What's your process for changing pump sites?


(bradvido) #1

 

Here's what I've been doing for a couple years, and although I'm sure it's not exactly the perfect, doctor approved, way to do it, but it's been working!  All A1C's between 6 and 7 :)

  1. I fill up my reservoir 100% full with insulin, or about 300 Units (Paradigm 722).
  2. On every third day, I change my infusion set only. I only change the injection site. I do not change tubing or the insulin reservoir.
  3. When my insulin reservoir gets down to 10 units, I fill it up again, and at this time change both my reservoir and tubing.

My doctor suggest changing both my reservoir, tubing, and infusion set every 2-3 days, but I can't think of a good reason as to why the insulin reservoir should be changed ever 2-3 days. To me, it just seems like a waste of insulin.  Comments welcome!

 


(golfpapabravo06) #2

i change my site on the same day i change my insulin reservoir.  I'll go 2-3 days, most times 3 days, and ill change both.  I usually only fill up my reservoir to 200units and ill still have 30 or so left over when i change next time but there are so many bubbles i dont want to use less insulin for the fear of air getting into the tubing.

It's probably a good idea to change the reservoir every 2-3 days in the summer cause it gets hot out and the insulin can only withstand certain temps.


(type1at18) #3

I change the infusion set and reservoir every 3 days, unless the reservoir happens to go empty beforehand. But it usually works out well, and it'll be practically empty on the 3rd day. I find it easier to do it all at the same time. Oh and on the 3rd day... I usually wait until the end of the day, unless the reservior is too low. Like I'll change it after dinner, this way I use up the most insulin.


(system) #4

as quickly as possible! i can do everything in less than 5 minutes and it still seems like waay to long for me. i want it streamlined so i can change the site in 2 mins :o) i think it's a pain in the bum.

first, i'll rip out the old stuff and furiously scratch my skin as it's been itchy for the last 3 days. then i'll peel off all the remaining sticky goo left on my skin. i'll scratch a little more and then move on to drawing up the resevoir, priming the tubing, cleaning the new area with alcohol, and inserting the site. then i'll delicately scratch the skin around the new tape as it's already beginning to itch again. for the next 3 days, it'll be a tricksy itchy-scratchy dance where i attempt to satisfy the intense itching around the tape while not tearing out the site.

i have sensitive skin :o) even bandaids leave blisters on my skin.


(bradvido) #5

So I guess my main question is why do you change your resorvoir at the same frequency as your infusion set?

For me, it's way easier to just change my infusion set ever 2-3 days, and change my reservoir about every 8 days.  This way, when I change my infusion set, I don't have to spend all the time getting the insulin warmed up, getting the bubbles out, priming a new tube, etc.  I can just change the infusion set, do a fixed prime, and away I go in 60 seconds or less.

 


(Doug D) #6

Hi Brady - I'm not sure if this is the case for you or others but the reason I change mine out every three days is because the effectiveness of the insulin really drops for me on that 4th day if I let it go that far.  I used to let it go to 4 days but I was taking 25% more insulin on the 4th day.  For me, the insulin gets compromised and although it's just a matter of bolusing more, it effected my bs levels and I'd rather not take more insulin.  I never really paid attention to it until my doc printed out 90 days worth of data and said - look, the numbers aren't lying.  So I do change it every 3 days.


(larawithhrt) #7

I've tried stretching it out longer too, but I too noticed that on the fourth day, the insulin is not as effective.  What Doug said about being 25% less effective on that fourth day is what I have found.

BUT, since we are not changing our sites on the fourth day- is it really the site area or insulin????

If you look at your daily logs have you noticed an increase in insulin on the 4th and up- even a slight amount- if you have the mini-med/paradigm, you can go to "Utilities" and scroll down to "Daily Totals" and it will tell you your totals there if you are not doing any manual logs.

I remember the pump company advising to change out the insulin on the third day too because of environment- they say the insulin could lose it's effectiveness-

Please let us know what your logs say- just curious.

Laura


(klahoffman) #8

! I'm so glad I found this comment - I get blisters from bandaids, too. (To the point where, when "healed," it looks like an old scar and takes ages to fade completely!) Aside from the itching, how does the adhesive treat you? Blisters and permanent red marks, or is it just the awful itching?


(bradvido) #9

[quote user="Doug D"]

...the reason I change mine out every three days is because the effectiveness of the insulin really drops for me on that 4th day if I let it go that far...

[/quote]

Are you sure it was the insulin effectiveness?  I agree that not changing your site every 3 days requires more insulin (because the site starts to absorb poorly), however I have never noticed a decrease in effectiveness of insulin at 4 days.

In fact, when I was on injections, using insulin pens, they said the insulin would be good for 4 weeks out of the fridge.  For my pump, I'm using the same exact insulin that was in those pens (Novalog), but now it just comes in a vial.... So why wouldn't the insulin in my pump stay good for as long as the insulin in injection pens?

Thanks for everyone's input!


(Doug D) #10

Yes - I am sure and the reason is because it goes from the air tight bottle to the infusion set and lets face it - the sets are not air tight.  Body heat and agitation will also make the insulin become less effective.   I have your same pump, I use about 40-50 units a day- I usually put in 220 just to make sure I'm covered in case anything happens.  I also used to do what you do and just switch the site but my sugars got worse on the 4th and 5th days.  I personally don't want to risk it anymore and if I don't have to mess with the roller coaster every 4th and 5th day.  If it's working for you then cool.  It doesn't for me.


(2Sweet4U) #11

3 days, then change both. I only fill the reservoir with about 130 units, which is what I use over 3 days.

I find the reservoir gets bubbles after about 3 days, I guess because I sometimes bump the pump or something. And I don't want to risk bolusing bubbles instead of insulin.

But I have wondered if the reservoir needs to be changed every 3 days. I know the site does to prevent infection, but... will be interesting to see what others have to say.


(BrianPQuinn) #12

I tend to change everything every three days. It just makes it easier. Plus that way I don't have an accumulation of extra reservoirs or infusion sets. I like everything matching numberwise. I just fill my reservoir up to about 180 since that is what I tend to use.


(system) #13

i change every 3 days because i run out of insulin every 3 days (with a full reservoir). i was also told not to keep the insulin in the fridge when on a pump because of the increase of bubbles. i keep it in my closet in a drawer full of medical supplies. i've never had a problem with it. i've noticed my insulin is less effective in the summer, i'm guessing because of the heat. i used to work at a summer and it was terrible because as long as it was under 95 degrees, we took the kids outside. now that i work indoors, i don't notice "bad" insulin as much.

i have the red bumpy/blisters on my skin. it takes about a week for the itching & blisters to go away, then it looks like a faded scar, like you said. i have track marks all over my belly from old pump sites. it looks like a battlefield.


(bradvido) #14

 

I check my chart from the last time I went to the Diabetes Specialist (in April).  Anyway, here's what my insulin usage looksed like. I marked when I changed resorvoirs, because that data is in a different report.

Anway, as far as I can see, for methere is no correlation with using more insulin as the reservoir gets older....

Any thoughts?

And here's my corresponding BG stats:


(20years) #15

I have track marks too, and I feel like my belly is bloated from scar tissue, due to 8 years of pumping!  Does anyone else have that problem?


(Rosemary5) #16

There are many reasons to change the reservoir and tubing every 2-3 days. The heat of your body which you where your pump up against 24/7 can cause a decrease in the effectiveness of the insulin. Also, the longer you use tubing for the more like you are to get an infection, similar to how in the hospital IV tubing is changed every few days to reduce the risk of bacteria thinking it's a cool place to live and grow. So, personally I don't fill my reservoirs all the way so that I don't waste as much insulin by changing it every 2-3 days. I can understand wanting to stretch out the time u use these things due to the cost, so maybe 4-5 days would be okay but the longer you go without changing the tubing the more of a risk you are at for infection.


(bradvido) #17

I guess unless I have data and/or personal experiences that support the idea that bad things come of changing your reservoir and tubing infrequently, I think I'll just keep on doing it....  Especially when my data charts show that it has no effect.

Although, I will keep an eye out for infetions now that you mentioned that... Good Point!


(system) #18

i have 8 different sites i rotate to around my tummy and hips. while i have scarring on the surface of the skin, i don't feel like i have a lot of built up scarring underneath the skin. if i look bloated, it's because i'm a chub! :o)


(Nads) #19

I change my infusion site every 3 days and my reservoir every 5-6 days, whenever it is empty or close to it.  I may reconsider and start changing the frequency though, after reading this discussion!


(Vivian) #20

I wear A Minimed 522 and I change my infusion set after 5 days. This is because I used the Quick Set and had failures in the fiiting, once every 3-4 changes and for hours I couldn't control my blood sugar. Therefore after several months I switched to the Silhouette infusion set which is much better.

Another important think was when I abandoned the insertion device and inserted the needle by myself in order to have better control. It proved a good decision for me. The other problems that you mention about the scars are the same for me too.