Constant No Delivery Alarm - Allergy?


I have had diabetes now for 23 years and have been pumping for 14 of those years. I use the Paradigm 522 insulin pump along with the 6mm, 23 inch tubing Quick-Sets. Since November, I have been having many, many No Delivery alarms. I have received a new pump, tried other infusion sets (except for Sure-Ts… I’ve heard about a lot of problems with them), other sites (some of which haven’t been used, ever) but the problem persists. This is the first time I have ever had this issue considering the amount of time I have been using the pump. The No Delivery would happen when bolusing. Also, sometimes I wouldn’t even know the insulin wasn’t being delivered properly until checking my blood sugar.

Since my endo and I can’t find any reason why this may be happening, I thought maybe that I have now developed an allergy and that my body is now rejecting the cannula… Maybe because it has been so long that I have been using them. Instead of having a tiny bump when I do my site changes, I now have an inverted bump with “swelling” around. Has anyone encountered this? Has anyone been tested and confirmed that they have developed an allergy? I’ve done everything they make you do when you call Medtronic. It is confirmed that it is literally something with me and not the devices.

I have since restarted MDI and am at a loss. Thinking about ditching the pump because of all of this…

Looking forward to your ideas!
Thank you.

I am sorry you are having this issue. Insulin does little good if it is not being absorbed or delivered.

Honestly, it sounds like a pump error. I assume it passes the self-test? I suggest next time it happens immediately do the self-test and see what happens. My guess is your motor may be having an issue, but I question that you will find it without it being sent to Medtronic, if it is out of warranty I think I would start the process to get a new one.

It is most unlikely that an allergy is creating a problem to all cannula. People do get skin irritation or allergies to the adhesive. But if there is an allergy to the cannula going to the steel set should solve the issue.

Hi AR11,

I have been having the same problem that you have been having with the insulin pump and the no deliveries. I have had diabetes for 25 years and have been on the pump for 9 years. I have been using the Paradigm 751 pump with the 9mm, 23 inch tubing. For the last 3 months I have been getting the no delivery message. Like you I have changed out the infusion sets many many times, have placed them on spots that I have never used them, have changed out the reservoirs, called many many times and keep getting told that my pump is working fine. Even convinced them to send me a new pump and I’m still getting the no delivery. I’m at my wits end as to what I need to do to fix this problem. I am like you and about ready to ditch the pump and go back to the shots. I have done the self test and of course it says it’s working fine.

Quick Sets are your problem!! Switch to a steel set such as Sure-T. I had the same issues and nearly quit pumping because of “no delivery” with QS. It doesn’t happen with Sure-T’s except about every 2 years or more. With QS, it happened to me CONSTANTLY.

The cannulas, being so pliable, will kink, especially if they are touching tough tissue or a bit of muscle. Just look at them wrong and you’ll have issues. I fought with the problem for a long time because I didn’t know about the existence of a trouble-free set such as Sure-T.

Remember: if something isn’t working, it is time to change things up.

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Hi @smilinja and @AR11,

I’ve had Type 1 for 26 years and have been pumping for 11 years. In about 2011 I developed an allergy to the cannula on infusion sets. In addition to receiving a lot of occlusion (no delivery) alarms if I tried to use a set for more than about 24 hours, I also had welts, hives, and rashes at the infusion site and the site would get extremely itchy and stay itchy for about a week after removal.

At the time, I found switching to metal infusion sets was a HUGE help and basically solved my problem. I would highly recommend this if you’ve developed an allergy to the plastic cannulas.

Since then I’ve also become allergic to the metal sets as well as the tape. I’ve nearly given up pumping several times, but the pump works so much better for me than MDI that I’ve persevered through. (Also, my allergies are insane in general, so this is something that affects my entire life, not just my use of the insulin pump.)

What I’ve found works best for me is to use Cavilon cream on the site before insertion, stick to tapes that I know I don’t react to (which for me is Hypafix and Opsite Flexifix, and avoiding Skin Tac and Tegaderm), taking a daily antihistamine (or in my case several!), moving sites every 1-2 days or at the first signs of irritation (even if that’s just 12 hours after insertion), using Uni-Solve or a similar product when removing adhesive (so skin isn’t irritated/traumatized by being pulled too much), and putting Benadryl cream on the site a few times after the set is removed (otherwise it itches for a week). I also put Polysporin cream on if it looks particularly irritated, just in case.

Because I use sets with needles, if a set gets irritated after only 12 hours, it’s possible to take it out and move it to a new location without having to use a new set. I’ve also heard people have had success with spraying Flonase on a site before insertion, and this is something I plan to experiment with in addition to my above regimen (I tried Flovent once before and didn’t notice a huge difference on its own, but maybe in combination with my current regimen it will have more impact). Also, even with my current regimen and using needle sets (which are supposed to not be able to “go bad”), I have high blood sugars at times caused by my body reacting to the infusion sets. If I have a modestly high BG that won’t come down with a couple corrections, the first thing I do is try changing the site. Often that works, and if it doesn’t, then I start fiddling with temporary and/or permanent basal rates and other settings.

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Hi everyone!

Thank you for all of your replies. I have been off an on the pump since December '16. I was able to put it back on in February of this year after all the time off of it and had no problems, still using the Quick Sets (6mm, 23 inch). Well, a few weeks afterwards, all went to $%*& again (No Delivery alarms). Back on injections. Fast forward to mid-March while on injections, my husband and I went away for March break and found out we’re pregnant! I knew I wanted to have the best control (even though my A1C was 6.5 at conception) and went back on the pump. I’d have a No Delivery alarm every few days, a kinked cannula here and there… All thanks to the Quick Sets. I’m a very stubborn person and hadn’t gone through all of the free samples Medtronic had sent me the year before. I had one sample of the Mio 30 left and 2 of the Silhouette. The Mio 30 didn’t go far enough under my skin (only a 30 degree angle) and only lasted two days because of a huge welt it left me and insulin leaking out. I have been using the Silhouettes (13mm, 23 inch)(ordered some myself) since last week and have not looked back! It really was the Quick Sets the whole time causing me all of this misery. I manually insert the Silhouettes, as recommended, at about a 45 degree angle. So comfortable, no complaints, no issues (so far!). I’ve been inserting it in areas where I thought I couldn’t anymore because of the No Delivery alarms I’d get with the Quick Sets and so far, so good. I’ll still keep the Sure-Ts in mind for later in pregnancy. I know they have been recommended… I just don’t know how I feel about having a needle in me at all times.

Seriously, @smilinja, if you’re at a loss, for me at least, the Silhouettes were the way to go!

When I first started pumping Silhouettes were a life saver. Almost every Quick set I used kinked. I have been using Silhouettes for 6 years now and have never had one to kink

I used quick sets for a few years and had problems with kinking. What was really annoying was the pump never picked up on the issue when only delivering basal, something to do with not enough pressure to be detected as an issue. I would just see blood sugar creeping up and then when I’d go to bolus I’d get the no delivery alarm. Saw some temporary improvement with sillouhette but ultimately and reluctantly ended up switching to Sure T and I love them! Been using them for a couple of years and never had a problem. For me they hurt a lot less going in, manual insertion which scared me until the first time I inserted and now I prefer it and you don’t feel them once they are in, unless you hit one of those sensitive spots which can also happen with plastic cannula. Just wanted to share in case you ever need to switch, they are nothing to fear :grin:

I’ve been telling people about Sure-T’s for years, but somehow not everyone gets on board with them, thinking they will hurt. heck, I can’t feel mine, but I sure felt the cannula sets. When they think “steel”, they think pain, not realizing the diameter of the Sure-T needle is FAR smaller than a cannula. oh well, can’t say we didn’t try to help.

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I will try the silhouettes. I tried the Sure-T’s and they didn’t help at all. Still get the no delivery. It is so frustrating. I’m starting to think it’s the insulin that’s not going through the vials.

Good luck with the silhouettes, you must be so frustrated, I feel for you. Let is know how you get on with them.

I have been having similar problems for over two months now. I have used both the Quik Sets and the Sure-Ts. I have more problems with the Sure-Ts as they cause no delivery alarms wuthin a few hours after insertion. The quik setts now are starting with the no delivery alarms a few hours after insertion and prior to this they were lasting at least 12 - 24 hours. This all started about 3 months ago. I am now debating on whetehr I should continue with Pump therapy or go to MDIs. I am no longer comfortable with having to get up at three AM with blood sugars in excess of 400 on an almost daily basis.

Medtronic sent me a replacement pump and that did not solve the issue. I was told by a Medtronic representative that I have probably developed extensive scar tissue and that is why it fails. It is interesting that it fails with an infusio set, but when I inject in the same spots or ares, the insulin is absorbed without difficulty. I will see if I can get a few silhouettes and see if that helps.

I also have to use the Libre system now as my transmitter for my Enlite sensor is no long made and now I have sensors that cannot be used. It makes no sense for Medtronic to discontinue supporting their products while there is still use for more time and pumps are still in use. I have no problems with the Libre System.

Welcome to TuDiabetes @CJ-MA.

So sorry you are having these no delivery issues.

Where are you placing your infusion sets?

How do u get no-delivery using a Medtronic pump and Sure-T?? I get one about every TWO YEARS. Using cannulas, I’d get as many as two per week. What insulin are u using?

I use Apidra Insulin. In various places I always get a no delivery after a few hours with Sure T. I have repeated it using previous sites and newer never used sites. I tend to have to change my infusion set several times during the day, I usual know when my Blood sugar is high over night, especially at 3 AM. When I used the Quiksets, sometimes it doesn’t alarm, but I don’t seem to be getting any insulin in my system or absorbed in various sites. Again, I have used sites that I have used befoe and have never used.

For more information, I have been using an insulin pump since 1981 and I started with the AS-6C. This is the first time I have ever had a problem with infusion sites.

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I have tried my abdomen, my thighs, my hip. I used to only use my thighs and then the no delivery alarms and the impaired absorption started.

I use Apidra Insulin.

I have used the quiksets which provide absorption issues and at times No Delivery alarms and the Sure T which always provide a No Delivery Alarm after a few hours.

I have to take insulin by injection to bring my BS down.

Ahhh, Apidra …

There is some anecdotal reporting of more frequent occlusions in pumps using Apidra. Most of the reporting I have seen is for Apidra in use with the Tandem pump, but I did my own Apidra trial several years ago, and got my first occlusion in years near the end of one of my Silhouette infusion sets.

If you are using a Medtronic pump be sure fast delivery is turned off. Fast delivery on the 630 and 670g pumps has been known to cause delivery alarm issues. Since I turned mine off the number of alarms is down to less than one ever few months.

Note: I am a Medtronic ambassador. My opinions are my own. They did not pay me to say nice things about Medtronic devices or the company. OK, they sent me a shirt and a cup but even I am more expensive than that.


Try humalog and see if that stops your problem.

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I have been using Humalog for the past week and it seems to work better in the pump than Apidra did, but now I have to fine tune my basals and boluses as Humalog has a different half life and onset time. I want to thank everyone for their input.