Using an insulin pump

December 19, 2006 8:53 AM

I just bought an insulin pump. I've been using it for about a month and would love to hear any tips, hints or suggestions from other pumpers.

[asking for my mom, who will be checking this thread and commenting/clarifying if need be]

I’ve recently purchased a Medtronic Paradigm insulin pump and have a few questions regarding its operation and use. I’m delighted with the pump itself; it’s making an immediate difference in the quality of my life.

I am consulting frequently with an endocrinologist and a diabetes care team but would very much appreciate real-life anecdotes from people who have used or are using insulin pumps. That being said, I know that replies in this thread are not medical advice and I would not presume to construe any answers given as medical advice. And, so, here are my questions:

1) How often do you need to change the infusion site? I’ve been told it’s ideal to change the site every two to three days, but is it possible to leave it for longer? Obviously, I don’t want to cause any sort of infection or irritation but, realistically, these things are expensive! The pump’s consumables (infusion sites, reservoirs, etc) are not covered by my health insurance, though I am appealing this. I don’t want to take (and will not take) any unnecessary medical risks but, let’s face it, the cost of consumables adds up quickly. Will it really matter if I leave it for an extra day? Have others found a timeline that suits them?

2) Is it safe to reuse the pump’s insulin reservoirs? Some people I’ve talked to say that reusing them once just doesn’t matter; others say it’s best to use a new one every time.

3) I’m still getting used to carrying the pump around with me. I’d appreciate any advice regarding conveniently and comfortably wearing it. I generally keep it in my pocket but am concerned that it could fall out (and I sure don’t want to break it!). I’ve thought about wearing it in my bra but am not quite sure how that’d work and if it would be comfortable.

posted by lumiere to health (3 comments total)

1) I've found that longer than three days, and the infusion site gets irritated, painful, and a bit swollen. It goes away, but I figure it's the tiniest bit infected and it's safer to change it. Then again, I'm paying ~$50/4 mos. of supplies, so I don't have the pressure you do.

2) The biggest problem with reusing the reservoir is if they jam up and get harder for the pump to push. Worst case would be that it thinks it'd delivering the basal when it doesn't. I'd guess reusing once wouldn't give too many problems. Track your glucose levels on the recycled syringes in comparison to the fresh ones--particularly the morning/fasting. That should tell you if it's an issue.

3) I usually clip mine on my belt or keep it in my pocket.

One tip I might offer is to use some first aid tape to "pin down" a small part of the infusion tubing to your skin, just outside the rectangular adhesive they provide. I've found this will give way before the main adhesive should you catch the tubing on something, or jerk something oddly, and alert you before you yank the whole site out and have to replace it.
posted by stevis23 at 10:06 AM on December 19, 2006

I also use a Paradigm, with 6-mm quicksets and 23-inch tubing.

First, I hope that your endocrinologist is expressing his very strong opinion to your health insurer that these items are medically necessary and should be covered. A doctor's word can do wonders sometimes. If you got that problem out of the way, then these questions wouldn't be so important. But I guess you know that.

1. Anyway, my experience has been that leaving an infusion set in for 4 or 5 days occasionally is not a problem, but that it's not a good idea to do on a regular basis. I think this really depends on a body's personal tolerance for the thing, which varies person to person and also from site to site (i.e., belly, side, thigh, etc.) Sometimes I change a set after two days if there's itchiness or irritation. (I exercise a lot, which may contribute to the problem.) Then again, sometimes I'll go for four days, and the skin looks fine underneath. Usually I stick to an every-three-days regimen. You should experiment, within certain limits.

2. I've never done this, but I don't see why it would be a problem.

3. I keep mine in my pocket. Occasionally, the pump will fall out if I'm sitting in a deep chair, and that can result in an unpleasant tug when I get up. Or sometimes it falls out during sleep (I wear shorts with pockets). Overall, this is a minor annoyance. I have read that the bra is a popular location for women. But I have not personally verified this fact.

The pump is a brilliant device. It can really give you a remarkable degree of control over your diabetes and over your life. I can't imagine my life without it. Also, if any children happen to see your infusion set in place and ask you about it, it's fun to tell them, "Why, that's the plug that holds my guts in! For God's sake, don't touch it." Sure, they will look scared at the time, but later they will find the joke hilarious.

Just kidding.
posted by chinston at 10:51 AM on December 19, 2006

Disclaimer: I am not diabetic but two of my close friends are and use pumps. They both clip the pump the the center of their bra most of the time, seems to work well.
posted by fshgrl at 6:31 PM on December 19, 2006