Does anyone use an untethered approach with their insulin pump?

[novorapidboi26]

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The flexible benefits of the pump is the basal rates.......

 

[Marie 2]

DKA on a pump is something you always have to be aware of and watch for. And it quickly can be life threatening. With a pump it puts you at more of a risk because you are counting on a low fast acting continuous dose and when that stops your numbers can rise pretty fast, the lack of enough insulin is what causes the DKA process. That's why we test for ketones and watch for symptoms so we can catch any change as early as possible to stop it from happening.

 

[Chas C]

I have to say, and trying to be little sensitive, scare mongering about DKA on a pump is not helpful. Pump's can fail and CGM's can fail but if they do they would alarm and warn you - if you choose to turn those alarms off then you know your taking a risk.

 

[Marie 2]

I can't see someone being dismissive about DKA. It is something that can happen and is dangerous. A couple of people have gone into DKA at lower numbers than expected. In this particular case his sensor had a lost signal and since it was the middle of the night he ignored it. The pump never did alarm and he never did figure out why there was a failure with it. There are various reasons pumps fail without any warning or alerts. It is something to always be aware of to keep an eye out for.

I don't see this as scaremongering, it was just a mention in the first place as to why someone was trying a different approach. I only talked about it again because I believe it shouldn't be dismissed as something that everyone needs to be aware of.

Here is an account written by Wil Dubois over at DiabetesMine on Feb 19th 2019
He went into DKA and is a Diabetic Educator and had written several books.
It is significant because of who he is and yet it still happened.
https://www.healthline.com/diabetesmine/landing-in-hospital-diabetic-ketoacidosis#1

 

[sleepster]

Pump's can fail and CGM's can fail but if they do they would alarm and warn you - if you choose to turn those alarms off then you know your taking a risk.

I have to say, I don't know about pump users in general, but of the pump users I've met in real life, only a very small number had CGMs in addition to their pump, I don't have a CGM, so if my pump fails, I get no warnings or alarms

 

[MeiChanski]

Tbf, DKA can happen at any point like I was enjoying my sleep and all sudden I yanked out my cannula. Thankfully I was some what awake but imagine if I continued sleeping. You don’t need a pump to fail, a small accident can do it. I know some pumps or all pumps will warn you if there’s a blockage etc but I have experienced a kinked cannula without a warning, my BG wouldn’t come down. I think DKA was one of the number one things we are at risk at when using a pump.

 

[novorapidboi26]

I pulled my cannula out today actually, but noticed immediately..............the clip connection however has not engaged properly sometimes and this has caused high blood sugars to follow.......i only noticed when i felt and smelled the high......

didn't go in to DKA though......just clipped back on corrected and put on a temp basal of 200%

 

[Chas C]

I have to say, I don't know about pump users in general, but of the pump users I've met in real life, only a very small number had CGMs in addition to their pump, I don't have a CGM, so if my pump fails, I get no warnings or alarms

So you don't need a CGM, you test your BG's with finger sticks. When I was not on CGM I tested every two hours when I was awake. Also if your going high and getting towards DKA you'd be feeling unwell and thirsty too - so sensible to test.

Also pumps do alarm you for occlusions or failures, what they can't cover is cannula issues but again testing should cover this when feeling unwell.