Insulin Pump-Associated Adverse Events: A Qualitative Descriptive Study of Clinical Consequences and Potential Root Causes

A very interesting report with comparative data.

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@pstud123 are you a subscriber to liebert publications? I am glad to be able to read more than a synopsis of the paper. I checked on the subscription cost but it was out of this retiree on a fixed incomes range.

I was able to read it off the link, thank you for the information. I do wonder one thing. Why was the Medt 630g and 670g pumps used with no mention of the 770g. This is a 2023 article. But it seems terribly out of date.

The number of reports for MedT reflects a product near the end of its life cycle. However, we do not know where the Tslim was in its life cycle since we do not get a notion of software version.

I think the comparison might be useful as the number of people who report issues, instead of the hardware being reported.

I don’t think reporting adverse effects is going to happen soon. Except when you don’t have a choice because of an emergency visit.

I’m never going to report what I absolutely don’t have to. Sure I call in pod failures and my endo knows I am prone to them… but that’s the extent I probably would consider reporting. I report anything more major to her, I would possibly lose access to all sorts of things.

Examples;
You are having drops using a pump, the endo becomes liable knowing and might not decide to keep prescribing me a pump or something else I want.
Or I report something happened and the DMV finds out, a doctor reports it or someone does else that knows and takes my license.
I report to the pump company that I keep repeatedly hitting the wrong buttons on your pump and they decide their liability is at risk for me to keep using it.
I report to the insulin company that this happens sometimes when I use your pen or insulin and the insulin company says, hey you need to switch insulins.

We don’t want the liability that we know about now.

So not only is it a liability issue for the different people involved, but it’s also I might not get what I want to use and have it taken away from me. So why on earth would most of us chance that?

However complaining about something is far different than reporting adverse events.

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What if you could report anonymously?

Same!

Insulet asks if the pod failure affected my blood sugar.

No, of course not! I had no pod for a certain length of time while putting on my new pod, but somehow my blood sugar remained exactly the same as if I had continued to have basal insulin delivered! Craziest thing!

And they ask what my blood sugar was.

Gosh, I never tested it. Sorry!

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The article stated that it used the pumps that were available as of August 2020 and I think the 770g came out in October 2020.

I guess I do not get the issue. I have reported issues in the past, without any problems.

Thank you, I just bookmarked that. It’s always good to know the right place to complain.

The reason may be the people using medical diabetes devices are more conscientious than those who are not. I tend to take these kind of statistical “studies” (in quotes on purpose) with more that a bit of salt.

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very few people use a self dosing dangerous drug, using our own judgement, the dosing can be modified, and it uses devices repeatedly. I would have been shocked if PWD’s were not the top five reported negative outcomes.

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I’m sure there are also many “adverse events” from syringe and pen injections that are not recorded.

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One would have to think that severe outcomes are just inherent with insulin.

I agree. Insulin is a dangerous drug people die from insulin overdose every day. I’m sure very few medications have a track record like that

Severe outcomes are possible with insulin. Severe outcomes are guaranteed without it.

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Social research methodology: How we ask the question frames the answer.

It sounds like if there is an adverse effect that they blame the make of pump. I am a user of Tandem (10 years) but my experience is it does what I tell to do. I have a lot of criticism for Tandem around ergonomics and usability but it is still a dumb pump designed by dumb engineers. I am shocked in 10 years no significant improvements have been made. Very weak blue tooth, small pump is good but small screen is bad. The weak link in the system is the Dexcom G6. I have to calibrate it once a day and I don’t get good readings first 36 hours. I have 5 instances of G6 reading 83-85 when I do a finger prick and it reads on the 40s! Is the pump to blame? My last A1C was 5.5 a week ago.

Sorry for the rant. I do wonder how the profit motive can overcome good sense.

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are there stats you’ve seen for that? I’m just curious as to the actual numbers

I don’t know if this is international or just the USA.

“ 2.2. Overdose

Toxic and lethal doses of insulin are dependent on the patient’s baseline glycemia. The toxic dose introduces the patient to a state of severe hypoglycemia, the treatment of which is discussed below. The threshold for hypoglycemic symptoms depends on many factors and is individual to the patient. The daily blood glucose levels on which the patient works and the speed at which the blood glucose level is lowered are crucial. Severe hypoglycemia is said to be when treatment requires the help of another person [10]. For each patient, the threshold for the onset of severe hypoglycemia is different. The same applies to the lethal dose—there is no conclusive data on its value in the literature because it depends on many factors, such as baseline glycemia. Insulin-induced hypoglycemia is the cause of approximately 100,000 emergency department visits per year [22]. Severe hypoglycemia accounts for up to 10% of deaths among young people with type 1 diabetes [23].”
Toxics | Free Full-Text | The Other Face of Insulin—Overdose and Its Effects

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Thank you!

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Here is a nice blog on the issue of death by insulin

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