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What To Do If Insulin Pump Fails

High Blood Sugar Due To Pump Or Site Issues?

High Blood Sugar Due To Pump Or Site Issues?

High Blood Sugar due to Pump or Site Issues? Posted by ids on Mon, 07/10/2017 - 16:26 in Anyone who uses an insulin pump knows there are many benefits in terms of lifestyle and glucose control. However, there's also a lot that can go wrong. Just the other day, I got one of those annoying occlusion alarms for no apparent reason. And last week, one of our patients developed pain at their infusion site and had to move to a different spot. Problems like these can result in high blood glucose (BG) levels. There are a number of "parts" that all have to be working properly for the pump to perform well. The insulin itself has to be at full-strength (unspoiled, and/or not expired), the reservoir and tubing have to be free of air pockets, the infusion set/cannula must be properly seated under the skin, the pump itself needs to be in good working orderyou get the idea. Pumps use rapid-acting insulin, which typically takes 3-4 hours to finish working. If something goes wrong, it is important to identify and fix the problem quickly. This requires good troubleshooting skills. Otherwise, it is possible to have very high BG levels, produce ketones, become dehydrated, and slide headfirst into Diabetic Ketoacidosis (DKA). If you are on a pump and have unexplained hyperglycemia, you need to act fast. Unexplained hyperglycemia can occur because of a "mechanical" issue related to the pump and its components. So how do you become an effective problem-solver? A little knowledge goes a long way. Knowing whether an elevated BG is related to a pump issue or some other cause can help you resolve the problem in a timely and effective manner. If you have had an unusually high BG for several hours, it is important to test for ketones (either in urine or a blood sample). The presence of ketones indi Continue reading >>

Tips And Tools For Insulin Pump Use

Tips And Tools For Insulin Pump Use

Insulin pumps can be great tools for managing diabetes in people of all ages, including children, teens, and even infants. Because pumps constantly deliver a low level of “background” insulin, and larger doses need only be taken before meals (or to “correct” unexpected high blood glucose), they can allow a user greater flexibility with respect to meal schedules and food choices than conventional insulin injections. Pumps also deliver more precise amounts of insulin than can be measured with a syringe. And modern pump technology tracks how much insulin has been delivered, when it was delivered, and how much of it is still active in the body, so there’s less of a chance of taking too much and ending up with low blood glucose (hypoglycemia). (Click here for a list of insulin pumps that are currently on the market.) Clearly, all of these characteristics can help a person achieve optimal blood glucose control. However, an insulin pump is only a tool: It can’t think for itself, and it is therefore only as “smart” as the person who is using it. In the hands of a motivated, diligent user, a pump can be a very helpful and precise tool. In the hands of a user who expects the pump to do the work for him, however, it may help to control blood glucose levels no better than any other method of insulin delivery. Even with a pump, it’s still necessary to count the carbohydrates in meals and snacks, match insulin doses to the foods being eaten, monitor blood glucose levels frequently, and make adjustments to meals, exercise, or insulin doses based on monitoring results. Everyone who uses a pump should receive comprehensive training on how to use it. But no matter how much training you receive or how many instruction manuals you read, some issues don’t become apparent Continue reading >>

My Pump Almost Killed Me… Twice

My Pump Almost Killed Me… Twice

One of the greatest technological advancements in diabetes care has been the insulin pump. For one, it gives you the illusion of being “normal” because you no longer have to inject insulin throughout the day. Instead, you “bolus” by pushing a button on the pump itself or using a remote control. It allows better glucose management because you can adjust your basal rate (the “background” insulin dose) by increments of one thousandth of a unit every hour. Especially when you’re moving from the peaks and valleys of NPH or the restraints and hazards of Lantus, the freedom of living with an insulin pump is incredible. But pumps do not come without their kinks. Most people in the diabetes community know what a pump is, but for those who don’t, I’ll give a quick overview. A Medtronic MiniMed insulin pump, for example, carries about 200 units of fast-acting insulin in a machine about the size of an early pager. The insulin moves from the pump via a tube that is connected to your skin through a cannula. The cannula is inserted into your subcutaneous layer via a two-inch needle. After insertion, the needle is removed and the plastic tube remains under the skin, held in place with sterile medical tape. The pump pushes insulin through the tube into your body in increments as small as .05 units per hour. Pumps like the OmniPod don’t even have a tube; they’re connected directly to your skin after being pre-programmed with your insulin requirements. When you’re using a pump, you no longer require insulin injections via syringe and you no longer use basal insulin (NPH, Lantus, or Levemir). I have learned many lessons while on the insulin pump. For example, I learned how my body reacts to the Dawn Phenomenon, that early morning rise in glucose levels that occurs w Continue reading >>

Ketones & Insulin Pumps

Ketones & Insulin Pumps

Check for ketones if you have the following: There is a higher risk for developing ketones on pump therapy. This is because long-acting insulins are not used, and rapid-acting insulin is delivered in extremely small amounts. If this basal insulin delivery is interrupted for more than an hour, check your blood sugar and ketones. If you continue to not get insulin, blood glucose and ketone levels may increase into a dangerous range. See also Acute: Diabetic ketoacidosis (DKA). Insulin pump-related ketone buildup may be caused by: Site problem Air in tubing (resulting in missed insulin) Extended pump suspension or disconnection (for more than one to two hours) Pump malfunction Insulin leakage (at insertion site or infusion set connection site) Illness or infection Vomiting or dehydration Severe emotional stress “Spoiled” insulin Ketones checklist The presence of ketones while using an insulin pump can indicate a serious medical emergency. Check for ketones if you have: An unexplained elevation in your blood sugar Persistently elevated blood sugars Symptoms of nausea or vomiting This is because you want to be sure you are not developing diabetic ketoacidosis. Remember that ketoacidosis occurs more commonly in pump users. Here’s what you should do. Use the mnemonic KISS. K – Check for Ketones I – Give Insulin by Injection (using an insulin pen or syringe – not through the pump) S – Change the infusion Set S – Check blood Sugar If ketones are positive, you need to obtain emergency medical care. Treating ketones If you have elevated ketones, insulin replacement must be delivered via an injection with an insulin pen or insulin syringe instead of the pump because the pump or infusion set may be malfunctioning and causing ketones to develop. Remember! Ketoacidosis Continue reading >>

Insulin Pumps/ Pump Center

Insulin Pumps/ Pump Center

Our experience in treatment of diabetes with insulin pumps has led to creation of a comprehensive Insulin Pump Center (IPC) where patients with diabetes who are on treatment with insulin pump are managed. This is the first center of its kind in the nation for patients on insulin pump therapy. The Pump Center provides services from basic teachings about pump therapy to advanced treatment and online monitoring of patients who are on an insulin pump. Our goal is to provide as close to real time monitoring and treatment adjustment as possible to achieve optimal control of blood glucose to avoid complications from high or low blood glucose levels. In order to achieve this goal services are available in person as well as online. Our staff includes our medical director, a board certified endocrinologist, a pediatric endocrinologist, nurse practitioners who are very experienced in pump function and therapy, as well as a registered dietitian and certified diabetes educators. All of our staff are certified pump trainers and are very well versed in pump therapy and adjustment of pumps as dictated by patients status. Based on our comprehensive approach and experience, we have been designated a center of excellence for insulin pump therapeutics by the leading manufacturers of insulin pumps worldwide. We offer educational services specific to pump therapy throughout the year in scheduled sessions, as well as individual sessions to patients that can be scheduled as needed, catered to meet patients schedule and specific needs. In addition, we offer certain education sessions online. We take pride in our insulin pump program for patients with type-I as well as type-II diabetes. Our experience dates back to 1998 when first patient with insulin pump was enrolled in our program. We are dis Continue reading >>

Guidelines For Temporary Removal Of The Insulin Pump

Guidelines For Temporary Removal Of The Insulin Pump

correction factor (insulin sensitivity factor) is 4.0 the basal rate is 0.60 units/hr until noon correction bolus: 14.8 – 6.0/4.0 = 2.2 units Total dose: 2.4 + 2.7 + 2.2 = 7.3 units, rounded off to 7.0 2- Long term off pump (24 hrs or more): There are 3 options Give long-acting insulin (Lantus or Levemir) as basal, and rapid insulin for boluses Give intermediate-acting insulin (NPH or N) ** call the doctor on-call for this dose Give rapid-acting insulin every 4 hours including overnight, as per the “short term” example Calculate the total daily basal amount of insulin and give as a single dose of Lantus or Levemir. It can be given as soon as convenient. Then continue every 24 hours thereafter. These insulins cannot be mixed with other insulins in a syringe Take rapid insulin for meal, snack and correction boluses The carb ratio’s and correction factors remain the same as for the pump Children who are too young to give their own insulin may need to have a parent go to school to give the lunchtime dose. The basal rate is 0.50 units from midnight to 6:00 a.m., and 0.40 units for the rest of the day until midnight. The total basal is 10.2 units. The dose of Lantus or Levemir will be rounded off to 10.0 units, given once every 24 hours until the insulin pump is resumed. Since Lantus and Levemir are basal insulins, you cannot have a basal rate running when you restart the pump or severe hypoglycemia may result! Restart your basal approximately 18 hours after the last Levemir dose; 22 hours after the last Lantus dose.    If you want to re-start the pump earlier, set the basal rate at 0.00 units/hr until all the Lantus or Levemir has worn off. Extra blood sugar checks will be needed to see how your adjustments are working, especially after the first inj Continue reading >>

Experts Call For Transparency On Insulin Pump Problems

Experts Call For Transparency On Insulin Pump Problems

Experts call for transparency on insulin pump problems (Reuters Health) - When diabetic patients report problems with their insulin pumps, the pump manufacturers collect that information but theres no easy way for researchers to analyze the data independently, a new paper says. In a joint statement, experts from the American Diabetes Association and the European Association for the Study of Diabetes say regulatory agencies should work together to create standards that apply to all pump manufacturers. People who use these devices shouldnt be alarmed, however. Overall they are really pretty safe as long as people follow the instruction and do what theyre supposed to, said Dr. Anne Peters, director of the University of Southern California Clinical Diabetes Program and coauthor of the new statement. But anybody who wears a pump knows they do sometimes fail, she told Reuters Health by phone. Five percent of the 29 million Americans with diabetes have type 1 diabetes and need to use either daily insulin injections or an insulin pump to survive, according to the Centers for Disease Control and Prevention. Insulin pumps combine an external pump case, which can be attached to clothing, with a catheter placed under the skin. They deliver the hormone continuously and can be programmed to deliver extra doses during meals or snacks. Up to one million people worldwide may use these pumps, although it is difficult to estimate since the number sold and currently operating is not reported by manufacturers, the authors write in the new statement, published in Diabetes Care. As the devices become smaller and more sophisticated, updated versions have entered the market rapidly, they write. Analyzing patient reports of problems with the new devices could help assure quality and improve saf Continue reading >>

Insulin Pump Risks And Benefits: A Clinical Appraisal Of Pump Safety Standards, Adverse Event Reporting, And Research Needs

Insulin Pump Risks And Benefits: A Clinical Appraisal Of Pump Safety Standards, Adverse Event Reporting, And Research Needs

Insulin pump therapy, also known as continuous subcutaneous insulin infusion (CSII), is an important and evolving form of insulin delivery, which is mainly used for people with type 1 diabetes. However, even with modern insulin pumps, errors of insulin infusion can occur due to pump failure, insulin infusion set (IIS) blockage, infusion site problems, insulin stability issues, user error, or a combination of these. Users are therefore exposed to significant and potentially fatal hazards: interruption of insulin infusion can result in hyperglycemia and ketoacidosis; conversely, delivery of excessive insulin can cause severe hypoglycemia. Nevertheless, the available evidence on the safety and efficacy of CSII remains limited. The European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) have therefore joined forces to review the systems in place for evaluating the safety of pumps from a clinical perspective. We found that useful information held by the manufacturing companies is not currently shared in a sufficiently transparent manner. Public availability of adverse event (AE) reports on the US Food and Drug Administration’s Manufacturer and User Facility Device Experience (MAUDE) database is potentially a rich source of safety information but is insufficiently utilized due to the current configuration of the system; the comparable database in Europe (European Databank on Medical Devices [EUDAMED]) is not publicly accessible. Many AEs appear to be attributable to human factors and/or user error, but the extent to which manufacturing companies are required by regulators to consider the interactions of users with the technical features of their products is limited. The clinical studies required by regulators prior to marketing are Continue reading >>

What To Do If Your Insulin Pump Isn’t Working

What To Do If Your Insulin Pump Isn’t Working

A certified diabetes educator provides a step-by-step guide. We asked Jennifer Smith of Integrated Diabetes Services to give us a guide for what to do when problems with your insulin pump arise. Here’s her advice: An insulin pump can be a wonderful option for managing blood glucose levels, one that can add a lot of flexibility to life with Type 1 diabetes. It’s important to remember, however, that no machine runs perfectly all the time. If you have unexplained high blood glucose levels for several hours which may be accompanied by ketones, this could indicate a disruption in insulin delivery and lack of insulin in your body. The pump, and its pieces, may be the problem, and there are a few steps you’ll need to take to see if you can get pump therapy working again for you. sponsor Some pump problems are easily fixable, while others are more complicated. Because of this, don’t wait until after a problem has been resolved to treat yourself. When needed, make sure you treat your levels with an insulin injection and test for ketones; if ketones are positive, then drink water to flush out the ketones and prevent dehydration. Here are some of the troubleshooting factors to consider: Settings: Check your settings to ensure the pump is delivering insulin as programmed. It helps to keep a printed sheet with current pump settings to refer to in case of pump failure. Is the time on the clock set correctly, and is “AM/PM” in the right place? Is the pump suspended? Is the basal rate programmed right and enabled? The insulin: Don’t forget that insulin is affected by temperature. Has it been hot outside or have you been out in the heat more than usual? Has the insulin vial been out of the refrigerator longer than 28 days? Is the insulin discolored? sponsor The reservoir: Continue reading >>

Everything You Need To Know About Insulin Pumps

Everything You Need To Know About Insulin Pumps

Everyone needs insulin to live. Insulin is a hormone that helps our bodies use and store the food we eat. People with Type 1 Diabetes no longer make insulin and have to give insulin in order to sustain life. People with Type 2 Diabetes don’t use their own insulin well, and over time can have trouble making enough. So, all people with Type 1 diabetes and some people with Type 2 diabetes need insulin. When people give insulin injections, they may take 1-2 injections of a long acting insulin every day and 3+ injections of rapid acting insulin for meals and snacks. The typical person with Type 1 Diabetes could take anywhere from 4-7+ injections a day. Many people currently give insulin through an insulin pen or a syringe. But, there is another option, an insulin pump. An insulin pump delivers rapid acting insulin in two ways. First, the pump is programmed to give you insulin every hour throughout the hour referred to basal insulin. Basal, think “base,” is the insulin your body needs even in the absence of food, it is also referred to as background insulin. This basal rate replaces the long acting injection that you take. Second, is bolus, this is the insulin you take for food or to correct a high blood sugar. If you get basal and bolus confused, think “bowl”, as in you eat out of a bowl, to help you remember bolus is for food. Once you are on a pump, all insulin is delivered through the pump and shots are no longer necessary. Components There are a few things necessary to make a pump work. When a pump is shipped to someone: they will also need to send infusion sets, reservoirs, and possibly batteries, depending on your pump. Let’s talk about each component. Infusion Sets An infusion set is the part that is actually inserted into the body and has tubing that conn Continue reading >>

My Backup Plan When My Insulin Pump Fails

My Backup Plan When My Insulin Pump Fails

Chris Stocker Insulin Pump Problems , Medtronic The other night I was up late working and needed to rewind my pump and fill up a new reservoir. I knew the battery was low, but I was hoping I could just make it to the morning because I was in my office where I didnt have any spare batteries. While in the middle of rewinding the pump alerted me that the battery was dead and the pump needed to be restarted. Once I restarted, I tried to rewind the pump again, but I could tell that it already finished rewinding. I attempted to rewind and it would get another area and need to be restarted. This just kept happening over and over and over. At that time, I knew the pump was having some sort of motor issue and was done. Luckily, I always try and keep some form of long-acting insulin at home. I usually get this from my endo as samples that havent been used and she needs to get rid of. I took a lower dose of what I would normally take for basal insulin because I knew I had a lot of insulin on board at the time. First thing in the morning, I called Medtronic and went through the troubleshooting and determined that indeed the pump was not going to work. Since the pump is under warranty a new one would be sent out to me overnight and I would receive it by noon the next day. Thats almost a 24 hour turnaround time. The point of the story here is that we all must have a backup plan if using an insulin pump. Do you have any long-acting insulin? Do you have your pump settings saved? Do you know how much basal insulin you need? If you dont have a plan yet, then I highly recommend speaking with your doctor or healthcare professional in order to create an insulin pump failure backup plan. As I was finishing this up, I heard the horn. There was the big brown truck with my replacement pump. He Continue reading >>

Diabetes And Your Child: Considering An Insulin Pump

Diabetes And Your Child: Considering An Insulin Pump

// Diabetes and Your Child: Considering an Insulin Pump Diabetes and Your Child: Considering an Insulin Pump Youve been told that your child has diabetes. He or she has to be given a hormone called insulin. Insulin helps to give your childs cells the energy they need. Insulin is most often given by shot, using a needle and syringe. Most children with diabetes need several shots each day.A device called an insulin pump can also be used to deliver insulin. A pump may help reduce the number of shots your child needs. An insulin pump can also give you more choices about your childs treatment plan. Many parents and children find that an insulin pump helps improve blood sugar management. But pumps do have some drawbacks. Your childs healthcare provider can help you decide if an insulin pump is a good choice. An insulin pump is a small device about the size of a pager or cell phone. Insulin is delivered from the pump to the body through thin plastic tubing. The tubing is attached to a soft, flexible tube called a cannula. The cannula is placed under the skin. The pump can deliver a steady dose of insulin. This is called a basal dose. It acts like the bodys natural release of insulin. The pump can also deliver a single dose either before meals or to correct high blood sugar. This is called a bolus dose. The pump is worn all the time, day and night. It is easily hidden under loose clothing or clipped to a waistband or belt. But it can be disconnected for short periods (for example, while bathing or showering). Some of the advantages of an insulin pump include: Reduces the number of shots needed (good if child is afraid of needles) Acts more like the bodys natural release of insulin than with shots Allows for both quick and around-the-clock delivery of insulin Gives child more f Continue reading >>

How Insulin Pumps Could Give A Fatal Overdose To Diabetics: The 'foolproof' Alternative To Daily Injections

How Insulin Pumps Could Give A Fatal Overdose To Diabetics: The 'foolproof' Alternative To Daily Injections

Shayla Walmsley, 44, is suspected to have died from an insulin overdose She was using an insulin pump which her family believe was malfunctioning The catchphrase ‘In better control . . .’ appears again and again on the Medtronic website. It is the pharmaceutical company’s clever marketing strategy to promote their insulin pumps – medical devices often thought of as a foolproof alternative to the daily injections of lifesaving drugs needed by diabetics. Yet last week, an inquest was launched into the death in her sleep of financial journalist Shayla Walmsley, 44, with the family’s legal team examining whether it could have been caused by a malfunctioning insulin pump. A year before, a 26-year-old woman, known only as Ffion as she wishes to remain anonymous, claims to have suffered a massive overdose after her pump released a large amount of the drug insulin into her bloodstream. She spent two days on a life support machine and lay in an induced coma for a further two days, but has since recovered fully. In May, a week after Shayla’s body was found, the Medicine and Healthcare Products Regulatory Agency (MHRA) watchdog sent out a warning regarding the device after the manufacturer discovered some to be faulty. Problems identified included mechanical faults that could result in too much insulin being released – a potentially life-threatening overdose – by accident. Medtronic, who make the MiniMed Paradigm pumps, one of the most popular brands – models of which were used by both women – say their products were not at fault in Ffion’s case. They tested her pump and found it to be fully functional. Human error is a known cause of overdose with all methods of taking insulin. The cause of Shayla’s death is yet to be determined by the coroner. But lawyer Continue reading >>

How To Avoid Problems When Traveling With An Insulin Pump

How To Avoid Problems When Traveling With An Insulin Pump

It’s the time of year in the United States for spring breaks. That means there will be lots of travelers in the next few weeks. Florida gets lots of travelers from the south. We love going to the beach and plan on going to Hilton Head in a few weeks to try a new place. Traveling with kids with diabetes requires extra packing and preparation. Here’s some advice and tips from a mom of two kids on pumps and years of traveling: Take extra supplies! No matter how many days you go, or how prepared you think you are, always take extra! I recommend taking double what you need of infusion sets, reservoirs/cartridges/pods. Plus an extra vial or so of test strips and insulin. Even if you are on a pump, take syringes for backup. You never know when a pump will fail or you need a syringe due to ketones. If you are on a pump, have a back up prescription or a sample of long-acting insulin in case of pump failure. Supplies you may need (take them, even if you rarely or never use them!) Syringes or pen needles Short and long acting insulin (if on pump at least take a prescription or have one on file at a pharmacy that you can fill) Meter plus extra meter Strips plus extra strips Ketone strips and blood ketone meter Snacks High blood sugar liquids (water/sugar free Gatorade) Pump supplies (take double) Alcohol wipes and adhesive wipes Take a Cooler This is probably something everyone takes, but it’s great for keeping an insulin pump cool at the beach and traveling with insulin. Take some ziplock bags to put a pump in and pop in the cooler. Try not to bury it in the ice, you don’t want the insulin to freeze, just to stay cool. Also great for low blood sugar snacks. Note from your doctor if flying We have never had to actually show the note, but I think it’s a good idea to have o Continue reading >>

Broken Pump. Help Please

Broken Pump. Help Please

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Hi everyone, my insulin pump has broken again. It's late and I don't have any long acting insulin. I know I should and I know I should know what to do by now but it has been one of those days, weeks actually and I'm just not thinking straight. What should I do before my replacement pump gets here, which could take 24 hours. Any help or advice would be so very much appreciated. i thought pumps only use short acting insulin???? but if you have no insulin in the house....don.t worry too much...cut the carbs and phone your gp in the morning for an emergency prescription to be faxed to your usual chemist x Thank you so much for your reply. I am not all alone after all! Yes you are right they do but when they break down there is no basal insulin in the body so we are always advised to have an emergency long acting to see us through until we get a replacement or whatever. What a pain. I will just need to keep checking all night I suppose and give myself micro doses of humalog as and when. All guessing. It's been quite a week . . . . things can only get better from here! check before you go to bed and when you get up....your bs will be higher but your body will be ok as its a rare occurence just correct it in the morning.. now go to bed and sleep...good luck for tomorrow xx Maybe I should just do that as you say. Thank you so much. All alone here today and have had the worst day ever so I really appreciate it. Hi everyone, my insulin pump has broken again. It's late and I don't have any long acting insulin. I know I should and I know I should know what to do by now but it has been one of those days, weeks actually and I'm just not thinking straight. What shou Continue reading >>

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