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Can't use dilute Novolog in a pump?

Discussion in 'Parents of Children with Type 1' started by virgo39, Jun 8, 2010.

  1. virgo39

    virgo39 Approved members

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    We are moving towards using the Omnipod pump. One concern is the minimum fill, which is a lot more than DD's TDD.

    The Novolog web site's Patient Information page says do not use dilute insulin in a pump.

    Anyone know the reason for this? I can see how you'd need to be careful that you were adjusting ratios and correction factors appropriately -- but presumably anyone who is diluting insulin faces that same issue -- so I'm wondering if it is something else.
     
  2. jilmarie

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    What's the minimum fill level? If you're tossing Novolog vials at 30 days, would there be any added wasted insulin by just filling the pod to the minimum level and using it that way?

    I'm not sure if any of the really young kids on here are pumping with diluted insulin or not, but I would assume that it's not advised because of the dosing confusion. Are you guys using diluted insulin on MDI?
     
  3. chammond

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    I believe the ping also said that. It is approved for U100 insulin only or something to that affect (effect?). We did use diluted insulin though for quite a while and it worked well for us. We were using U33 insulin until he was about 1 1/2. We were using humalog though. I will say that make sure you have a pharmacy that will dilute the insulin for you first though. We did our own, and even though it isn't difficult it was stressful. Everytime his numbers were erratic we would have to try to figure out if our dilution was correct, the site was bad, etc. I must say that I was very thankful when we were able to finally switch to undiluted insulin. Good luck however it ends up.:)
     
  4. hawkeyegirl

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    Personally, I wouldn't dilute insulin just to reach the minimum fill. I'd just resign myself to throwing away some insulin with every pod change. Will that be a financial burden for you?
     
  5. swellman

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    We use the a little more than the minimum fill of 85U (around 100U IIRC) to avoid pod errors but we usually have left over insulin after 30 days.

    Unless the 0.05U increment is still too large ....
     
  6. susan

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    Davis uses the pod and doesn't come anywhere close to the min fill..We just toss it after 3 days, he never used the whole bottle when he was on mdi so I figure either way we are throwing it away..
     
  7. Flutterby

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    Diluted insulin seperates, that is my guess as to why you can't use diluted insulin in a pump.. it'll seperate and you won't get an equal/accurate dose of insulin/saline all the time.. Also, you can not dilute novolog, only humalog.. If your daughter is on a low TDD then she's probably not going through the entire vial in a month anyway.. so you are tossing it.. we don't have a minimum fill but we over fill anyway, just in case.. and we also don't go down to nothing, there is always insulin left in the reseveroir.

    If she's on a really low dose of insulin, make sure the basal/bolus rates will be OK for her.
     
  8. virgo39

    virgo39 Approved members

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    We are not using diluted Novolog now. Kind of wish we were as DD's meal boluses are .5u often enough for me to pull out the syringes; lately, I've used syringes for .25u increments a couple of times as well.

    The .05u of the pump will be a huge improvement over what we are at now.

    Right now, DD's TDD is just under 7u, so it seems like we'll be tossing a lot of insulin, especially if the Omnipod rep is correct and we'll be using a new pod every two days. I don't really know how our costs will be impacted, I'm assuming we'll be paying more. Just wondered if we could be less wasteful and more precise, but it's probably not that less wasteful or that much more precise.
     
  9. swellman

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    Why? Just curious. We get over 3 days on a pod - well, 3 days and then some.
     
  10. sam1nat2

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    just a fyi, but when we started pumping, the script for insulin was changed to use 100 units/day. We don't come close to that, but we do get 3 vials for the same copay.

    As for what the rep says, remember they get more commission if they tell you to change it every 2 days since you are using more of their products
     
  11. Flutterby

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    When Kaylee started pumping her TDD was 2-3u.. One of the (many) reasons we didn't choose the pod was because of the minimum fill requirement BUT many people do it and it works for them (Kaylee also has ZERO interest in tubelss, I can't figure out why though.)

    I agree with what someone else said, selling more pods means making more money for them.. unless there is some absorbtion issue or tape reaction you should be able to do 3 days just fine.
     
  12. swellman

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    I know it's late but I do not understand this and you're not the only one to have said this but if you're using less than the minimum fill and assumed to change the pod every three days the only conclusion I can draw is you are using your insulin past the 30 day mark? Otherwise why is the minimum fill an issue? Not to mention that you can recover insulin from the pod if absolutely needed. I'm befuddled.

    (you in general)
     
  13. Flutterby

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    We don't use novolog past 30day.. I think its a mind set.. it obviously doesn't matter if I'm tossing it from the vial or through a pod/reseveroir.. but when we were considering pumps 4 years ago, this is something we considered.. I didn't want to HAVE to put a certain amount of insulin in the pod.. I wanted to be able to put how much I wanted to put in it.. maybe its a control issue:rolleyes: lol. I actually over fill reseveroirs now (and have for a very long time) because I like her having extra insulin in the reseveroir 'just in case'.

    Obviously is Kaylee really wanted to use the pod, I would have gotten past this issue, many people have.. she has NO desire to go tubeless (I don't know why, the only thing I can figure is that she'd rather have the 'little' site than the 'big one'..maybe she things because its bigger its got more needles, who knows..no matter if its tube or tubeless, its still attached.).
     
  14. SarahKelly

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    my son is on the pump and we usually fill it with about 40 units per change, he uses 5 units a day which means we 'waste' 25 units per site change, but you know what we'd be wasting that much or more anyways. I say, not a big deal. Just fill it without diluting and don't worry. You'll still have plenty of extra.
     
  15. virgo39

    virgo39 Approved members

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    Thanks all.

    Right now we use the Novopen Jr. and we go through one (300 unit) cartridge each month. We would clearly need a lot more than that to fill a pod with 85 units every couple of days. How many units are in vials of Novolog that one uses to fill the pods anyway? I'm guessing a lot, so that I may just be throwing out one vial after 30 days or so? We have decent prescription coverage, so for now cost is not really an issue. I'll just get over the feeling of being "wasteful".

    @Swellman-the Omnipod rep told us that in her experience a lot of younger kids need to change the pods more frequently -- every two days -- related to an strong immune response that can lead to the cannulas getting blocked. I posted here about it a while back, and it did not seem to be a common issue, but I'm thinking "worst case scenario."

    We have an endo appointment today, but while our endo will support whatever pump we choose, she had commented that in her practice, she has noticed more site issues with Omnipod compared to the Medtronic pump that most use (however, she also made it clear that site issues were infrequent -- maybe one or two a year).
     

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