Ketones... again

Over the past 3 months, this is my third (known) episode with high ketones.

The first was clearly from a no delivery alarm on my pump. I think that the second was based on a kinked infusion set. This time, I have no idea.

My insulin reservoir was running low. I usually wait to change it until it really runs out. So last night it said 0 units. But I knew that there was still enough for my overnight basal. I got up and gave my breakfast bolus and my pump (MM722) allowed me to give the bolus. Later, it gave me a no delivery warning, which I interpreted meaning that my pump was REALLY out of insulin. So I re-filled the cartridge. Now I checked 4 hours after a carefully carb counted breakfast. I was 243. So I decided to test for ketones and I have large ketones.

I gave a insulin injection and now will change my infusion set and insulin…

Does anyone know how you know when your Minimed pump is really out of insulin?

Perhaps this was caused by my bad habits (not changing the reservoir right away, trying to use evey last drop of insulin that I have). But I have been doing this for 5 years and just know I keep having these ketones “events”. I’m hoping its not related to my pump change from Cozmo to Minimed…

Just venting and frustrated to need to flush out ketones… again. This is not helping me get my A1c back under 7.

Today I want diabetes to just go away. I don’t have time for ketones today. (OK, end of pity party).

Kirsten,Pity parties are good sometimes,better to get that stress out or you will be having more keytones! Do you need to have the pump checked or maybe see your endo?,You have been having lots of trouble here lately and am getting worried about you! Especially if you are doing what you always have! Let us know!,Deb

PS,I should explain that that is not really a typo,lol,My husband left me a note one day and thats how he spelled ketones and we have a little joke about key-tones,lol

I’m going to the endo on Wednesday. So I will mention these episodes. We’ll see if he has any suggestions.

I don’t know. I think the MM allows less slack on this count than you’re used to, Kristin. I know the Coz will continue to deliver basal when “empty,” but I used to find that if I was under 20units on the MM715, my delivery was shoddy - both basal and bolus. I would get highs (and ketones) toward the end of nearly every reservoir. Now, it might have been an absorption issue with a site as it neared time for a site change, too, BUT I blame the reservoir volume. MM customer support used to tell me that they insured delivery was still functional at low volume and it was user error or hardware malfunction, but I experienced it consistently with my 2 MM508s, my MMP712, and my MMP715, so I never bought that theory.

My advice is to change your reservoir when it hits the 20unit marker.

Kristen, I did this exact thing with MM. You can have no insulin left, and it lets you bolus. But it gives a great warnign when there are 20 units left (I set my alarm for low reservoir at 20). But I only take 20 units a day, so I can forget. Also I have a 14 hour auto-off alarm. So if I skip breakfast, it can go into a big alarm. I am often looking around asking what is that noise and it is my pump with its auto-off alarm. But no a peep out of it when it hots zero and then you can continue to bolus afterwards. Thanks for letting me vent. I know I need to change it before it gets to zero, but once in a while life gets in the way and it doesn’t happen, it would be nice to have a little siren go off on the MM522. It costs more then my computer and iphone combined, so you’d think it could have a little notice when it goes to zero.