Hi all,
I’m curious if there is anyone who thinks/noticed that the paradigm reserviors have more bubbles (fine or large) that just dont seem to come out. I have had many that looked like they were o.k (flipped them upside down and such) but after being in use for while had air in the line. I had the 507C prior and other 500 series and never seemed to have this much trouble.
Thanks for your time and I’m glad I found you!!!
I can’t speak for other pumps, but here’s what I do to avoid bubbles:
If you’re really getting a lot of gaps or bubbles even though you think you’ve been careful, call MiniMed and see what tips they may have.
Just out of curiousity, do you remove your pump often? Is it possible bubbles are getting in that way?
Terry
I get bubbles often. They are less frequent now that I move the plunger up and down several times before filling the reservoir – I read somewhere that this lubricates the inside of the reservoir and helps maintain the seal.
Bubbles usually result for me when I am trying to unscrew the plunger and that twists the seals on the reservoir, letting the air in. I’m usually able to get them out by tapping on the reservoir and then pushing the air out the top.
Do you keep your insulin in the refrigerator? If so that is one reason why you are getting air bubbles. Before you load the cartridge take the insulin out of the frig and let it warm up. Basically cold insulin leads to Champagne bubbles which after they regroup many hours later form several large bubbles that will affect your BG.
Well I do all of the things listed(at least the advice is consistant!)
Terry: That is exactly what I do.
Jon: I work hard not to let the plunger go too far.
David: I take out my insulin about a day before I need it.
All good advice that I learned from my CDE.
I appreciate all the help gentleman.
Just a thought here – do you think it could be the product, not the users of the product (since we are all getting the same advice and doing the same things)? Just a thought. But, who am I to question Minimed. Their products are perfect!!! Right? That’s what they tell me. (BTW, I liked the older reservoirs better – the ones where the capacity was on a sticker, rather than printed on. I could peel the sticker off, and it was much easier to see if there were any air bubbles. But, who am I to complain? Right?)
How DARE you complain about Minimed!
Not perfect, but if the same thing keeps happening the same way the choices are human error or a defective design.
If it was the design it would happen to everyone every time, or most of the time. And we don’t have any evidence, yet, about how other pump reservoirs behave. They may be the same. Or worse.
Good advice, by the way, about manipulating the plunger. In addition, I untighten the discardable portion it before filling the reservoir.
I’ve heard these facts before, for what it’s worth:
1 inch long bubble in tubing = approx. 1 hour missed insulin
1 minute without insulin = approx. 1 mg/dl rise in blood sugar
One way to get small bubbles out is to prime them through when they get closer to the infusion end of the line, but it would require vigilantly watching the progress of your bubbles.
I too get these bubbles with the paradigm. I get mostly fine champagne bubbles that are impossible to get out. I had the 508 before and did not have the problem nearly as often. I don’t know if it is the machine or the operator, but it is frustrating and I will try all these tips and hope they work. Thanks to all of you.
Exactly what is happening with me. I’m not saying I’m perfect but I am pretty capable and had no problems with the 4 other pumps I had. I am glad to hear that I am not crazy! 
It’s very important to know this information, but it also depends on what our basal rates are at the times that we have the bubbles. Mine vary from 0.4 to 1.5 units per hour, so a hard and fast forumla is hard to apply, including if it happens with a meal-time bolus. What I would be interested in knowing is how much insulin is in an inch of tubing.
I never had a problem with bubbles in my previous pumps, but have had them often with the Revel, causing very high blood sugars. They have replaced my pump twice since I upgraded to the Revel. I love a lot of other things about this pump (tinier doses, missed bolus warning, CGM) but the bubbles are raising my A1c. They are often difficult to diagnose, not always visible or are masked by white tubing where it's kinked. I'm diligent about using not too cold insulin and getting the bubbles out initially, but a day later there are bubbles in the reservoir that migrate to the tubing.
i have exactly the same problem w/ mine. whenever i am filling the resevoir, i make certain to push all the insulin in, then push 1/2 out, shake it a little, make certain there are no bubbles, and then i hook up. but at times, i get those nasty little bubbles in my tubing (generally near the pump, not the infusion site) and i cant get rid of them i even do a "fill canula" bolus just to see if any insulin comes out. i see little drops, so i think i am ok, but still...those pesky air bubbles.it messes up my BS and i dont have a solution to offer you, but if you hear of one, please let me know.
power in numbers!
Those fine bubbles come from loading the insulin too fast. The MM uses a very small needle to load the cartridge. Why this is I do not know esp since the sensor needle is the size of a garden hose.
In any case I have solved this trouble for myself by pushing more air into the insulin bottle than you need, I have a 722 pump but I only load 200 units. I push 300 units of air and then invert the whole thing and allow the insulin to load the cart just by the pressure alone. It loads more slowly that way and I find no champagne bubbles at all this way.
A second way to get out bubbles once they are in there is to hold the cartridge in your hand with the opening facing up. then make a circular motion like you are cracking a whip. very fast. It seems to work better than you might think.
I agere w/ Timothy about using a whiff of overpressure in the bottle to help. Rather than the whipping, which sounds pretty good, I hold the reservoir up when I'm getting ready to prime, tap the bubbles to the top and prime them out. I haven't noted any problems with bubbles and often run down < 5u before I swap reservoirs.
This has been an ongoing battle with Medtronic for me. I saw a post on here from way back that there were no bubbles when the reservoir is inserted, but later there will be small and large bubbles. That poster was told that was impossible; there is no way air can get into the resorvoir once it it attached. Well, that is just wrong.
I do all the stuff--room temp insulin, tap bubbles to the top and remove them--all Terry's tricks. And no one is going to tell me I left large bubbles in that reservoir!
A couple of years ago, I had a huge problem with this. I contacted Medtronic each time and sent the reservoirs to them for testing. I even returned another entire shipment that was having this problem and were from the same lot. It stopped happening for quite a while. Recently, it has become a problem again--just had one on Monday.
If my glucose levels get high for an unknown reason, bubbles are the first thing I check.
Personally, I think it is the product, not the users. I think there are problems with the "O" rings in tthe reservoirs. It irritates me when anyone feels it is something I caused by not "following instructions."
I think the trouble is in the fill needle. It incorporates millions of tiny bubbles.
You can hardly tell they are there sometimes, after a while they condense into one or a few larger bubbles.If the o rings were failing, you would have insulin leak into the inside of your pump and it would be noticeable.
I used to have an Animas pump that used a 22 gauge needle to fill and did not have that weird double cap thing to load. I never had this trouble with it. I mean any bubbles could be removed by flicking it, and no bubbles would magically appear later on.
It seems like an easy fix to make that needle larger, It seems like they take for ever to change things though. I don't know if that is because of the FDA or just them.
I had this problem on Monday with over 50 units remaining. I "pressurize" by injecting air prior to filling, about 50% of my fill goal (about 100 units.)
Yes, if you pull the plunger too quickly, you get small bubbles because you jostle the "O" rings from the side of the tube as it fills. Makes scientific sense.
No matter what, if the fill is a problem, it should be taken care of before the prime.
My problem always occurs 2 days or so after the fill. I still think it is a problem with the product.
I think it is leaking into my pump because I can smell the insulin although it isn't enough for it to be wet.
Does anyone else smell insulin in the chamber in which the reservoir goes?