Wacky numbers and pod bubbles

We started on the OmniPod two weeks ago, having used the Cozmo perviously. While using the first two pods, I noticed that Derek was going high for no apparent reason, in an unpredictable fashion, especially in the first day after putting on a new pod, as if we were dealing with bubbles in his insulin reservoir. I dissected two failed pods and noticed substantial (~1/8" diameter) bubbles in the reservoirs. In the pods that caused the bad numbers that were used for their whole three days, and then dissected, the bubbles were smaller or missing all together, thus explaining the wacky numbers. We have since meticulously attached Derek’s pods with the insulin reservoirs facing down (canula facing left or up relative an observer facing the pod) to keep the bubbles away from the little delivery tube opening, and doing this has nearly elimiated the “unexplained” highs.

I cannot imagine that other people have not been dealing with some of these same wacky numbers due to these bubbles. The bubble problem appears to be intrinsic to the design of the pod reservoir, the insulin injection setup, and the priming process. The bubbles are not eliminated during the normal automated priming like could be done manually when we filled the tubing on Derek’s Cozmo pump.

I have hunted in vain for anyone else commenting on or making suggestions about these bubbles. Do other people not dissect the pods? The pods are truely awsome engeneering and well worth exploring.

Anyway, if anyone else has found any other ways of dealing constructively with this bubble problem, please share your ideas and experience.
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I have never ever had a bubble problem. As Cody said, I get all the bubbles out of the syringe and have never seen any bubbles in use.

I make sure to use room temperature insulin and I get all of the bubbles out of the syringe before filling the pods.

I never had problems with bubbles on my Minimed or Cozmo pumps either because I was meticulous about getting them out of the reservoir cartridge syringe and back into the insulin bottle before I ever attached the tubing. If, on the Cozmo, you were relying more on priming to do the job of 86ing the bubbles, focus instead on the fill syringe.

I think the point is being missed here. It’s reassuring that others are not having problems with bubbles in their pods, BUT, I am not injecting a bubble into the pod reservoir while filling it. I believe that the bubble gets into the reservoir due to the design and, I’d be willing to bet good money, that a substantial bubble will be found in amost every filled OmniPod (go ahread and take a filled pod apart and look for yourselves). I am and have always been brutally meticulous about removing air bubbles from syringes, cartidges and tubes. We also always fill with room temperature insulin. With the OmniPod, which has a more difficult syringe to get bubbles out of than most, after I remove all the bubbles and turn in upside down to fill the pod, I tap the syringe to make sure any remaining bubbles I might have missed migrate back toward the plunger and away from the needle, then I eject a bit of insulin to make sure there is no air in the needle, all so that I don’t inject any unseen bubbles into the pod.

I probably would not have though much about our little (200-300) unexplained highs, except for the exceptional predictability we were previously able to get while using Derek’s Cozmo pump. What I’m hopping for is some insight or trick, maybe well beyond the normal insulin “tricks” to dealing with this air bubble without having to eliminate half the pod site possitions because of having to keep the reservoir at the bottom of the pod. Has anyone tried priming the pods in a possition other than flat like we were trained? Has inslulet considered redesigning the end of the inslulin reservoir so that the air bubble cannot be pushed into the intake tube quite so easily?

By the way, I don’t ever believe anyone that says they haven’t ever had any unexplained highs. :wink:

In the pods I’ve had fail early I always do some dissection to see if I can spot a problem (never can but it’s a fun game anyway and it makes drawing the insulin back out easier!) I’ve never seen a bubble in any of them and I’ve drawn back up to 150 units of insulin out of the pods that only lasted a few hours before occlusions or pod errors. I too am very careful not to inject air and I fill the pods very slowly and completely (all 200+ units) so maybe that’s the difference but I’ve never seen an air bubble in the ones I’ve dissected.

Maybe the basal rate is set incorrectly and you need to adjust. There are a few other things that can cause high numbers beside bubbles in the pod. I have had unexpected highs but those have been really minimal, nothing that a correction bolus can’t take care of.

I believe there were some posts about this topic earlier in the year.

I’ve been using the pods since December and only once have I had a problem like this. I couldn’t get my blood sugars down that day and there were no alerts from the pod or pdm. I ended up changing the pod and afterwards I noticed a fairly big bubble in the reservoir. I’m not super careful to remove bubbles but I generally make sure the big ones are gone and I fill the pod slowly.

When I talked to the omnipod reps about this, they stated that bubbles should not affect the delivery of the insulin. I sent the pod back and they checked it for problems. The report was that they couldn’t find anything wrong with the pod but, yes, there was a big bubble in there. So take that as you will…

My diabetes educator told me that some people usually have high glucose right after changing to a new pod (or changing sites using a “regular” insulin pump). I seem to be one of those people. At her suggestion, I give myself an extra bolus of one unit when I change pods. I usually use the old pod for that unit since I’m so cheap that I want to get every last bit out of that pod before I have to throw it away. :slight_smile:

You might want to try using pods from a different box. There might be a problem with the pods in the first box. I’ve had trouble with several pods coming from the same box – and then no trouble at all when I used a new box. There seem to be some quality control issues with the pods once in a while.


I don’t know. The way you describe how you’ve been rotating the pod so that the bubble heads up toward the plunger feels a little counterintuitive to me. If I thought I might have small bubbles in the reservoir, I’d prefer to have them pushed into the cannula (and into the body) and miss some insulin I can make up for (on tubed pumps they say 1 inch of bubble in the tube is equivalent to an hour of missed insulin) than have a bubble in the pod reservoir where the pressure of the plunger could be affected for the duration of wear. The plunger needs to press against the liquid, I would think. Or am I bonkers? Champagne sized bubbles should be able to safely enter both tissue and bloodstream without causing the bends. And if you choose to prime it additionally after it enters the skin (giving a small ‘fake’ bolus, as it were), that might take care of the bubbles present in the cannula.