Starting around mid-morning, my daughters BG started to rise They continued to rise event though she was checking herself ever 1.5 to 2 hours and giving herself a correction. When she got home for school, she checked BG and this time she was 457. This was her highest BG ever, including when she was in the hospital at diagnosis. Fortunately, ketone testing was always negative.
As she was giving herself the correction, she noticed that insulin was leaking out from under the pod. This was strange to her because she could see that the cannula was still inserted. She went ahead and changed the pod and I called Insulet to report the situation. I found out that on a rare occasion, there can be a manufacturing defect in the pod that allows insulin leakage around the area where the cannula is attached to the pod. They are sending a replacement pod and have asked us to return the defective pod to them for study.
We now know that in the case of unexplained high BG to be diligent to make sure that there is no leakage around the pod. If it happens in school again, she will leave the classroom and go to the nurse since the pod is under her shirt and it would be obviously awkward to check leakage at her desk.
That happened to my first pod. I placed it on a spot that didn’t have a lot of cushion for the cannula to work with. Eventually, the cannula kinked under the skin. It looked fine from the outside, but I noticed my BGs were started to creep up and that correction boluses were not working… That’s when I noticed the insulin collecting behind the plastic window. Insulet replaced the pod.
I had a series of pods last year, about three, where I was running very high and posted what I found here: http://bit.ly/bq8tPb
Basically it came down to an internal leak somewhere in the pod plumbing, so that there was no evidence of insulin escaping to the skin surface by “channeling”, nor was there ever an occlusion alarm because any pressure buildup would be relieved by the internal leak. There was some insulin delivered to the site because I could bolus and basal “rage” some correction, but never enough.
Interesting info: I found that in a properly operating pump, the occlusion alarm would trigger at about 2 units of bolus with a pinched catheter.
If you suspect this is happening, don’t deactivate the pod, rip it off the site, and check if insulin is delivered by programming a bolus and seeing droplets form at the tip of the cannula. Then pinch the cannula shut: I found these the best because the cannula is somewhat delicate and can shred with cruder tools: http://bit.ly/c2yYmg
Program in a 10 unit bolus. If it delivers that massive amount and you see no insulin appearing at the pinched catheter tip, and the occlusion alarm doesn’t go off, then you likely have an internal leak in the pod.
I reported to Insulet but no followup occured. Haven’t had the problem since though.
Also, the condensation you see behind the window on the pod is normal and does not mean that insulin is leaking, just body humidity condensing.
I have had a few pods when I could not tell the cannula was kinked, but during the day my BG rose steadily - even with the extra boluses. Finally I felt the wet on the outside dressing and smelled the insulin smell. That is when I changed it. I called Insulet about them - and they are replacing the pods. A new trick they told me to due - when I pinch up the skin to perform the “start” function - also take a finger and push down on the window area - this will insure that I am not pulling back when it clicks without being aware of it, allowing the cannula to kink.
It seems to be doing the trick now!
I’m new to the site and am finding it very helpful to hear other pod users discuss some of the issues they’re having. I’ve had quite a few pod site failures; had the same problem with the Minimed paradigm. I’ve just decided that if I have an unexplained high BS and a correction doesn’t fix it in an hour, I change the pod. If it looks leaky around the window, I change it immediately. I do have excellent insurance coverage but pods are still expensive…but way worth it!
