pump worry

I'm still new to it, and I worry on behalf of my son rather than myself.

Is it possible that the cannula itself is kinked? If the tubing looks fine with no air bubbles and you know you've bolused, I would probably look towards changing the cannula and site.

The one time my son didn't feel any pain after insertion (and we thought brilliant!) his blood sugars went sky high like your's. I changed the cannula and found the original was so kinked, we doubt that it actually went into my son at all and that was why he felt no pain.

Another thing is having been told to recheck after half an hour (from Diabetic Nurse and the Pump Support Team), I kind of went in to obsessive mode, because I found the sugars weren't coming down as I would expect (discounting pen corrections). Now having reviewed with the diabetic nurse, I will check no earlier than an hour later but usually two hours, and I feel we are probably getting more realistic readings. Of course I appreciate you are more experienced in how to sense the changes and I don't have any direct experience myself. Have you got any ketones?

Hi

Just had a thought, if your problems are related to using the Quickset, Medtronic now do a new set called the Mio. This is more or less a copycat version of the Animas Inset II so should be easier to put in as the inserter is self contained in the set.

Also, a tip from my mate - put the Quickset in standing up or laying down on the bed. That ensures that the cannula goes in ok and shouldn't kink.

Hi Tracey,
I'm glad your blood glucose levels went down OK.
It does seem as if you have had a very brief 'education'. I assume that you know about the veo tutoriial online.
http://www.medtronic-diabetes.co.uk/education
but its really important to know what to do when things aren't working as they should.
I found this pump workbook online. (it's from a UK source, one of the authors I recognise as being the specialist nurse at the Bournemouth diabetes centre ) It starts from basics but has a useful chapter with a flowchart on what to do if your blood gluose levels are high (p29)
http://www.diabetes-education.net/pdf/resources/insulin_pump_workbook.pdf

I have the predecessor of the Veo and am very happy with it . I don't live in the UK so I don't have the problems you seem to have had in dealing with medtronic direct ( my supplies come from a 3rd party) I also had a 3 day pump training.
The good thing about the veo is that it is also a cgms. Once you've become familiar with pumping, if at all possible try to try to see if you can get some access to sensors and use the CGMS element of the pump for a short period.. I'm at the end of a 2 weeks with a cgms and I have learned so much about what my blood glucose levels do after meals, during exercise and in the night. It's really helped me to fine tune things .
Remember though, it's really early days yet and a lot of people aren't happy with their pump at the start, it takes time to gain confidence.

Hi Tracey. My partner's son went onto insulin pump therapy a week ago. The first three days was fab with great reads, all within the target levels, then it went pear-shaped.

His reads on the fourth day on waking was 14.5 mmol, so did ketone test and a correction via the pump. An hour later he was 14 mmol, so did a correction dose with the insulin pen. There were no errors flashing up on the pump until he had his tea. Through the bolus wizard, Cameron entered all the figures and it calculated how much insulin to give. We watched the numbers counting up as the insulin was delivered. Two minutes later it flashed up with a NO DELIVERY (4) error. We checked the history to make sure we hadn't missed any other errors through the day and we hadn't.

Tried contacting Medtronic on their 24 hour hotline and was on hold for over 20 minutes. While hanging on the phone, we did a SELFTEST and gave up hanging on the phone. We monitored Cam's blood glucose levels closely unti supper time and it was on it's way down. Supper time, we administered the dose via the bolus wizard, retested 90 minutes after supper and glad to say, his BG was back in the target range.

I guess at the end of the day these pumps are sophisticated pieces of software which are going to have glitches from time to time.

Non delivery alarms are set off (on a paradigm 515/715) after an average of 2.77 units of insulin have not been delivered, something physical (an occlusion) is stopping the delivery. This is most likely to be discovered during a bolus delivery ( highly annoying just as you've sat down to eat, the most likely reason, I've found is a bent cannula)
If you have a basal rate of 1.0u/hour the pump will take a minimum of 2.2 hours to detect an occlusion but may take up to 4 hours. If you had a very tiny basal of 0,05u/h it would take a minimum of 37 hours and a max of 87 hours to detect it! (but this is only theoretical , most people would have eaten and bolused by then)

Thats one of the reasons why if your blood glucose rises unexpectedly and doesn't come down with a correction you need to correct with a pen and change site, tubing etc.
The pump is checking itself for malfunctions at frequent intervals and you would get a different type of alarm if it stopped working.

Thanks for the info. Cameron is on 0.6 u/h. We did a set change and injected insulin to bring him down. Pump came up with error of NO DELIVERY (4) by the afternoon. After the self-test, everything was good and his levels were in target range.

Just wanted to find out what the (4) meant when we contacted Medtronics helpline, but got fed up hanging on waiting for them to take the call. :?

Hi Angie,
(I just posted this but seem to have lost it!)
I didn't notice the (4), I don't think I've seen this. I can't find any mention of it on the manual or internet, I think that you should persist in trying to contact Medtronic, just to be on the safeside. In the meantime just keep an eye on glucose levels.

Yeah, I've checked out the web and the manual, but had no luck finding what the error code meant. Have been monitoring him every two hours and his levels are OK (no HIGHS as yet).

It is the Paradigm Veo MMT-754 pump. I have tried again today, but it's just as busy as yesterday. When I find out, I'll post.