Hey. So I’ve been having a lot of issues with high blood sugars lately and have had to change my infusion four times in almost as many days; twice there were air bubbles and once the canula was majorly bent, and I had no idea why this was happening. In more than a year, I’ve never had issues like this. So finally I called Animas yesterday and they suggested I was drawing the insulin out wrong … somehow putting air bubbles into the insulin vial … but I find it odd that it’s only starting to cause me issues now despite doing it the same way for more than a year. I’ve explained the situation better on my blog at http://princessofpavement.wordpress.com/2011/02/23/drama-on-the-diabetes-front/ but I was hoping maybe some of you could give me other suggestions as to what could be going wrong, or maybe even suggestions for making sure no more air bubbles get in there. Thanks.
To avoid air bubbles, I always fill my pump with room temperature (not cold) insulin and I fill the reservoir slowly and then tap the bubbles to the top. Sometimes a few champagne like bubbles remain, but I don’t think that they cause an issue
To avoid kinked cannulas, you may ask your pump rep to give you samples or call the Animas number and ask the technical assistance people to send you samples of new types of infusion sets. (I heard that the sales people won’t send them, but the technical support staff will.)
I used to get kicked cannula when I used a 9mm straight in (not angled) infusion set. The problem disappeared when I switched to the 6mm version. Now I use the Sure T (with the Minimed pump) with a metal cannula – so there are no issues with kinking. You may ask what infusion sets with metal cannula are available for you. I didn’t like the idea at first, but I find them surprisingly more comfortable than the teflon (plastic) cannulas!
My very first pump had a bubble problem and being new, Animas thought I did not know how to draw up insulin. It took 3 months and my listening to every Rep they had. Everyone who worked for them, told me how to draw insulin. I’d been on MDI a long time so was not new at drawing up insulin. The problem got worse the more practice I had and not better! I finally showed my doctor. That did the trick as the Rep showed up and said he’d never seen anything like it. Long story short - I’ve had that issue with 2 pumps. I went through 6 pumps my first year for various problems - 2 for bubbles. Finally got a good one I think. At least they honor the warranty. Anyway, it happens and if I were you, I’d call Animas and insist on a new pump. You’ve not had this problem for a year and suddenly they say you are doing it wrong? I doubt it. If you tell them it is malfunctioning and you need it to be replaced I think they will do it. Also, this problem will get worse in my experience. My first one with bubbles went from occasional to totally full of air within 30 min. of filling a new cartridge. Good luck!
Thanks guys. I’m still having major issues, so I really don’t think it was the supposed air bubbles causing the problem like Animas seemed to think it was. I contacted Animas again, and now they’re saying that it’s probably scar tissue despite me telling them I’m diligent about rotating my sites and despite the fact that I really haven’t been on the pump that long, just a little over a year. I’ve adjusted my total daily basal and am hoping that will make a difference, but who knows. It’s just vexing that I was perfect for so long and now, nothing I seem to do (I even omitted snacks today, which for me, is a desperate measure) is bringing them down I’ve posted more on an updated blog if you want to check it out: http://princessofpavement.wordpress.com/2011/02/24/operation-blood-sugar-fail/
Have you tried testing for ketones? I often use that to distinguish between pump problems (which limit insulin delivers) and other reasons for highs (increased insulin needs, etc).
The kinked cannula seems to be an obvious issue on your blog! More minor (less visible) kinks can also create a problem. Have you tried different types of infusion sets?
Also, try correcting with a needle or a pen. If it doesn’t lower your blood sugar then it could be that something changed and your insulin needs have increased.
I’m not a pump user, so please bear with me. In none of your discussion have you mentioned the possibility of bad insulin. Did you change insulin cartridge/vial? Have you manually corrected with a syringe? Did the correction work as expected?
I have tested for ketones, which I haven’t had yet. I changed out my infusion again this morning and put it in the upper part of my butt which I’m a little nervous about as the last time I used my butt and legs I ripped the infusions out when changing my pants, and or going to the washroom. I don’t usually use skin prep as I don’t like that it takes forever to wash off, but I used it this time and am hoping it will help keep the infusion in place. When I changed the infusion there were no air bubbles or bent canula this time, so who knows. The infusion sets I use are the manual ones as I couldn’t get the hang of the ones that came with insertion gadgets (truthfully, they kind of freaked me out) … I’m not sure if Animas has metal ones, but I’ll be checking that out next.
And I am carrying a needle and insulin with me today for just in case, so we’ll see how it goes.
Thanks so much for all the tips/information Kristin!
I’ve posted more on an updated blog if you want to check it out: