Pump issues, maybe you have solutions?

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Pump issues, maybe you have solutions?


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Old 02-16-2012, 03:54   #1
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Default Pump issues, maybe you have solutions?

Hi there. So I'm a type 1 and I've been pumping for about 2 years.

When I first started pumping I was using Humalog, but switched to Apidra as I heard it was better for pumps. I'm having some issues with it, however. Despite being diagnosed in Florida, where the summers reach the 90s, I'd never seen a vial of insulin become cloudy. Now, if I carry the Apidra in my pocket when I'm at work (see below for why) it gets cloudy after a couple of days. Also, I've started getting occlusions and have found clumps in the insulin inside the pump. I wear an SPIbelt and keep the pump there, usually under my shirt... but it's not like I'm an oven, and now that I'm in WA the temps are 40-60 everyday. At times it's made pumping unbearable, and I've had an entire reservoir go cloudy and jam up the pump within 12 hours of starting a new infusion site.

This isn't a new problem. It seems like it's happening more and more frequently, however, and I'm not sure why. I keep my insulin in the fridge, and a vial usually only lasts about 8-10 days.

Have any of you had these problems and found a solution? Do I need to switch insulins again? Any idea why it's happening more frequently all of a sudden? Any thoughts on how to keep the insulin inside the pump from becoming cloudy and clumpy, so I don't have to change infusion sets every other day and waste hundreds of units of insulin?

If I can't figure it out, I may have to go off the pump... I can't afford to blow through infusions sets, reservoirs, and insulin at this rate.

Thanks!

--------------------
Why I carry insulin even though I have a pump:
When I first started pumping I thought I was having problems with Humalog, because my sites would get red and hurt, and infusions would burn. After a day the site would start leaking and have to be changed. I switched to Apidra, on the advice of someone here (way back then, 2 years ago), and at first it worked great. Slowly, over time, however, the problems have returned. The sites still aren't as bad as with Humalog, but I no longer bolus through them. I use MDI for meals, and let the pump handle my basal.

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Old 02-16-2012, 04:54   #2
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Hi Dogen,

I am a pumper and have been for over a very long time. I can't speak for the troubles you are having, but I can tell you I lived in Houston for many years with my pump doing it's thing, and never ran into to clouding insulin issue.

I do know that pumping is not for everyone. I wonder if you should not just return to MDI since you are having to bolus for meals anyway. I can't imagine a reason for your insulin to degrade so quickly. What size reservoir do you have in your pump and how much basal are you using that you would waste hundreds of units to change every three days as recommended?

Does the insulin you bolus cover your meal okay? Are your bg's okay?? I use Novolog and like it very much, but I have never used Apidra to compare.

 
Old 02-16-2012, 08:01   #3
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My BGs are fine... since switching to the pump my A1Cs have dropped from a little over 6 to 5.6, which is really the only reason I'm trying so hard to stay on the pump.

I'm using the Animas One Touch Ping, which has a 200 unit reservoir. The reason I waste so much is that once it becomes cloudy (which can take anywhere from a couple of days to less than 12 hours) it begins to occlude the tubing, so whatever's left in the reservoir gets wasted and I refill it.

I wish I could figure out what's happening to the insulin. I just don't understand it. I may try switching to Novolog. It didn't help with the pain I felt when bolusing, but that's irrelevant if I'm using MDI for boluses anyway. If I can just get it to stay clear I'd be happy.

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Old 02-16-2012, 22:54   #4
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Quote:
Originally Posted by Dogen View Post
When I first started pumping I was using Humalog, but switched to Apidra as I heard it was better for pumps.
What characteristics make it better for pumps?

I've been using Humalog in my pump for over 10 years and haven't had a problem, yet. In my entire diabetes experience, I've never had any insulin cloud on me at all even when I don't keep it refrigerated.

What causes insulin to cloud?

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Old 02-17-2012, 02:24   #5
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Who knows why the insulin is cloudy, it certainly isn't okay though and I'd pitch it but not if it meant pitching newly opened vials after 8 days (Apidra isn't cheap that's for sure). Usually rapid insulin gets cloudy from warm temperatures or shaking the insulin bottle. If regular insulin becomes cloudy, throw it away because it has lost its effectiveness.

That is interesting and really great that the bg's are fine in spite of the cloudy product.

 
Old 02-17-2012, 18:33   #6
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Quote:
Originally Posted by Stargazer View Post
What characteristics make it better for pumps?

I've been using Humalog in my pump for over 10 years and haven't had a problem, yet. In my entire diabetes experience, I've never had any insulin cloud on me at all even when I don't keep it refrigerated.
Well, I don't know exactly, but the makers of Apidra say it's less likely to occlude (jam) the tube... which is the exact opposite of my experience. But that's why I was convinced to switch. Now I'm switching back. Called my doctor yesterday for a prescription for Novolog.

If there's any plus to any of this, it's having an endocrinologist who takes requests over the phone and trusts me/knows me well enough to know I've got a good reason.

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Old 02-17-2012, 19:00   #7
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I think aprida is known to degrade a little faster than the others. Have u tried keeping it out of your pocket. Maybe it is too warm for it there. Just a thought.

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Old 02-17-2012, 19:39   #8
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I've thought of that, but I use the vial for my boluses, so I don't know how else to carry it around. Maybe I need some kind of pouch slung around my neck.

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Old 02-17-2012, 21:45   #9
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I hope the Novolog works out better for you. No need to put it in a pouch around your neck. My pump is under my clothing all day in warm and cold and the insulin is fine. Let us know how it goes.

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I've thought of that, but I use the vial for my boluses, so I don't know how else to carry it around. Maybe I need some kind of pouch slung around my neck.

 
Old 02-17-2012, 22:50   #10
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I don't know if I understand your situation correctly, but have you considered something like the Frio insulin cooling case

insulin cooling travel case | Frio Insulin Cooling Case

I asked my CDE about using Apidra vs Novolog and he said in his experience that he found Apidra tends to have a bit more occlusions than either Humalog or Novolog. I don't have problems with the bolus hurting, but I do have problems with infusion sets being used anymore than 2 days. So that means, no matter which infusion set I try, I have to change every 2 days. It is a bit of a nuisance, but I sure appreciate having a pump - so I do whatever it takes

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