how often do i need to change the site

[JOSE]

ok first time posting , this is a great site and a lots of help, my daughter is 9 and was diagnosed 3 years ago...and she has been on the pump for like 3 weeks, my question is they told us to change the site every 3 days, but when we do we have more than 1/2 her insulin so we change the site because of fear of not having insulin or it is just not healthy to have in on the same spot more than 3 days in a row? and any idea when do we have to stop the checking her every day at 12 am , 3 am and 6 am? she is getting tired of it and i am afraid she wont like the pump any more........thanks

[wendyc]

We have to change the site every two days (sensitive skin) and unfortunately waste a good bit of insulin sometimes. I wouldn't go more than 3 to avoid the possibility of infection. Over time, you will get better at estimating insulin needs, and can fill up as much as you think is neccessary.
As for the nightime checks, talk with your CDE, they should be able to tell you when to pull back on checking. For example after week 2, we were able to check at 10, 2 and then when she woke up, then about week 5 we went down to the 10 and then middle of the night as dictated by the 10p sugars.

Good luck!

[CarrieP]

We sometimes leave the site longer than 3 days...usually when we forget. Supposedly the insulin can become less effective and the site may start to close after 3 days, but we have not had that prob. We try to change the site every 2-3 days.....

We have been pumping for a year and still check at 11pm, 2 and 4am.... I just do it practically in my sleep now.... We still experience lows at night, sometimes.

Hope I helped...

CarrieP

[Laura]

Hi Jose! You can always pull less insulin into the reservoir so you don't have that much left over. The site is supposed to be changed every 3 days because of the chance of infection. I would stop doing as many checks at night when those checks are ok and you feel confident she won't go too high or low. Maybe you can at least cut out one soon. As she grows and her basal rates change you will most likely have to do it again though. I envy my friends who sleep all night every night. :p Do you wake her up to check her or does she wake up on her own? My son just sleeps through the whole thing, luckily.

[selketine]

We often change the site without changing the reservoir. It seems like you could do this with any type of set? We use Rapid D's. Otherwise you could put less insulin in the reservoir - put in perhaps 10 units more than you normally use over 3 days.

You should generally change the site every 2-3 days just to give the site a break and let it heal. I know some adults on pumps don't do it as often but I wouldn't start that practice with a child.

[Amy C.]

You need to change the resevoir, the tubing, and the site every three days because of three factors. The insulin in the resevoir starts to interact with the plastic and become less effective. The site needs to be changed because the skin needs a rest from the canula and the tissue around the site needs a rest from getting all the insulin.

If your child doesn't use up a whole resevoir of insulin, don't fill it up. Figure out how much she needs for three days, then add a little for priming and fill the resevoir with what you need. We were told this in the pump training.

[JOSE]

Hi Jose! You can always pull less insulin into the reservoir so you don't have that much left over. The site is supposed to be changed every 3 days because of the chance of infection. I would stop doing as many checks at night when those checks are ok and you feel confident she won't go too high or low. Maybe you can at least cut out one soon. As she grows and her basal rates change you will most likely have to do it again though. I envy my friends who sleep all night every night. :p Do you wake her up to check her or does she wake up on her own? My son just sleeps through the whole thing, luckily.

thanks to every one.....she sleeps through it, but her fingers are hurting , they told us thst when she wanted a snack to check her BG and today she wanted one and when i told her to check herself, she just said nevermind i dont want it...so i just bolus for the carbs without checkin her

[Laura]

thanks to every one.....she sleeps through it, but her fingers are hurting , they told us thst when she wanted a snack to check her BG and today she wanted one and when i told her to check herself, she just said nevermind i dont want it...so i just bolus for the carbs without checkin her

My son does that too. It really makes me sad that he would rather not eat a snack than check his blood sugar sometimes. :(

[jeep_bluetj]

If you are seeing good stability overnight, and you feel confident in your ability to predict large changes, I'd sure drop a few of those checks.

I'll check "because" now. Not on any real schedule, but "because". Because he was sky-high at bedtime and got a correction. Because he was uber-active all day. etc... Those sorts of things.

We'll re-use the previous reservoir for 2 days or less. (Unless it's been really hot). We'll just switch reservoirs if we run out inbetween set-change times. We've had maybe 3-4 times with bad insulin in 5 years that we don't worry too much about it. Sneaking an entire bag of chips -- we worry about that :)

[Ben'sMommy]

We change Ben's infusion site every 2-3 days sometimes more often. The risk of infection and kinking of the cannula grows significantly with each day and it's not a risk worth taking. We don't worry about wasted insulin as we don't have to pay for it but perhaps you could half fill the resevoir in future? The pump alerts you when the resevoir is running low so you won't have to worry about running out.

My advice is to only stop the nightime checks when you are confident that you have her overnight basals down and that her levels will remain within range overnight.
Ben has been pumping since Feb. '05 and we still do overnight checks. If all is well at midnight then we don't check until morning but if he's up or down or sick etc we check every 2 hours.
It's a small price to pay.

Good luck!!! :)
Stick with it. The pump is awesome!!! :D

[bethdou]

My son does that too. It really makes me sad that he would rather not eat a snack than check his blood sugar sometimes. :(

Meghan, too.... :(

[kiwikid]

You need to change the resevoir, the tubing, and the site every three days because of three factors.

I change Rachels Rapid D set every 3 days. I fill the reservoir full with 300 units of insulin (from a penfill) and I use it, and the same tubing until it runs out. We do have the odd day with whacky numbers, but they usually iron out and I am definite that it is not the insulin or the tubing - its just one of those things that happens with D. There is never a significant change of bsl's straight after a reservoir change to those at the end of 20 or so days. I would definitely change the reservoir if I thought the insulin was bad.
In New Zealand we have to pay for every pump consumable we use. A box of reservoirs (25) is $255 +GST (12.5%) + freight.
A box of tubing (10) is $80 plus the above costs. 25 Rapid D sets cost $225 (plus costs) There is no way we could afford to use a pump if we changed everything every 3 days.
In New Zealand Pumping is called a "lifestyle choice" and there are no subsidies or co pays :(