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Possible pump problem?

Discussion in 'Insulin Pumps' started by GChick, Mar 29, 2014.

  1. GChick

    GChick Approved members

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    I've had a run for the past week of near perfect blood sugars.

    Then for the last three days or so unexplained highs that won't fix without at least two or thee times the amount that should be required.

    I now have over 11 units of IOB for a scrambled egg and bacon breakfast and a waking bg of 201 ( should have only required 1.47 units to bring me down to my current 128)

    I held the pump and listened for like 10 minutes and never heard/felt any basal being delivered. Can just the basal part be broken?
     
  2. mamattorney

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    That's a good question. We've had a near perfect run with the t:slim, but have had stubborn highs over the past couple of days as well. I thought it was hormones and it may very well be, but we are dealing with one right now where I'm running a 225% basal and have given probably 3x as much insulin as I thought she needed for lunch and it's finally starting to come down after a three hour steady rise. It's puzzling, but I'm wondering if it is a basal issue, too. I did have her disconnect and ran a unit bolus and I saw insulin, so I don't think it's that, but I don't know of a way to test the basal.
     
  3. Nancy in VA

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    If the basal was broken, I woul think a bolus would get you back to close. If you woke up at 201, was tear with overnight corrections? Otherwise I'd say basal as to be working. We had a situation a few years ago where basal wired but bolus didn't. I could mean pump on for basal and bolus with an injection and shed be perfect but bolus it's the lump and shed be on the 500s. Those numbers don't sound right regardless and I think you need to call the pump company.
     
  4. mamattorney

    mamattorney Approved members

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    :redface: OK, I'm embarrassed. I think I figured out our "basal" problem. My daughter and I were walking the dog and all the sudden I saw tubing dangling from her waist. The infusion set had completely come apart at the luer lock. I have no idea how long it was loose, but I'm sure that's why she needed all that insulin just for one lunch. Some insulin was getting through - just not all of it.

    our t:Slim is back to having a perfect record in my book.
     
  5. RomeoEcho

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    I think it's highly unlikely that bolus is running and basal isn't, also it sounds like your boluses aren't very effective right now either. One thing that can happen, if there is a partial occlusion or a leak somewhere is that only some of the insulin is actually getting to your body. This will become more obvious in missed basal than in missed bolus. It's also possible that you are seeing resistance from an illness that you are not (yet) having symptoms from or other stressor.

    Couple things I'd try:
    1. Have you changed out everything? Cartridge, tubing, set.
    2. Check for ketones. Because you have no long acting insulin, a pump malfunction will cause insulin deficiency and probably ketones, even if you never got them on MDI.
    3. Try giving a normal correction by syringe. Does it work better than a similar bolus through the pump?
    4. Disconnect, set a temporary basal very high, multiple units per hour, and watch for basal delivery that way.
     
  6. GChick

    GChick Approved members

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    Apologies for posting a question and then not coming back for a while.

    I *think* my issue had nothing to do with the pump but just had to do with "life". I honestly think it all boiled down to stress. Bin having a rough time at work (well... rough sometimes and "OK" others, so was hard to pin down). I am one in which stress "usually" lowers blood sugars, not raises it so it didn't occur to me as quick as it should... but I think its the ~kind~ of stress that either raises or lowers things.

    I'm usually more prone to "worry" stress, which is what generally brings my blood sugars down... at the time of my question I was in the midst of more "angry" stress which I'm sure is a little more tied to adrenaline, so I think that is what brought my sugars up and kept them there. It wasn't even as drastic as a 2-3 times basal increase needed. Once I consistently increased it to 110% (and up to 120% very briefly) of my normal it seemed to work itself back out. I'm currently back to my normal amount for <ahem> this time of the month, but I expect the stress to be back, so at least I know approximately how much to increase things for next time.

    On MDI, things were never "horrible"... but they were also ~never~ perfect, which from time to time, on the pump at the very least basal can actually be "perfect" (even if my carb counts aren't)... at least for a while. So figuring out all the options is still just taking time. But having the options is great.
     
  7. vgage03

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    I know this post is old however I wanted to add in case someone is ever looking for answers. I agree that if bolus is workin than basal should be too. If its not delivering insulin your pump should have a no delivery alarm. So first I'd check the settings if this is a new pump, perhaps a basal was never set in the settings. Second I would get a new vial of insulin. 99% of the time when that happens to my son its because the insulin has gone bad. Mark the bottle as to when it was opened and keep it in a safe temperature.
     
  8. GChick

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    Thanks. It is quite old so I'm not sure of all what went on to fix things or if they even needed "fixing" per say and possibly it really was just all about stress? Still get more variability of insulin requirements for no good reason than I had expected to need prior to pumping, but I'm slightly better at just going ahead and making much more drastic basal changes now than I was then. On MDI it was rare that I would even CONSIDER a 10% increase of the basal without weeks of empirical data to back it up, but with pumping... why not, you can always shut down the increase if it was too much.

    While it still may have been bad insulin, I doubt it since I don't take it out of the fridge till a few hours prior to filling the cartridge and use a whole (pen) vial to fill the cartridge so there is generally never any "left over" insulin.
     
    Last edited: Oct 2, 2014

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