Hi everyone, I only used about 18-22 units of insulin per day, and i've been on the pump now for a year. of course as a newbie, i followed the directions to the letter. now that i'm a "seasoned pro", i've been filling up my insulin more and more to the point where i can go almost a whole week without having to change out my inset and fill up more insulin. it not only is less time consuming, but of course it's going to cut down on costs, especially now that my new insurance only pays for a cap of 50% and $2,000 per year for diabetic supplies.
so far i haven't had any issues with irritation or infection. just wondering if anyone else is doing this? what about reusing the infusion sets/cartridges? i know one of the cons that i've read is that having the insulin in the cartridge more than 2-3 days can make it go bad, but so far, i haven't noticed a problem.
Yup. I do this. Not the set for so long, but definitely filling the cartridge and re-using it. I get 3 ml. sterile livestock syringes w/needle from Jeffers for just about nothing ($13/100?), so only a sterile needle goes into my insulin vial. I only re-use the cartridge once, but I have heard of others doing this multiple times. Also for me, only the stainless steel sets work properly (teflon allergy), so when funds are short, I can even re-use sets - Just clean the needle with an alcohol swab and reinsert, tape it down. No problems with 1 week of insulin in cartridge so far. I use Humalog, BTW.
I have a friend who routinely runs about 6 days between changes. The caveat is similar to yours in that the per-day insulin dose (TDD) is quite low and a 300 unit cartridge lasts the entire session.
Site preparation and personal hygiene seems to be the big prerequisite for making this extended-wear trick work. And even then, I think most folks will have a minor problem or two occasionally. But then again, if ya gotta... well... ya gotta.
On that subject I guess it goes without saying that this sort of "off-label" use isn't really proper and goes against "the rules". But I'm reminded of my old flight instructor. He lectured me on caution, responsibility and observing the rules, and then he promptly took me out barnstorming. When I asked him why, he didn't mince any words. "Because you WILL do this, and since you WILL do this, I figured I'd better show you how so you don't kill yourself the first time out. Now you know. And now you know better why you shouldn't do it. So if I ever catch you doing it, I will personally see the FAA suspend your ticket!".
So it goes. :) There are the Rules... and then there is Necessity. :)
My daughter uses hers for about 3 to 4 days deppending on her high's and the need to change her sites. We extend it a bit due to medicaid only covering 10 a month for infusions and cartriges. I check it periodically and if nothing is wrong I leave it, but if I see any weirdness then I remove it and change it.
I usually fill my reservoir to about 185 units of Apidra. For me, that lasts about three and a half days. I change the infusion set and the reservoir at the same time, and haven't had a problem. I am told that with Apidra and warm weather, the canulas or tubes may plug, but have yet to enjoy the experience. I don't really see the need to change every second day, as recommended to me by a pump trainer. I have never had infection or problems with heeling the canula wound.
I use the cartridge until it runs empty, 4-5 days. Until recently I changed the inset every three days but recently learned that I am authorized to change it every two days, which I am now doing because the red mark left after two days is much smaller than after three days.
I use the steel cannula (due to allergies). If I leave the set it longer than 2-3 days I need more and more insulin, as though there were something blocking the tip of the cannula. Sometimes I have to take it out early because my sugars go over 300. So long as your sugars are OK and you do not experience infections, then I think you are fine.
I can wear an inset in my stomach for 4 days (sometimes 5 if I forget). My sugars may slightly trend up, if I forget to change the site. A small red spot goes away after a few days and no bumps, so I don’t worry about it. If I use my butt, the sites only last 2 or 3 days before my sugars go crazy. Lets just say I use my stomach 90% of the time.
I have a bad habbit of wearing mine to long. Usually I keep the same inset on for up to 6 days...but if my BS have been really high than I will change it regardless.
So far I have not had any infections, but I do get those red hard areas that take a few days to heal
The actual cartridge- I just use the same one over and over again until I feel like putting a fresh one in lol. But yea, my cartridge holds 2ml (I think) and it usually lasts 2 1/2 days or so.. >:
If my blood sugars are doing really good then I will ride the infusion set out as long as I possibly can which is usually a week before I change it. But if my numbers are borderline then I will change it in three days.
Now that I've been on the pump for a week I am starting to do budget calculations and seeing what a difference it makes to reuse the cartridge, at least once or twice, is making me inclined to try it. I don't think i could push my site change more than 4 days, 3 days and i start to feel it, gets a bit itchy and sore and when i take it out there's this popped zit looking bump with ooze (i know, gross, sorry).
My last set change I wasted 3 canulas before getting it right, it made me sooo upset:
first one didn't spring properly and bent and ripped the canula thing...ohshit there goes $20,
second one I try, i forget to take the protective plastic off the needle, try to stab myself, realize it, and when i go to pull it out i get stuck to the sticky paper and the whole thing comes apart... there goes another $20,
then i decide to use the 30º insertion and the sticky gets all stuck to itself but the needle is already in so i'm like whatever i'll reinforce it with some ductape but oh wait the tubing (which is already primed) is for the 90º, why do they not fit together!!.
By this time i lost $60 dollars and i'm feeling like i rather go back to injections, at least you can poke yourself with the same needle until you get it right :/
Sorry for the rant, in the end i cried it out, got the forth one in and moved on. But it just made me worried, how many of these supplies will get wasted in a year? How much money am i gonna lose? Can I afford it?
Not only did I waste infusion sets when I first started, it also took me forever. Never did figure out how to insert the sets that come with the insertion contraption, to use them I had to pull the needle out of the contraption and just push it in. Still have a box of the contraptions. My husband just said that I couldn't do it and would need to go back to MDI. (He was so encouraging.)
Maybe the metal needle sets would work better for you? Like Contact-D or Sure-T. You can re-do it if you mess up. I re-use the set one time. Trim off the sticky adhesive paper, clean the needle with an alcohol swab and then pop it back in, in a new spot, tape it down. Also, for me they don't cause the pimple thing you mention, whereas the plastic cannula kind did. Saves a lot of $ too.
I have been on the pump for two weeks on Thursday. My first change was so frustrating I wanted to quit right then and there! I had to do the whole thing over also. The second try was much better. I was due to change yesterday but will change today. I'm so new, I'm nervous to break the "rules". I also have some high numbers so I wouldn't necessarily think it was the insert. With time, I'm sure I'll will know how to handle things better.
I have a lot of problems with skin infections anyway, and I am allergic to the teflon cannulas, so I use the Contact Detach with my Ping, and change it every two days. I clean the site with Betadine and then use skin prep, and if I go longer than two days, I am still likely to wind up with a oozing bloody, pus-filled mess. Fortunatley I have good insurance, for now anyway.
I am an ex Minimed pump user. When I used the MM I could fill it to 300 units and go for 10 days or so with no problems. With the Animas I get much less and I am not sure why. Now I can only go for 3-4 days. But I have let insulin sit around for a long time and it survives quite well. Just don't spend too much time at the beach or in the sun. That might hurt the length of time you can use it. Jeff
