# NovoRapid Pump carts problem.



## CosmicHedgehog (Feb 18, 2019)

hi all, is anyone else having problems with novorapid pump carts? In my nearly 30 years of type 1 i have only ever had a few bad batches of insulin. But since i have had the insight pump with the pump carts it seems nearly every other batch of insulin is bad or less effective.

 It obviously does something as i run higher in a straight line for example 15mmol and go steady but it is not where it should be. Had 3 days of horrendous blood sugars again and multiple site and insulin changes that did not resolve till i opened a new box. Had this happened quite a few times now since being on the insight. Its definitely a problem with certain batches. My fridge is the right temp and i have a thermometer in the insulin/butter compartment. Just wondered if any one else is having these problems? (also i'm not ill now and a manual pen correction from a pen cartridge worked perfectly and i had change my site multiple times so it was definitely the insulin)


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## Pumper_Sue (Feb 18, 2019)

Why not manually fill your pump instead of using the prefilled cartridges? Ask for a vial of novo to try. I would suspect though it's not the insulin.


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## CosmicHedgehog (Feb 18, 2019)

Pumper_Sue said:


> Why not manually fill your pump instead of using the prefilled cartridges? Ask for a vial of novo to try. I would suspect though it's not the insulin.


the pre filled carts are what i get on my prescription that go with the insight. My clinic don't approve of the manual fill ones. I corrected with pen cartridge / injection and that did the trick, then changed my pump cart to a new one from a different box and i have been in range ever since. Its definitely the insulin from that batch. Why do you suspect its not the insulin? 

Proof is in the numbers


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## HOBIE (Feb 18, 2019)

Its easy ! You put  Butter in that Compartment. (I think we all do it )


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## Northerner (Feb 18, 2019)

CosmicHedgehog said:


> the pre filled carts are what i get on my prescription that go with the insight. My clinic don't approve of the manual fill ones. I corrected with pen cartridge / injection and that did the trick, then changed my pump cart to a new one from a different box and i have been in range ever since. Its definitely the insulin from that batch. Why do you suspect its not the insulin?
> 
> Proof is in the numbers
> 
> View attachment 10868


Have your insulin pen cartridges been kept in the same place? How long have you had them in comparison to the pump ones?


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## Pumper_Sue (Feb 18, 2019)

CosmicHedgehog said:


> the pre filled carts are what i get on my prescription that go with the insight. My clinic don't approve of the manual fill ones. I corrected with pen cartridge / injection and that did the trick, then changed my pump cart to a new one from a different box and i have been in range ever since. Its definitely the insulin from that batch. Why do you suspect its not the insulin?



Logic says it's not the insulin as it's happening far to often and if you think logically insulin is a life saving medication so it's not likely to be faulty if it was there would have been a recall as lives would be at stake.

If it were me I would be putting my nose to good use and sniffing around the pump esp at the connection point and see if you can smell insulin and also check the very tip of your cannulas and see if they have been kinked.

In 54 years of insulin I have had 1 vial that was off and it was my fault not the supplier.

As to your clinic not approving of a manual fill that surely is down to what you prefer surely?


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## trophywench (Feb 18, 2019)

Well - you don't have the choice of a refillable reservoir with an Insight pump - it EXCLUSIVELY uses Novorapid pumpcarts and there's an end to it.

Seems very odd I know but my clinic only give us a choice of Roche Roche or Roche though they do tell you that you're at liberty to opt for another sort however they probably won't be able to assist you much if you do.  It IS wrong I agree but there again it's suited me so far, so I'm not going to complain.

Cosmic - I've never yet had such a problem with the pumpcarts at all though in the past I have had the odd last third of a vial become rubbish or the last pen cartridge in a box fail BUT they've usually been in and out of our household fridge and a caravan or motorhome fridge a few times in between, so I can't blame Novorapid for that. 

Do you always use the same pharmacy and if so - do they always use the same supplier, plus have any other regular insulin users complained?  I wonder at what point in its journey to your fridge, it isn't stored properly?


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## Lucy Honeychurch (Feb 18, 2019)

I've been on the insight since October and, thus far, haven't encountered this problem. I think Jenny makes a good point about the pharmacy, supplier etc.


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## Pumper_Sue (Feb 18, 2019)

trophywench said:


> Well - you don't have the choice of a refillable reservoir with an Insight pump - it EXCLUSIVELY uses Novorapid pumpcarts and there's an end to it.


Not according to this http://circles-of-blue.winchcombe.org/index.php/2014/03/18/first-look-accu-chek-aviva-insight-pump/ 
It would be a very limited market if you could only use Novo in the pump.


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## trophywench (Feb 18, 2019)

Ok - whose got one which has a refillable reservoir cos someone must have them?


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## Lucy Honeychurch (Feb 19, 2019)

Not me!


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## CosmicHedgehog (Feb 19, 2019)

trophywench said:


> Well - you don't have the choice of a refillable reservoir with an Insight pump - it EXCLUSIVELY uses Novorapid pumpcarts and there's an end to it.
> 
> Seems very odd I know but my clinic only give us a choice of Roche Roche or Roche though they do tell you that you're at liberty to opt for another sort however they probably won't be able to assist you much if you do.  It IS wrong I agree but there again it's suited me so far, so I'm not going to complain.
> 
> ...


I am starting to think it may be a supplier problem, My pharmacy is known to have its stock delivered to an outside step and it takes them ages to bring it in and unbox things. not best practice for insulin in extreme temps. I have a suspicion that it is either the pharmacy or supplier that are not handling correctly.. but who knows.


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## CosmicHedgehog (Feb 19, 2019)

Pumper_Sue said:


> Logic says it's not the insulin as it's happening far to often and if you think logically insulin is a life saving medication so it's not likely to be faulty if it was there would have been a recall as lives would be at stake.
> 
> If it were me I would be putting my nose to good use and sniffing around the pump esp at the connection point and see if you can smell insulin and also check the very tip of your cannulas and see if they have been kinked.
> 
> ...


As far as i am aware they told me that there is a cartridge for filling your own, but they said there was problems with it as it has an automated device for filling the cartridge and apparently is a bit crap.and if you are on novorapid  then you automatically get pumpcarts


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## CosmicHedgehog (Feb 19, 2019)

HOBIE said:


> Its easy ! You put  Butter in that Compartment. (I think we all do it )


As yes! thats the problem  hehe


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## CosmicHedgehog (Feb 19, 2019)

Northerner said:


> Have your insulin pen cartridges been kept in the same place? How long have you had them in comparison to the pump ones?


Yep kept in the butter compartment, although the box of pen fill cartridges have been in there longer than the pump carts. I keep a fridge thermometer in the bit of the fridge so i know the temp is good. Can't account for what happened to it before i got it though i suppose.


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## trophywench (Feb 19, 2019)

My pharmacy (within the doctors surgery building) is tiny - however their twice daily (at least!) pharmacy deliveries are delivered inside to behind the counter in plastic stackacrates, with the fridge items in an insulated oblong 'holdall' similar to the one that blood samples are transported in to the lab.  All the deliveries have to be signed for by one of the pharmacists - NOT an assistant.


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## Pumper_Sue (Feb 19, 2019)

Have a read of this https://forum.diabetes.org.uk/boards/threads/a-bit-of-a-mystery.74508/ @CosmicHedgehog ring any bells?


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## CosmicHedgehog (Feb 19, 2019)

Pumper_Sue said:


> Have a read of this https://forum.diabetes.org.uk/boards/threads/a-bit-of-a-mystery.74508/ @CosmicHedgehog ring any bells?


Nope absolutely not a cannula or leakage problem, 100% positive. while i was having problems this time i did 4 set changes. The whole kaboodle. because i was convinced it was a cannula problem. There is no way of it leaking from the top of the pump because it doesn't have a luer lock system like a combo or medtronic, It has a top not dissimilar to a pen cartridge and pen needle, where the underside of the tube end of the pump inserts a needle into the cartridge. anywho That's when the last attempt was changing to a new box of insulin and it all settled down. I understand that for others that might have been a problem, and i too have had leaking sets in the past, but that was definitely not it this time.  thanks for your suggestion.


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## trophywench (Feb 19, 2019)

… and it seizes the piston up on the Combo when it leaks a few times LOL - guess who's been there done that and knackered the pump - no, it can't happen with an Insight using mini pen cartridges like Becky and I use, Sue.  The black bit at the top of the pump that the tubing comes out of, is pushed round so it's at an angle to 'unlock' it, then you can remove the 'needle' from the empty/useless cartridge and do that in reverse with a fresh cartridge to replace (then prime as per usual with a pump)


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