Yesterday, I was coming back home after dinner and I knew I had about 2 hours left of insulin in my pump. I got deep into other things and completely (I mean absolutely forgot about it).
This morning I wake up to a BG of 149 (not super-high, certainly not low) and was going to bolus when I realized: CRAP! I never put in a new reservoir/infusion set.
I just took care of it, but I estimate I was out of any insulin for about 10 hours or so. Has this happened to any of you? What did you do the day after to avoid huge highs?
Damn, I would have been in the 4-700’s if I’d been out for 10 hrs.
Count yourself darn lucky.
I’ve done this twice recently - two set changes in a row! I’ve been super busy with a lot going on and … (excuses, excuses). I haven’t had much fallout afterward, but I do just keep a close eye on things - extra testing with any necessary boluses. But truly, it leads to a question: WHY IS THERE NO ALARM FOR 0 UNITS LEFT!!!
I think if you are busy during the time you are out of insulin…you can maintain medium level blood sugars…but if you are just sleeping and not doing much you should go high…my pump beeps “low reservoir” but never when you are completely out. Yes, I think it should because I am sure many people forget. Do you always change your reservoir anyway after three days ??
Sheila
Yep I change it after three days. Normally I use up almost all my insulin in the reservoir by then.
HI Manny.
I regularly let my MiniMed 722 run until I receive the “NO DELIVERY” message.
When you say “ran out” does that mean you had no bars or indication on your pump of insulin left in the reservoir. Did you not receive any warnings from your pump?
If I went 10 hours without insulin, I would be much higher than your 149bg.
I figure AFTER my last bar disappears, there is still about 20 units left that continue to be dispensed (basal and/or bolus) before the “NO DELIVERY” message appears.
My “NO DELIVERY” message is 5 buzzes, about every 5 minutes, after about 3 of those warnings, there is an audible beeping which grows louder.
My words! :S
damn, my bg skyrockets if i set my basal to 0 for more than 90 minutes!
Ran out as in zero units left. Clearly when insulin was all depleted I was either:
a) Fast asleep; or
b) Fast blocking the sound of the pump in my head. 
I don’t know the details of every brand of pump… but every one I’ve seen, will register as “0 units left” but still have a little left in the reservoir and tubing.
I mean, I happen to know that my wife’s car will still run even though the gas tank needle is pointing to “E”, but I wouldn’t recommend that anyone else do this! I suspect that you still had some insulin left in the reservoir or at least in the tubing. Did you check the tubing and find that it was empty too?
Actually running a vial of insulin completely and totally to zero, is hard. There’s always some small number of units left in it that I could never get out with a syringe etc.
Tim.
You may have been somewhat protected by having some residual endogenous insulin production. And after all, you did not eat, helping the situation.
As to your question, I would think the right thing to do the following day would be to test/correct often and aggressively expecting that a high may have occured with potential extreme hormone reaction leaving you with insulin resistance for a day or two making restoration of normal blood sugars difficult.
Of course, I don’t use insulin and have never had this happen.
Don’t feel too bad Manny. I’ve done that more than 1 time (usually forget to hook it back up till really late after going swimming with my grandkids here as of late) I have to say though I would be more like Jenny (and have been more times than 1 in the last 2 months) Tell you what I done last thursday, I went swimming with my daughter and g-kids (made a family day out of it my husband was even there LOL) Went for 4 hours w/o the pump and he was grilling out hamburgers so as hungry as I was I ate one w/o the pump. Thought of it later (after drinking 2 diet cokes back to back then REALLY having to go to the bathroom) Checked my bs and it was like 495 I think then. Just brought it back down by giving myself more insulin and exercising.
That’s my experience too: turning off the basal insulin for 6 or 8 hours results in a bg in the 400’s. And if a meal with no bolus insulin is involved I can shoot off the top end of the meter. Only rarely happens to me but it has happened.
I’m surprised (or is it jealous?) when folks come here and talk about how they never go above 180 etc no matter what dose they didn’t get.
Know what you mean there Tim! I think I just get plain jealous about it! I WISH for those numbers.
My OmniPod wouild have made such a noise, I would not have been able to forget to “feed” it…LOL
HI Manny,
You must’ve been protected by the FEDORA!!
If I’d been off insulin for 10 hours, I’d have been sky high! I’d have had to do a few revenge boluses, as described by _Dave.
Cheers, Mike
Oooohhhh…revenge boluses…I like it!
I’m not sure what kind of pump you’re using, but I have a minimed 722, and prior to that I had a 512. The 512 used to say empty reservoir and beep like it does when it has a low reservoir.My 722 now says "no delivery "when empty and beeps 6 times.If you have one of these pumps and it’s not alerting you, maybe it has a malfunction?
Well, I am still baffled… I have been VERY careful so far to avoid any high carbs… and I am at 110. I don’t get it. I was pretty sure I had no insulin production left in me!
I mean, not complaining, but just confused (scratching bald head… after raising the fedora up in the air). 
Done that…I wasn’t out of insulin as long as you but long enough. Don’t remember what bs was. Live with this disease long enough and you’ll trip up. When I was in the working world I forgot to take insulin before leaving home and didn’t realize it until about 8 hours later…left work a little early and went home to take it. I have a list of things I’ve done or forgot to do in 51 years and I’m sure I’ll have things to add to that list for as long as I live lol.