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Unused Insulin Remaining In Pump Resevoirs when changing ....
by TonyAlmeida, Dec 08, 2003 12:00AM
Although I have been carefully trying to estimate how much I use and load into the pump's resevoir - I sometimes don't use as much between site changes depending on what I have been doing those 3 days and end up with quite a bit (not just a couple units) of insulin left unused when I have to discard the resevoir.
Now, no one has told me you can or cannot do this .... but ....
I let the Humalog warm up, then fill the new resevoir (trying like heck to keep bubbles out, lubricating the resevoir stopper so I don't get any non-delivery alarms, etc.). After I put in the fresh resevoir into the pump and change the site, I use the new resevoir's removable plunger and the resevoir filling adaptor and if I have a large amount of insulin left in the old resevoir - I put the filling adaptor on it and the plunger and squeeze that insulin back into the same vial it came out of (I don't mix batches).
The insulin in the old resevoir and vial are room temp when I do this. And I check the resevoir for any discoloration or strange stuff before doing this. And afterwards, I toss the filling adaptor.
My situation is that Insulin is, quite frankly, expensive for me (like it is for all of us). I try not to waste it. Now - I don't do this every time .... but sometimes, there's just too much left over in the old resevoir to say "oh well, just toss it" ....
Now, no one has told me you can or cannot do this .... but ....
I let the Humalog warm up, then fill the new resevoir (trying like heck to keep bubbles out, lubricating the resevoir stopper so I don't get any non-delivery alarms, etc.). After I put in the fresh resevoir into the pump and change the site, I use the new resevoir's removable plunger and the resevoir filling adaptor and if I have a large amount of insulin left in the old resevoir - I put the filling adaptor on it and the plunger and squeeze that insulin back into the same vial it came out of (I don't mix batches).
The insulin in the old resevoir and vial are room temp when I do this. And I check the resevoir for any discoloration or strange stuff before doing this. And afterwards, I toss the filling adaptor.
My situation is that Insulin is, quite frankly, expensive for me (like it is for all of us). I try not to waste it. Now - I don't do this every time .... but sometimes, there's just too much left over in the old resevoir to say "oh well, just toss it" ....
Doctor's Answer
by JDRF-Team-wak, Dec 08, 2003 12:00AM
Tony,
I am not a doctor or a pharmacist, but I have asked my pharmacist about adding old insulin to new insulin. I was told on the record the obvious, that it should not be done. However we have had to change my daughter’s site and tubing due to air bubbles. I also did not want to waste the insulin. I was told to add fresh insulin to the reservoir that was already filled. By moving the insulin from the reservoir to the vial and out again there is more a chance of contamination. But the best is to always start fresh. I will tell you that I found out recently that when you are running low you should order. Most people think that their insurance will only pay every 39 days. Actually most insurances will pay for refills after 21 days, check with your pharmacist. When you call your insurance always speak to a supervisor, they have more access than the reps that answer the phone. And if you run low your doctor usually just needs to right a new script.
Wendy
I am not a doctor or a pharmacist, but I have asked my pharmacist about adding old insulin to new insulin. I was told on the record the obvious, that it should not be done. However we have had to change my daughter’s site and tubing due to air bubbles. I also did not want to waste the insulin. I was told to add fresh insulin to the reservoir that was already filled. By moving the insulin from the reservoir to the vial and out again there is more a chance of contamination. But the best is to always start fresh. I will tell you that I found out recently that when you are running low you should order. Most people think that their insurance will only pay every 39 days. Actually most insurances will pay for refills after 21 days, check with your pharmacist. When you call your insurance always speak to a supervisor, they have more access than the reps that answer the phone. And if you run low your doctor usually just needs to right a new script.
Wendy
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(1) the insulin is still fresh & safely useable,
(2) your techniques & work area are clean, and
(3) your experience has shown that your blood sugar control is not different when using the mixed insulin.
I've become more careful to mark my vials of insulin so I don't use them much beyond the suggested 30 days. That's been a new discipline for me in recent months. I've also become more diligent to change my site AND reservoir more frequently than my insulin usage would demand. I have to admit that my blood sugar control seems to have improved with these steps.
While I do take shortcuts & reuse some supplies -- in ways that are NOT RECOMMENDED by the mfg'rs or even most CDEs -- I allow myself to test out reasonable ways to economize while not jeopardizing my health. It seems to me that's what you're doing, and if your results are reasonable, then your methods seem reasonable, too. The extra $100s in your pocket must feel pretty good, too :-)