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[IP] Seven ways to "K.I.S.S."(*)


I've been a Type 1 diabetic for over 30 years. I've been on the pump,
first a Minimed 507C and now a 508, for close to three years. I use
Sof-set Ultimate QR 42" infusion sets and Humalog U-100 insulin. My
A1C's are in the normal range.

I've learned how to keep pump management _simple_ while being frugal
with supplies and without compromising my well-being. I originally
posted these tips on July 4, 2001 (see
http://www.insulin-pumpers.org/cgi/archives/mail-insulin-pumpers/Jul2001/msg00189.html ).

I've updated them with another year's experience. All of the following
is *strictly* YMMV.

1. Reservoir K.I.S.S.

I change reservoirs monthly. A box of 24 reservoirs will last me two
years. To avoid NO DELIVERY alarms, I need to remember to push and
pull the plunger in the near-empty reservoir several times (until the
motion feels free) before refilling with insulin. I occasionally get a
NO DELIVERY alarm; when I do, I change the reservoir.

2. Site prep K.I.S.S.

I normally change a site right after I shower. I insert the cannula
with the Sof-serter and apply the supplied Smith+Nephew OpSite
adhesive. I use no "lotions, potions or notions" (site prep ointments,
solutions, glues, pain-reducing cremes, or extra adhesives).

3. Insulin K.I.S.S.

I refill a reservoir every week on the same day, so it's *never* gone
empty. When I fill it, new insulin is mixed with the old. I only throw
out insulin when I change reservoirs monthly. (There is _no_
correlation between my insulin requirement and the day of the week or
month, which refutes any insulin aging hypothesis.)

Insulin is the "stuff of life".

4. Infusion set change K.I.S.S.

When I first started using the pump, I got frequent skin infections,
but they've gradually disappeared. I found, much to my surprise, that
my body went through a LONG adjustment period, one that may still be
progressing. For several months, I changed every 2 days/2 days/3 days
(12 sets/month), so I was changing on the same days of the week. Then,
I found that the 3-day period was being well-tolerated and I tried
changing every 3 days/4 days (8 sets/month). When I found that 4 days
was being tolerated, I extended to 5 days/4 days/5 days (6
sets/month). Months later, I simply forgot to change my set for a
whole week. Since then, I leave a set in for 5-7 days. (5 sets/month).

I think the adjustment period was actually the time needed for my body
to pad the infusion sites with fat. I'm of slim build and am not
overweight. I've noticed that I now have more substantial fat deposits
(not exactly "love handles", more like "friendship bulges") on my
abdomen. The lumpy fat deposits I used to have on my arms, legs and
buttocks have completely disappeared, since I no longer use these
sites for injections. As the fat's built up on my abdomen, the
inflammation at the infusion sites has subsided. Most of the time,
when I remove a cannula, I can hardly tell it was there, which is
NOTHING like it was at first.

5. Bubble K.I.S.S.

Some people report all kinds of problems with bubbles in the tubing
after a reservoir fill and they use all sorts of strategies to avoid
them. I have *zero* problems with bubbles -- I never EVER see them.

It's not magic, it's the procedure:

6. Battery K.I.S.S.

No matter what battery source I've tried, I get a maximum of 6 weeks
from a battery set. It's just a matter of buying from an inexpensive

I've purchased batteries from
http://www.wholesaleadvantage.com/battery_index.htm (click on
"Electronics"). They have lasted as long as any others, but cost only
about a dollar each. (No, I don't even get a single AAA battery from
them for this testimonial.) A year's supply can easily be stored in
the fridge.

Another even less expensive source posted to the IP list is
http://www.jewelrysupply.com/noframes/watchbatteries.htm , but I have
no experience with this supplier.

I decided I did not ever want to see a LO BATTERY or NO POWER alarm,
so I change the batteries *monthly*, when I change reservoirs. Since
doing both is "hard", it's noted as a "BRICK" day on my log, for a
change of Battery, Reservoir, Insulin, and Catheter, then a Kiss for
my wife.

7. Lancet K.I.S.S.

I don't need a yearly reminder to change a lancet, but it'd help. <g>
I know that some people, OTOH, change it every time they test. I
change mine whenever it hits the floor or it hits me to change it.

Please remember that the practices I've outlined above are *all* YMMV.
It might help novices to know that the pump can be downright easy to
manage once you get the hang of it, after it hangs on you a while.
What's much harder to manage is the person wearing it. ;-)

regards, Andy

(*) K.I.S.S.: "Keep It Short & Simple" (also, "Keep It Simple,
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