly desirable!

 

[brett]

Yes, was told to keep in use vials out of fridge (forgot that). Was told ten days use though but will fill enough for 6 days plus a bit extra, so that I'm not wasting more than I have too.

 

[Redkite]

Sorry, coming across something all the time lol. I'm sure I read to change the insulin cartridge every 10 days. Is that right? I would estimate that if it was full it would last maybe 20 days maybe less depending how greedy id been. If that is correct could I fill l the insulin cartridge half way only and keep the rest of the vial in the refrigerator to be used next time. Using accu chek combo

Hi Brett,

We change the whole set (reservoir, tubing and cannula) every 2 days, only filling the cartridge to 1ml which is more than enough when he's on no more than 30u total daily dose. The reasoning being that although insulin can be kept at room temp for 28 days, the insulin in the pump reservoir and tubing is right up against his skin and therefore closer to body temp than room temp so deteriorates faster. If we go into a third day we sometimes get bubbles forming in the cartridge, which is a sure sign the insulin has warmed up.

 

[HOBIE]

Hi Redkite, Bubbles can not form ? They must be in when filling.

 

[Redkite]

Hi Redkite, Bubbles can not form ? They must be in when filling.

Hi Hobie, just reporting what we see 🙂. I am very careful to eliminate all bubbles on filling, though can't guarantee 100% bubble free, def 99%! but by day 3 some start to appear. We were told by the Medtronic Rep when we were trained a few years back that the reason for keeping the vial out of the fridge is that using cold insulin in the cartridge leads to bubbles forming when it warms up to room temp, because there is nowhere for the dissolved air to escape when it begins to evaporate.

 

[m1dnc]

Hi Redkite, Bubbles can not form ? They must be in when filling.

That's not right I'm afraid. The solubility of a gas in a liquid is inversely proportional to temperature (Henry's Law). So if you fill your reservoir at, say, room temperature, bubbles will form as the gas comes out of solution at the slightly higher temperature of the reservoir in the pump next to your body.

This was what was noted by Redkite, and which most of us with pumps will probably have noticed. I certainly have.

 

[HOBIE]

Is it some new insulin with gas in ??? It must be majic water into wine

 

[m1dnc]

No need for magic! The original insulin will have some air dissolved in it which will come out as gas bubbles when it warms up.

 

[m1dnc]

No need for magic! The original insulin will have some air dissolved in it which will come out as gas bubbles when it warms up.

Think of a saucepan of water for boiling an egg. As you heat it up before the water itself boils, you get lots of little bubbles. This is the air that had been dissolved in the water coming out of solution. It's the same for the insulin in the reservoir warming up against your body.

 

[Redkite]

Is it some new insulin with gas in ??? It must be majic water into wine

Lol, if only! Actually, when I've been decanting things out of the sharps bin I've come across used cartridges which look like they contain champagne, they're that bubbly 🙂

m1dnc, you're obviously a scientist - it's a very long time since I did any physics, in fact the only law I can remember is s0d's law!!

 

[everydayupsanddowns]

No matter how much I flicked and jiggled reservoirs in the early months I would always get bubbles appearing (that hadn't been there before) after 12 hours or so. I now tend to fill with a slight vacuum (not filling with all the air in the reservoir for the amount of insulin) - seems to help me a little.

 

[m1dnc]

One trick I've tried a few times, is to warm up the insulin phial in a pocket next to your skin for 10/15 mins before filling the reservoir. The trouble is that it tends to shake up the insulin at the same time. What The Lord giveth, The Lord taketh away!

 

[HOBIE]

There SHOULD be BIG warning signs on where you get YOUR insulin from. Warm a few degrees & covert to AIR ?????????????. People going to a hot country on holiday be very careful of hot air. After 5yrs of pumping i have Never had air in a cannula.

 

[Hanmillmum]

There SHOULD be BIG warning signs on where you get YOUR insulin from. Warm a few degrees & covert to AIR ?????????????. People going to a hot country on holiday be very careful of hot air. After 5yrs of pumping i have Never had air in a cannula.

So what is your technique? Is it how you draw up, or how you carry it ? We still get the odd bubble here and there when there are none in the reservoir to start with ! V Frustrating!!

 

[everydayupsanddowns]

So what is your technique? Is it how you draw up, or how you carry it ? We still get the odd bubble here and there when there are none in the reservoir to start with ! V Frustrating!!

I still find those bubbles very frustrating. They are NOT there when I fill the reservoir, but later on I've caught a big fat bubble wandering up the tubing more than once!

 

[Hanmillmum]

I really do think it has something to do with temperature. DD carries hers close to her by it being in her vest against her abdomen, quite a warm spot. Noticed too on hols in the heat there were a few more bubbles than normal.

I find I have to do a check as part of the routine of bolusing, there is probably one incident each change of cannula/new reservoir.

 

[HOBIE]

I use a medtronic pump. You fill canula & get air out same as syringe. Connect cannula to tubeing & hold vertical with pump & cannula on bottom. Needle etc on top, set pump away to fill tube holding needle in air & wait for drips coming out. No air. 😉

 

[Redkite]

I use a medtronic pump. You fill canula & get air out same as syringe. Connect cannula to tubeing & hold vertical with pump & cannula on bottom. Needle etc on top, set pump away to fill tube holding needle in air & wait for drips coming out. No air. 😉

Perhaps there's an element of luck! My son has a Medtronic Veo too - I'm pretty good at getting a bubble free reservoir to start off with (using the technique of leaving a small vacuum in the vial), but as I said by day 3 there will be a few bubbles in there. We keep an eye on the tubing when bolusing to make sure no bubbles are moving along, and haven't had any problems. He wears his pump in a pouch next to his tummy under 3 layers of clothing, so a bit warmer than if clipped on a belt for example.

Hobie, if you're not troubled by bubbles then great, but for those who are, changing the reservoir more frequently is a good tip. The original poster wanted to know if you could keep the same reservoir for 10 days, which personally speaking we certainly couldn't.