Very high blood sugars on insulin pump

I am using Accu Chek Spirit Combo Pump for last 1.5 years but since last 15 days i am not able to get my sugar under control.

Morning sugar for last two days around 250

It seems that the insulin in reservoir/cartridge is losing potency in 5-6 days (earlier i have used the same reservoir for 15 days without any problem)
When i took insulin from the same voil which i used to fill the reservoir using syringe, my sugar comes back to normal
So, i feel the problem is the excessive heat which is effecting the insulin potency.
How do you guys deal with this heat? Are there any cooling pouch available for insulin pumps in India


A pump is usually kept close to your body and in most cases insulin is approved (i.e. fine) for at least a week at body temperature.

It may be that your reservoir has become contaminated. There are things like polymerization that can occur with insulin (it is a protein after all). Once it has started it acts like a catalyst. Do you have a backup reservoir? Perhaps you can try another reservoir and see if you have the same problem.

Have you tried using a syringe to extract insulin from the reservoir and injecting somewhere else? This would let you know if the reservoir insulin is bad.

How frequently are you changing and rotating your infusion set sites?

How about air bubbles in the tubing?

Many diabetics seem to like the Frio products. Sorry, I don't know if they are available in India.

Brian, FWIW, to avoid contamination, the protocol with the Accu-Chek Spirit Combo is to discard the reservoir when it is empty and start with a fresh one.

Of course, not everyone does this ...

Thanks Mike. I hope Inderjot is following that protocol.

How old is your pump? I had one (Medtronic) that was kind of long in the tooth and had some odd issues for a couple of months before it officially blew up and cranked out an error message that got me to swap it for a new one.

Hi Mike,

Thanks for your reply.

Generally, I change infusion set site every 4th day, reservoir every 15th day (refill insulin after 8 days) and this has been working for me for the past 2 years
There were no air bubbles in the tubing
As of now, i have changed the reservoir and tubing and blood sugar has come back to normal

But i am worried whether the insulin in the reservoir again loses potency after 4-5 days because of heat since this year temperature has really gone very high.
Although if it happens again, i will extract the insulin from the reservoir using syringe and check if it works

Thanks & Regards,

Hi Brian,

Thanks for your reply.

Even i think the reservoir has contaminated. I never followed the protocol to discard the reservoir when it is empty and start with fresh one; instead i refilled at the end of 8 days and used it for another 8 days.

But now i feel due to very high temperatures in India, i will have to follow this protocol.

Thanks & Regards,

Hi Acidrock23,

It is only 1.5 years old.


I have re-used the cartridge also when I am getting near the end of a supply or my new order has been delayed.

It certainly sounds like your methods have worked over the last 4 years, but with this heat, you might want to consider only filling the cartridge with enough insulin to cover 4 - 5 days.

You might also want to experiment with a quicker infusion set change, maybe 3 days rather than 4, while the heat continues.

BTW, I did a quick Google search on temps in India recently - WOW! HOT!!! 40+ Celsius!

Have you seen the frio pump wallet? It uses an evaporative gel that can be reused indefinitely as long as you have access to water. Does not need refrigeration/ice to work. I've used it while traveling to keep my insulin cool with out access to cold storage. As long You have air circulation it will work.