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> Reusing cartridges, Is it ok to reuse insulin cartridges
Darian A. Caplin...
post May 28 2010, 09:04 PM
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Wow, glad I found this thread. I refill my reservoirs all the time. I usually go a week between site changes, and end up refilling my reservoir at least twice during that period. I have plenty of supplies in stock, so I don't have an excuse, but it seems such a waste to change so often.

I have *NEVER* had a leak. I have *NEVER* had a reservoir or infusion set fail. It just works.

Regards,

D

This post has been edited by Darian A. Caplinger: May 28 2010, 09:06 PM


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Darian A. Caplinger, EMT
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Linda B
post May 28 2010, 09:49 PM
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QUOTE(Darian A. Caplinger @ May 28 2010, 05:04 PM) *
I usually go a week between site changes, and end up refilling my reservoir at least twice during that period. I have plenty of supplies in stock, so I don't have an excuse, but it seems such a waste to change so often.


It is not a good idea to leave a site in for a week. I did that when I first started pumping in 1995. And I agree, it seemed as if it worked fine. I had no more highs at the end of a site than at the beginning.

But after 5 years of wearing sites for 6 or 7 days, I started having uncontrollable highs. Nothing I tried worked. Until my CDE figured out that I had created scar tissue underneath my skin. I had to stop using my abdomen completely for a full year to allow that scar tissue to heal and clear up. I was forced to use my legs and hips.

So if you have plenty of supplies, I urge you to use two sets each week instead of one.

Linda B.


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speckles
post Aug 4 2010, 02:27 PM
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QUOTE(Linda B @ May 19 2010, 05:14 AM) *
Pre-filling reservoirs is not recommended. It is thought that sitting in a plastic container can degrade the insulin.
I have found that to be true.
I was told I should change the reservoir every 3 days (I use a MiniMed 522.) The reason given for doing this is that the plastic of the reservoir reacts with the insulin and causes it to lose potency. Of course, I had to put this to the test. I am fortunate to have fairly low insulin requirements (avg. 18 u daily) so 1 reservoir holds 10 days worth of insulin. I found that around the 6th day my insulin abruptly seemed to stop working as it should. At breakfast, everything was just fine, and 4 hours later (and until the reservoir went empty about 2 days later) I'd have to nearly double my insulin amounts to maintain my BG range. This happened several times until I realized that the insulin had lost its potency. Now I only fill the reservoir half full, which gives me 5 days, and I haven't had any problems of that nature since.


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Elyod
post Sep 12 2010, 11:13 PM
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I even refill them if they are going empty on like a Friday night and I am going out. I don't want to have to mess with refilling so I will refill it before I leave to make sure I have enough to last however long I need it. I have been doing this for over 5 years and have never had a problem...but this is me, don't follow me, come up with your own system.

I also change my infusion sets on Sunday mornings and Wednesday nights so I can keep track and have never had an issue with the 3.5 days. I have let them go up to 4.5 days before when I forgot but never over that...also without issues. (IMG:http://dblclx.com/column/forum/html/emoticons/images/thinking.gif)


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Aini
post Sep 13 2010, 12:14 AM
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QUOTE(Elyod @ Sep 12 2010, 04:13 PM) *
I also change my infusion sets on Sunday mornings and Wednesday nights so I can keep track and have never had an issue with the 3.5 days. I have let them go up to 4.5 days before when I forgot but never over that...also without issues.


I also have set days when I change my site. I'm Monday afternoons and Friday mornings. I've been doing that for three years now, I think. My school schedule has me on eight to ten hour days at school, and I definitely don't want to be changing my site there! Most of the time, I don't have any problems, and I use different homeopathic stuff to help with the scar tissue.

I tried reusing cartridges once. Maybe I hit the cartridge too hard to get the air bubbles out, but insulin started leaking into the space between the reservoir and plunger. I didn't want it getting past the second black band and into the pump itself, so I stopped reusing them. I do store the last drops of insulin from the bottle when it's too little to fill a full reservoir, but I don't want to throw it away, in a cartridge, and then use that to prime through the tubing of a new set since I change my reservoir and site separately. I haven't noticed a problem with insulin degradation.

I know I may seem overly frugal, but I'm coming up on that age where I transition from my parents' insurance to my own (if I'm lucky enough to get a job quickly). And having supplies to get me through the transition is important to me.
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ang
post Sep 13 2010, 01:31 AM
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I never leave an infusion site in more than 3 days(I use the Mio's). But i will leave a sensor in for 6-7 days if its working well and doesn't hurt. I will re-fill a res. to use the last of the insulion in a vial. I don't like mixing old and new insulin either.
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Liz
post Sep 13 2010, 02:02 AM
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QUOTE(Aini @ Sep 12 2010, 08:14 PM) *
I also have set days when I change my site. I'm Monday afternoons and Friday mornings. I've been doing that for three years now, I think.


I've started changing on a twice weekly basis only recently, the last few months. I do Sunday morning & Wednesday evening. I have to say that it's really nice not having another thing to do in the morning when I'm getting ready for work and this schedule lets me avoid that. I don't refill reservoirs but I do fill it completely and use it until it's empty and that's longer than 3 days. I have not had any problems doing this. I believe that Novolog (or maybe Apidra?) says that it can be used in a pump for 6 days now.


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Elyod
post Sep 13 2010, 09:31 PM
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QUOTE(Aini @ Sep 12 2010, 08:14 PM) *
Maybe I hit the cartridge too hard to get the air bubbles out, but insulin started leaking into the space between the reservoir and plunger.

I understand your concern but as an old timer with "D" I refill the cartridge and if there is a small bubble I ignore it and hook it back up the the tubing. I've never noticed a problem with weird highs afterward. I just can't imagine there is enough insulin lacking from a bubble (or two/three), but to each their own.

Also, after a year or two on a pump and testing the first strip in each new bottle of test strips I quit doing the strip verification too. To me that just wastes a dollar and I never had one test out of range during that time. That saves a bunch of money...over 52 years of it.

Oh yeah, my A1Cs (since I've been pumping) are always between 6.1% - 6.5%. I'm just a very fortunate guy. And I'm in a closed loop research test with UVA. That is a pump that does the Dexcom Seven Plus thing and a pump all in one. If anyone cares I'm trying to post my experiences about it at a new site I created for "positive type 1s" diabetics.

This post has been edited by Elyod: Sep 13 2010, 09:39 PM


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Bec
post May 6 2011, 05:20 AM
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QUOTE(Liz @ May 19 2010, 10:55 AM) *
I did do that a couple of times but usually I just fill them one at a time. When I see that my reservoir is getting low I will often fill the next one a day in advance. That way I've always got one ready to go. I know it's not a big deal but I really do hate filling reservoirs and that's why I fill mine completely and use them until they're empty.



If you change reservoirs when using the same infusion set do you have any problems with air bubbles when you first reconnect to the new reservoir?


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Liz
post May 6 2011, 03:12 PM
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QUOTE(BeckyNewToPump @ May 6 2011, 01:20 AM) *
If you change reservoirs when using the same infusion set do you have any problems with air bubbles when you first reconnect to the new reservoir?


When I start a new reservoir I almost always use a new piece of tubing as well. Suppose I insert a brand new set and reservoir the same day. After 3 days, my reservoir still has plenty of insulin but I need to change the set. I insert a new cannula and then put the tubing from that set into a heavy duty ziploc baggie. I then reconnect the tubing to the new cannula. The tubing is already full, so all I need to do is the fixed prime to fill the cannula. Suppose 2 days later my reservoir is running low and I know it won't last 3 days until I have to change the set again. I fill a new reservoir, retrieve my unused piece of tubing from the baggie and attach that to the new reservoir and prime the tubing. Once I see drops coming from the end, I attach it to my cannula and that's it. No need for a fixed prime because the cannula is not new.

I have tried to reattach old (full) tubing to a newly filled reservoir but I have found that I do get air bubbles in it no matter how hard I try to push them out of the reservoir before attaching the tubing. I then end up having to completely prime the tubing anyway to push it out so I just use new tubing. I have a ton of extra tubing.


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aggie168
post May 10 2011, 04:18 AM
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I think it is what works as a routine for each individual. That dictate the cycle. The following is my "cycle".

For myself, I have a MM723, I fill each 300u cartridge to actually about 325u. Yes, I pull it out a little more than the double o-ring limit. Then when I insert it into the pump, twist it to lock, it push some insulin into the 43" tubing for my Quickset. Most of the time, it actually fill it 100%. I only then engage the PRIME and run it 1u to 2u to be 100% certain everything works. Once I insert the set and do the Fixed Prime, I should have 295u to 297u left on the pump status screen. If you follow their instruction, you will end up with about 280u left after everything is set and done. I always think that is kind of dumb.

Doing the above routine 3 times completely draw out a 10ml (1000u) bottle. I typically have just 20u - 30u left in the bottle that I can never get it out. It produce the minimum waste in my book.

For actual usage, I typically use 60 to 70u per day. One 300u cartridge give me 5 days average. So on day 2.5, I will pop in a new Quickset. Click my already filled and 2.5 days old tubing over to the new canular and do a Fixed Prime. Life goes on afterward.

To me that is a fair use and minimal waste (IMG:style_emoticons/default/smile.gif)


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Richc
post May 11 2011, 02:38 AM
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QUOTE(aggie168 @ May 10 2011, 12:18 AM) *
I think it is what works as a routine for each individual. That dictate the cycle. The following is my "cycle".

For myself, I have a MM723, I fill each 300u cartridge to actually about 325u. Yes, I pull it out a little more than the double o-ring limit. Then when I insert it into the pump, twist it to lock, it push some insulin into the 43" tubing for my Quickset. Most of the time, it actually fill it 100%. I only then engage the PRIME and run it 1u to 2u to be 100% certain everything works. Once I insert the set and do the Fixed Prime, I should have 295u to 297u left on the pump status screen. If you follow their instruction, you will end up with about 280u left after everything is set and done. I always think that is kind of dumb.

Doing the above routine 3 times completely draw out a 10ml (1000u) bottle. I typically have just 20u - 30u left in the bottle that I can never get it out. It produce the minimum waste in my book.

For actual usage, I typically use 60 to 70u per day. One 300u cartridge give me 5 days average. So on day 2.5, I will pop in a new Quickset. Click my already filled and 2.5 days old tubing over to the new canular and do a Fixed Prime. Life goes on afterward.

To me that is a fair use and minimal waste (IMG:style_emoticons/default/smile.gif)


That's exactly how I attack it too. I usually have to refill during the three days but not completely because I almost always change the set, reservoir and tubing at the same time.
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countrylivin
post May 23 2011, 04:15 PM
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I reuse my cartridges and have so for years. I will reuse a cartridge until I feel like I've used it far too long. I would guess that I use it for 3-4 site changes. I always push out the insulin that is left in the cartridge. I think the insulin degrades over time. Body heat, outside temps all help with this degradation. Plus I don't want to mix old insulin with new. The only issue I ever encountered was the plunger got stuck, therefore error warning because of nondelivery. Other than that I've never had a problem.

I do change my sites every 3-4 days. I can definitely see a change in readings after day 3.
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clau
post Jan 7 2012, 05:38 AM
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Hi Liz, what insulin do you use?
about plastics and insulin: don't pens have plastic reservoirs? they hold for 28 days (or more in my experience)
I worried that during sleep I will get to "cook" my insulin because my body temp rises (IMG:style_emoticons/default/Hot.gif) and used the pump at my waist (and for more than 3 days! -but changing the set every 3 days!) but didn't had any problem...just in case I try the pump in my arm and I find it more confy...and is at lower temperature (IMG:style_emoticons/default/smile.gif)

This post has been edited by clau: Jan 7 2012, 05:40 AM
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Liz
post Jan 7 2012, 06:51 AM
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QUOTE(clau @ Jan 7 2012, 12:38 AM) *
Hi Liz, what insulin do you use?
about plastics and insulin: don't pens have plastic reservoirs? they hold for 28 days (or more in my experience)
I worried that during sleep I will get to "cook" my insulin because my body temp rises (IMG:style_emoticons/default/Hot.gif) and used the pump at my waist (and for more than 3 days! -but changing the set every 3 days!) but didn't had any problem...just in case I try the pump in my arm and I find it more confy...and is at lower temperature (IMG:style_emoticons/default/smile.gif)

I use Humalog, which is approved for use in a pump for up to 7 days. I have no problems with bad insulin. At night I clip the pump to my underwear and the pump & tubing are right next to my skin and under blankets. I don't worry about it getting too hot.

I think the cartridges in pens are made of glass, like tiny vials.


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clau
post Jan 7 2012, 07:30 AM
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yes you are right!: the reservoir in pens are made of glass (IMG:style_emoticons/default/ohmy.gif) I used them for years always thinking where plastic... (IMG:style_emoticons/default/Tomato.gif)
had you Liz ever used Apidra - to compare-
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Liz
post Jan 7 2012, 05:02 PM
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QUOTE(clau @ Jan 7 2012, 02:30 AM) *
yes you are right!: the reservoir in pens are made of glass (IMG:style_emoticons/default/ohmy.gif) I used them for years always thinking where plastic... (IMG:style_emoticons/default/Tomato.gif)
had you Liz ever used Apidra - to compare-


I started out using pens that used cartridges, so the pen was refillable. I definitely remember that the cartridges were glass. When Lilly stopped making the smaller 1.5ml cartridges and I couldn't find any refillable pens for the 3ml cartridges I ended up using the disposable Humalog pens. Since I never had to touch the cartridge I can't say for sure, but I always assumed they were also glass.

I have only used Humalog, never Apidra or Novolog. Since it works for me and I'm used to it I don't see any reason to change.


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ajanibisha
post Jan 10 2012, 02:50 PM
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Its recommended for 2-3 days. I know alot of people use them past that time however if you are having issues such as no delivery or high bgs, its probably due to wearing it for longer than that. this is because the inside of both the reservoir and the infusion set have a lubrication to prevent the insulin from building up after so long, that lubrication wears down and the pump has to work more to push insulin through and may end up sensing that back pressure. that however is specifically for medtronic supplies.
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Bollar
post Jan 10 2012, 03:16 PM
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Animas only mentions why this is is a potential problem once in all of their literature.
QUOTE
It is important to remember that the insulin in your cartridge should not remain more than 2 to 3 days. After that, you may see a reduction in its effectiveness as the insulin binds to the plastic cartridge.
http://www.animas.com/sites/default/files/pdf/Workbook.pdf page 56.
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tedm
post Jan 10 2012, 08:31 PM
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QUOTE(ajanibisha @ Jan 10 2012, 06:50 AM) *
Its recommended for 2-3 days. I know alot of people use them past that time however if you are having issues such as no delivery or high bgs, its probably due to wearing it for longer than that. this is because the inside of both the reservoir and the infusion set have a lubrication to prevent the insulin from building up after so long, that lubrication wears down and the pump has to work more to push insulin through and may end up sensing that back pressure. that however is specifically for medtronic supplies.

Actually, at least for Medtronic pumps, both Novalog and Humalog (AFAIK) are FDA certified for up to 6 days in a reservoir. I routinely run 6 days on a reservoir with Novolog with no issues. I do not reuse cartridges, however.
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