I can understand about the sleep and not wanting to do it in the middle of the night.
If the insulin has been in there for 2 or 3 days, maybe it’s better to discard it. But if it’s only been in there for 1 day, it doesn’t matter if you put it into a different pod. The insulin doesn’t care if you take if from pod A and put it into pod B.
Maybe the insulin would be in a pod reservoir for 4 days max instead of 3 days, but that isn’t really an issue. It’s not as important as the length of time an infusion site has been used.
I’m genuinely curious what is the concern? I routinely fill my t:slim cartridge with insulin that will last 5 or 6 days, and refill the cartridge when it empties, so I don’t understand why transferring insulin from one pod to another would be an issue. Insulin has preservatives. Some folks on MDI re-use their own needles a couple times before switching to a fresh one. I haven’t heard of problems caused by these practices (for folks with immune systems that are operational.) Is there something special about a pod that quickly makes insulin go bad?
Possibly the only difference between using insulin in a pump like Tandem and the omnipod is that the insulin in the pod is pressed up right next to your skin and attached with adhesive. So the exposure to body heat might be a concern. Using a Tandem, the pump might be attached to your belt with a clip or in a pocket, so it isn’t as close to the body and might not be as likely to become heated.
Additionally, if you take a hot shower or bath, the pod goes in there with you. But with the Tandem, it does not.
I think that is probably the main cause for concern, the exposure to hot temperatures.
I personally don’t think it is much of an issue. But the temperature exposure might be a concern for some.
I think that is the main issue, really. I agree with @Eric. It remains at skin temperature from the moment you fill the reservoir.
If you always refill a reservoir, from tank to tank, you will end up having a percentage of your insulin that has been warm for many days. Organic substances are known for chain reactions, so having just a small % of an organic substance degrading may sometimes quickly contaminate a whole container. For instance, you may be able to keep a clean oil in a bottle for many months without degradation, but if you add a couple of drops of the same oil, but rancid, for many oils you will have the whole container go bad in a short time.
Interesting. We could examine this by looking for a decrease in insulin potency on the third day of pod usage, but I don’t know how to distinguish that from the normal deterioration in site function that some folks experience on day 3.
Now that seems like a significant concern. The insulin temperature would be between body temperature and ambient, but that could exceed the 86 degree threshold, depending. And when sleeping on the pod, I’d expect it to reach 98.6, just as it does in my t:slim when I sleep on it.
Someone, somewhere must have studied thermal degradation of insulin. Hmm a quick search shows articles in this area, but I didn’t find one directly on point.
On the other hand, @Eric, I believe, does it every time—is that correct, @Eric ? It does not appear to have created a problem for him. If that is his MO, most likely the concern is only theoritical. I don’t know for a fact that insulin degradation is a chain reaction: it only may be. A risk factor that may not be a practical issue.
Think about it - if you do it every time, you are taking insulin molecules that - for example - were in a pod that you wore in a hot-tub a year ago and putting it into your new pod with new insulin. I would never advise anyone to do it every time.
It’s diminishing returns. If you have a new pod only a day old, you might have 150 units in there you don’t want to waste. But it’s only 1 day old, so it is reasonable to put it in a new pod.
On the other hand, if the pod is 2 or more days old, you might only have 40 units, so it’s not worth saving. It’s older insulin and it’s not as much. It’s a diminishing return the older the pod gets.
I use insulin that has expired or been left out of the refrigerator. I don’t waste insulin by throwing it away in a vial. But I am not extreme about saving it from the pods. I have a big prescription and a huge stash, so it is not a big concern for me. Maybe if it is a relatively new pod, but not every time.
OK, then. If it’s not your regular MO for every pod, then I think that my concerns are valid. So I would also only reuse insulin if it’s a fairly new pod and there is a lot of insulin in it. I would not recycle insulin from the next pod:
My sons insulin goes to crap on day 3, I would say after 48 hours it’s about 1/2 as good, he is extremely brittle, I would not reuse that body temperature insulin after the 48 hr mark… i have extracted it from the pod after 72 hours and it doesn’t seem clean anymore, white particulate floating about in it… I know it sucks throwing away 60 plus units but with Omnipod you need to…
If you have any questions, I could try and help, my boys 4 now and he’s been t1 since he was 1…
We don’t reuse either unless the pod is a flop from the first moment it’s applied (every so often it hits a muscle and hurts really bad so we pull it off.)
One of the other members told us to try switching insulin from Humalog to Novolog to get better lasting results with the Omnipod and we did. The results were outstanding and we haven’t looked back.
When we first found FUD I was super hesitant about changing stuff up because when something sorta worked, it seemed silly to modify. But the insulin switch was easy and worth experimenting with - and in the end has really helped with days 2 to 3 on the pod. Might want to try a different insulin! Next up for us is Fiasp, but we haven’t been home lately to give it a whirl.
Is it the insulin that goes to crap, or maybe his sites that don’t absorb so well over time? Absorption problems aren’t uncommon by day 3, and there are various fixes that you can experiment with.
Also, given the amount of wastage, maybe the Omnipod isn’t the right choice for your son? I know changing pumps can be a right pain, especially in the US, but if you are throwing out 60 units or more after the 72 hours, and the pod requires a minimum 80 units, then your son is only using about 6 units a day, boluses and basal, which isn’t much. There are other pumps (albeit tubed) that you’d be able to fill with enough insulin to keep him going longer than 72 hours.
Those are good points, nice to know there are pumps with less volume required.
Also, if @DRMSquared is filling the pods all the way up that might be one of the issues - we did that for a while until we knew how much EH was using every day. Then we added a margin above that and generally only fill pods to 150 units. Which is half of a PenFill refill so that’s handy. The other day on day 3, he got down to 20 units, but it had been a really carb heavy week. I do not believe he has ever run out of insulin. Also, we got the prescription written for changing the pod out every two days. Because they do fail, and sites do stop working effectively.
It has also occurred to me that very shortly, her 11-year-old will become a much bigger kid! So maybe he’ll need more insulin?
