Tandem Insulin Pump Glucose Is Staying High

Hi everyone,
I use a Tandem Insulin Pump. My glucose is not going down. Ex. 225, I will give myself insulin and I will check an hour later and it’s the same number or higher. This is scaring me. Last time this happen I changed sight and my levels went down. This time it is not working. Besides the stomach, is there another place I could insert my infusion set. I have been a T1 diabetic since 1995. My pump says it is giving me insulin. I’m using Novolog. Could it be defective insulin, dropped pump too much on the floor or I have damaged something internally. Thank you for your insight. :slightly_smiling_face:

Hi @Clifster . I’ll give some suggestions but please know I am not a medical professional and if you have concerns you should call your doctor if you feel it is serious enough. Overnight you can have their answering service reach out to them. That said:
My endo told me that unless I had miscalculated my carbs or taken in extra ones, I should wait x number of hours before adding more insulin, otherwise I might end up going low due to stacking. I don’t want to say what “x” is because the number may be different for you; but I found that if I did wait it out (and yes, it is like watching paint dry🕛), sure enough they would start to come down - perhaps very slowly but they did start. If you are concerned about a bad site or crimped cannula, but all means change that first.
I find that if I have ketones in my urine no amount of insulin will work until I start washing them out with sugar free fluids, so drinking some water or your favorite sf beverage might help as well.
I’ve used my thigh and bicep (with extra long tubing) as alternatives to the abdomen. You might find your body is more responsive to insulin in the thigh from simply walking around - same for bicep if you lift weights.

Here’s an extract from Tandem’s website about sites - links can sometimes be problematic so I just copied these but you can find them there.:

Tandem infusion set sites

Site selection

** Your infusion set can be worn anywhere on your body where you would normally inject insulin. Absorption may vary from site to site. …*
** The most commonly used sites are the abdomen, upper buttocks, hips, upper arms, and upper legs.*
** The abdomen is the most popular site because of access to fatty tissue.*

Keep us posted on how you’re doing!

@Clifster Hello Cliff, and welcome to the JDRF TypeOneNation Community! This is a fine place to hear and offer tips for managing diabetes, but what is offered is not medical advice.

To respond to your direct question, a pump infusion set can be placed anywhere on your body where insulin can be injected - virtually anywhere. Based on the senario you described, I would suspect that there isn’t any fault with your equipment, but rather with the information you enter - the Tandem is not a “plug-'n-play”. And my question to you; do you bounce your $700 phone on the floor as often as you drop your $7,000 delicate Tandem on the floor?

As you have lived with Autoimmune Diabetes for 27 years, you should be aware that your body’s diabetes demands change and do not remain constant - specifically insulin sensitivity and how that insulin affects your body glucose level [BGL]. Have you adjusted your Profile?, do you have different Profiles to match your various activity levels?, etc. There are five settings to consider for each “timed interval” of your profiles that interact with the carbohydrate count and BGL entered to calculate a bolus. Also, if you are utilizing an automated insulin delivery assist - BIQ or CIQ - the Profile settings you have entered affect basal flow and bolus-correction.

I suggest that you reread your Tandem User Guide that matches your pump software version, take notes and make necessary adjustments.

This is good info. Thank you! I did change my site and went for the leg just below my pants pocket. So far still high. 216 and now 295 with insulin. I had a gluten free Rip Van cookie 23 carbs along with insulin. Now my glucose is 295. I did check the pump by bolusing .3 to see if insulin would come out and it did. I am going to drink more water.

My doctor have me protocols to follow as a guide to when I should switch from pump to injections so check yours. If injections still don’t help I’ve found I have an infection of some sort. You might start with a visual check for anything visible, but I’ve had a UTI with absolutely no symptoms but my numbers so that’s a possibility as well. And if you have any tooth pain do check with your dentist. On a few occasions mine was dental and I ultimately needed a root canal.

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Thanks Dennis,
I thought I emailed you earlier today. Hopefully, you get my reply. It is like a plug and play. I did some changes to my profile by increasing insulin amounts. Yeah I dropped pump when it came off my belt loop. Usually it stays. The weird thing is that this time the tubing disconnected so it hit the ground.

Never happened before. When it does fall from my belt it just hangs or swings by the tubing. I got a new tandem clip this morning from Amazon.

You could also wrap your tubing around a belt loop a few (several) times, then clip your pump to your waistband or tuck it in your pocket. If it did come loose it wouldn’t fall too far.

Cliff @Clifster , you are welcome. I hope that the new Tandem protective case you got today is the one with the 360 degree rotating clip. In my use, it has been terrific; can be rotated so screen is always correctly aligned for viewing and NEVER slips off a bet or any piece of clothing including a t-shirt sleeve.

Your graph is interesting, and I don’t want to play doctor with your readings, but … What I see, the bolus you may have taken for [I’m guessing] a 5:30 PM meal was not sufficient and whatever corrections were made never brought you back In-line didn’t work - very strange. If this happened to me, I would have pulled out a syringe and needle and taken a shot, or shots in my arm.

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It’s not. Did know they made that. I will look into it. Yeah, should have myself the needle. I should get a prescription for them.

I’m going to ask for prescription needles tomorrow. Hopefully I can get in. I do do have some new scabs.

In addition to protocol for when to switch to shots, be sure your instructions are up to date on how much to take - units of basal insulin, and how much to take with meals. It sounds like you need to call your doctor first thing in the morning. All the best.

The advice last time was super helpful. Well I’m at it again. Being distracted, I did not take the cannula out while loading insulin. So basically, air went in my leg until 10.5 or so before insulin came out. That’s when it usually comes out or 11. I have a big knot on my leg. It’s by the bottom of my pants pocket. It’s swelling up like it would do sometimes in my stomach area. I hope it goes down. Any advice on how to make it better?

HI @Clifste. I don’t really have anything to suggest about how to bring the knot down, but with overnight issues is best to call a 24/7 nurse hotline that for advise - there may be a number for one on the back of your insurance card.
This has happened to you before - do you make a habit of loading insulin while you’re connected? Although you have determined how much air goes through the tubing first you really should not prime your pump while you’re connected - another distraction could leave you with insulin you don’t need and aren’t ready for. When I was on a tubed pump I inserted the infusion set but did not connect the tubing until I had primed it. Much safer.

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