Pump Site

So I was wondering how often you accidently pull your pump site out and what you typically do? i pulled my site out today on accident and was almost in tears because there were 45 units left. :frowning: I feel so wasteful when I do not get three or more days out of one site.

I have a MM pump and if the set comes out, the tube plugs into it so I just put a new site in and plug the old tube/ tank combo in. I am the same way about throwing out insulin.

That is what I do also, but then I usually use the “new” site for more than 3 days (most of the time it’s good for me) so I get back on track with tubing/reservoirs.
Also, I tape the tubing down above the insertion area - no more dropping the pump and ripping the site out. That has save me a bunch of times I am sure!

Are you on the pod or a tubed pump?

Omnipod - I personally would use a syringe to remove the insulin if it were day 1. This is not FDA approved and Omnipod won’t tell you about it because there could be sterility issues.

Minimed – Just re-use the same reservoir. You can change out everything else but the cannister.

Animas – I think it should be same as MM, not positive.

Same as acidrock and korrie. I’ll insert a new set, detach and toss out the tubing, then attach the old tubing/resevoir to the new set and do a fixed prime with a little more than usual. Of course, then I feel bad about tossing out more plastic, but it’s better than wasting insulin!

Ditto. I didn’t learn to do that my first couple months on the pump, and between that and sites that weren’t in right I went through so much insulin I had to get a new prescription. Now if the site goes bad (happens less now) and there is a lot left I just attach the cartridge to the new set. If there’s a smaller amount I draw it up into the new cartridge. (I use the Ping)

If you use a little cloth tape to fasten down the infusion set’s adhesive, it’s really well anchored. I don’t want one of my dogs to disturb it, so I go one step further–probably not necessary for most people–and also put an elbow sized bandaid over the whole set. Nothing’s going to pull that set out!

LOL Trudy. The only time my set’s been pulled out (admittedly, it’s only been 3 weeks) was a dog incident. Picked her up and her back leg got caught in the tubing. I’ve learned that if I use a site on the right side (dog pick up side) to run the tubing to the left and tape it.

Hi jrtpup, that is funny! At least now that it’s all over.

You are better changing at day 2 - I am just now realizing that many of my high blood sugars are on day 3 of my infusion set - A couple studies have been done and scientifically show increases in insulin use and average blood glucose levels on day 3, 4 and 5 of infusion set. I am now getting established on a 2 day frequency. I think the issue is the temperature degradation of the insulin which must be approaching the average body temperature of 98.6 (or is it 96.8?) Insulin is not supposed to be stored above 84 degrees F. Yes I lose a site about once a month or so - it is frustrating. To me the worst culpret is the knobs on drawers and cupboards in the kitchen!!

copied from web site http://www.ncbi.nlm.nih.gov/pubmed/20663464
BACKGROUND: Continuous subcutaneous insulin infusion (CSII) by means of insulin pump devices is considered to be one of the most optimal therapies to achieve treatment targets in patients with diabetes mellitus. In CSII, the insulin is delivered through Teflon catheters or steel needle infusion sets, which need to be renewed on a regular basis. This pilot study was performed to investigate the optimal change frequency in daily practice and to explore potential problems that may occur when the sets are used for a more prolonged time than the recommended up to 72 hours of usage (Teflon catheters).

METHOD: Twelve patients with type 1 diabetes participated in the trial [age (mean +/- STD): 40.3 +/- 12.6 years, body mass index: 26.2 +/- 3.3 kg/m(2), hemoglobin A1c: 6.7 +/- 0.6%]. They were asked to wear their infusion set (Comfort or Silhouette) for increasing periods of 1, 2, 3, 4, and 5 days. After each use, patients completed standardized questionnaires regarding technical and medical issues associated with infusion set use. A health care professional investigated the infusion sites and infusion sets and completed an “infusion set inspection” questionnaire. Blood glucose was measured and recorded to assess a potential influence of duration of catheter use on glycemic control.

RESULTS: Infusion set and injection site problems (itching, bruising, swelling, and pain) started to occur in measurable amounts on the 3rd day of catheter use, and about 40% of patients reported significant issues when using a catheter for 5 days. In parallel, there was a consistent increase in mean daily blood glucose levels that correlated with the number of days of catheter use (e.g., day 1: 7.5 +/- 3.8 mmol/liter, day 3: 8.4 +/- 4.2 mmol/liter, day 5: 9.0 +/- 4.0 mmol/liter, day 7: 11.6 +/- 2.2 mmol/liter, p < 0.05 vs day 1).

CONCLUSIONS: Using the catheters for 2 days resulted in a safe and well-tolerated therapy. Clinically relevant adverse events started to occur during the 3rd day and their incidence increased constantly with longer use. This was associated with undesired changes in mean glycemic control. Data support the recommendation by the drug and device manufacturers that insulin pump catheters should only be used for 48-72 hours to avoid adverse events and potential metabolic deterioration.

2010 Diabetes Technology Society.

I think that this is why animas limits their pumps to 200 Units not 300 units! I used to think that was a bad decision, but the data does not lie.

I also just put a new site in & wait to change the cartridge out. You can always put less insulin in the cartridge to try & get them back on the same schedule if you want. I have Flexifix tape for my Dexcom and I use that on sites that are in a spot that can be easily torn out. I have trouble getting the tape off!

Thank you for the tips. I reused the reseviour and just used another tubing. I really wish they would send one or two extras of each in the boxes.

Engel: Thank you for the link. Great information.

Been there, done that. If not the reservoir can be used again. Just a waste of a good site.