I hope this is allowed… 2 new threads in such close proximity of one another…
I always took those warnings very seriously about the amount of insulin that was left in my reservoir and always made sure to change my set, at the latest, at 10 units left. And then there were a few people about a year ago who convinced me 0 doesn’t mean EMPTY. There can still be a decent amount of units in there and not to worry. So I stopped worrying and began to see my “0” as a “you’re getting close, but you have a few minutes to change”.
I sat an hour tonight on an empty reservoir because I have convinced myself ‘empty” isn’t empty, and now my blood sugar is a 450. Can anyone tell me what it means to you when your pump says your reservoir is 0??
I imagine it varies by the pump. I have no experience with the medtronic, but I posted about the OmniPod’s “reserve tank” here: the-omnipods-reserve-tank
(On this thread, @Gary said the medtronic reserve is about 10 units, and @Thomas said that for Animas and Tandem, zero means zero)
Just like in a car, when your fuel gauge says you are empty, you may not be exactly empty yet. But you know pretty soon you will be stuck on the side of the road. So unless you know exactly how much you have, there is no reason to push it too much.
Is there nothing on the pump that beeps to let you know it is actually empty? On the pods, it will sound an alarm when it actually gets to zero. I just always assumed that is something that all pumps would do.
It might be useful for you, when you first see a zero, to take the reservoir out and extract insulin with a syringe and see what is left in there. Do that a few times so you know how much you have left when you see zero.
Another way would be to wait for next reservoir change. Maybe it shows 5 units left. DISCONNECT from your site. Do a 5 unit bolus. Now do more bolus, maybe 1-2 units at a time and check end of tubing to see what comes out, and for how long. My guess is might get another 5-10 units.
I have run my MM 523 several times for a couple hours past 0, and did not have unexpected rise. Could depend on whether there are bubbles at the end, inside reservoir or in tubing.
With my old Medtronic 723, when it said 0 there was about 4u remaining, and that could be used for bolus or basal. I would change it right away, but it was nice to know that there was a little bit of reserve, kind of like with the gas gauge in a car. On the t:slim and t:slim X2, when it says 0 the pump immediately stops delivering insulin and starts frequent, persistent alarms; there is no reserve.
On the 723, when it is actually empty you get a No Delivery alarm. The same alarm that is given in the case of an occlusion. It is sensed by excessive back-pressure on the plunger, either because of a plugged tube or set, or because the reservoir is empty so the plunger has physically bottomed out.
I used the Cozmo. It will bolus past zero.
I’m now on the Vibe. No way you can bolus past zero.
But, this is my suggestion. If you want to squeeze and use the remaining insulin after hitting zero, just re-use the same cartridge (15-20 units still left) and same tubing (another 12 units saved to prime 23" tubing, (old tubing is already primed), you save 32 units of insulin everytime you reuse the same cartridge/tubing. Of course you still move and use a new cannula, just throw away the new tubing.
I experimented on this. I was able to reuse the same cartridge 3 times with no problems. Leaking rubber seal is what you have to watch out for. You see, you already do this technique with your lancing needle. How long does that last?
In the US, a vial of insulin costs $270.
In Canada, $30.
I’m in Canada, so I do not reuse my cartridge anymore. My insulin is 100% covered by insurance.
I have never let myself run out I guess. I always thought at 0, I just wasn’t getting any insulin. I know that at 15 years of having diabetes, you would think a person would know these things… but I was a REALLY bad diabetic for about 14 of them. I’ve got some catching up to do.
I’m going to have to give this a try. I was trying to fill a new reservoir using the end of one vial and the start of the next so as to avoid losing insulin at the end of the vial, but I’m not sure I got it right. I only did it twice, and both times I had unexplained high blood sugar. Hopefully what you’re talking about will be easier…
That’s definitely not much padding though. I usually change it once I’m down under 10, and I think I’ll just keep the habit. I’ve heard people say they continued to get insulin for a full day, but I had my doubts. Approximately 4 units sounds more likely.
Although extracting insulin from the reservoir with syringe seems to be all the rage around here, I think your way sounds a little easier. I’ll try to remember to do it at the end of the next reservoir. It would certainly be good information to have.
Whenever I had to change the reservoir in my Minimed pump, I would always wait until I received the no delivery error. It seemed to deliver the expected amount until that occurred. Hardly a scientific experiment of course… but that’s what I always did. Seemed silly to waste the insulin… also, I suppose I’m a bit lazy