Yet another question

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HOBIE said:
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. 😉
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Yep, can do all that fine, have been pumping a while and feel technique is fine thanks, it's what occurs after - maybe on day 2/3, close to being due a change ( just as Redkite finds)
 
I have been told to use the cartridge for 6 days only. I used to go 14 days when I self funded.
Only time I have had bubbles is user error in filling the cartridge. (x2 in 5 years)
Insulin stays in the fridge until 20 mins before a refill is needed. Then removed to warm up to room temp.
 
I do keep the pump under the duvet clipped to waistband - the stuff about temp differences is very interesting and could explain a lot!

Hobie and Sue - hats off to you both for your 'no bubble' record, but I can say with 100% certainty that some of the bubbles I have seen at the end of 2.5 days when I tend to change were not there when the cart was filled.
 
I often get teeny bubbles appear in the cartridge, but so far they haven't caused any issues

They definitely weren't there when I filled it so presume its from the change in temperature
 
Bubbles can not appear from thin air (majic). A temp change cannot do it. People on injections would be same, you cannot produse air without a chemical/gas reaction. Does it make any differance what type of insulin ??
 
Half fill a glass of water and leave it for a day on a warm window sill. Bubbles.
 
As a little experiment... I changed my set/reservoir at lunchtime (so it hasn't been under the duvet yet). I just tapped and knocked it, and have taken a pic. I will post a compare-and-contrast tomorrow if any bubbles appear overnight!
 
It is in a vacume ??? Or should be. Think about a syringe. Long acting insulin in it, lasts for weeks ???
 
everydayupsanddowns said:
As a little experiment... I changed my set/reservoir at lunchtime (so it hasn't been under the duvet yet). I just tapped and knocked it, and have taken a pic. I will post a compare-and-contrast tomorrow if any bubbles appear overnight!
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That will be interesting to see. Why not keep the cartridge for a few days after you next change it and take a photo after a week? Bet there will be lots of little bubbles.....
 
HOBIE said:
It is in a vacume ??? Or should be. Think about a syringe. Long acting insulin in it, lasts for weeks ???
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The air is already present dissolved in the insulin, just as it would be in any other liquid, and as one of the previous posters said, it begins to evaporate out as the insulin warms up. Not magic, just science!

Hobie, if you prefer to think those of us who get bubbles are just incompetent at reservoir-filling, we'll just have to agree to disagree lol! What's important is that everyone who pumps has a strategy for preventing bubbles from mucking up their insulin delivery - that's all that matters at the end of the day 🙂
 
Some people find the bubble solution is to fill the cartridge tap out bubbles and stand the cartridge for 30 mins then have another look and knock out any further bubbles.
The slower you fill the cartridge the less likely you are to have bubbles, also make sure you have all connections tight enough (without breaking connection) so no air gets in.

If you think things out in a logical way if being to warm causes the problem then no one in a hot country would have a pump.
 
Sue and Hobie - can I just gently point out at this point that you are trying to convince me that something I can see happening doesn't happen. As I say - I am pleased for you both that you don't get bubbles forming in your cartridge, but you telling me that they can't appear and must have been there all along just does not match with repeated (and repeatable) experience of 'no bubbles' at fill followed by 'bubbles' some days later.

As to keeping insulin in the fridge in between changes, I was specifically advised by pump DSN to keep the 'in use' insulin at room temperature because it helped prevent bubbles forming.

This article (the intro of which closely matches both sides of this conversation funnily enough) makes many suggestions on how to attempt to avoid bubbles if people find that they are a concern for them.

http://www.insulin-pumpers.org.uk/airbubbles/BubbleSuggestions.pdf
 
everydayupsanddowns said:
Sue and Hobie - can I just gently point out at this point that you are trying to convince me that something I can see happening doesn't happen. As I say - I am pleased for you both that you don't get bubbles forming in your cartridge, but you telling me that they can't appear and must have been there all along just does not match with repeated (and repeatable) experience of 'no bubbles' at fill followed by 'bubbles' some days later.

As to keeping insulin in the fridge in between changes, I was specifically advised by pump DSN to keep the 'in use' insulin at room temperature because it helped prevent bubbles forming.

This article (the intro of which closely matches both sides of this conversation funnily enough) makes many suggestions on how to attempt to avoid bubbles if people find that they are a concern for them.

http://www.insulin-pumpers.org.uk/airbubbles/BubbleSuggestions.pdf
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With respect Mike, I am not trying to convince you of anything.
You have bubbles, I do not. So there must be a diff somewhere. :D

I have always kept my insulin in the fridge it stops it breaking down over the month it's kept out of the fridge thus losing it's potency 😛
 
Pumper_Sue said:
Some people find the bubble solution is to fill the cartridge tap out bubbles and stand the cartridge for 30 mins then have another look and knock out any further bubbles.
The slower you fill the cartridge the less likely you are to have bubbles, also make sure you have all connections tight enough (without breaking connection) so no air gets in.

If you think things out in a logical way if being to warm causes the problem then no one in a hot country would have a pump.
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The scientific logic is the same in hot countries - you just start from a warmer temperature in the first place, and any further warming leads to air bubbles evaporating out. Excessive heat will obviously cause the insulin to deteriorate, so we use a Frio pump pouch when travelling in hot climates.
 
Pumper_Sue said:
With respect Mike, I am not trying to convince you of anything.
You have bubbles, I do not. So there must be a diff somewhere. :D
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Indeed there must! I get more bubbles sometimes, and fewer bubbles at others, so I suspect there must be a number of factors at play (as with everything D eh!). You'll forgive me if I misread some of your earlier references to 'user error' being the only reason you'd ever seen a bubble in years of pumping to be a suggestion that any bubbles I got were my own silly fault :D

Pumper_Sue said:
I have always kept my insulin in the fridge it stops it breaking down over the month it's kept out of the fridge thus losing it's potency 😛
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Not sure about animal insulins, but analogues are rated to be fine at 'room temperature' (with all the variation that involves) for 28 days so I'm not so worried on that score unless we are somewhere hot/holiday etc.

Following the temperature tip on this thread though, I may well see if I can get a filled cartridge up closer to 'operating' temp (in/around body heat) for a short while before trying to flick out any last bubbles prior to connecting tubing etc.
 
everydayupsanddowns said:
Indeed there must! I get more bubbles sometimes, and fewer bubbles at others, so I suspect there must be a number of factors at play (as with everything D eh!). You'll forgive me if I misread some of your earlier references to 'user error' being the only reason you'd ever seen a bubble in years of pumping to be a suggestion that any bubbles I got were my own silly fault :D
Nope I wasn't suggesting you or anyone else's were due to own silly! fault. I do know though the 2 times I have ended up with bubbles was due to me not getting rid of the bubbles completely in the first place.


Not sure about animal insulins, but analogues are rated to be fine at 'room temperature' (with all the variation that involves) for 28 days so I'm not so worried on that score unless we are somewhere hot/holiday etc.
This really peed me off. analogues have been proven by many to lose potency by the end of the 28 day's I am also shocked by the amount of off insulin that is dumped by members on this forum and world wide. Not once in 48 years have I had to dump insulin for being off even when living with no fridge for a year. Keeping in the fridge just takes the potency issues away if ever brought up.

In the last year 2 batches have gone back due to a problem which was due to cracks in the vial.

Following the temperature tip on this thread though, I may well see if I can get a filled cartridge up closer to 'operating' temp (in/around body heat) for a short while before trying to flick out any last bubbles prior to connecting tubing etc.
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Another logical thought ( I need a rest) if bubbles were a major problem with everyone then the pumps would not be a viable medical device, esp for small children due to DKA.
 
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Pumper_Sue said:
Another logical thought ( I need a rest) if bubbles were a major problem with everyone then the pumps would not be a viable medical device, esp for small children due to DKA.
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Sue please!!

I never said they were a 'major problem' for me. They are an occasional nuisance. More often than not the bubbles stay benignly in the reservoir. A handful of times I have spotted a 3-4mm bubble making its way up the tubing and dealt with it. I think perhaps twice in nearly 2 years I've had a minor high (low teens) and thought 'I wonder if that was a bubble?' because I couldn't think of another more likely reason.

Look... I've just fished 3 old reservoirs out of my sharps bin. You can see that the top 2 have a couple of fairly fat bubbles stuck near the 'o' rings, while the bottom one has almost nothing. I think it is fairly safe to say that I would need to be VERY inattentive while filling not to have spotted these biggies if they had been there when I filled the reservoir!

bubbles_marked_zps06053dc3.jpg


Let's just accept that we have a different experience of this. 🙂 🙂 🙂

EDIT: Just read your 'inline' notes. So sorry to have peed you off. That certainly was not my intention, I just genuinely didn't know if animal insulin was more heat sensitive. Ironically in 22 years of being D the only time I have ever dumped insulin it was Lantus that was *in* the fridge (which had developed a fault and had developed some warm spots).

I'm going to back out of this thread now. Hope you can forgive any annoyance I may have caused you.
 
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Great photo everydayupsanddowns, that's exactly what we see too!

I agree there's no point bickering about it. So long as all pumpers are aware that bubbles are to be avoided, it doesn't matter whose technique we use. There are lots of "right" approaches 🙂

Kids don't go into DKA from bubbles because parents are taught to keep vial out of fridge and regularly inspect the cartridge and tubing during use. And most importantly of all, to test BG frequently and respond appropriately to highs.
 
I know this is a long time after this thread started (I searched 'bubbles' and looked for replies in the Pumping section) but these answers have been enormously helpful, (even if there was a bit of dispute)
It's what makes this forum so incredibly useful, I am grateful for peer replies that I feel are trustworthy. Pumping for 2 weeks now, not brilliant, but getting somewhere I think!
 
I've had a problem with bubbles in my cartridge on filling. This seems to have gotten better with practice 🙂

I am on a medtronic and have noticed bubbles that were not there on filling are there on removal.

Just adding my tuppence worth 😛
 
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