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How often do you change out pump reservoir/cartridge?

Discussion in 'Parents of Children with Type 1' started by forHisglory, Oct 5, 2015.

  1. forHisglory

    forHisglory Approved members

    Jan 26, 2015
    Reading the instruction sheet that came with our Novolog vial tonight....."If you use Novolog in an insulin pump, you should change your insertion site every 3 days. The insulin in the reservoir should be changed every 6 days even if you have not used all of the insulin."

    We are running close with our Animas cartridges until the next shipment arrives.....so now I'm wondering, is it fine to change the site/tubing, etc. every 3 days, but fill the cartridge with 6 days worth and therefore get 6 days use from a cartridge vs. changing the whole system every 3 like we have been? Our CDE said EVERYTHING should be changed every 3 days, but honestly, changing the cartridge every 3 doesn't make sense to me when we have plenty more room for insulin??
  2. caspi

    caspi Approved members

    Oct 11, 2006
    They have to say that, just like changing the lancet after every check. :wink: My son is a teenager so we have to change the cartridge every 2-3 days because he eats like a horse, but in your case I'd wait until it was empty.
  3. DiabetesMama

    DiabetesMama Approved members

    Sep 4, 2015
    I also would like to know this answer. I have checked a lot of the forums here and couldn't find any real answers. We just started pumping, so I am working on my stash. I won't risk his health over having some extra, but if this has been done and no real drawbacks have been noticed, I am more than willing to stretch the cartridge life out a bit. Thanks for bringing this up. :triumphant:
  4. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

    Sep 23, 2007
    There's absolutely nothing wrong with filling the cartridge with 6 days worth of insulin + about 30u for low limit and tubing fill 2x (that depends on the pump and length of tubing and how low you are comfortable going)
  5. kiwikid

    kiwikid Approved members

    Dec 29, 2005
    We always fill a cartridge full and use it until it runs out. That used to last us about 15 days - now it lasts about 3.. we find it better than dealing with bubbles.
  6. forHisglory

    forHisglory Approved members

    Jan 26, 2015
    Exactly, I wouldn't risk his health either, but right now the insurance is covering for 3 months worth= 10 cartridges a month. Well, sometimes we have to change a site after 2 days, one gets pulled, etc. and I really need an extra box. I'm working on that at our next appt......but if the Novolog insert says every 6 days then I don't see why I have to change the whole thing....the only thing I was thinking was if bacteria or something can work their way up the tubing from the site and therefore contaminate the reservoir supply.....I don't know. Just trying to understand if I was missing anything.

    Thanks for all the responses!
  7. Dad_in_Canada

    Dad_in_Canada Approved members

    Aug 23, 2013
    Related to this bubble thing, we change everything out after 2 or 3 days (for us it's every Mon, Wed & Saturday......routine is sometimes a good thing). When we change out the cartridge, there are usually bubbles starting to form in it, despite being zero bubbles when we filled it 3 days prior. When we fill the cartridge, it's just with enough insulin to last the 2 or 3 days, plus prime, plus enough to avoid the low cartridge alarm (which doubles as a safety, in case something unexpected delays a set change).

    I think if we left it for 6 days, those bubbles would eventually make it into the tubing, and start to cause problems. Yet another variable that I try to eliminate if possible.
  8. dpr

    dpr Approved members

    Dec 17, 2013
    We fill it all the way up and change it when it gets low. It generally lasts about a week.
  9. Megnyc

    Megnyc Approved members

    Nov 8, 2012
    I don't use animas but I go 10 days on a tslim cartridge without issue. I have always filled cartridges full and just used until empty. With medtronic I could get nearly 14 days but tslim wastes a lot of insulin so I can't get more than 10. I also use the same tubing for the full life of a cartridge. I change the actual infusion site every 2-4 days.
  10. mmgirls

    mmgirls Approved members

    Nov 28, 2008
    I have never filled the cartridge full, and reuse the same cartridge several times so we use a cartridge for 6 plus days. I will change it out if refilling feels Ackward.
  11. Mimikins

    Mimikins Approved members

    Jun 22, 2014
    I fill the pump with enough insulin to last me three days (plus a few units of backup). Once the TSlim uses the insulin it needs to fill the tubing (plus that inevitable 10-20 units of mysterious disappearing insulin), my pump is only a third of the way full.

    Maybe I'm weird. It's easier for me to know exactly that I primed enough insulin to get me until my next site change window than having to constantly worry about running low on insulin but not being able to change everything right away (or doing a site change one day and then a cartridge change a day later). The priming process doesn't take that long if I prepare a little bit the night before by drawing up my insulin and getting the rest of the supplies out in open (and then multi-task by making breakfast while the tubing fills).
  12. mamattorney

    mamattorney Approved members

    Apr 9, 2013
    My daughter fills the cartridge all the way and uses it until empty. She also uses the same tubing until that cartridge is empty. Changes the infusion site every 3 days. These days she only gets around 4 days out of a cartridge, but over time I think it saves insulin through reduced tubing fills and the reduced "disappearing" insulin of the t:slim.
  13. susanlindstrom16

    susanlindstrom16 Approved members

    Nov 29, 2012
    When we first started pumping we estimated how much she needed for 3 days and changed everything out at the same time. Then somewhere along the way, we just started filing up the cartridge and using it until empty, while still changing the the actual infusion set every 2-3 days. We now have waaay more cartridges and tubing sets in the stockpile compared to infusion sets.
  14. MomofSweetOne

    MomofSweetOne Approved members

    Aug 28, 2011
    We were told at pump start that it was fine to fill the cartridge to full rather than estimate three days' worth of insulin, so that's what we've always done on the Medtronic. Initially I ordered reservoirs like suggested, but I stopped ordering them probably two years ago and still probably have 9 boxes in our stash.

    When my daughter started wearing the pod, I found it really stressful initially to estimate how much insulin she would need for three days so that we would waste as little as possible but still have it not end during the night.
  15. Michelle'sMom

    Michelle'sMom Approved members

    Aug 21, 2009
    We do the same, but a cartridge lasts 5-6 days, & sites are changed at 2 days. I agree it cuts down on insulin waste.
  16. GChick

    GChick Approved members

    Nov 9, 2013
    Use a tslim here so ymmv:

    I change the cartridge (about) every 7 days (sometimes 6), as it is generally used up by then. When I am eating better I can get more days out of the amount of insulin in there, but after 8 I find the insulin to be unreliable/unpredictable (I know meg says she gets a lot more our of hers with no issue, so that might be an ambient temperature thing as where I live is very warm year-round)

    I change sites (about) every 3.5 days (less if I'm noticing a problem with insulin absorption from a particular spot). which makes timing work out well so that I get almost "exactly" two per cartridge.

    I change the tubing whenever I change the cartridge. I have changed it maybe once or twice "mid-cartridge" just cus I was having highs that I couldn't explain so was just trying different things. It didn't help on those occations btw.

    Those are my standard practices and only do different when a "problem" arises. At those times I swap out in the order of easiest to hardest (easiest being set, next being tubing and last being cartridge) and generally the "problem" isn't usually fixed by anything I swap out (but occasionally is) and its just a body chemistry/needs thing and its up to me to figure out new dosages at that point is all.

    I wouldn't go whole hog if your not comfortable doing so, and sets it seems you'd want to stretch the least as that is where most occlusions seem to occur. But it wouldn't hurt to start stretching things in small increments to find what works for you, even if you don't do that all the time, just so you know if there is an issue, you know what the "minimum" is that is needed to "get by".
    Last edited: Oct 6, 2015
  17. kim5798

    kim5798 Approved members

    May 7, 2009
    We change everything out, every 3 days. 4 when my kid decides to push it...usually it is fine with me, I would rather change sites in the morning hours, or at least daytime, as opposed to right before bed & risk "no delivery" or a bad site right in the middle of the night. During daylight hours, at least she is testing regularly & it will be noticed sooner. I would reuse the tubing/cartridge but insurance provides us with enough & I don't need something else to cause problems, whether it be infection or ??? We were taught at inception to change out everything every 3 days.
  18. obtainedmist

    obtainedmist Approved members

    Aug 3, 2010
    We've always done just this! Molly always has a baggie full of new tubing. We once tried to switch out the tubing while using the same cartridge...BIG MISTAKE! We had a massive air bubble!!
  19. Ding O

    Ding O New Member

    Jan 9, 2018
    Having read some of the posts, it is worth noting that the insulin is only stable in the reservoir/cartridge for 6 days. Filling the reservoir with more than 6 days worth of insulin will, at best, make that insulin less effective. Furthermore, reservoirs are replaced at the recommended frequency because of the potential build-up of bacteria, and possible breakdown of the cartridge materials. I would suppose the former the more demanding criterion.

    "...because [reservoirs/cartridges] are typically made of some sort of disposable plastic and insulin is only stable in those up to about 6 days... It is not advised to reuse supplies for risk of bacteria and the possible breakdown of the actual reservoir/cartridge itself..." (The Diabetes Council: https://www.thediabetescouncil.com/everything-you-need-to-know-about-insulin-pumps/)

  20. MEVsmom

    MEVsmom Approved members

    Aug 2, 2013
    We have always filled the cartridge all the way and used it until it was gone, while changing the site every three days or less. Now a cartridge only lasts about 3 days, but when we were first diagnosed it lasted much longer....probably at least 6 days. We never had any issues. Estimating usage for three days is really difficult and is likely going to result in waste or running out at a bad time.

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