Insulin pumps linked to more reports of injury and death than any other medical device, records show
I have been a T1 Diabetic for almost 58 years and on Minimed pumps the last 17 years, none of which ever had a problem. My only issues of really high or low BG was of my own doing. I am extremely analytical and was a fanatic about trying to manage my Diabetes, complaining to my doctor at each visit that my BG meter results made no sense to me at times. He finally told me (about 25 years ago) there are about 20 things that can affect BG (e.g., taking a shower) and that it would never be possible to take everything into account. As hard as he and I tried to control my BG, my A1C was never under 12 until I went on a pump. That took my A1C into an 8-10 range (still pathetic), but not until the past 3 years when I drastically restructured my diet to eat lots of raw vegetables and fruit and zero processed food could I consistently have an A1C <7. Even though I had a terribly high A1C for so many years, I have very few problems that long-term Diabetics are known to have. I expect being very active my entire life has had a effect on that, but I would always recommend T1 Diabetics go on an insulin pump vs. taking injections.
I wasnāt aware of this government-funded print subsidiary of CBC undermining private market journalism. Iām not Canadian, so please excuse any ignorance of your system.
My biggest worry with this kind of set-up is that it could manipulated by a corrupt government like the current one in place in the US. I am a believer in the vital role that a free press plays in a well functioning democracy. I think government can play a needed role in some functions like infrastructure and public safety but I think the free press needs to be separate and distinct from any government.
I better stop now before I raise the ire of the no-politics police.
No one want to rile the no-politics police, least of all me.
Your worries are shared with millions of others, who have witnessed suppression of journalists either by arrest, imprisonment or worse, or by paying off the journalist to manipulate the news.
I also have not heard of this being a problem. I have been pumping for over 27 years with MiniMed/Medtronic and now Tandem and in all that time had to replace one due to it hitting a tile floor. Most problems I have had with blood sugars has been the infusion set not the pump.infusions sets are the biggest problem with pumps. All I can say is once you find one that works for you, you better hope and pray they donāt discontinue it. I personally think pumps are a great tool but they can be a lot of work. And you get a lot out of them if you put in the work. I love the flexibility it gives me and with a CGM, I feel any problems that might come up can be quickly handled, whether the sensor says going high or going low. Technology can be our friend!
The article doesnāt say anything about the CBC reporting fake news on their website. I think we can have a healthy debate about whether the federal government should be funding a broadcaster, but I happen to know a few reporters at the CBC who take their jobs very seriously and are subject to rigorous journalistic standards when doing their work. I donāt think we should be smearing our institutions as untrustworthy, unless they actually are, on public forums and give people the impression that they shouldnāt trust Canadian news sources when that isnāt the case.
The CBC is federally funded but operates independently, sort of like the BBC. Some people think it is too liberal, but in a way I think that proves it acts independently as this is the case no matter which government is in power. I get what youāre saying but I think Fox News proves a broadcaster doesnāt have to be funded directly by the state to be nothing but a mouthpiece for it!
What does cnn prove then?
From my perspective, any malfunction in a machine that my daughter relies on to deliver insulin can potentially be life threatening. We follow strict protocols (checking BG 2 hours after site or cartridge changes, correcting via syringe for unexplained highs).
Years ago during a pump webinar, Dr Stephen Ponder told about an incident he had with what he referred to as a ārunawayā pump. It was an early model MiniMed. The pump dispensed the full cartridge. He was working at diabetes camp at the time. He used the story to reinforce his teaching that pump users must be knowledgeable & vigilant, & there is always the potential for malfunctions. The protocols we follow were his recommendations.
My daughter used the Animas Ping for just under 5 years before switching to the Tandem sheās now used for 4 years. She had 7 replacement pumps with Animas. The first was 3 months after starting the pump. Halfway through a bolus, delivery would stop. While looking through the uploaded data, tech support noted a 10,000 unit bolus. Obviously it never happened, but it was a good reminder early on that software glitches can happen. One Animas simply died. It gave an error number & a message to call tech support, which I did immediately. It was a fatal error, but of course we were never informed of exactly what happened. We also had issues with cracks & 2 had constant no delivery alarms.
The first Tandem had serious issues. The 2nd day I realized it wasnāt just a matter of needing different settings than on the Ping. She had constant high BGs & ketones, which only cleared with injections. When the injected corrections wore off her BG climbed regardless of how much we increased basal, which proved to me the pump wasnāt delivering. After arguing with the area sales/training reps with no results, I called tech support. It took 3 calls, a request to return the pump for a refund & mentioning filing an adverse event report before they finally agreed to consider it wasnāt user error. A week later we started the replacement pump & have had no other issues.
Any of these issues, at the right time (ie overnight) & without proper vigilance could have been life threatening. As always, itās a question of risk vs benefit.
Eddie, I will PM you.
Because Iād heard of runaway pumps (many years ago), that was a major concern for me when I decided to get my first pump. Medtronic reps were adamant that with all of the redundancies built into their latest pumps, it should no longer be of concern. Iām talking back in the mid 1990ās.
I think a similar problem occurred, unintentional large bolus, by a member that posted here several years ago. She accidentally did a large bolus during the night. On the bolus screen, you used to be able to quickly set the highest amount with one arrow press. Her max was defaulted high, and being half asleep didnāt realise how much she bolused.
Current MM pumps have to scroll starting from 0. I have my max set to 4 just for protection against accidental high bolus.
Here is the prior post.
ā¦ and they always do.
From what I recall, the pump simply malfunctioned, which is why Dr Ponder referred to it as a runaway.
Iāve had problems with Rocheās Accu-Chek Spirit and Spirit Combo pumps multiple times where buttons have failed, the link in the Combo pump failed, and battery drainage error where I had to switch the battery with a new one every week, but it was nothing life threatening, only annoying. They replaced them after only one call to their customer service. I got a new one 4 times. Iāve only had infusion site problems three times in the 8 years I had used those two.
I use a Medtronic 640G now since February 2018, and have had bent cannulas where it has squirted insulin on my skin instead of under my skin at least 5 times, where two of those times had been during sleeping where Iāve awoken with BG over 30 mmol/l (over 540 mg/dl), but I was never really in danger of going into a DKA coma.
I had one issue with a Cozmo in 2007 or 2008 where I tried to bolus 10.9 units and it only delivered 0.9 units. Something went wrong with the calculation as far as I can tell (it was not me programming in the wrong number or cancelling the bolus accidentally as it delivered). I checked the pumpās history when my blood sugar skyrocketed and saw what had happened. I donāt think I called technical support, but if I did, Iām sure they replaced the pump. That only ever happened once in the five years I used Cozmo pumps, and Iāve never seen anything similar happen during the seven years Iāve used Animas pumps.
So glitches can happen. These are computers, after all. Thatās why itās important to stay vigilant at all times. I often tell people that using a pump is more attention and work than using injections. People shouldnāt start on the pump thinking itās going to be less work.
That has happened 3x for me, near dka, once I was very close and hospitilized, but not due to pump malfunctions. It was most likely due to illness, dehydration and once maybe to insulin degrading in the cartridge or a combo. A pump is definitely a higher risk for dka because like you I go quickly into it without basal with very high ketones and not super high bg although for me very high. People need to understand it is not bg that determines dka it is ketones and blood ph. That never happened on mdi, but I had much worse lows and terrible instability.
I agree, I never had ketones on DKA except for when I was sick.
Iām pretty paranoid and conservative about my health. So I think Iām much more attentive to diabetes than most people. I will correct via syringe and chug water if Iām high and have ketones, and eat as well if I needed to. Iāve had a few times where I was so nauseated I almost went to the hospital, but Iāve never had to. Would not hesitate to go if I felt I needed to, though.
Yes it is odd, although this is the first one I have seen. There are risks with pumps and risks with mdi. I think there are far more overdoses and user errors with mdi than with pumps. And not very many life threatening pump or inset malfunctions. The ones I read about were all with Medtronic pumps.
My greatest concern was with being overdosed which was why I chose Tandem because they have the only system which guards against that and it can also bolus very small amounts and have low basal and numerous basal rate settings. When I was on mdi I often had trouble remembering if I had taken my basal shots and there is still is no good system to help you do that as far as I know. It is also easy to misdose and or use the wrong insulin. On my pump I have a max bolus set to help prevent things like this and I have a record of everything.
In dka ketones are always present, usually very high ketones. The arterial blood ph and co2 and serum bicarbonate confirms it. You can have very high ketones and bg above 250 or so and not be completely in dka. Last time I was hospitalized I had 350 bg and 3.8 blood ketones I think as well as other off numbers, I was starting to vomit but I was not fully in dka, but very close. I had done an injection and jacked up basal so bg was dropping when I got to the er. I was on iv fluid for 24 hrs and it took 24 hrs for ketones to reduce that time. It happened very rapidly too, I woke up with 100bg, went back to sleep and 2 hours later it was 350 bg going up and 3.8 ketones. I am very aggressive with inj and basal now if there are any ketones etc and I change everything out including insulin.