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Re: [IP] Tiny Bubbles...in the Cartridge



Forrest:

That big bubble at the top of the cartridge should not be a problem. I get
them frequently, but if I spend some extra time when I fill the cartridge,
I can usually reduce it in size or eliminate it. I have only had one or two
times when it passed into the tubing. I spotted the bubble when it was in
the tubing and was able to bolus it out when it got to the "business end".
No harm caused.

The worse case scenario would be high BGs resulting from air in the line
instead of the expected insulin. A one inch long bubble in the tube is
generally equivalent to one unit of insulin. If that bubble passed into you
instead of the insulin, you would have been "shorted" approximately one
unit during this time.

Tricks I have used to eliminate this bubble include "flicking" the end of
the cartridge neck with my finger when I prime the pump. This tends to
break the bubble up into smaller bubbles, and lets them pass into and
through the tubing during priming. Also, cold insulin tends to hold more
air which is then released as the insulin in the cartridge warms. If you
let your insulin bottle warm to room temp before filling your cartridge, it
helps reduce the amount of bubbles.

If you are using Humalog, the bubble may seem a bit "stickier" than bubbles
caused by Regular or Velosolin - seems to be a characteristic difference in
the insulins. For some reason, the bubbles can be tougher to dislodge.

When all else fails, build something ;-) I know a user who jokes that she
uses the bubble in her pump cartridge like a carpenter's level. I can't
argue with that creativity ...

Bob Burnett

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