ughhh! i just had an apt. with my endo today, and my a1c went up from 6.8 to 7.6! This is what the summer months do to me.Luckily she changed a few of my basal rates etc.
ALSO, i didn't know that the insulin has to be replaced every 72 hours, i just usually use it till it gets over, which is a little bit over that, & thats why she saw the trend in my Bg's on like he third day before replacing.
ALSO. When do you guys change your site? i know changing at night is not okay, because you have to make sure it works, before you go to bed. but today my endo told me that you have to change before a meal, because the insulin from filling the cannula goes just to the top, but when you bolus its whill flus out any fat or anything that is around it, and lower you chances for it getting clogged.
LASTLY. i found out why the insulin has been stinging sometimes when i first change my pmp site, because the insulin is cold if it just comes out of the refrigerator, and that makes it sting.
hmm. i need to start working on my control more..thanks for listening to my vent! :)
I change my site whenever I run out of insulin in my pump...usually 48-72 hrs...sometimes more. I haven't run into any problems changing the site before bed either...always works *knock on wood*. I would only change my site before a meal if I had run out of insulin, or didn't have enough insulin in the pump to make it through the meal.
That's good that your endo spent that much time working with you on that. Mine takes my blood pressure and talks about my eating/exercising habits and then sends me to get blood work. Ah well.
I try not to go longer than 72 hours, but I do not like to waste the insulin in the pump, but for me, on that third day, i i know it isn't as effective.
And sometimes I feel the burn from the insulin, and i should pay attention if it is when I first change it, because that is interesting info!!
I did ask during pump training about the time limit of insulin in the pumps and was told no more than 3 days max. Insulin and plastic do not do well together. The insulin will stick to plastic and reduces it effectivness. That is why it is shipped in glass and stored in glass vials. The pen are also glass. My son wants to go three days and I want every other day, but he is the one who has to inject himself so most of the time I let him go 3 days if his BG are good.
i change mine every other day - i use a lot of insulin and i'm sensitive to the adhesive, so changing more often is better for me (about every 48 hours). i usually just wait and change it whenever it happens to run out (i don't like to waste insulin either - expensive!), but that usually ends up being in the morning around the time i shower.
your doctor spent a lot of time with you, that's great! because i used to work in my endo's office, she spends more time telling me about her plans to bike ride around MN than she does talking about diabetes. i like to pretend i know everything about D, but sometimes i can use the extra help. i see my endo tomorrow, so we'll see what we chat about then :o)
good luck! a lot of it is just being more conscientious about BGs and insulin dosages. let us know if you have more questions :o)
I change the insulin in my pump when it runs out - which is also, for me, every 2 days. I used to be able to go every 3, but that was when I had a pump with bigger cartridges. (The Cozmo held 300 units, while the Animas I use now only holds 200).
I change my site either when I refill the pump, when it starts to look irritated (red), or when I notice my numbers aren't coming down like they normally do.
Insulin goes through extensive testing for stability before they print the insert that comes with the bottle. Insulin kept in the refrigerator can be stored there (as long as it doens't freeze) for up to the expiration date on the bottle.
Insulin at 68-78 degrees F (otherwise called ambient) can be stored that way for a month after the bottle is first used.
Insulin at 98+ degrees F (in a pump, for example) is "good" for 3 days.
Insulin does not react with or become adulterated by plastic reserviors, infusion tubing, or cannula (or syringes for that matter). It's stored in glass vials because it's easier for the pharms to sterilize glass - compared to sterilizing plastic. It happens to be way cheaper and it's also easier on the environment than sterilizing plastic with EO or other ridiculously harmful chemicals.
I keep my infusion site in for 3-4 days, or less if I am near muscle and it starts to hurt. Once I open a bottle I will leave it out, because I find that it's easier to get the bubbles out of the reservior when the insulin is ambient temperature. Also, if you use 40F insulin from the fridge and put it in the reservior, you will get about a 1 unit bolus as the insulin warms up and expands. hope this helps a little.
Thanks for all the good advice! Yeahh, i bet the summer is having an effect on my insulin because its so hot and i've been out running a lot as well..!
All this is good advice to keep in mind, its crazy how much you have to keep in mind as a diabetic, with the constant ifs/ and buts! i'm shooting to change it every 3rd day in the morning, so that the insulin will hopefully be more effective!
I did get imformation about plastic and insulin for our pump trainer. When Joe said that was inncorrect I called Nove Nordisk makers of novolog to get more imformation. They told me that thier studies showed insulin to be stable in pumps for 6 days. So the imformation I got and passed on was inncorrect and I appologize for and confusion. I really do want imformation that I pass on to be accurate.
I did get imformation about plastic and insulin for our pump trainer. When Joe said that was inncorrect I called Nove Nordisk makers of novolog to get more imformation. They told me that thier studies showed insulin to be stable in pumps for 6 days. So the imformation I got and passed on was inncorrect and I appologize for and confusion. I really do want imformation that I pass on to be accurate.
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thank you for finding out. Do you use nove nordisk? I use humalog. (sp?)
Also, if you use 40F insulin from the fridge and put it in the reservior, you will get about a 1 unit bolus as the insulin warms up and expands. hope this helps a little.
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Yikes! I try not to do this, but have on occasion with my son's pump. Since 1 unit will lower his BG by 150, I better watch that!
Thanks to K Burley for the follow up with NovoNordisk, I thought the insulin/plastic thing sounded strange. The 6 days sounds realistic but I would assume depends on your pump and where your tubing is.
As for our son, we change every 3 days. We only load the amount he will normally go thru, plus 8-10 units extra and then the 9 or so units for priming. So we aren't wasting. Though, we still end up wasting isulin since even at that, he is only going thru 1/2 vial a month.
As for time of change, we do it at night at our son's bath time. But my husband or I check when we go to bed, so we know if it worked. As for eating with a site change, could probably accomplish with just a snack - as long as you are bolusing 'something' it probably doesn't need to be a whole meal's worth.