I know that you are suppose to change your pump set every 3 days but I wonder if anyone changes every 4-5 days. Any problems from leaving it longer then 3 days.
I use 60-70 units of insulin per day. I change every 4 days.
Same as Edoshea.
I change every three days. I found leaving sets in place > three days caused scar tissue and absorption problems. I’m a long term insulin pump user and losing some sites threatens my ability to use the pump.
This is a big deal for me as I use an automated insulin dosing system, an awesome management tool that produces great results with much less effort. Changing sites every three days is a small price to pay for this quality of life boost. Closed loop systems are the future of diabetes treatment; don’t jeopardize your ability to use them.
I went through a period when my insulin absorption was poor and likely caused by leaving my sites in for more than three days and leading to scar tissue. I don’t think the tradeoff with convenience and economy is worth it.
For convenience, I fill up the entire pump reservoir and use it until it’s empty (about 10 days) but I still swap out infusion sets every three days. This usually means that changing my infusion site does not also mean the extra time and work to change the reservoir.
I set a reminder on phone to change site every 3rd day (72 hrs) but admit as often as not I go 4 days. My total daily dose is typically 18-24 units hence I have a lot of latitude to work with.
I also usually don’t change the set I’m usually, rather I pull the set from the original site, and while leaving the anchor firmly attached, start a new site at least 2" away from last one. Skin tac is all I use to keep adhesive set, occasionally some surgical tape.
This is not to say I never develop site problems … we all do. My site problems are all tissue absorption, as I only use stainless steel cannulas.
Lately I’ve been changing mine 2-3 times a day. Apparently I’ve gotten a bad lot of Mio insets with crappy adhesive, so they keep yanking off, sometimes pulling off with the inserter when I remove it. Yank-off, replace, replacement pulls off, replace again. Skin-tac helps, but I’ve never had to use it for insets before, just CGM sensors. VERY FRUSTRATING.
But normally I think I’m somewhere between 3-4 days.
Hello Terry, I also am a long time diabetic and found out that leaving the pump infusion set in more than 3 days DOES build up scar tissue and I have plenty of that on my abdomen from being a pump user for many years. I’m totally with you it’s a small price to pay for what the future diabetic treatments will be.
Thanks for the advice on the reservoir. It sure would save on loosing insulin when you change those reservoir’s and make the change so much faster! Great idea!
I find that I have less belly scar tissue now that I use a pump as opposed to many years of MDI … particularly in the era when 27 gauge needles were state-of-the-art.
I try to switch sets every 3.3-3.5 days to correspond to either 7-day G5 or 10-day G6 sensor changes just because it is easier to do two things at the same time. Of course, when I have a premature sensor failure or I accidentally scrape one off, I have to adjust that timing a bit to re-synchronize sensor and infusion set changes.
I am fortunate that my insurance pays for all my infusions sets. So I change mine every Monday, Wednesday and Friday.
Curious, are you using the t:slim yet? You were wanting to switch, I think? I’m pretty sure the t:slim has a site-change reminder feature.
As to the topic of the post, I change my site every one to two days. In the past, I’ve had problems with bad allergic reactions to sites and sometimes had to change them every 12 hours due to reactions. My immune system seems to have calmed down a lot lately. Sites often last the 24-48 hours they’re designed to last (for steel sets), and even Fiasp no longer leaves a big lump under the skin. But I still find if I push the steel sets past two days, my blood sugar goes high and will not come down.
@Jen - No Tandem pump for me yet, and I’m not sure given the COVID pandemic whether Alberta will ever approve the t:slim for insured pump program. As you know, Tandem has federal approval but it’s up to each province to approve the device for its population.
My sites - both pump infusion and Dexcom sensors - seem to last significantly longer than others. If I had to guess I’d say some of the immunosuppressant drugs I take tend to moderate my body’s inflammatory response.
I don’t gamble with the pump infusion sites, but I typically have Dexcom sensors last 4-5 weeks before data degradation.
I use OmniPod and had built up a lot of scar tissue on my belly over the years. I now rotate my arms and thighs, although I haven’t used my thighs recently. My Dexcom (G4 and G5) have always been on my belly, off to the far side; I rotate sides. I haven’t had a problem with scar tissue from the Dexcom.
OmniPod alerts when it has been 72 hours and will give you an extra eight hours before it must be changed. I generally change it close to the end of the eight-hour window, to use as much of the insulin left in the pod as I can.
Been a T1 for 54 years but a pump user for only 6 yrs (Animus Vibe for 5 yrs and Tandem TSlim for 1 yr). Always able to go for 4 days between insets with no adverse effects.
Several years ago I started going 3.5 days between changes. I went on Medicare, and they won’t let the company ship until I’m down to 4 (used to be 3) sets left. Problem: if I’m going on a month-long trip, the timing won’t work: my “four sets left” day may happen a week after I’ve left the country! So I used the 3.5-day interval to build up a backup supply that can carry me through a trip. I also tell the company that I have only 3 left 90 days after the last time I did so, even if I’ve developed an extra set or two in the meantime. Don’t tell Medicare… But I don’t see any other way to fix this problem. It’s not easy to ship supplies overseas, especially when you don’t spend much time in any one place. One time I found I didn’t have any supplies at all with me (my mistake), and was on an ocean cruise. That was a little tricky…
I agree that travel is tricky under the Medicare rules. I’ve had more of an issue with Dexcom sensors because they are only allowed to supply 30-day rather than 90-day supply bundles. However, on 2 or 3 occasions, they have sent me the next monthly allocation of sensors early to accommodate travel. While it takes some advance planning, I would hope that your infusion set supplier would be equally accommodating in terms of “advancing” you a 30- or 90-day supply of infusions sets to accommodate your travel.
Talk to your supplier and explain to them your situation. Most all will give you the supplies needed for the trip and take that amount out of your next regular supply order.
Ha! I never tried to wangle some supplies from my suppliers because I figured they were bound pretty tightly by Medicare rules. I’ll know better for the future! Thanks!
I change the infusion site every 3 days, but the insulin cartridge and tubing only when the cartridge is empty.
I second that with cannlas but I would not fill the resivoir for more than 4 days worth about 35 units a day I find that especially in the summer heat 30to 40 deg kills off the insulin.
Use in an External Insulin Pump
Infusion sets (reservoirs, tubing, and catheters) and the APIDRA in the reservoir must be discarded after 48 hours of use or after exposure to temperatures that exceed 98.6°F (37°C).
My real-life experience, however, varies from this more cautious approach. Insulin producers often publish very cautious policies around the use of their product. For example, they say that insulin in an opened vial may not be used beyond 28 days from when it was first tapped. I think they do this out an abundance of caution and they cannot guarantee that the insulin is at 100% strength after 28 days.
Insulin manufacturers also place an expiration date on the vials and pens they produce. I’ve used expired insulin often and have not experienced any harm or any detectable performance deficit. This is insulin that has been in my care and custody for almost its entire lifespan and I absolutely know that it has been refrigerated and not frozen. By the way, I am a person who carefully watches his blood sugar, uses a CGM and an automated insulin dosing system.
I am not arguing that anyone cut corners on the insulin manufacturers’ recommendations but also realize that their recommendations build in a large margin of safety.
By the way, I live in a temperate climate but I’ve also spent some time in hotter climates like the US midwest in the summer, Florida, and Hawaii. I never leave my insulin supply in a parked car or directly exposed to the sun. I’ve even used Frio water envelope coolers for my opened vial to help it retain its potency.