NEW PUMPER INFUSION PROBLEM

[DONNAZANG]

MY SON IS SEVEN AND NEW TO THE PUMP.  WE ARE USING A PARADIGM 512 BY MINIMED, WITH QUICKSET INFUSION SETS.  WE HAVE HAD A LOT OF PROBLEMS WITH EITHER THE PUMP OR THE INFUSION SET.  THE BASAL RATES SEEM FINE, BECAUSE YESTERDAY HIS SUGARS WERE THE SAME ALL DAY, UNTIL WE HAD A READING OF OVER 500 WITH LARGE KEYTONES.  I GAVE HIM A SHOT AND INSERTED A NEW SET AND THAT WORKED OVERNIGHT UNTIL BREAKFAST TODAY.  MY SON WAS IN A LOT OF PAIN FROM THE NEW SIGHT, SO I CHANGED IT.  I TESTED HIM AND HE WAS HIGH WITH MODERATE KEYTONES.  HAD TO AGAIN GIVE A SHOT AND CHANGE THE SIGHT. THEN I GOT A LOW BATTERY SIGNAL.  THE BATTERIES HAVE ONLY BEEN IN THERE SINCE TUESDAY (IT'S FRIDAY).  I CHANGED THE BATTERY AND RECEIVED A NO DELIVERY WARNING.  HE WAS HIGH AGAIN, CORRECTED WITH INJECTION.  THE DOCTOR SAID TO CALL MINIMED AND HAVE THE PUMP REPLACED FOR THE INTERMITTENT PROBLEM.  THEY HAD ME RUN TESTS AND TOLD ME BASICALLY TO DO IT ALL AGAIN THE SAME WAY.  THEY ARE NOT REPLACING THE PUMP,  JUST THE SETS I WASTED.  DOES ANYONE HAVE SIMILAR EXPERIENCE OR ANY IDEA AS TO WHAT HAS HAPPENED?

[JDRF-VOL-LS]

Hello Donnazang,
We are volunteers and not medical professionals, here.  We have a lot of experience with Type 1 diabetes.  I happen to also be a pumper and - despite periodic episodes like you're having -  pumps can achieve good control & flexibility for many years at a time.  I've been pumping for about 10 years.  Each generation of pump is smarter & more precise.

At this point, make a call to Minimed's 24 hour support line because clearly something is wrong.  As you point out there could be a number of issues, and they are expert at stepping through the troubleshooting in a systematic manner.  They will also send a replacement overnight if needed.

Some things they'll likely check with you are (1) insertion technique, (2) type & age of insulin, (3) attachment of infusion set to the pump & your son.  Sometimes they have you test insulin delivery once the infusion is removed from your son but still attached to the pump.  If delivery is good then, it often means the blockage occured 'in' your son.  It could be from a bend in the cannula when under the skin, for example.  That can occur if the cannula is 'too long' for his body composition or if insertion happened to hit a capillary or scar tissue or or or... The point is that they will step you through a process of elimination to identify & correct the problem.  Do pay attention to they analysis they'll do with you, so if it happens again.

Also, it's *excellent* that you cover your son's high with a shot while you're trying to figure things out.  Your pediatric endo should work with you to ensure that you have a plan in case, for example, your son needs to go, say 12 - 24 hours or longer without pumping (It's happened once to me in 10 years.)  Many docs recommend keeping a supply of longer acting insulin on hand.

Good luck and enlist Minimed to help you -- today.  IF you have a moment once it's all been resolved, will you send us an update?