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Why don't pumps come with pre-filled cartridges?!!

Discussion in 'Insulin Pump Forum' started by Herbie72, Nov 15, 2011.

  1. Herbie72

    Herbie72 · Well-Known Member

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    I'm on the Accu-Chek Spirit Combo combo and still find it a complete pain filling up the cartridges from vials of Humalog. Why can't they just produce a pre-filled cartridge that saves all the bother? It would make the pumps much more attractive...
     
  2. ebony321

    ebony321 · Well-Known Member

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    Re: Why can't Roche produce pre-filled cartridges?!!

    Brilliant idea, but i'll have mine filled with Novorapid instead pleeeeeeeeease! :)
     
  3. Herbie72

    Herbie72 · Well-Known Member

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    Re: Why can't Roche produce pre-filled cartridges?!!

    How are you finding it with the NovoRapid, Ebony? I was on that, with Levemir, before going onto the pump, but there was no discussion about insulins when I made the switch. To be fair, the Humalog's been pretty good, though.

    I just get fed up with all the air bubbles / froth. It's like being back in the eighties again having to fill the vials with air first etc etc. And it's another thing to factor into control - it's not just diet, exercise, dosage, the air bubbles can make a big difference :crazy:
     
  4. pianoman

    pianoman · Well-Known Member

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    Glass is far more inert than the plastic from which most syringes and pump reservoirs are made. Over time, chemicals can both leach into and out of the plastic; such that I doubt insulin stored long term in plastic, would still be effective.
     
  5. Herbie72

    Herbie72 · Well-Known Member

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    But we replace glass cartridges regularly in pens, so why not simply do the same with pumps? It seems really strange to me.
     
  6. annettekp

    annettekp · Well-Known Member

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    I asked the Animas rep exactly this when we were fiddling about trying to fill our first catridge. Apparently its not cost effective as there are too few people on pumps.
     
  7. jopar

    jopar · Well-Known Member

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    Nope you'll wrong ..

    Some pumps have an options of glass or plastic cartridges, and Accu-chek D-Tronplus can use either glass, plastic or the standard 3ml pre filled cartridges. But not sure whether this pump is now discontinued or not now!

    It is purely cost that prevents pre-filled pump cartridges being manufactured..

    The different pumps have slightly different cartridge design, about 10 years ago the pump manufacturers did look into the viability of producing pre-filled pumps...

    To make it work it required a standardisation of pump cartridges and an investment of well over £20 million to get production set up..

    Another problem is the sheer cost of production the pre-filled cartridges were also very steep, and too uneconomic pushing up the over-all cost of insulin pump therapy..

    In the UK insulin pens are now the most popular method of insulin delivery, In countries such as America the syringe and vial method of delivery is the most popular method of delivering insulin, Pumps only make up a very small percentage..

    Oh this information comes from the horses mouth, a pump company
     
  8. ebony321

    ebony321 · Well-Known Member

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    Re: Why can't Roche produce pre-filled cartridges?!!

    I've always used novorapid as my fast acting insulin so i don't really know any different! I've used humalog once when i switched back to injection for a day out as thats my back up insulin, but didn;t use it long enough to figure out if there's any difference.

    I still can get a fair few bubbles when filling a cartridge, i tend to fill my cartridge the night before a change so they settle at the top so easily primed out when i swap. Sometimes i think the cartridge is clear then when i check later a bubble has appeared from what seems from nowhere, i've also caught a big big bubble in my tubing once that could have caused a mis-hap. Sometimes if i have a unexpected higher BG i think air bubbles can be the cause.

    I've also only been diagnosed a few years so i know nothing of drawing up insulin injections, i'll consider myself lucky for that one and for my pump :)
     
  9. jopar

    jopar · Well-Known Member

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    Air bubbles can appear at any time, due to temperature changes, Insulin is a liquid so as it's temperature fluctuates it will release and adsorb the air molecules.

    Tip, is to wear your pump with the luner lock facing downwards, if air is released from the insulin, it then collects at the other end of the cartridge away from the tubing out of harms way.

    If you've got frothing in your tubing then this means that you have a lose luner connection, if the lock isn't tight it will allow air to seep back in frothing the insulin,

    Tip, when you check for air bubbles which you should do regularly during the day give the luner connector a twist to ensure that it's tight..

    Priming out bubbles when filling up a cartridge, if you are getting frothing at this stage it means that you are pulling the plunger back to quickly, let the air you've pushing to the vial slowly push the insulin into the cartridge then slowly without wobbling the plunger from side to side pull plunger back the rest of the way..

    Tip when filling from the vial, inject the air with the vial stood on the table top, the handle to vial gently when you rotating it into the upward position to fill the cartridge, as quick fast movements will froth up the insulin and create more bubbles which are finer and very much harder to knock out when you got them in your cartridge
     
  10. Herbie72

    Herbie72 · Well-Known Member

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    Great advice, Jopar, many thanks. I had a funny feeling that cost would be the main reason why disposable cartridges aren't available. I store my insulin in the fridge door, so I think I may change that as opening / closing of the door must shake the insulin up a little, maybe introducing more bubbles.

    Enony, sounds like you're doing really well - your Hba1c is fantastic, well done! Bubbles, for me, are the biggest downside to the pump, as is the rigmarole of changing cartridges. But ho hum!
     
  11. gollymax

    gollymax · Well-Known Member

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    Hi Herbie72
    My wife made the same comment the other day, why dont they make pre-illed cartridge for Accu-check Spirit Combo.
    I am not on the pump yet, but my day for going on the Spirit Combo is this friday 25th November 2011 :thumbup: going straight onto insulin not saline :eek:
    But I will ask the rep/DSN this friday the question why it is not in pre filled cartridges :thumbup:
    Kev
     
  12. jopar

    jopar · Well-Known Member

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    Herbie didn't realise that you've only just started on your pump..

    Another tip I forgot to mention,

    it's referred to has degassing the vial, the problem is that because we've got to pump air into the vial the insulin will adsorb some of this air that's left behind.. So you need to degas the vial..

    Easy way of doing this, is when you've finished filling up your cartridge, is to clip the cartridge from the blue collar first, leaving the blue collar in situ on the vial.. Carry on with sorting out the pump and getting this set up.. By leaving the blue collar you equal out the pressure inside the vial and this help cut down on bubbles..

    Don't get too down hearted about bubbles, a lot at the moment will be due to being pretty new to pumping, the more times you fill up the cartridges your technique will improve and lessen the bubble problem..
     
  13. Herbie72

    Herbie72 · Well-Known Member

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    Thanks Jopar - I've actually been on the pump for just over a year now, so I'm not entirely new to it anymore, but compared to the length of time I've had diabetes, it still feels new!

    Your de-gassing tip sounds great, thanks - I'll give that a go next time I do a new cartridge. To be honest, when the Roche rep came into the hospital a year ago and talked a few of us through the pump and showed us how it worked, it did feel as though the introduction process was a bit rushed. We had no practise on saline like some people, so I did feel a bit of a guinea pig. I have a meeting with my DSN on Wednesday morning, so I'll talk to her about it, too.

    :thumbup:

    Golly, you must have seen some technological advances in your 50 years of having it; it's a different world now to what it was when I was diagnosed in 1983, so I can't imagine what it must have been like in the early sixties :shock:
     
  14. spideog

    spideog · Well-Known Member

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    The way I've landed on my pump a couple of times, or had it bash into doorways, I think I'd rather stick with the plastic cartridges than have the chance of glass shattering inside the pump. They have to be rated to take some serious amounts of abuse in order for us to be allowed to use them as day to day medical devices, glass cartridges are not going to be able to take the same abuse.

    I'm not abusing my pump. :lol:
    Just the nature of it being attached to me all day everyday means that it will take some knocks along the way.
     
  15. Herbie72

    Herbie72 · Well-Known Member

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    Very good point, I often bash mine in everyday use. Is there any reason why they couldn't do pre-filled plastic cartridges?! :?
     
  16. jopar

    jopar · Well-Known Member

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    Actually some pumps do come with an option of glass or plastic cartridges..

    And Asante released their Pearl pump in May 2011, with take pre-filled standard cartridges. But alas it's only sold in America http://www.asantesolutions.com/index.cfm?langid=1

    I assume that the pump was designed from scratch to fit the standard insulin pen cartridge..

    Insulin pump development goes way back to the 60's before human insulin's became available, so in the pump's infancy there was no such thing as a glass 3ml cartridge or insulin pen.. And over the years the developers have kept their designs of the next generation pump in line with the original pumps as it helps to keep both development costs and licencing costs down..
     
  17. Herbie72

    Herbie72 · Well-Known Member

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    Had a meeting with my DSN this morning and I asked her about this - she said that Roche are set to bring out a new pump which will use pre-filled cartridges, apparently in response to the sort of criticism we've been raising on here. Very interesting. Maybe people power does work :)

    Watch this space, I suppose...
     
  18. azure

    azure Type 1 · Expert

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    Hi everyone - newbie here :) I've lurked around this site for a while but it was this post that spurred me on to join :D

    This is emphasis not shouting :) : ACCUCHEK D-TRON PLUS IS STILL AVAILABLE AND IT'S BRILLIANT! :thumbup:

    I don't know why HCPs (or Accuchek!) never mention it, but I've been on it for years and have no desire to change. It's still available, yes - check it out (hope I do the link right but copy and paste if I mess it up):

    http://www.accu-chek.co.uk/gb/products/insulinpumps/dtronplus.html

    The D-Tron Plus takes normal 3ml cartridges just like you'd use in an insulin pen. It's so quick and easy! I can't be bothered to faff about so I've stuck with the D-Tron and have no complaints with it. It's easy to use, comes with a good choice of sets and needles, and takes normal pre-filled cartridges! :clap:

    I suspect that Accuchek simply don't mention it because they try to encourage people to use their own newer pumps (the D-Tron was originally made by Disetronic which was taken over by Roche, I think). I got a new D-Tron recently (this Autumn) and Accuchek still tried to persuade me to have one of 'theirs' but I'm more than happy with the D-Tron, as I told them quite firmly! Then the lady admitted to me that 80% of people who have a D-Tron Plus stick with it. I'm sure the ease of being able to use pre-filled cartridges is a big part of that. Obviously, it has other features too, of course. I find it very reliable and simple to use and I lead a busy life.

    Different pumps suit different people and we should all choose what suits us personally as we're all different, but I do get annoyed when people aren't given the full choice or made aware of all the pumps available currently.
     
  19. Herbie1972

    Herbie1972 · Member

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    Great first post, Azure. My DSN only ever gave me one pump to choose, there was no option, so interesting to read your comments. Will read up on it, thanks :thumbup:
     
  20. azure

    azure Type 1 · Expert

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    Thank you, Herbie1972. I was lucky enough to be offered the D Tron almost 8 years ago when I first started pumping, so it was just good luck initially, but I think your experience is pretty common. I've noticed PCTs tend to opt for one pump company and one pump. I don't know why - one size never fits all, after all - but I hope anyone else reading this whose PCT use Roche/Accuchek will have a look at the D Tron to see if it would suit them - even if the DSNs and Roche remain strangely silent about its existence! :D

    Thanks for replying to my first post and for being so welcoming. :)
     
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