For the past 9 months my insulin needs have almost tripled. I went on the Ping a little over a year ago and love it. However, i am having to change pump everyday because the Ping only holds a max of 175 after you prime the tubing. I am getting tired of changing everyday and have to reuse the cartridges because my insurance will only pay for supplies to be changed every 2 days. I talked to my doctor and he suggested a oral agent in addition to insulin such as glucophage. However, he said that along with any medication there are side effects and it may affect your insulin level. So, we ruled that out. Another option was switching from Animas to Minimed because the minimed holds 300 units and it is the only pump approved that does. I love my Animas and my numbers are very good, just require a lot of insulin. Anyone have any suggestions/comments?
Brian,
I save my needle and holder and reload each syringe. I am using almost 100 units per day also. The other trick I use is to CAREFULLY overload each cartridge with about 210 units. Then after loading, priming and filling the cannula, I have 192-194 units in the pump.
PM if you have other questions. jaj
My only suggestion would be to look into another medication that my doctor just started me on…Symlin. It’s an injectable, and comes in a pen (like an insulin pen). It works by slowing down the rate your food is absorbed…and often means you’ll need less insulin.
I was having problems with my morning “after breakfast” BG’s going into the 250-300 range (despite being relatively “low” before meals (120-140). SO FAR, the Symlin helped keep my after breakfast glucose from rising more than 20 or 30 points.
Symilin would be a very good option. I have heard of some people actually mixing the symilin with the insulin in the cartridge. Otherwise this would be a seperate injection using an insulin pen. The Endo I work with usually has most insulin resistant folks on glucophage with their insulin. Another possible option would be U-500 insulin but you loose all the benefits of rapid acting insulin with this.
Hey Brian what size tubing do you use 23in or 43in . longer tubing means more insulin when primed.
just saying you might save a little bit more insulin.
Its 42in tubing but I am 6’2 and when i lay in bed on my side the pump lifts off the bed with the 23 in tubing. I tried that and it is too uncomfortable. I looked into Symilin but my CDE isnt sold on it and said she hasnt had a overwhelming success with it. I know its a fairly small part of the diabetes community but I really wish Animas would make a pump with 300 units!
Some people use u500 in their insulin pump (5 times the strength of u100) . . . The biggest draw back is that u500 insulin is Regular rather than Rapid Acting insulin and may or may not control your BG as well.
Understand I’m 6’1 and use the 6mm inset 23in & cleo 90 31in I wear a V neck tee shirt to bed and wear my pump on the collar between the V .pump stays right on my chest Try it .
unit are units try to save as much as possible . D is to expensive to waste anything in my case.
wow. These replies are off the wall. No one should mix symlin w insulin. That makes them both innefective.
I have two suggustions. My insulin use is between 80 and 150 unts a day depending on what I eat. I use a ping. Ask your doctor to contact your insurance company about the cartridges. I change my infusion set and cartridge every 1 to 1.5 days. I had to get a special override for insurance (bs if you ask me).
I would also really think about what you eat. If I don’t snack and go low carb I can get by with 70 or 80 in one day. I also use 42 in tubing. (so much more comfortable). I can go 2 days before changing if I eat low carb.
They have been talking about even a 600 unit cartridge but I have not heard of any plans that will be happening any time soon. As far as the Symilin I have seen people have great success with reducing their total daily dose and others have very little change at all. See if your CDE or MD has access to samples (we have quite a few samples in the clinic I work in) and give it a try. Perhaps you may be able to reduce your cartridge changes to every 1.5 days which would get you pretty close to what the insurance company will allow. I think one of the biggest parts of success with Symilin is taking it 30 minutes before your meal which is tough. As another poster stated it may be your only option to reuse the cartridges once. I have done this a few times and have never had any problems. I hear you about the 42 in tubing. Most people prefer the 23in but I can’t even sit down on the toilet without having to unclip it from my belt and I guess I move too much during sleep because I always wake up feeling pulling at the infusion set site when using 23 inch.
Of course mixing insulin with Symilin in the cartridge is not FDA approved and has not been studied. I did not suggest this is what he should do…just said I know of people who do. Those people who do it seem to have success with it but I can say I would never do it this way. I agree with you- I do not think this is the most effective way to use Symilin and insulin but I do not think you can make the blanket statement that mixing them makes them both ineffective. Not the same thing as mixing Humalog/Novolog/Apidra with Lantus/Levemir.
Well, I was told by my Endo that it is acceptable to mix Symlin with Insulin for injection “IF” you inject within 10 seconds of drawing it up . . . and you have to draw up the insulin first. Symlin and insulin can also be stable without precipitation “IF” the proportion of Insulin to Symlin is very low on the Symlin side . . . which unfortunately is so low that the therapeutic effect is extremely minimal. And you are right that mixing Symlin and Insulin is “Off Label” use.
As for mixing Lantus with rapid acting insulin . . . that should NOT be done as it negates the long acting effect of the Lantus by changing its pH so it is unable to precipitate into crystals following injection . . . which is the mechanism that allows Lantus to be absorbed over an extended period of time. I don’t know for certain about mixing Levemir with rapid acting insulin . . . but suspect it could impact its absorption rate as well.
You definitely can reuse the cartridges and recap the needles to use them again to refill. I’ve done that without any problems. I also use the 23 in tube because I found the 42 in too long. I just tuck the tube and clip my pump to my jammies, but you might want to try the V-neck t-shirt and clip it at the V like it was suggested. Also, you can get a swivel clip from Animas that allows the pump to turn so it doesn’t dig into you as much. You might have had that with your 1250 (it came with my 1250 when i had it)? You could use that clip when you sleep. Another thing to consider, which some might say I’m nuts, is see if there are supplements that might help with resistance.
Reuse of the cartridge/tubing can contribute to loss of prime and occlusions in the pump . . . so be sure to rotate to new ones if you do reuse the cartridge . . . and keep everything as clean/sterile as possible.
One other thing that some people do to avoid changing the cartridge is to inject some of their bolus . . . If you try doing that, however, you need to remember that your pump will not know what your IOB is!
People who used the H-tron have been known to reuse tubing excessively . . . as they use to ship 2 sets for every 1 tubing . . . And, some people don’t like to waste their insulin in the tubing . . . but the concentration of insulin can change with ongoing use of tubing because the insulin binds with the plastics and your concentration of insulin can go down the longer you use the tubing. . . and of course there is increased chance of occlusion!
Hi Brian - I might suggest that you do some research on insulin resistance - I think you are a classic case. If so, there are things you can do to fight the insulin resistance - reduce carb intake, take glucophage (yes, it is indicated for T1s with insulin resistance), and doing the right kind of exercise. Weight training, especially anaerobic lifting has been shown to be very effective in reducing insulin resistance (even more so than aerobics).
I have no side effects from glucophage, especially when taken with food.
Interesting that he/she should specify 10 seconds. So far as I know there is no research that would say 10 seconds versus three days is better. Again I am NOT advocating using Symilin in this fashion. Only saying I know of people who do use Symilin in conjunction with insulin in a pump cartridge/reservoir for a three day period.
I would also say I know of type 1’s who have been using Victoza (again this is totally off label), which is just a once a day injection, who have seen a significant improvement in their glucose (particularly post-prandial) and a reduction in their TDD.
Brian- I do wish you luck in figuring out how to make this all work.
