I was discussing with my endocrinologist this week about how much I love the t:slim and all of it’s features except for one of the main components – the cartridge with its “bag” design rather than a syringe. The reason being is that even though they may tell you that the average loss of insulin is comparable to that of other pumps, I have done my own personal testing (seriously – like, removing excess insulin out of cartridges and tubings and measuring them) and the t:slim, for me, does waste a significantly larger amount of insulin by the end of a month’s run. I know this may not bother a lot of people, but it bothers me. It’s, as my endo calls it, the Great Depression syndrome.

photo (12)I’m not typically a extremely wasteful person, but I’m not exactly the all-about-reduce/reuse/recycling person either. If I recycle, it’s because I’m reusing sturdy plastic cups from restaurants or water bottles that I’ve bought and refilled just to save from paying another $1.50 for water. But when it comes to my supplies and insulin, I’m very frugal. I cannot stand to waste. The reason being is because when I had my prior job, I had an insurance plan with a very high deductible, no offer of an FSA plan, and NOTHING, not even prescription medications (meaning insulin too) was covered until that deductible was met. During those years, I had to skip seeing an endocrinologist and simply rely on whatever stock I had built up, and when that ran out, I paid the full cost to see a doctor to get a script for insulin that I knew would last at least another year, and I didn’t go back and see him again. Of course, it all went against insurance, but even with all of these costs, I would have never met that deductible. So, throwing out a cartridge that I know probably contains about 40u of insulin even though my pump says “0” drives me purely batty. And I know, you can just simply recover it and use it to fill the next tubing and all, but remember, I have a very active 3 1/2 year old who barely lets me get through a straight-forward cartridge change now, so adding another lengthy step to this process, well, it ain’t gonna happen.

But I’ve been entertaining the idea lately of going only slightly off-label. See, the tubing and insulin that I use are both approved for up to 6 days of use. Only the cartridge is approved for just 3 days. I’ve heard of others who fill and simply change out their sites every 3 days, I’ve just not taken that plunge myself. If it works, I could at least save an extra tube fill (roughly 22u) AND cut the “cushion” of about 40 to a per-site-average of 20u. That would cut my monthly loss by a good bit, and I could handle the waste a bit better then. I used to do the fill-cartridge-every-6-day thing and change-site-every-3-days back when I had my Disetronic H-tron+ pump. It was what I was taught to do, actually. So doing it now shouldn’t be an issue other than hoping the insulin doesn’t break down differently in the cartridge. My next change-out will be tomorrow, so I’ll try it then.

“But what about the un-used tubing?? Won’t you be wasting that?” Yes, but I’ve also done some research on that. See, a few years ago, you could get split-boxes – 5 complete sets of tubing and sites, and 5 site-only sets. Apparently, this wasn’t cost effective, and really, in the end, it didn’t save the customer money at all. My thoughts are – a customer can reuse tubing (although off-label), but sites, once they’re done, they’re done. So, sites are the most important part of the set anyway, so why lessen the charge? Granted, it seems the only company that still recognizes that people like to change just the site at times is Asante because you can order the Conset infusion sets in split boxes since you shouldn’t need to change the tubing but – you guessed it – every 6 days along with your pump body. The sites are to be changed out every three, so you get 4 or either 5 complete sets and 4 or 5 site-only sets. Lovely, isn’t it? But, since their sets are proprietary and not Luer-lock, there’s no use pining over them. Besides, I could just save up all of that extra tubing and make some art with it for Diabetes Art Day too, so it won’t technically be wasted. Wish me luck!!


So, what about you? Any other frugal pumpers out there?



Filed under dblog, Diabetes

4 responses to “Frugality

  1. Christina

    I know many people that keep the cartridge in until it’s empty and only change out the site. And I’m right there with you on the waste of insulin with the tslim. We LOVE the pump, just hate the waste. Unfortunately right now with my teenage son we’re *just* getting 3 days out of a full cartridge, lol. But I know in time that will change. .

  2. I currently use the reservoirs and tubing with my Ping for an average of 7-8 days. I did the same thing with Medtronic. Using Novolog I have never noticed degradation in my insulin. I often change out the reservoir with about 15 units left, but after a week it is usually a mess of bubbles and I figure 7-8 days is long enough to use the same insulin.

    I do end up with a lot of extra tubing. I keep some of it and trash the rest. From Medtronic I used to be able to get Silhouettes that came with 10 sets and only 5 tubings. I think it was slightly cheaper. I don’t know whether they still offer that.

    I have good insurance and don’t have to extend reservoirs to save money. But I’m lazy and it makes life easier. I change my sets every 2-3 days and only change tubing when I change the reservoir.

    Even with the Ping I wonder where all of the insulin disappears to. I fill the reservoir completely to 200 units, prime 13 units, and then have 170-175 left. So I’m “losing” 10-15 units. That’s much better than the disappearing 40 with the t:slim:-)

  3. NC montain Bruce

    I have some Scotch/Irish blood. With poor insurance, I started reusing cartridges and now with ridiculously generous Affordable Care Act insurance, I still reuse them for months. I have 19 months of backlog for cartridges, 8 month backlog of Dexcom sensors and 3 months backlog of Novolog, which I am giving away.

  4. Eva

    Yes! I use the t:slim cartridges for 6 or 7 days, and change my site every 2 days (steel cannula). Works great! And for me, too, it feels much better to waste only about half as much insulin or less. Good luck!

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