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What makes insulin crystallize in the tubing?

Discussion in 'Insulin Pumps' started by BrendaK, Apr 22, 2007.

  1. BrendaK

    BrendaK Neonatal Diabetes Registry

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    We had this happen this morning. As soon as the breakfast bolus was given there was a blockage error. I looked at the tubing and the insulin had completely crystallized right above the luer lock in the tubing and also right above where the tubing connects to the site.

    This has never happened before. We've been trying to go for 3 days on the Cleo instead of 2 days -- this was day 3. We won't do that again. But it looks like it wasn't the site that failed, it was very obviously crystallized in the tubing.

    Why does this occur and how do I prevent it from happening again.

    I was relieved that the breakfast bolus actually worked -- he was 159 1 1/2 hours later. Because the alarm occured immediately after the bolus was completed.
     
  2. bkfkmc

    bkfkmc Approved members

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    While I have no answer for why it happened, I do know that our Endo. said that if we ever have that problem she will change us from Humalog to Novolog. She said Humalog is more likely to crystalize, but she will not change us unless we have a problem (which she said is unlikely). So, do you use Humalog in the pump? If so, you might ask your Endo. if it is possible to switch and see if this will help.
     
  3. BrendaK

    BrendaK Neonatal Diabetes Registry

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    We use Novolog. It was the end of the vial -- but not over 30 days old. Maybe that had something to do with it....
     
  4. Jen Jen

    Jen Jen Approved members

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    Temperature extremes will make it crystalize, especially if it goes back and forth, hot to cold to hot again, etc, or even just cool to warm back to cool again. Other than that, being in the reservior and tubing too long will do that, as well as too much exposure to air, but I doubt too much air got to it.
     
  5. payam7777777

    payam7777777 Approved members

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    suspending a pump or a temp basal of zero causes the insulin not to move and xtalize. here i suspect a bad site has caused the insulin not to move and xtalize.
     
  6. payam7777777

    payam7777777 Approved members

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    Brenda,
    i know how hard it is to have to do a set change every other day and i know you're trying to find a way to do the insertions every 3 days.
    maybe your sterilization technique is the culprit. it's just a guess of course but it might not e a bad iddea to try a meticulus sterilization this time, like what people do while insertingg sensors.
     
  7. BrendaK

    BrendaK Neonatal Diabetes Registry

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    Hmmmm....I'm leaning toward the temperature changes idea. We did have 5 inches of snow last week and this week it's 80 degrees out. Gotta love Michigan. I'm thinking the vial had also been through the temperature changes -- we took that vial with us to Kansas over Spring break. Even though it was always at room temp and not too hot -- the vial did travel with us.

    I do think we're pretty good with the sterilization technique. I'm very careful about using alcohol wipes on the vial and using the preppies/sterilization on the site area. The reason we decided to try every 3 days was because the rep told us that the early versons of the Cleo were made with the luer lock part being to narrow or something like that and just about everyone was getting bad sites on the 3rd day. He said they fixed that problem so we should get 3 days now.

    We're fine with 2 days -- it was weird because in over 2 years of pumping we've never had this happen.

    Thanks for all the replies!!
     

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