How Do You Cover Emergency Injections?

Before going on the Pod, I used a pen and Novolog for post-meal injections and a pen filled with Lantus for my 24 hour coverage. After going on the Pod, I continued to carry a pen filled with Novolog in case of emergencies if the Pod failed for long periods of time or the Pod was not working.

In five months of Pod use, I have only had to take ONE injection to bring down a high reading that the Pod did not seem to handle. Unfortunately, during that same five months I was throwing out unused but 30-day-old cartridges of insulin from the pen. What a horrible waste! Last week I finally disposed of the last of my supply of cartridges, and even though my prescription for a new box is still good, I refused to fill it. Instead, I explained my reluctance to throw out expensive, unused insulin and asked my endo for a prescription for good, old-fashioned syringes. She agreed that carrying a couple of syringes with me and the ever-present bottle of Novolog that I use to fill the Pods was a better, far less wasteful choice. The syringes are smaller and fit in my kit better, and I do not have to throw out insulin.

I am wondering, though, if that is what the rest of you do. Do you carry syringes that you can use in an emergency and draw from your insulin vial? Do you always carry a vial with you like I do? I never carry the Lantus (24 hour) with me because I figure I will be home at night if I should need to go off the Pod for more than 12 hours. Do you carry a long-acting insulin with you at all times? (Naturally, when I travel I would take the Lantus too.) Currently I just keep the Lantus in the refrigerator and thus it does not expire in 30 days. I have not used the Lantus once in the past five months.

I am just curious as to what you carry with you for emergencies.

My emergency kit is a syringe, a Pod and Apidra. For emergencies I am willing to inject a little bit of Apidra every couple of hours. I have no plans to every carry long-lasting insulin only to throw it away unused most of the time.

I always have the ever present vial of Humalog which I use in my Pod. I also carry a few syringes as well. When I travel far away from home, I carry the same PLUS vial of Humulin N (NPH) kept in a Medi-cool. I have the following instructions in case of insulin pump failure: 1.Take 1/2 of the total basal insulin as bedtime NPH (16U for me). 2. Take 1/6 of the total basal insulin as NPH before each meal (5.33U for me). 3. Take rapid or short-acting insulin as usual before meals. 4. Eat a bedtime snack consisting of at least a starch and a protein. 5. Check a blood sugar at 3:00 a.m. 6. Discontinue mealtime NPH preceding anticipated insulin pump restart. Fortuately, I never had to do this. I’ve returned the NPH to my home refridgerator upon my return home from each trip. As long as you keep the NPH cool in the Medi-cool, it’ll be fine until the expiration date as long as the vial is not opened.

Same thing Helmut said. I carry a couple of syringes in my pod change kit that I can use for Apidra in a pinch. That’s been especially helpful throughout my pregnancy as, at some meals, I’ve had to go over the max bolus allowed by the pod. My endos, over the years, have given me a bag of syringes here or there when I’ve asked for some.

I have pumped for 10 years and, until a couple months ago, never cared about or stocked a back-up long-acting insulin. My endo gave me a bottle of Lantus, however, and told me it would be good for a year in the refrigerator. I’ve never used Lantus (it came out about 3 years after I went off of MDI), but I’m sure I could figure out how to be a shot-taker again in the event that my gen 2 PDM, gen 1 PDM, and Cozmo weren’t options. I have back-up for back-up for back-up. :slight_smile:

Melissa, my max bolus is set at 10 units, but I could increase it to 30 units. I also think that I can take as many max boluses in a row as I like. Am I missing something?

During the last trimester of a pregnancy, the placenta makes growth hormones that are actually anti-insulin. Most diabetic women see their insulin needs increase to anywhere from 3-6 times the normal amount. My TDD went from under 40 units to well over 120 units. My insulin:carb ratio is now 1 unit:4 grams of carb. So I can hit that 30 unit max without even trying. :slight_smile:

And while I could just do multiple boluses in a row, the Pod can take as long as a minute per unit to deliver large boluses, whereas a syringe delivers it all at once. If I am trying to keep my highs in check by bolusing before a meal, I want to know that it has completed delivery in a reasonable amount of time. So for a while, just to make pods last 3 days, I was doing bolus via injection and using the pod for my basal.

For this last month, I’ve actually switched to my Cozmo because I’ve burned through too many of my pods due to reservoir volume and can’t reorder for a few more weeks. On the Cozmo, I can accommodate the huge amounts of insulin I’m taking until the baby gets here.

Thanks, Melissa. I had no idea.

My CDE gave me a few syringes for emergencies when I was trained on the Opod. I never dosed that way…always pens and now the Pod. If needed, I’m sure I’ll be able to use the needles. I do carry my Humolog with me and it lasts a month without a problem.

I’m sure I’m in the minority, and my risk tolerance is perhaps higher than most people, but I carry neither insulin nor syringes with me on a day-to-day basis. I work only 30 minutes from home and so if a pod were to fail I could usually be changing it within an hour or 2. I can live with a high BG for that long, especially when considering that the alternative is having to carry the extra bulk (some kind of cooling pack/device) and extra burden (remembering not to leave it in the car or other hot place) of keeping a vial cool (I live in Florida).
In almost 2 years on OmniPod, I’ve only had a pod fail away from home 2 or 3 times, so I just don’t see the risk being worth the cost of mitigating it. Yes, I’ve had days when I could not bring a high BG down and ended up switching pods when I got home, but like I said, I can tolerate a rare high BG for a couple/few hours more than I can tolerate carrying extra stuff and mental burden for 9-10 hours EVERY DAY.
Of course when I travel I take extra of everything (pods, insulin, AAA batteries), but never on a “normal daily life” kind of day unless I’m going to be more than an hour from home.
Maybe that’s just me, but my control is pretty good (last two HbA1c of 6.2 and 6.9) and my endo has no issues with it.

I can completely relate, Eric. That’s certainly the way I used to handle my pump therapy. For the eight years I was on a Minimed pump, I honestly never carried anything. Supplies were cumbersome and I had no interest in messing with them.

Many times though, it came back to bite me big time, but it didn’t really change my habits. One time I was a bridesmaid in a wedding and ripped a set out as we were getting ready (strangely enough another bridesmaid wore my pump - what are the odds - and was packing supplies). Another time, I was over half an hour from my supplies (which were locked in my dorm room) and singing a concert and passed out from a high (during my big solo) brought on by a couple of hours of an empty reservoir. Another time, I was traveling abroad and visiting another city 8 hours from where I was staying and forgot to bring insulin and had no way to get back. I nearly went DKA. You’d think that at least would have told me I’m one of the people who should have supplies on me!

When I started wearing a Cozmo in 2008, the supplies were a lot easier and more compact to carry and I was older and already carried other crap around in my purse. Then, once I started podding, compact supplies continued to make it easy for me to carry what I needed…so I just picked up the habit. Even so, twice I’ve been in a situation where I needed a new pod and didn’t have one. I hate that feeling and, unlike you, do NOT handle being basal-free well for very long.

Do what works for you…and change it if it stops working.