Need help right away pump bolus error

I just bolused 1.77 had occlusion alert, bolused the rest which was 2.22. Another occlusion alert and pump says it DID NOT RECORD HOW MUCH WAS BOLUSED, WTF??? I have no clue what to eat now etc. ate half my dinner. Just went for walk and bg seems to be up a bit at 80 according to dex, but not I am sure.

4 units is a lot for me normally, especially after a walk but I don’t want a spike or a crash etc.

I am on the phone with tandem, on hold for 15 minutes now.

Any idea what to do here?

I have no idea about a tandem pump. Soif you are asking about what that means on the pump I’m at a loss.

To me it becomes one of the guessing games because with an occlusion there is no way to know how much you are getting anyways? So you might be in for some higher numbers. I think you have to wait it out and see what numbers you go to with maybe some small corrections along the way if you see yourself trending up (with a shot, just in case) or a hypo treat if going down too much.

Look at your insulin on board. That will tell you how much u actually got

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Yes this sucks big time, it never happened to me before. If it bolused a lot of the second bolus I am in for a bad crash possibly. I ate about 23 g so far, normally 1.74 would not cover it though, it is a mix of the food and everything else and my total bolus is important over time.

It was 4 units for 44 g. I would have bolused an extra .22 as well.

The only pump record I have says the time between bolus and occlusion was 2 minutes, so I wonder if It delivered most of it maybe? Bg is dropping now so I don’t know if I should just eat more. I don’t know how long it takes to bolus a unit etc. normally.

No, it said it was not able to record how much was bolused on the second occlusion so it won’t tell me. It said it was added nothing due to that.

This is by design. The T-Slim manual says this will happen if a second occlusion alarm occurs during a bolus. The manual does not say why this happens but I speculate that it is because this is the second bolus to end abnormally and it has left the pump in a confused state. This is just my opinion.

Personally I find any amount the pump says it delivered before an occlusion to be questionable. While the pump may have delivered that amount there is no way of telling how much was actually absorbed. Its always a matter of keeping a close watch afterwards.

I know it has been a few hours since this happened, I hoped you managed this bump in the road without too much disruption.


Thanks Gary,

I made it through the stressful few hours of having no clue what was in board etc.- this is a major design flaw in the pump. The customer service confirmed what you said after I finally got to talk to someone after waiting for at least half an hour on hold. There should never be a situation where the pump boluses insulin that is not recorded, they need to change that ASAP. Which I told them.

I am going to time how long it normally takes to bolus one unit. From the start of the second bolus until the second occlusion alert there was 2 minutes in which time I believe most of the 2.22 units was bolused.

One of the tech’s managers tried to tell him that if it didn’t record anything it’s because a negligible amount was bolused. They are wrong. My bg started crashing and I had to drink juice. It kept crashing until hour 2.3 or so, or felt like it would again so I didn’t raise my basal as usual when it finally went up. It never went higher than 150’s so there is 1- no way no insulin was bolused, and 2- no way it was a negligible amount. I ate 40 g o r so, so nearly the full amount was bolused.

If it happens again I will do the rest of the bolus with an injection and try to air bolus it after in the pump, since the pump can not be trusted in this situation which tandem has apparently intentionally created.

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@meee, you haven’t mentioned what pump you have and if you also have a CGM.

I’ve had an occasional occlusion alarm with my Tandem t:slim X2 (with Dexcom G6 and Control-IQ) and there’s no reason to panic. Figure out what caused the alarm if you can (more often than not, I can’t figure it out) and then watch your readings.

If you are in the middle of a meal, finish it. You are probably going to go high if it was the bolus for the meal that was interrupted, but you can do a correction bolus (one or more) later as needed.

While I do try to avoid going low, I still don’t panic when I do. Instead, I see it as an opportunity to indulge in things I normally don’t eat like chocolate, soda (with sugar), etc. I do have glucose tablets handy as well.

Please do not tell me how to manage it or feel etc.- my bg can crash badly and I go into dka easily so it is a very bad situation not knowing what iob is due to a faulty pump system which has apparently been built in by tandem. If you read my entire post you would see that I went through several hours of extreme stress due to this.

As I mentioned above I’m using a tandem (X2) and I dexcom g6, that’s not relevant to what happened though.

My blood sugar started crashing and it was a stressful few hours having no clue what was actually on board, That was after eating most of what I had bolused for when bg was dropping.

So the tandem response when I finally got a hold of someone that only a minimal amount was bolused if the pump doesn’t record it, which automatically happens apparently on the second occlusion, is false. These situations have to be assessed individually as they happen, there is no one way to look at it or to deal with it. If you have easy-going BG I guess you can just keep an eye it, or let yourself spike etc. Knowing why the occlusion happened probably would not be of any use here for the immediate situation because the crucial immediate point is how much insulin has actually been delivered.

My advice to anyone using tandem is to be aware of this malfunction in their design. If you get a first occlusion alert with a partial bolus, especially if you are eating a meal with a large amount of insulin for you, my advice is not to try and bolus again with your pump, not to try and change your inset immediately, and certainly not to get on the phone with tandem to troubleshoot it as they tried to tell me to do if it happens again, LOL. I suggest you just to bolus the rest of it by injection so you actually know what iob is most likely. Or so that you have some clue anyway.