Before I publish a lengthy manifesto on the pros and cons of insulin pumping versus injections in regards to my recent switch over to shots, there are a few long overdue housekeeping details that I would like to highlight for those interested.
1.) Meeting of the Diabetes Minds
Around Halloween, I had a big appointment with an insulin pump representative and my nurse. My doctor also sat in during her lunch break. I know that it was around Halloween because I brought a bag full of insulin pump supplies as well as Halloween cupcakes coated in frosting (see above) as sustenance for those who were kindhearted enough to meet with me on their free time. So, it was a meeting of the multifaceted diabetes minds, fueled by large amounts of sugar for those with properly-functioning pancreases.
We went through every scenario, including a live insulin pump site change. They all nodded their heads in agreement when I showed them how Humalog bubbled up quickly in the reservoir. We were all baffled as to why the Sure T infusion sets continued to pool insulin at the connector site. And so on. Basically, we knew there were problems, and we had to try to tackle them each individually.
2.) Sure T infusion sets
Regarding the Sure T, I have said it before and I will continue to say it: I like Medtronic. Their pump rep nurses were as gentle as possible when we did the “human pincushion” trial and error game of inserting into different sites during appointments over the past two years. Those days were not easy for any of us, on a mental and physical level, but their confident reassurance that it was going to be okay is something that I will always carry with me. Medtronic’s customer service is timely, polite, and helpful. One manager in particular has logged dozens of hours on the phone with me while we documented and troubleshooted what we believe to be a rare Sure T product defect. Medtronic has sent me various lot numbers of Sure Ts to try, and I have sent them back my problematic sets for analyses, the results of which are still to be determined.
In a nutshell, we have tried repeatedly to make the Sure T work for me, but maybe the Sure T doesn’t like people with very light, no sugar coffee orders. Sure T might perform better for a different diabetic coffee enthusiast on a different day. You tell me.
The recent product warning sent out by Medtronic is believed to be unrelated to my issue. See image above; note that insulin droplets pool at the connector site and do not get into my body. The proof is in the sugar-free pudding: after many site changes, subsequent ketone spikes, stubborn high blood sugars, and droplets of insulin falling out at the site, we have decided to hold off on using the Sure T until new lots are manufactured in the future. Although I like the steel needle aspect of the Sure T, as bent cannulas cannot occur, if/when I transition back to the insulin pump after doing multiple daily injections for awhile, I will most likely give the Medtronic Quick Sets another try.
Whenever I switched a Sure T site out, I always ate low-carb for a few hours afterwards in case the insulin was not getting into me. My fear is that someone who is unaware of this risk might consume a big pasta dinner and have an infusion set failure unbeknownst to that person, leading to a very dangerous situation very quickly. I disclose this information so that you are at least aware of this potential problem if you also use Sure Ts.
Note: If you experience any insulin pump problems, please contact your respective pump company so that they can document the issue and investigate safely.
3.) Bubbles in insulin pump reservoirs
I detailed this extensively in Broken Record, but to summarize briefly: These were more than champagne bubbles, they blocked proper insulin delivery, and they caused blood sugar to stagnate at high levels until the problem was identified and the reservoir changed out.
A Facebook user recommended that I pre-fill a reservoir a day before an expected site change, let it sit undisturbed to allow big bubbles to settle, and then prime those bubbles through the tubing on the day of the site change. For some reason, letting the reservoir sit for a day helped immensely. I also found that Novolog produced bigger bubbles which were easier to eradicate than Humalog’s millions of feisty bubbles which had a knack for procreating over time. Get a room, Humalog love birds!
Please note that this trick is not recommended by pump companies, as insulin has been shown to lose efficacy over time in the plastic reservoirs. However, given the frequency and degree of problems I encountered with pump site changes, I found that pre-filling the reservoir was a risk I was willing to assume, and I was always cognizant and on the look-out for problems related to this risk. So far, the benefits have outweighed these risks.
I hope that this update is helpful to anyone who was curious about the possible solutions identified for my insulin pumping problems. Thank you again to all who offered encouragement and advice along the way. More to come soon with a post chronicling the transition back to insulin shots. Yeehaw!