Filling your insulin reservoir is one of the most important things we do as diabetics on insulin pumps. We have to do it every few days, and even small bubbles can really ruin your blood sugars! Today we’ll talk about the dangers of air bubbles in your reservoir, and a few tricks to minimize them.
Why Are Air Bubbles So Bad, Anyway???
Look, it’s not like one of those old movies where the bad guy gets injected with an air bubble and dies right away! In fact, small amount of air bubbles are perfectly harmless! They get absorbed into the bloodstream and done away with properly. The bigger issue with bubbles in your reservoir has to do with dosage.
Basically, you might be thinking you’re giving yourself a certain amount of insulin, but if there are bubbles in the dose, you’re actually getting less than you thought.
What do I mean by that? Let’s look at an example we used in Calculating Your Insulin Dose. Imagine you’ve just eaten a sandwich that was 50 grams of carbohydrates, your carb-to-insulin ratio is 10g to 1 unit, and you have no active insulin-on-board. So you dial this into your pump, which recommends that you take 5.0 units of insulin. Great! You confirm and you get the dose.
Now, let’s say that you hadn’t filled your reservoir correctly and there is a bubble the size of 1 unit of insulin. The pump dutifully pumps 4 units of insulin plus the 1 unit of air for a total of 5.0 units, just like you asked. But since you only received 4 units of actual insulin, your blood sugar level 2 hours later won’t be where you expected it, but actually higher! These erratic blood sugar levels are bad for your health and increase stress!
Tips For Keeping Air Bubbles Out of Reservoirs
Prime Your Insulin Vial with the ‘Same-Same’ method.
Basically, for whatever you are pushing or pulling, make sure you are pushing/pulling the ‘same’ material into the ‘same’ material.
When pushing air into the vial, hold the vial right side up so that you are pushing the air from the reservoir into the air of the vial. When pulling in insulin, hold the vial upside down so as to only pull insulin into the reservoir.
When filling your reservoir, the typical steps are to:
Fill the reservoir with air
Attach the insulin vial to the reservoir
With the insulin vial on the bottom, push the air from the reservoir into the vial
Notice how when you do this, you don’t create any bubbles, as you’re not pushing air into the insulin itself!
With the insulin vial on top, pull insulin out of the vial into the reservoir
When you flip the insulin vial to the top before pulling insulin into the reservoir, you reduce the chance of pulling in air.
There’s still a chance you might have some small air bubbles in the reservoir. Gently tap the reservoir to dislodge the bubbles so they can float to the top, and then push them out. I do this with the insulin vial still on top so I can visually check that the bubbles are leaving as you can see them travel through the vial.
Pre-Load Your Insulin Reservors
Some diabetics I know fill their reservoirs a few days before they’re actually going to use them. When filling a reservoir, the bubbles can be so small that you don’t notice them until they’ve had some time to all group together. If you fill the reservoir a few days before, the bubbles will be more noticeable and easier to eject before the time comes to use it. If you do this, make sure you place the ‘on-deck’ reservoirs back in the fridge to keep the insulin fresh.
We’ve all been there. You’ve had a pretty normal day – standard breakfast, standard lunch, standard workday. But when you test your blood sugar level, it’s super high! What could be going wrong? Here’s a quick guide to help figure out what’s happening and the best/fastest way to fix it.
What Could Be Going Wrong?
When your blood glucose levels are high and you’re on an insulin pump, there’s 5 basic things that could be going wrong:
- ‘Emergency’ pump errors
- Your body
- The connection between your pump and your body
- Your pump
- Your insulin
If you go straight to insulin injection with a syringe, then it’s impossible to know where the ‘failure’ was – was it a massive pump failure, a simple dosage mistake or something easily fixed? Use the following checklist to systematically diagnose the problem in a way that will make you better prepared in the future.
Emergency Pump Errors
Is your pump trying to tell you something? If there are any delivery errors, then the pump is having serious issues and may be either temporarily or permanently broken. Examples:
- Motor Errors or Delivery Errors. This can range from permanent failures to simply changing your pump setting that connects to your body or trying a new insulin vial. Check your manual if you have any questions.
- Low Battery. If the battery needs to be replaced, then replace it!
Any sort of serious pump error needs to be fixed immediately, or you should go to your back-up plan of insulin pen or syringe injections. There’s no need to continue this checklist.
Diagnosing ‘Body’ Problems
Basically, it’s important to think about how you’re feeling and how your routine has changed throughout the day. Here are some questions to ask yourself:
- Am I having a particularly stressful day? Stress is a well-known factor in raising blood sugar levels.
- Did I have an unusually heavy meal before? If you had a big meal that was either high in carbohydrates or had a mix of carbs and fatty foods such as cheese and meat, then it’s possible that you didn’t bolus correctly.
- Did I remember to bolus, or did I bolus enough? Related to the last one, just ‘sanity check’ your last bolus and how long it’s been since you bolused. Remember, it takes time for insulin to become ‘active’ in your body.
If anything is different today from your ‘routine,’ it’s probably worth trying a correction bolus to see if that brings your blood sugar levels down. Otherwise, move onto the next stage.
Diagnosing the connection between your pump and your body
Did you try a correction bolus (as recommended before?) If you’re still high, then it might have something to do with how your insulin pump is connected to your body. Maybe the ‘setting’ (the part of the insulin pump hose that connects to your body) has started to fail. This can be due to the fact that you’ve had it in too long, or just that it’s kinked up because of movement or impact. Ask yourself these questions:
- Have I had this setting in for more than the regular time? Most people keep insulin pump settings in for 3-4 days and no more. Are you at the end of this setting’s lifetime?
- Is it a new setting and this was the first time I had dosed with it? Sometimes insulin pump settings become ‘kinked’ on insertion – if this is the first bolus you’ve done with this setting, it might not be delivering insulin the way it’s supposed to!
- Is the area where the setting is connected super-itchy or painful? If so, that’s a HUGE sign that it’s time to change the setting!
- Is the setting visibly loose? Sometimes the ‘stickiness’ of the tape wears off early, and the setting becomes loose. This is no good.
If the answer to any of the above questions is ‘yes,’ then you better change the setting! Once you’ve changed it, be sure to re-bolus any correction bolus you gave yourself before, as chances are it wasn’t delivered properly. You might need more insulin to fend off any ‘insulin’ resistance – once your blood sugar level gets high, it can actually take more insulin than normal to bring it down.
Diagnosing Your Pump
If you’ve tried a correction bolus with/without changing your setting, and you’re still high, you want to check your pump configuration.
- Are there any pump errors on screen? We covered this in the first section.
- Are there many air bubbles in the insulin reservoir? If there are, chances are you’re not getting the insulin doses you think you are.
- Is the pump correctly configured for you? Is the insulin sensitivity, active insulin time, or carb-to-insulin ratios correct for you? If you’ve been having a lot of problems or had a recent lifestyle change, then you may need to change these. Consult your doctor.
Insulin reservoir problems are simple to fix – simply get a new reservoir or get the air bubbles out of the one you have. If you suspect your pump is failing, then it’s time to resort to injections. You should have pen or syringe backups, and you should start using them immediately. Consult your doctor and the company that manufactures your pump to find out how to get a new one.
Diagnosing Your Insulin
Sometimes there’s just something wrong with your insulin.
- Is the insulin past its expiration date? If so, it could be completely ineffective, and you need to get a fresh vial!
- Is the insulin ‘dirty’? Sometimes insulin can get contaminated. Sometimes it’s visible and sometimes it’s not – when it is, the insulin can become milky or you may see tiny things floating in it. If this is the case, switch immediately!
If your insulin is bad, you need to get a new one ASAP. There is no excuse to keep using bad insulin.
In conclusion…
This checklist is a simple way to determine what part of the system is ‘failing’ for you so you can be most effective in knowing if it’s a permanent or temporary problem, and the fastest way to fix it. It takes patience and a bit of common sense. Never be afraid to consult your doctor, and you should do so if you are having extraordinary problems!
Insulin doses can be tricky business. Today we’re discussing the doses you take when you eat food or need to correct your blood glucose level – these are called boluses. There’s a lot of different factors, and even more annoying, they’re different for everyone! Today we’ll explain all the things you need to know, and provide you with a nice little excel file you can play with to see how everything interacts.
Watch the video or read below!
As a Type 1 diabetic, we need to test our blood sugar levels up to 10 times a day in order to make sure we are staying healthy. Each time we test we need to prick our fingers to draw blood to place on a test strip. Sometimes, this hurts! And at 10 times a day, it can be a source of stress for many diabetics. Here’s a little trick I picked up early on to help minimize pin prick pain. Read on for a video and explanation.
Hi DIYers!
Diabetes all over the world are using technology to get better control of their blood glucose levels. Today I thought I’d demonstrate a new technology – the Continuous Glucose Monitoring System, or CGMS for short. I’ve briefly blogged about my initial impressions of CGMS before, but never in detail. Just like preparing a pump and insertion set, there are many steps to getting the CGMS prepared and sending signals about your blood sugar. At first it can be scary – the sensor/needle is a bit bigger, the contraption to insert it into your body is confusing, and must be inserted very carefully. Oh, and there’s a slightly higher chance of blood. But then it gets easier over time. So read on to find out the devils in the details! Become an empowered Type 1 diabetic!
Setting Up Continuous Glucose Monitoring: The Video
[Note: This is a supplement to the article Insulin Pump 101: Setting Up the Pump. Go there for a video.]
“Priming” the QuickSet hose basically just means filling it with insulin. You need to do this because otherwise if you tried to dose, you would just be giving yourself air, which is at best useless and at worst probably dangerous! Why is it called priming? If I knew I’d write a blog about that, too!
This step is relatively short and sweet. Read on to find out how!
We’ve all been there – exam time. As if you don’t have enough on your mind between worrying about your course grade, the test grade, if your calculator has enough battery power, whether or not all your life goals will be achieved – but now you have to worry about diabetes, too??? Well read on for some tips (and maybe share a few of your own!)
Low blood sugars make you shaky, sweaty, unable to concentrate, and likely to pass out. High blood sugars can make you feel terrible, and in my case, I’ve noticed they make me much more prone to silly mistakes. So managing the blood glucose level is oh-so-important!
Read on to learn how.
One question I get a lot is whether or not an insulin pump reservoir (the vial full of insulin that you place in your insulin pump) can be used again? After all, these things aren’t cheap, and we go through one ever 3-5 days (depending on your usage).
Well, the short answer is, “Yes, you can!” However, you can’t do it forever and a great deal of care needs to be taken and there are some precautions. Read the rest of the article to learn more!
[Note: This is a supplement to the article Insulin Pump 101: Setting Up the Pump. Go there for a video.]
When setting up your insulin pump, after you’ve filled the reservoir, it’s time to prepare the QuickSet for insertion. (Note: It’s called a QuickSet for the Medtronic Minimed Veo pump – it may be called something else if you use another company). The QuickSet is the piece that you literally inject into your body in order to connect the insulin pump to your body and deliver insulin.
Hi all!
Today I thought we’d discuss/demonstrate what all us diabetics on insulin pumps go through when we’re setting up our insulin pump. I’ll talk about how you load the reservoir with insulin and insert the quickset into your body so you can start dosing. I’ll be using a Medtronic Minimed Veo insulin pump – if you have a different insulin pump the details will be different, but the idea is the same.
I think there’s quite a bit of mystery on the ‘how-to’ aspect of a insulin pump – there can be quite a few steps but once you get the hang of it becomes more and more normal. Watch below for a video or read the following links for a basic summary!