New to Pump & Having Problems

I just started on the mini-med paradigm pump & mio infusion sets and I'm having problems with insulin delivery. Every time I change my set out I shoot up to the 300's. I wake up in the morning, take my BG & prep the reservoir while still hooked up with my current set. When I'm ready to insert infusion set, I take out my current set & rewind the pump, insert new set, and fill cannula (.3 since I'm using the 6mm). I then give myself meal insulin & correction & jump in the shower for no more than 20 minutes. I hook back up to pump, finish getting ready and then have breakfast--all within 30-40 minutes. When I test myself an hour after eating I'm in the 300's. What gives?

I've checked for air bubbles in the tube, kinks in the tubing, etc. and found nothing. One time I gave myself an injection and started coming down. So I changed out set and noticed cannula was bent. All other times though, the cannula was fine. I've noticed some air bubbles, so I unhooked from pump and pushed bubbles out. But other than that I have no idea what's going on. Does having excess tubing cause problems? I have the 32" length and I'm inserting in abdomen and storing in my pant pockets (I'm short too, 5'1"). Medtronic was supposed to send the shorter, 18" lenght, but they sent all 32."

Does anyone have any ideas for me? I'm so frustrated I feel like crying and I don't know how much longer my boss can be understanding about it.

FYI--I have the mini-med sensor, but I haven't gotten training for that yet, so I'm not wearing. I'm flying solo until then.



Sounds like you may have a couple things going on.  

I'm also short (5'2") and only use the long tubing for arm infusion sites.  If Minimed sent wrong order, call and ask them to send correct infusion sets and explain you're glad to return those with 32" tubing if they'll pay for the postage.

You may also ask Minimed for sample of other types of infusion sets.  If you're thin the mios may cause you to hit muscle and bend the canula, which will inhibit insulin flow.

There is a good chance that between being disconnected and the stress of changing your infusion set that your blood sugar is shooting up.  Don't know what your basal rate is at that time of day, but bolus any insulin that you missed when disconnected.  You may also consider doing your site changes in the evening, when you aren't so tight on time and insulin resistance isn't bad.  

Most fast acting insulins take at least 2-4 hours to complete.  If you're testing an hour after eating your blood sugar will still be slightly elevated from the meal.  Think most doctors recommend testing about 2 hrs post meal.  

Make sure to get all the air bubbles out of the reservoir when you fill it.  If you flick the reservoir, then push the plunger, it should get rid of them.

Last, but not least, when you prime the pump before a set change, are you seeing little drops of insulin on the end of the canula?  Priming .3 units is only enough if you see the insulin drops.

Hope this helps.  -Jenna

Hi Amber,

i am using the paradigm pump also, but I use the 23 inch length tubing. I am 5' 6" and this works well for me. It takes about 5 units to prime this length tubing, so part of your high BG problem may be not getting enough insulin when first inserting the the quick set.

Hi Amber,

I noticed that when I change my infusion sets, it will shoot my BG up high like that more often than not.  I believe it takes some time for the new site to work to full effect.  For this reason I usually am very careful about what I do and eat when I put in a new site.  I sometimes even get an injection with a needle after I change it when the occasion calls for it.  I would recommend that you not get a shower right you change sites also.  If you need more tips or info let me know!  I would be more than happy to help.  

T1 since 1994, Minimed pump since 2000.

Hi Amber, I have been wearing insulin pumps since 1981.  I have found that I have to make sure I am seeing insulin drop from the needle before I insert and then I give at least 1 whole unit as a prime and that has worked for me but you will have to see how much you will need to give after insertion to get it working for you.  I am sure I have a lot of scar tissue in my abdomen after all these years and that is possibly why I have to give such a dose after insertion but you could start with less and keep increasing until you find what amount works for you.  I have always used as long a tubing as I can get and if you make sure you prime till you see a steady flow of insulin before inserting you know that it is primed and then give the extra dose as the pump allows following insertion.