Set failure

[Lucie75]

I've had my first set failure after only 2 months on the pump. Tested mid morning and was 14mmol, but still had IOB and had to walk around a bit at work so didn't do a correction, thinking that just the gentle exercise would lower it a bit. 2 hours later I'd gone up to 17mmol so I gave a correction. An hour after that I was 17.7mmol so gave another correction and started to wonder if my set was working (I changed it yesterday) or whether I was coming down with something. I thought I'd leave it one more hour, at which point I'd risen to 22mmol and was feeling pretty ill. In the end I injected 5 units using a syringe and sure enough, an hour later I was back down to 17mmol and then an hour after that I'd gone down to 11.1. What a relief!!

Despite being told that it's very easy to go into dka on a pump I hadn't appreciated the speed at which bg rises with no background insulin. I felt pretty rough quite quickly but also felt better quickly once it started to drop back down. You really do have to learn new rules on a pump don't you, and have to react very quickly to any abnormalities. I've learnt a lesson today.

 

[Julie1471]

Well Lucie, at least you realised what was going on, I had a set failure Christmas Day, when I still couldn't my bloods below 14 on Boxing Day, I called my out of hours team, who helped. Sat just gone changed my set tested 2hrs after and blood was ok. By breakfast Sunday morning had gone up to 18, tested 30mins later 18.7, went to hubby I've got a problem. He drew up new cartridge while I sorted my pump and removed my old set which was completely bent over. So did a temp basal of 120% for 4 hrs, blood dropped, but not below 10, so raised to 150% for 3hrs. 2hrs in I was 8.9. But at least you know the signs. By the way what pump and sets do you use??

 

[Lucie75]

I'm using the Animas Vibe and I use the inset II sets. When I changed it there was no sign of any problem - it wasn't bent, no blood, site wasn't sore, no nothing. Whether I hit scar tissue or not I don't know but I changed sites and the new set is working fine now.

I was told by the pump rep that if you get unexplained high bg then you should assume the set isn't working - were you not told this? Me being me though I tried to explain it away (miscounted carbs etc etc) and it was only when repeated corrections weren't working (when normally they are spot on) I could only think that it was the set. Did the bent cannula not hurt at all?

 

[Julie1471]

I use the same sets, no it didn't hurt at all. I did the same as you, when I had the problem at Christmas it stang a bit when I did it, but that went away. I was told by one of the staff at Animas that the last thing to do was to put the tube into the little cut out bit last as it can put a strain on the rest of the set. Have you been told that? I have never meet a pump rep, just been taught by my DSN and for the past weeks, been feeling grotty as have had a cold, so thought that might have kicked in a bit more, that's why I tested 20/30mins later, rather than waiting any longer. And then acted straight away.

 

[Lucie75]

Yes, I was told to always pull the mechanism back and then put the tubing in the little notch otherwise it can stretch the tubing and prevent correct insulin delivery. I think I just inserted this set too close to the last but one site so hit scar tissue before it had had enough time to recover. We were taught by the pump rep over the course of two half day sessions. The dsn didn't really know enough about the Vibe, although she appears to know her stuff when it comes to solving problems that are dosage related.

To be honest my sets always sting when they are new, at least for an hour or so, and after 2 days the skin that is in contact with the 'plaster' part itches like crazy. It's fine until the end of the 2nd day so I always change early on the third day. I might look at getting some sort of barrier cream from the chemist, as long as I don't react to that as well.

Do you have 'good' sites that don't hurt at all and others that are too painful to use? In the 2 months since having my pump I favoured using my legs but after only a few weeks it just hurts too much when insulin is delivered. Have you used your arms?

 

[K8tie_x]

Thanks for sharing this I'm new to pumping so will definitely take this advice on board x

 

[Julie1471]

Mine start to itch on the 3rd day. My stomach is a good site, I haven't tried my arms or legs. Sometimes it hurts if it's a large dose. Have you tried Aloe Vera gel, you may find that helps, also do use anything like Zoff wipes, to help remove sets??

 

[Lucie75]

I tend to use my lower back more than anywhere else - I find this the most comfortable. I was thinking about using my arms but I'm not sure how I'd get on the tubing going up sleeves etc. I haven't tried anything for the itching yet - do you put Aloe Vera on before inserting the set? I don't have an issue with removing the set, it always seems to come off fairly easily. By the way, if you're giving a large dose you can adjust the setting prior to giving the dose so that it delivers it slowly. It's on the setup menu, adv 2. Mine is set to normal, but you can slow it down to stop it hurting.

 

[Engineer88]

Ive had the same a couple of weeks ago and did emergancy set change in work which wasnt ideal. Ive always got the setting on slow release as the first time I did it with the pump rep it shocked/hurt she altered it straight away!

On a side note I'm not sure if my previous pump was faulty as I can see a improvement in BG reactions already with new pump :/ my previous one was alarming all over that it wasnt primed... Only I could manage that!

 

[Lucie75]

So Engineer, what you're saying is that your pump is even better than you first thought!!

 

[Engineer88]

Kind of. If it works its amazing! however I think the previous one wasnt delivering as much insulin as it said it was - there seems to be problems with the delivery pin?? anyway fingers crossed!

 

[Julie1471]

Great I didn't know that you could slow it down on the delivery rate, will try that next time I need a large dose. I use the aloe gel after I've removed a set it helps with the redness, I have a bit of a problem when I remove them, so I use Zoff to help.