Prefilling Insulin Cartridges

[BrendaK]

Do any of you prefill the insulin cartridges for the pump?

We are having to do site changes every 2 days instead of every 3 days and it would save time if I could just prefill the cartridges. I don't see why I can't. The insulin is already at room temp and the cartridges would be too. As long as I don't go past the 30 day expiration.

Does anyone else do this?

[Amy C.]

I personally would not prefill the cartridges. When we were in pumping training, we were told the reason that you have to change the site every 2-4 days is for the following reasons:

The tissue around the site becomes weary of accepting the insulin and of having the cannula inserted there.
The site doesn't adhere as well.
The plastic of the cartridge interacts with the insulin, making it less potent by the third day.


It is this third reason -- the cartridge is not a good long term storage container for insulin.

[BrendaK]

Thanks, Amy. I appreciate the input. That makes me even more glad that we're changing sites every 2 days. We have always gone 3 days, but with the new Cleo sets we're going 2 days. I wonder how much impact on Carson's blood sugars that 3rd days has had for the last year and a half.

I just ordered Pumping Insulin Saturday -- I'm really motivated to try and get things more stable for Carson.

[kiwikid]

Are you changing the set, cartridge and tubing every time?? WOW! Theres no way we could afford that. I change the set religiously every 3 days, but I fill a cartridge full from a 300 unit penfill and use it, and the same tubing until it runs out (about 15 days). I haven't noticed any loss of potency at all.
There is a blog that shows several prefilled vials sitting in the fridge waiting to be used.

[Amy C.]

Wow - 15 days! It makes me wonder if what I was told was correct. The insulin manufacturers (Novalog, Humalog, and Apidra) all say to change out the insulin after 48 hours in the cartridge. I think this is a conspiracy to get folks to change out more often.

[BrendaK]

We do change cartridge, sets and tubing every time. That's just how we were taught and our insurance covers everything at 100%, so we don't have to worry about that part.

But I did just talk to the endo nurse about something else today and asked her this question. She didn't know the answer, except that she remembers that when she worked at the hospital, there was an issue with insulin being in contact with plastic and the insulin always had to be in the glass bottles.

She referred me to the pump nurse -- I guess I'll ask her next. It's not that big of deal to me, but it would save some time doing the site changes!!

[Becky]

I fill my cartridges to 176 units, but only use about 25 units a day. So the insulin is in there for about 6 days with no problems, and I do set changes every third day. I have heard of other adults who fill 2 or 3 carts at one shot, thereby emptying an insulin vial, and don't seem to report any problems. YMMV....all you can do is prefill one and test a lot to see what happens.
Good luck!

[ramrummy]

Are you changing the set, cartridge and tubing every time?? WOW! Theres no way we could afford that. I change the set religiously every 3 days, but I fill a cartridge full from a 300 unit penfill and use it, and the same tubing until it runs out (about 15 days). I haven't noticed any loss of potency at all.
There is a blog that shows several prefilled vials sitting in the fridge waiting to be used.

We change the set, cartridge and tubing every day, but I am playing around with the amount of insulin I draw up so there is the minimum of waste whilst covering the 3 days.

[rickst29]

But my old DTRON+ uses glass cartridges, not much different than insulin bottles (except for the rubber stopper at the bottom).

Still, I think that HARD plastic (they kind they make cartridges from) is gonna be a lot less reactive than the softened plastic they use in infusion set tubing. So, if I ever get a new pump with plastic cartridges, I'll probably continue doing them in big "batches":

Flick on South Park, get 3 bottles of insulin out of the fridge, get a dinner plate and wipe everything down with alcohol, and fill between 8 and 10 cartridges all at once. It goes really fast when you've got all the stuff out and arranged, kind of like a production line.

The, I never have to worry about being interrupted by an inconvenient cartridge change: instead of 5+ minutes to get all the stuff and fill a new one, it's just "grab one" from the plastic bucket in the 'fridge, takes about 10 seconds.

[kiwikid]

We change the set, cartridge and tubing every day, but I am playing around with the amount of insulin I draw up so there is the minimum of waste whilst covering the 3 days.

Is this what your hospital or pump rep has advised? :confused:

[Ben'sMommy]

I would never do this. I change everything every 2-3 days, sometimes more often.
I don't want to take any chances.

[Ben'sMommy]

Is this what your hospital or pump rep has advised? :confused:


Ours advised to change EVERYTHING every 2-3 days and NEVER re-use any of the supplies for any reason.

[kiwikid]

Our pump rep is selling $7000 pumps to people who are paying for the pump AND all supplies privately. Thats a huge cost, and if he suggested we change everything every 2 days I doubt whether he'd sell any pumps! He has suggested we can reuse the cartridges at least once. The pump nurse at 'Starship' (the only Childrens Hospital in NZ) also suggested we get as much use out of them as we can. Its the only way to get kids pumping here unless you have a LOT of money :( If the Government, or an insurance company is paying - the pump companies will obviously get as much money as they can.
I was chatting to a Mum last night who has recently changed from a Paradigm pump to a CoZmo because of the astronomical cost of the Paradigm supplies here in NZ. She loves the fact that she can reuse the cartridges. I don't actually reuse them - I just use them longer until empty. ( She also noted that there were features on both pumps that she liked and disliked) :cwds:

[kiwikid]

I would never do this. I change everything every 2-3 days, sometimes more often.
I don't want to take any chances.

What don't you want to take chances with? Infection? Bad Insulin? If I noticed anything that wasn't right I would fix it straight away. :confused:

I do hope that doesn't sound rude :cwds:

[Ben'sMommy]

What don't you want to take chances with? Infection? Bad Insulin? If I noticed anything that wasn't right I would fix it straight away. :confused:

I do hope that doesn't sound rude :cwds:

It's not rude at all. :)

But I'm a bit anal when it comes to Ben. Probably OTT, in fact definitely OTT.
I would not relax unless I knew that I had changed everything.

Perhaps the reason I feel ok to do this every time is that all D supplies
(including pump and all resevoirs/sets) are 100% state funded here.
I don't worry about the financial impact if I change the entire thing every time.
We often had to change it twice in one day, or every day for a while.
We don't think about the money.
Our government does!!!

So, therefore, I change the whole thing each time. If I had to fork out all that money, you can be sure I'd feel differently....

[EmmasMom]

I've also heard/read that insulin doesn't last as long in plastic containers. I will fill a reservoir a few hours in advance to allow the bubbles to rise, but I've never done it days in advance.
I read a headline on the Minimed website about a week ago that says they're working with Novalog to perfect prefilled insulin reservoirs for their pumps. I'm interested to see what kind of material they'll use for the reservoir and how long the insulin will last inside. (It must be a long time)
There will be a variety of issues with this, Emma only uses about 40 units in 3 days so we would be tossing 110 units from each vial if we opened a new one every three days. They must think the insulin can last long enough to use it all, otherwise no one would buy them. ???

I have continued to use an insulin cartridge with a new infusion set and tubing after Emma ripped a new site out of her leg once. I just hooked it up to the new tubing, re-primed, etc. It was still only three total days of use and we didn't have any trouble. I've never considered using every last drop of insulin because I definitely see a decline by the end of day three. If there's insulin left I always toss it!

[CarrieP]

After reading this thread, I checked out the insulin pens that I have for back up, the insulin is in a plastic container on those... Wonder if the kind of plastic makes a difference?

CarrieP

[Jen Jen]

I had found an online mail order company a while back that actually did prefilled reservoirs. You told them what pump and insulin you used, gave 'em all your insurance info, or however you wanted to handle that part of it, they shipped it next day delivery with special packing and everything to keep it cool. I never used the service, since I was having issues with my insurance as it was, but I thought it was a good idea.

[TaeandTiff]

I had found an online mail order company a while back that actually did prefilled reservoirs. You told them what pump and insulin you used, gave 'em all your insurance info, or however you wanted to handle that part of it, they shipped it next day delivery with special packing and everything to keep it cool. I never used the service, since I was having issues with my insurance as it was, but I thought it was a good idea.

who is this company??? Please send a link!