I've been expecting this to happen based on previous posts and now it has. It was the 6th pod my son has used I think and 8 hours after we applied it, it suddenly deactivated. No warning - just a long beep and it said "insulin delivery failed" or something like that.
We wasted about 80 U insulin as I did not feel comfortable removing insulin from the reservoir for re-use. I did draw up most of the insulin that was in the failed pod as 'practice' but then discarded it as it was filled with air bubbles and took multiple times for me to get it all out.
I have a few questions:
How many of you re-use insulin and is this safe? It is obviously not sterile any longer but does that matter?
For those of you who do this routinely, do you withdraw the insulin and then transfer to back to the bottle? This seems a bit risky (contamination-wise) or is this what everyone does.
Any bad experiences doing this that I should be aware of or should I not worry.
All of your reservations regarding the re-use of insulin out of an old pod are valid ones.
I have not had a large number of failed pods, but on a couple of them that were applied and died soon after insertion (12 hrs or less) I have tried to remove at least some of the insulin. From an "official" perspective I'm sure the insulin companies would say "no don't do this", but from the sterility factor that you mention, and from a heat degradation factor that is going to be entirely dependent on each individual (which is part of the reason for them having a general "no" policy if they were asked about it).
If I do try to recover some of the insulin, then No I don't put insulin back into the bottle. I think I'm fairly safe with my insulin tranfer from bottle to the initial pod (so risk of contamination is minimal), but once that port has been placed against my skin for the last x amount of hours, I am not able to effectively disinfect that item and so the risk of cross contamination of going from a pod back into the bottle is greatly increased. If I think I can recover most/all of the insulin left in the pod (based on time it has been used) then I'll just open the new pod and use that syringe/needle to pull it out of the bad pod and put it into the new one, knowing that I'll have a little less insulin in the new pod (b/c of not being able to get every last drop out, etc).
If I think I'll need more insulin to get a "full 3 days" out of the new pod, then I'll FIRST fill some insulin with the new syringe/needle from the bottle, then I will try to withdraw from the pod (always bottle then pod, never pod then bottle, to reduce that risk of contamination and/or of mixing slightly degraded insulin w/ insulin that's still full potentcy).
You will likely get the gambit of replies here advising both ways (i.e. yes you can mix old with new in bottle, and no don't do that for reasons listed). I think the best option is going to be whatever you are comfortable doing--you have to know (and be comfortable with) your own sterility maintenance techniques and you have to have your own perspective on how quickly you think your insulin of choice really degrades, based on lots of factors (e.g. how long was it close to your body; is it the middle of the summer and you've been outside all day at the pool so it's been in direct sunlight being heated up or is it the winter and you've been inside all day; etc).
Our CDE explicitly told us it was ok to withdraw insulin if the pod failed “right away”. She might have meant during priming, but we have reused insulin up to 10 hrs later.
We consider how long it’s been warm, too. If it’s hot outside, for example, I’m less likely to reuse it.
I would not put it back in the vial.
Were you using pen needles before? We had an old script for novalog cartridges that we were able to fill. That gave us some extra in the beginning.
I choose not to re-use insulin once I have placed it in a pod. I just make sure I am prescribed enough insulin to take these kinds of incidents into account.
I was told it IS a sterile environment inside the pod, so I have no problem taking out large amounts of insulin when there is a failure. I don't add it back to the bottle, however. I get out the air bubbles as best as I can, then add that amount to the new pod. I eyeball the difference in how much I'll need and take just that amount out of the insulin bottle to add to the new pod. I've definitely gotten better with withdrawing the insulin out of the old pod too. I've found tilting it towards the needle helps.
I have had no issues with glucose numbers due to reusing any of the insulin either.
Good luck.
I can see the conservative approach. I've only had one pod failure in the last 4 boxes I've used, and was during priming. I did re-use that insulin. I've been told Insulin survives well 3 to 4 days at body temp (one of the reasons for the 3 day change of the pods I think) so to me anything under 24 hours might be good depending on your situation.
I'm sorry to here about your POD failures, and I know how frustrating this can be. We have the POD system on our four year old and have had 20+ (yes 20) POD failures during bolus. We are honestly on the verge of giving up and going back to Animas. I don't want to scare you away from OmniPod because I like all of the "features", but we can't deal with the failures any more.
For anyone out there have GOOD luck with the new PODS, any advice? We believe the failures to be mechanical in nature (never happened with old PODS), but I can't understand how this issue is isolated to only several people. Any info you can forward on about good lot numbers, good manufacturing dates, etc. would be helpful.
If anyone out there has had problems with failures during bolus and was able to correct them, that info would be priceless. Thanks. -Dave
No problem! As you can see from all the other great replies, everyone kind of finds their own method/system of "what works for them". Hopefully you'll find your own version as well!
Yes, it's been great reading everyone's responses. I think for us, if we only experience 1-2 pod failures per month, we will have enough insulin available without needing to try to recover it. However, if this became a bigger problem, I may try, especially if it has only been a few hours after activating a pod!!
Never had a bad experience reusing pod insulin, unless you count the hassle of trying to withdraw a meaningful amount insulin from a pod after dealing with bubbles and such, especially with the new pods, as a bad experience.
I'm sure there is cause for concern when it comes to insulin sterility and temperature stability, especially if you are re-injecting back into a vial or wearing a pod during extreme temperature conditions, but those concerns have to be kept in perspective. If you're running low on insulin because of lost pods, you may not have a choice. Considering the many ways people inject insulin, multiple times daily, under less than sterile conditions without incident, I'd say you're probably going to be fine.
