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Re: [IP] Site changes



> We have been advised not to leave the old set in. It seems to me
> that if you prime the new set, then it is full to the end of the
> canula, and any basal/bolus will begin to flow immediately.  In
> addition, since you probably had the old canula full, leaving the 1
> unit or so that's in it (for a sil, less for a softset) would mean
> additional insulin...does this make sense?

No, the insulin that is "within" the cannula will not come out unless 
something else is pushed into the other end. i.e. more insulin, 
whatever....

The purpose of leaving the old set in place is to allow time for the 
insulin already infused to be absorbed. Two things happen when you 
remove the old set and there is insulin freshly infused either from a 
bolus or basal.

1) some insulin may actually leak out through the wound. Consider how 
small a 5 unit droplet of insulin looks when you prime your set. You 
don't need to loose much into the wound to affect bg's

2) removing the cannula disturbs the tissue into which the insulin 
has been infused. If the disturbance is great enough to cause damage 
to the tissue it will not be able to absorb the remaining insulin. 
For instance, consider what happens when you get a bleeder at the 
infusion site. You just put insulin into a black hole and nothing 
happens.

Both of these problem have small but measurable effects on bg's. They 
do not always occur, but the occur often enough to be an annoyance. 
It is easier to leave the set in place a couple of hours and not have 
the problems to begin with.


> 
> > A couple of weeks ago there was a thread discussing what to do when you
> > change sites. It was suggersted to leave the old site in for 2 hours for the
> > Humalog to finish being absorbed. Does this mean the canula itself or the
> > canula and the tubing? If it does also include the tubing, is it ok to set
> > aside the tubing for the next site change?
> >
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