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Hating my new pump

E

erasmusbee

Member
Messages
8
Type of diabetes
Type 1
Treatment type
Insulin
Hi,

I'm a T1 of 41 years and in the last month I have been put on the Insight pump. The idea was to stabilise my swinging blood sugars (although I have been telling all the professionals for years that there is no pattern so I can't see how a pump could be programmed to help).
Since being on it I have had 2 infected infusion sites, 2 lots of bubbles in the tubing, 2 cannulas pulled out just putting clothes on and lots of itching and bruising. I could put up with this if my BGs were better but they're much worse. All my diabetes team say is that I have to give it time but I can't see how anything will change. I've adjusted my basal several times but that doesn't seem to work - I was running high some nights between 2am and 7am so I increased my dose by 0.1 units and then I was having hypos. This used to happen on Tresiba and Novorapid but at least I didn't have to worry whether the random readings were due to the pump malfunctioning, the tube blocking etc.

Has anyone got any advice and/or come off the pump and gone back to MDIs?

Thanks
 
Hi there @erasmusbee
Sorry to hear you are having issues on a pump.

are you using a barrier spray before inserting your cannula ? I use Cavilon spray and this helps immensely to stop the itching.

i can only say that having 10 cannula insertions per month is much more pleasant to me than 140-175 injections per month.

I started on the omnipod just over 5 months ago and at the time my DSN said it would take at least 6-8 weeks to get basal rates sorted. And she also said i would need to review them ( basal testing) every 4 - 6 weeks as an ongoing exercise to ensure they were optomised. I really think you should give it at least 6 months before making a decision unless it is damaging your health.
 
Sorry to hear this - it's quite an upheaval to move to a pump if you feel it's not achieving anything from it, maybe you can compromise with your team to give it a bit longer before going back to MDI's ? I say this as there is a 'bedding' in period getting used to infusion set changes, insulin adjustments etc, if you give it another couple of months and there is still no joy then compromise with your team about going back onto MDI's ? There are positives to having a pump, I am 2 months in and still adjusting, have had a couple of bad set changes and jumped to 26/28mmol/l, took a day each time to recover, but more stable BG, less injections and easier to bolus for food is a bonus for me ;)
 
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try and get a change of pump....the medtronic models all be it not as visually pleasing are almost 100% reliable, i haven't even had one issue with the pump or canulla/tubing in 3 years....

only once you are happy with the hardware can you really see if its for you and can help you.....

i am confident it can.........
 
novorapidboi26 said:
try and get a change of pump....the medtronic models all be it not as visually pleasing are almost 100% reliable, i haven't even had one issue with the pump or canulla/tubing in 3 years....
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It could also be worth considering a change to the Omnipod as this doesn't have any tubing, I don't know anything about it's reliability or other issues though
 
@erasmusbee I had the Insight and hated it. I don't think its the best pump out there.... I now have an Animas Vibe and love it - simple, robust and reliable.

If you can't change your pump, you could try changing the type of set you're using. I'm not familiar with Insight sets so I don't know how much choice you'll have, but don't just stick with the one you were given.

My other thought is where are you putting the sets? They don't have to be in your tummy (unless your consultant has said you must put them there). I use my thighs and bum and get much better and more predictable absorption. You mentioned BS swings and that might be due to dodgy absorption and/or an unsuitable set.
 
So sorry that your finding the insight a nuisance at the moment.
I had a lot of problems when I first started on it, and I did complain to ROCHE on several occasions and I'd been pumping for 15 years previous without any problems with them. But as the saying goes patience is a virtue, I'm settled into using it well, the main problem I still have is too small a cartridge as I use to use 3ml and now I seem to be changing it every 2-3 days but as we live in a world where things aren't made to last I suppose it's pretty good.
They really need a lot of fine tuning at the beginning when you think the human body is so complex it's always changing so adjustments will be needed.
Give it a couple of months before deciding to change pump. I did and I'm pretty settled.
 
erasmusbee said:
Has anyone got any advice and/or come off the pump and gone back to MDIs?
Click to expand...

There's a book that comes highly recommended amongst the pump users of this forum, it's called Pumping Insulin by John Walsh & Ruth Roberts and is a must read for anyone thinking about changing to a pump or already using one.

With regards to the site infections, just make sure your skin is clean prior to insertion, I use Sterets alcohol wipes prior to applying my pod but always make sure the skin is dry prior to application, I've been pumping for 13 months and have had no infection issues so far.

Don't give up just yet and give it more time before deciding on going back to MDI. Good luck.
 
noblehead said:
There's a book that comes highly recommended amongst the pump users of this forum, it's called Pumping Insulin by John Walsh & Ruth Roberts and is a must read for anyone thinking about changing to a pump or already using one.

With regards to the site infections, just make sure your skin is clean prior to insertion, I use Sterets alcohol wipes prior to applying my pod but always make sure the skin is dry prior to application, I've been pumping for 13 months and have had no infection issues so far.

Don't give up just yet and give it more time before deciding on going back to MDI. Good luck.
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Thanks to everyone who has replied so far. I have the "Pumping Insulin" book and think I'm OK with the theory about adjustments etc. What I'm really struggling with is that I have no pattern (BG 12.1 yesterday 7am, 4.2 today 7am) so it's difficult to see how I can set profiles when I seem to be so random. Also, if my BG starts to shoot up, I don't know if it's a liver dump, a cannula problem, a bubble in the tubing, a kink in the tubing or what. That all adds to the stress, which puts my BG up even more. Any thoughts?
 
@erasmusbee When you get the 12.1 and then 4.2, is that with the same set? That is, has nothing at all changed?

What were your pre-bed BSs prior to those two readings?
 
It's early days @erasmusbee, go through all the problem solving and checks to see if there's a problem with the tubing or infusion site, but do also keep a detailed bg diary and show it to your pump DSN to get their input on where you should adjust your insulin.

If you get the chance go to the pump training days that are offered by the pump reps, I've found them to be quite informative and it's good to meet other people using the same pump as it can be a confidence builder.
 
On the Insight, can't you increase/decrease by less than 0.1 units?

I use the Medtronic 640G and can make basal changes of 0.025 units which is very helpful, as I am insulin sensitive.

You should ask your DSN to help you with all the problems you've had. A month isn't long enough to make a decision on the pump. It's unfortunate you've had such a lot of problems in that short time but I'm sure you're DSN will be able to help you.

When I started on the pump, I was warned that it wouldn't necessarily prevent the unexplained rises and falls in blood glucose but it would lessen the the range of these swings. I still have good days and bad, but things have certainly improved. My HbA1c is definitely much better now than it was pre pump.

Don't give up, you will get there - it just takes time!
 
The Insight is like marmite, lots hate it but at the same time lots also like it (I'm the latter).

It's hard to say in simple terms whether the pump is adding to your woes and if your issues are pump manufacturer specific. It took me at least two months to be fully stable, running 24hr basal checks (testing bloods every two hours) every other week.

I used to have real issues overnight when on four times daily injections, I could not get any kind of stability. The pump gave me that but as I said it took a few months and lots of patience. Hopefully you will find it works for you but if not at least its one more step to finding the cause of your issues.
 
noblehead said:
It's early days @erasmusbee, go through all the problem solving and checks to see if there's a problem with the tubing or infusion site, but do also keep a detailed bg diary and show it to your pump DSN to get their input on where you should adjust your insulin.

If you get the chance go to the pump training days that are offered by the pump reps, I've found them to be quite informative and it's good to meet other people using the same pump as it can be a confidence builder.
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Have done all the training days and shown the "professionals" my erratic Libre readings and diaries. They just quote me text book answers but my body doesn't seem to work like that. Their latest "solution" was to increase my basal by 0.1uhr between midnight and 7am. This improves things on the 50% of nights when my BGs go sky high overnight, but sends me hypo the other 50% when they don't rise. I think I have to accept that I am not a typical patient and that I will always buck the trend. My question is, if that is the case at least on MDIs I don't have all the other things to worry about.
 
One thing I have found with being on a pump, having a CGM and undertaking fasting Basal blood checks is that if I eat after around 7pm in the evening its causes my blood sugar to rise at about 3am - seems my body slows right down my food absorption whilst asleep. This was something I could not control (or even knew about) on MDI's. It's easier with my pump to control it but its not foolproof and I do sometimes get woken by my CGM at 3am to take a bolus correction.
 
erasmusbee said:
Hi, no nothing different, which is my frustration.
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Sounds silly, but have you tried eating exactly the same evening meal at exactly the same time two or three nights in a row? At least that might rule out some kind of effect from the previous evening. That's what I'd try if I was getting big variations like that - keeping the same set in too.

My only other thought was to ask about your sleeping. When I'm stressed or have a disturbed night, my blood sugar can go high, and over a period of a week or so I can get big fluctuations.
 
erasmusbee said:
Have done all the training days and shown the "professionals" my erratic Libre readings and diaries. They just quote me text book answers but my body doesn't seem to work like that. Their latest "solution" was to increase my basal by 0.1uhr between midnight and 7am. This improves things on the 50% of nights when my BGs go sky high overnight, but sends me hypo the other 50% when they don't rise. I think I have to accept that I am not a typical patient and that I will always buck the trend. My question is, if that is the case at least on MDIs I don't have all the other things to worry about.
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@azure suggestion about having the same sort of meal for a few nights is a good suggestion, meals that are high in fat can effect bg levels for several hours so do make sure your evening meals are lowish fat if you do do some bg testing.

With regards to your question, that may be true but as everyone says it's early days yet and 5 weeks is no time to make a decision if your pump should be handed back and you return to MDI, but at the end of the day the choice is yours and your decision only, but many of the problems you've experienced do come right eventually with experience and time.
 
Thanks for all your replies. Things are settling down a bit but I'm still getting a spike most nights which starts around 2am. My BG at bedtime is usually 8 or 9 (brilliant for me!) but most nights at 2am I shoot up to 15or 16 and stay there till I can have a correction at 6am. The trouble is it only happens on about 4 or 5 nights a week so I'm reluctant to put my basal up because on the nights I stay relatively stable, I would go seriously low. Any tips? I eat my evening meal about 7pm so I don't think it's slow release of the carbs, backed up by the fact that I don't go low in the evening. I wonder if a bedtime snack and some bolus would work but I'd rather not go down that road if possible.
 
erasmusbee said:
Thanks for all your replies. Things are settling down a bit but I'm still getting a spike most nights which starts around 2am. My BG at bedtime is usually 8 or 9 (brilliant for me!) but most nights at 2am I shoot up to 15or 16 and stay there till I can have a correction at 6am. The trouble is it only happens on about 4 or 5 nights a week so I'm reluctant to put my basal up because on the nights I stay relatively stable, I would go seriously low. Any tips? I eat my evening meal about 7pm so I don't think it's slow release of the carbs, backed up by the fact that I don't go low in the evening. I wonder if a bedtime snack and some bolus would work but I'd rather not go down that road if possible.
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I don't suppose it has anything to do with work days? When I was working, the stress raised my blood sugars quite badly and eventually we realised I had to use higher basals for work days.
 
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