Pump Malfunctions

Hello! I am new here, and I’m glad to have found an online community. I am a 30 year old t1d and I was diagnosed at 19. Currently, I have an OmniPod system which I have used for 5 years (this is my second OmniPod machine). I have never had issues with it, but over the past 6 months I have experienced my insulin pods not working. For example, I had to leave work today as my sugars skyrocketed from 4 to 29, I changed pods, and it still continued to climb (after over 15 u bolused and doubling my basal).

Has anyone experienced this before w their OmniPod? For those who have different pumps, is this common/have you experienced it with your pump? Thank you!

Hi @jmbl and welcome to the forum. I use TSLIM, not Omnipod and I rarely have issues such as you describe but here are a couple of personal observations:
I’ve found that if I’m high no amount of insulin will even start to bring me down if I don’t wash any ketones out of my system. It doesn’t take much for me - just a couple of glasses of water in my case gets things rolling, although it starts very slowly (agonizingly so).
My doctor gave me some guidelines on what to do in the event I’m not able to get my sugars back in line using my pump - at what point to go off pump and switch to insulin pens instead (I have some of those just in case). I don’t know if those guidelines are universal or whether your doctor has certain ones they want you to use - plus here we use mg/dl and you are using MMOL (I hope I got that right) and I don’t trust my math skills to do any conversions😊.
I also have instructions on how much basal insulin to use and a sliding scale for mealtime injections, although it may be good to revisit that from time to time.
If injections and washing out ketones still doesn’t do the trick I’ve found chances are I have an infection brewing somewhere. I once had a UTI with no symptoms other than my blood sugars, and I’ve let a toothache go to the point I needed a root canal - that was a costly infection. In that case antibiotics were a necessity.
Hopefully other pod users can help you with the technicalities of your particular pump but maybe these ideas will help as well. I suggest you contact your doctor right away for instructions geared specifically to you.
Stay well my new friend!

Thanks for the reply! Yes, after an IV bolus of fluids and 4 u of nova rapid, my sugars came down. I never thought about washing the ketones out of my system, but this makes perfect sense. Sometimes I wonder if catheter gets linked, and the doctor suggested that perhaps I have built up some scar tissue that is causing insulin to pocket? I switch my site every 3 days, but I’m kind of stuck to my abdomen due to my CGM (and getting my pump caught on everything when it’s on my arms!).

I will definitely use your advice going forward. This is about the 4-5th time that this has happened w my OmniPod so I’m quite curious about others’ experiences with it/other pumps (perhaps it may be time to try a different pump!).

@jmbl - Julia, I also use a t:Slim (pump with tubing and a site set) along with a G6 CGM. Changing sites every three days (72 hours) is good to REDUCE the occurrence of scar tissue. I have used my abdomen for 20+ years of pumping and Dexcom use.

May I suggest you consult your pump trainer or endocrinologist for a good rotation plan including alternate locations for the next three months. Additionally, depending on your country of residence and the approved locations for CGM placement, it may be necessary for your endo to obtain a letter of variance to use alternate locations for the CGM (this is recommended in the USA since arm placement is not approved for example).

Here is a sample rotation plan were you to be using a pump with 1 inch (2.54 cm) sites.

Hope this helps.

I’ve been taking insulin since the early 1960s. For many years I took a shot of NPH in the morning and that was it. About the time I finished college I was put on MDI, adding in Regular insulin at mealtimes. I started on a pump in the mid 90s, and a CGM some years later. I used my abdomen for shots for the most part and is surprising I didn’t/don’t have more issues with scar tissue even now.
I do use alternate sites for both my CGM and pump tubinG. My doctor gave me approval to wear my Dexcom on my arm and I’ve also worn it on my upper thigh (without her knowledge :wink::wink:). @987jaj wisely suggested speaking with your doctor about where to place your sensor: approved sites may vary based on where you live and just as important - even more so - could cause compression lows, which have been discussed quite a bit on the forum (you can search for the term).
As for wearing my infusion set on my thigh, I’ve found my insulin absorbs more quickly there simply from walking around. Longer tubing helps when I insert on my upper arm and it’s not as awkward as you might think it would be to run the tubing under your shirt and to your waistband or pocket. Some even tuck it into a bra. An exercise might speed absorption as well. I’m right handed and insert in my left arm. Typical motions don’t appear to affect the flow - perhaps because it’s not my dominant arm - but weight lifting did back when I went to the gym.
There are patches you can wear to help keep things in place. Attached is a picture of the Simpatch and shield I use to make sure my CGM sensor stays in place - the patches are made with and without a strap and I believe I’ve seen them for Omnipod on Amazon. The shield may not be necessary but I tend to walk too close to corners sometimes.There are also tapes pre-cut to fit around your tubing insertion site to help keep it in place while allowing you to disconnect - IV3000 is one.
Just adding a few things for you to think about regarding sites and/or tubing.

I don’t know if it’s possible to change your topic title (@moderators?) or if you would need to start a new one, but you might indicate that you use Omnipod to catch the eye of podders on the forum.

My daughter uses Omnipod. She has had something go wrong a handful of times, where her sugar just goes up and it’s clear the insulin isn’t getting into her system, but we’ve never had it not come down with injection and/or a new pod. Dorie’s advice about extra SF fluids might be the ticket, since that seemed to work for you. (FWIW, our endo has a protocol for giving extra insulin to correct highs when ketones are present. Depending on the size of the ketones, our daughter might take 1.5x or 2x the usual correction while also drinking extra SF fluids.)

And it hasn’t happened often. Sadly, we experienced it extremely frequently with the tslim, which is why we went back to Omnipod.

With your long track record of no issues, and suddenly frequent problems now, it does make me think scarring might be to blame, so maybe alternate sites would be the solution. But I’m definitely voting for checking with your medical team if you haven’t already. Sometimes, the endo, CDE, and product reps will all have different insights, so it’s worth asking everyone. Good luck!

Hi again. If you do consider trying a tubed pump there are different types of infusion sets to choose from. I use Tandem which has sets with soft cannulas at go in at 30 or 90 degrees; and steel needles that go on at 90 degrees and which some people say are more comfortable than they may sound😊.
Medtronic (Minimed) has comparable ones but they are not interchangeable.
I may be getting way ahead of you - you may well decide to keep your Omnipod. Those are just some things to keep in mind if you do decide to switch. A rep may be able to give you some to try before you commit to a particular type.

I used pods for 4 years and had that issue with almost every pod change. I fixed it by changing to a tubed pump with a different infusions set. Hasn’t happened except once I had a kinked canula.

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I’ve been on MDI since 1993 but I used the Omnipod Dash system from Feb 2020 to Jan 2021. I rotated sites among my stomach, lower back, and buttocks. I gave up on it partly because the pods malfunctioned frequently and my blood sugars were going through the roof all the time. Often my blood sugar would come down again after changing the pod but not always. Sometimes there would be evidence that the pod had leaked, but not always. Sometimes I experienced skin irritation like pain, redness, and swelling but not always. Instead of enjoying my freedom from injections I was always worrying about whether or not the pods were even working and I eventually decided the flexibility wasn’t worth the effort, pain, and anxiety.

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@bsteingard, you just exactly described our experience, except for us, it was with Tandem. I moved mountains to get our insurance to cover that so our daughter could have their Control IQ, but in the end we had to give it up and go back to what works for us, which is (wait for it . . .) Omnipod! It’s really eye-opening how different each person’s experience with the different options is. Just more proof that we’re all different, in case anyone could ever forget.

So here’s my moral of the story for anyone who’s really struggling with something that just isn’t working for them: try something else. Just because x works well for other people doesn’t mean it’s right for you.

I know, right? I’m a genius. :roll_eyes: But sometimes, especially when we’re stressed and feeling out of our depth, it can be helpful to state the obvious. Even if we’re really just reminding ourselves.