9+ hours of insulin delivery after my MM722 showed zero units in reservoir

Around noon yesterday I saw that my MM722 showed zero units left in the reservoir. Usually I change before it hits zero…sometimes when it shows 5 units and sometimes more, depending on what time of the day/night I change the reservoir. But I decided to let it give me the No Delivery alarm before I change. So, after 2 boluses for lunch and dinner and a correction bolus in between (totalling ~6 units in all, and a basal of 0.9units/hr on average for this period), I got the No Delivery alarm at 9pm. I was so surprised that there is still that much insulin that can be delivered even after the pump shows zero units available in the reservoir!

Anybody else had this experience? When do you usually change the reservoir?

NB: I change my infusion site every 3.5 days (twice a week) regularly, and my reservoir only when the insulin runs out.

Yep, on my 512, it was pretty common to get another 10-12u out after it said 0. I’d often wait until I got a no delivery to change everything out.

Yes…just upgraded to the 522 from the 512…was really concerned when I looked down and saw “0” bars of insulin left, but obviously it still has volume because I can see it! I thought about calling MM…I hate this because I am always looking down at it and waiting for it to alarm! MM make the information more accurate…if you are going to provide it on the face of the pump!! By the way…the tubed pump design has all of us throwing away good insulin every time w/ make a set change…seems like there would be a better way? Especially since there are kids in LA dying because they do not have access to insulin…ok, sounds like that saying about cleaning your plate! but, it is true:) I am looking forward to trying out the small Solo pump including for this reason…did not like the size of the Omnipod. Wish someone would design and bring to market a tubeless, low profile, “skinned” pump…I might even do a fundraiser to get that pump!

And in answer to your last questions…I run the pump until it alarms…if I can (not going somewhere, etc.) I always store the sets in the fridge if I do not, so I can recover what would be lost insulin. You can remove it w/ a syringe…I always keep it for “back up” supply in a different labeled vial. Learned this technique from a doc/diabetic friend of mine who traveled to 3rd world countries. Good to know if you are in a remote location and cannot get insulin:) same thing applies if your insurance company will not approve another vial! Change my infusion site when I need to (1-2 times per week) and often re-use reservoirs. If I let the site in a little longer I usually know it…had to once when I was in Africa…and the site got red and BGs will always go up if the cannula gets plugged w/ tissue or insulin starts tunneling. Think about how long hospitals will leave an IV in your arm (directly into your circulatory system)…most of the clinical trials on the new generation pumps show cannula patency for upwards of a week…so, I see no problem w/ doing it if you test frequently and know how to manage sites. I think ideal would be changing it when it needs to be changed and heals quickly w/o scarring.

Yes, I find that I can keep pumping for a while. But I noticed unexplainable highs at the end of the cartridge. Other users have said this too. So I try to change my reservoir soon after it tells me that there are 20 units left. I remove the insulin from that reservoir (but it back in an old vial) and use it in the next reservoir.

I just had a long high last night, which I think was caused by inaccurate delivery near the end of the reservoir, but I could be wrong.

The other question is if you got unseen air bubbles when the supply got low enough. Loading a cartridge with insulin direct from the fridge can do that to you for instance, since colder fluids keep bubbles in suspension which don’t separate out until the insulin warms up a few hours after loading the cartridge in the pump.
That’s why I always warm up the vial or cartridge just before loading the pump, then return the vial to my fridge for storage.
Also, when things don’t line up (or I forget to load the pump) and I’m away from home I’ve found during my 15 years of pumping that I can disconnect, separate the cartridge from the infusion hose, put some air in the cartridge, put it back together and keep going for the rest of the workday or whatever. Gives me an extra 21 units in my 43" hose as long as it’s short term and doesn’t use it all up. Not great unless you’re stuck without supplies for some reason. I thought this could work with the MiniMed pumps that I used for the first 10 years or so of pumping, but finally found my new Animas pump will let me do this too. That’s what happens when you think the instructions are correct. They said that when reloading a cartridge it would run the plunger in until it started pushing insulin. It only detecsts pressure, of course, so I can do it now too.

I don’t know, Kristin, if that"s such a good idea taking insulin out of a 3 or 4 day old reservoir
putting it back in a vial and reusing the insulin. It doesn’t seem like a good idea to me.

There have been times when the insulin was not good and after the first unexplained high, I just threw it away. For me the insulin is actually 10 days old (that’s how often I replace the reservoir). Insulin can last for 30 days without refrigeration-- so it could be OK. But I don’t recommend this to people if they are not comfortable with it. I try not to mix the “new” and “old” insulin. So after about three reservoir changes, I put all the insulin together in a reservoir and use that. Perhaps not smart, but it seems to work fine.

When I was on MDI I used Humalog from the same bottle until it was over. Since I used Humalog only for bolus, it typically lasted 6 months or more. I never saw any reduction in potency.

Now that I am on the pump and use Humalog for bolus and basal, I go through the bottle much faster. I still don’t discard any unused insulin. It works for me.

I think that “toss the insulin if it’s 28 days old” is the drug companies’ cover your ■■■ policy and not based in reality.

I agree! I also figure that if my insulin is not working effectively, I will know within a few hours. There have only been 1-2 occasions in my 6 years with insulin when this occurred.

In the early days, I asked my doctor if injecting “old” insulin could have any negative effect. She said only high blood sugar if it is not potent. I check my blood sugars often after I change insulin or infusion set. If I can’t explain a high, then I change. I have saved a lot of money this way and waste less insulin.

But I can understand why some people are more hesitant and afraid of the insulin not being potent. I think that if I am pregnant one day, I will only use new insulin :slight_smile:

I just thought that after being in a plastic reservoir exposed to various tempertures,
the insulin would break down and lose some of its potency. I can’t believe that
one reservoir, I guess 300 units, will last you up to 10 days. That’s something,
I’m happy when my reservoir’s make it 3 days. Kristin, are you type 1 or 2,
just curious why you use so little insulin.

Ray— I think you are right that the insulin exposed to various temperatures can break down more quickly, but for me it does not break down in 10 days.

I have type 1 diabetes and use a Minimed 722 (so yes the reservoir holds 300 units). I use the exact same method as Dave described about his wife. So I change my infusion set every 3 days and my reservoir about every 10. I use about 28 units of insulin per day.

And, yes, everyone’s insulin needs vary and it does not make them better or worse, just different. Everyone should take the amount of insulin they need.