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How many vials?

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SewK8

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Hi I am having huge issues with my gp about prescriptions for starting on my pump. (I start on Thursday)
Anyway, one new thing to worry me is I have been given 2. X 10 ml vials of novorapid . How long is this supposed to last me. Do you only get 2 at a time? I have been refused my optimum ketone strips and aviva strips for the blood machine and have been given an icare/sense test machine and been told that is all I need!
I am very worried about this and am going to speak to my DSN on Thursday. But what do you all get on prescription?




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Thats rubbish SewK8
You need to have a serious talk with your GP. I recently went on the pump and my GP was advised that I would need enough test strips for 8-10 tests a day and a minimum of 5 x 10ml vials per month subjetc to review if I needed more. So far this amount seems fine.
Whatever pump you start on, you will need strips that work with the pump so your GP cannot tell you to use a specific meter. Your pump will dictate what meter you use. Get you diabetic nurse to write to your GP and instruct them what you need. GP's can be full of ****. Luckily my GP gives me whatever I need and more. They gave me 10 boxes of test strips when I started on the pump because they knew id need to test every 2 hours for the first 2 weeks or so to fine tune the pump
 
About the insulin:
It depends on how much insulin you need.
A 10ml vial contains 1000 units .
You need your average total daily dose (and that may be a bit lower than with injections.) You also need some to account for the amount used for priming, and what's in the tubing. The amount not used when changing reservoirs and the bit you can't get out of the bottom of the vial. At the start you may need a bit more because you end up with bubbles or some other error. (that hasn't happened much to me but I keep reading of it happening to others who use a different pump)

I use from about 25-30 units a day. (30u x30d =900 units ie less than a vial)
I get prescribed 2 vials a month and don't need that amount every month . If I've had a month when I've used slightly more than average then perhaps I will need just over 1 vial, more often less. I like to keep some in stock because sometimes I have to make unexpected prolonged trips to the UK so initially I filled the full prescription each month. Now I quite often ask my pharmacist to give me only 1.
 
SewK8 said:
Hi I am having huge issues with my gp about prescriptions for starting on my pump. (I start on Thursday)
Anyway, one new thing to worry me is I have been given 2. X 10 ml vials of novorapid . How long is this supposed to last me. Do you only get 2 at a time? I have been refused my optimum ketone strips and aviva strips for the blood machine and have been given an icare/sense test machine and been told that is all I need!
I am very worried about this and am going to speak to my DSN on Thursday. But what do you all get on prescription?




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Hi

Try not to get yourself into a 2 and 8 over this.

The two x 10ml vials will probably last you about 1-2 months but this depends on how much insulin you will need in the pump cartridge every week. Usually about 20% less insulin is needed every day in a pump compared to what is needed as a total daily dose using mdi so you'll be able to calculate from that as your guide.

Regarding the problem with the prescribing of Aviva strips...... get your hospital pump dsn to liase with your GP surgery either by phone or email and then they will be able to explain the necessity for you to have Aviva strips instead of the Caresense. Unfortunately, the Spirit Combo pump and meter will only work accurately with the Aviva strips because of the bolus wizard being on the meter and not on the pump itself. I'm sure that communication from the pump dsn will sort it all out for you. In the meantime though, so that when you get the pump and insulin in it etc...... take 50 Aviva strips with you (from pharmacy or that well known online market place and forget morals etc) as the pump rep wont have any (mine didn't) and then you'll be able to do a bg test, eat some carb, enter the amount in the bolus wizard and heyho press the bolus delivery button and away the insulin goes through the tube and into the infusion set - amazing is what I felt as I thought there was nothing to using a Flexlink set in the inserter (easy .....) and the rep showed me (quickly mind) how to prime the tube and the set and the pump dsn set up the beginner basal rates for me and I programmed them in the pump and after about 1.5hrs with the dsn and rep, they were happy, I was happy and it was bye bye and I was off out of the hospital making my way home carrying what seemed to be a suitcase full of pump stuff and manuals.

Although the pump dsn will want you to have a blood meter to detect keytones...... unfortunately, its not the hospital that dispenses the keytone strips through the hospital pharmacy, the buck is passed to the GP and the CCG they come under to prescribe and question are raised because they are costly and often expire without ever being used.... but its sensible to get something to act as a prevention and take the correct action rather than have a diabetic becoming very unwell and needing to be admitted to hospital. But let your pump dsn sort this out for you and don't worry.

All the best
(Ive sent you a PM... pse look at it and then have a think)
 
I get 3 vials at a time. Seems to be enough.
Also people are right about the strips. 1 get 200 a pop which seem to last me.

Don't take it lying down. Tell them how YOU manage diabetes, not how they think you should manage it!
GPS are not specialists in diabetes and everyone is different.


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How long a vial lasts is the same as the length of string question as we are all on different doses so can't really guess on that.
You need as many vials as you need though, a couple will be enough to get you started and you'll soon figure out how long they last for. You should end up having a bit less insulin actually making it's way into you than when on pens, but there will be a lot more wasted with the last bit you can't get out of the vial, the 12 units or so in the tubing, the X units left in the bottom of the cartridge when you change that. Some people run the cartridge until empty, some don't fully fill them in the first place, some don't change the cartridge at the same time as each cannula.

The really important bit is that you get enough test strips and that is the one where I'd expect the GP to be trying to reduce your numbers that you use. Don't stand for that though and as said get the DSN to contact the GP if they are not prescribing you what you need. My DSN and hospital consultant gave me a letter for the GP when I started on the pump without me needing to ask, basically telling the GP to just give me what I asked for in terms of test strips.
 
I'm sure that communication from the pump dsn will sort it all out for you. In the meantime though, so that when you get the pump and insulin in it etc.
 
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