By: Barbara Bradley
Problems with blood glucose control need to be prevented and solved when using an insulin pump. When something goes wrong, do you blame it on the pump or suspect you made an error? Do you assume there is a pump problem with each alarm?
Whenever BGs are not in target range, you need a troubleshooting plan. Be prepared.
Check those BGs as recommended; don’t be cavalier about this. If you miss a BG test, you could have surprise numbers in either direction. Extra tests are needed before and during driving, exercise, and any symptoms of illness or hypoglycemia.
Keep a copy of emergency guidelines recommended by your healthcare provider and review it periodically. Be prepared to check for ketones, and give insulin by syringe if you have a pump failure.
Read all safety precautions. Read the troubleshooting or system error section. Learn the alarm system messages and icons. Follow the daily care and maintenance instructions.
Check the infusion site. Is the adhesive secure? Is it wet? Has the catheter or needle slipped out of place? Is there redness, pain, bruising or bleeding at the site? Have you rotated the site as recommended by your pump team?
Check the infusion set. Is there any insulin leaking from loose or damaged connections? Is there any air or blood in the tubing? Is the tubing crimped or occluded? Disconnect from the infusion site to fix the problem. Never tighten connections, rewind, re-prime or remove air from the system when the pump and infusion set are still connected to your body. Doing this can potentially cause hypoglycemia from an unwanted bolus of insulin. Each pump manufacturer should have this warning in the owner’s manual and training materials.
Syringe Prep Technique
Re-evaluate your syringe prep technique. Is the syringe plunger moving freely before you load insulin into it? Did you lubricate the inside while pulling back and rotating the plunger? Are you repeatedly reusing a reservoir or cartridge? The lubrication may be used up, making the drive mechanism work harder to deliver insulin. Review the directions for loading insulin and follow the guidelines.
Be sure to check the pump. Most technical problems will be obvious—a distorted or unreadable LCD screen, a malfunction of programming buttons, programmed functions not working, cracked housing. Check the programming and history status in the pump: Did you miss a meal bolus or correction bolus? Are basal settings correct? Do these need to be re-evaluated if your insulin needs have changed? Is the time of day correct? What information is in the alarm history? What’s the battery status?
For pump problems, call the customer support team for the manufacturer. Review training materials for answers, or meet with your pump team or pump trainer. When in doubt, check with both groups. Educate your support team. Family members or close friends should be able to help solve problems when you need assistance. Safe pumping!