Em--
I usually change my site every 2 days but I let my insulin get down to about 5 units left before I change the cartridge. When I first started pumping my educator had me change both at the same time, just so it was less confusing. As I got better at everything I eventually could get between 4-5 days out of one cartridge of insulin.

One thing I wish I had known when I started pumping is this....no matter how much you roll over on your pump you will not give yourself an unintentional bolus! I had a few sleepless nights at first for fear of bolusing myself.

Good luck with everything!!

I leave a site in three days. My pump holds 300 units, and I only use about 30 tops a day, so I leave the cartridge in for two set changes. You can change the cartridge or site separately quite easily.

I have never tried to use pen cartridges to fill a reservoir.

Em --

first, the place to go is http://www.insulin-pumpers.org/ -- several thousand pumpers, all in one place.

Second, you may want to reconsider leaving the site in place for more than three or three and a half days. The scars get deeper (and uglier), and the risk of inflammation increases. But whatever works for you is fine.

Do you use a lot of insulin? I am asking because with up to 100u per day, it would seem easier to just change the site when the reservoir runs empty after three days.

Cheers,
Felix.

Hi Kerri,

Sorry, but I can't really contribute constructively here, but I have stopped by to say thanks for your interset in A World of Bloggers. I have added your link there.

Regards,

Rhys

I have NEVER had a good experience with a pump site left in over 3 days--and I don't think I've ever had it in more than 6 hrs past that mark. I don't recommend stretching the dollar in that way.

I'm still fairly new to pumping (whoa, it'll be a year in about a month!) I use my insulin in my 3 days. If I know that I've been throwing insulin out after 3 days, then next time I fill my resevoir, I will put less in. After a couple of months, you should be able to figure out your average/most likely daily intake of insulin, mulitply by three and have a good estimate.

As much as I hate changing my site (not as much as I hated shots!), I really hate painful sites and "unexplained" blood sugar spikes.

Em -

Welcome to the pump world! I'm still pretty new myself, but far be it from me to let that keep me from offering advice.

I leave my sites in for 2-2.5 days. Any longer than that and it starts getting seriously red and itchy. I can go a week or more on one 300u. reservoir, so there's really no relationship between when I change my site and when I change my reservoir.

Things I wish I'd known when I first started pumping: Doorknobs are Public Enemy #1 and sushi has a surprisingly long absorbtion time and will convince you your site is bad when it's not.

Good luck!

Em,

Keeping in mind that none of these responses are "medical advice" and most of us are "completely winging it" and "Kerri is very frugal", here's my take on the pumping bits:

I leave my sites in for anywhere from 3 - 7 days. My infusion sets are in my outer thigh, which doesn't endure the same friction and general touchiness that my abdomen sites did. If the site starts to ache or throb, I rip that sucker out and start a new line, but if it feels fine and my bloodsugars are steady, I let it ride for a while.

I use the Minimed Paradigm 512 which has a reservoir that holds about 175 units. My total daily dose is about 25 - 32 units per day, so I usually fill the reservoir to approximately 130 units and that lasts about four days. If I run out of insulin in the reservoir but the site still feels fine, I'll remove the reservoir, refill it, and reprime the set. My fear, especially in the summer, is that my insulin might spoil from the heat, so I'm more apt to refill a reservoir once or twice than risk spoiled insulin.

I've got a whole post brewing about "Things I Wish I Knew About Pumping But Didn't Know to Ask" that I'll put up tomorrow. :) It does include doorknobs, though. And stupid cats.

And Em, I have a few things to touch base with you about via email. Can you send me an email because I don't have your address.

Thanks!

-- Kerri.

As you can see from the posts above, everyone ends up figuring out what works best for them. Like anything associated with the management of diabetes, fudging it and guesswork are involved. Lots of trial and error! I change both the site and reservoir every three days. As mentioned above, the sores and irritation increases as time wears on.

I don't know if your pump educator told you this or not, but I learned the hard way. DO NOT use the titanium energizer batteries, the long life ones, made for electronics. They fry your pump. I found this out the hard way Easter sunday two and half years ago. Not fun. I find that energizer batteries work the best; they last the longest and don't give me troubles with static electricity.

My 512 has been pretty resiliant to all the abuse it gets. I've dropped it, banged it, and submitted it to countless other forms of abuse and it keeps on pumping. I started pumping when I got pregnant, and I can't believe I didn't do it sooner!

Hi Em,

Ditto to the many others who have said that you have to kind of "trial & error" your way through it to find what works best for you.

I personally don't go longer than three days on a set. I worry about scar tissue and that type of thing, so I change them out three days religiously. I've been pumping for about 10 years, and I don't want to get to a point where I've got so much scar tissue under the surface that the site doesn't absorb good.

Keep the tissue healthy, change sites regularly and rotate locations to give the old sites time to heal.

The biggest thing that I've learned over the years is that the pump (any pump really) is the best tool for the job (of delivering insulin), but diabetes is still a lot of work. The pump makes life a bit easier in many ways, but it's not a cure all solution.

Amazing! I love this community! Our A1c's are going in the wrong direction. Too many highs ... so my daughter and I are going to a CWD Pumper's conference in late Sept. hoping she will get on board and want to try the pump. She is strangely resistant ... heard somewhere about site infections ... My mom-side says: it will improve control - you are getting it! My soft-side says: it is her body ... I will anxiously read this whole thread. Thanks Kerri. Stay well, all.

Amazing, I just learned a few things about pumping from all of you. I was just at the endo this morning going over why I am getting these big hard welts on my belly from my pump. I used to change site and resevoir every three days religiously. Then within last two months or so started leaving the site and adding insulin to the res. with a needle. I guess I found out just how long my sites last. Uh three days...I got a nice reaming from the endo this morning at my quarterly appointment.
It's all about trial and error!!!!
Kerri thanks for posting this question!

Em,
I am pretty new to pumping (since 6/8/06). I have a Minimed 722 and I fill my reservoir up with 300u and use it until its gone. It seems to last usually 3-4 days. I have not had an issue with infection. I did have one set that hurt like heck but I just kept an eye on my BG’s and since they were good, I dealt with the discomfort. Probably not a good idea but for me, the numbers are more important.

I am getting ready to place my first order for supplies and since my insurance only covers so much medical hardware a year, and this is the year I got the pump (20% was my portion), I have no more coverage so I have to pay for the supplies out of pocket! Yuck! I may be stretching out those sites as long as I can for a while! Next year my supplies should be covered.

One thing I wish I knew before I started pumping was that I would become obsessed with my BG. I am checking about 3 times more then I did before pumping and I don’t mind one bit. Congrats on joining the pumpers, and as I am sure you have heard before, and may say yourself, it has changed my life and it is the best thing I could have done for my DB management.

Carol-
I just had to add my 2 cents about why your daughter might not want to go on the pump. I went on the pump for 6 months when I was in college but was not ready to "out" my diabetes. It was much easier to pretend it wasn't there when I could go into the bathroom and shoot up and tell only those people whom I chose that I had type 1. Meeting kids her own age who pump will be a tremendous help, and in hindsight I wish I started pumping ages ago so that I didn't have to deal with retinopathy and worry every day about nephrology rearing its ugly head.

Okay, I'm one of the evil ones. I try to leave my sites in as long as they will stay. I am an adult. I would not recomomend this on a child. I leave my sites in for up to 6 days sometimes more. I won't tell you the longest i keep in sites. I generally just fill up another reservoir attach it to the tubing. I then make sure i pump insulin through the tubing to remove the air bubbles attach to site and DO NOT prime the site.

Hi,
I used to leave my sites in for 3 days. I was getting high sugars. Now I change it every 2 days. I change it in the morning and I notice if I leave it in a few hours after 2 days that I get a reading in the high 200s or low 300s. I wouldn't say i have a lot of scar tissue (at least this is not a known issue to me). Anyway, it is a good idea to keep batteries with you and keep extra sets at work. And don't be afraid to call Minimed for difficulties with your pump. The 24 hour line is good. Also, if you call about ordering supplies and they ask you your last blood sugar, you can refuse to tell them. I always do b'cause I got tired of hearing their reactions.
Maura

Thank you for all of the great advice!
I've been changing every three days like I am supposed to, but my last site change had me wondering. And I've been checking my bloodsugar so much I wouldn't be surprised if my fingers start to bleed on cue. I don't have very good insurance right now so I'll soon have to pay out of pocket for more test strips.
Luckily, no encounters with door knobs. So far. :)
Em

Hi Kerri,

Sorry, can't help with this discussion.

Thanks for your comments on my blog. Feel free to add mine to your blogroll. I've added yours to mine :)