Insulin Pumps

Bubbles

Air bubbles in the reservoir are not a problem unless they are large and enter the infusion line to replace insulin. If air bubbles are seen in the infusion line, an inch of air in the line is equal to half a unit of insulin. In most cases, up to an inch of air in the line is not of concern. Requires visual inspection.

Solution

The small bubble to the left in the picture can be ignored.

Tunneling

This problem appears to be more common with Teflon infusion sets, and is often encountered in golfers, tennis players, and active individuals. Blood sugars rise unexpectedly due to leakage of insulin along the Teflon tubing back to the skin. No warning is given except for high blood sugars! Occasionally, leakage of insulin out to the skin surface will be seen after a large bolus.

Pump Problems

Pumps generally behave themselves, but like other mechanical devices they can misbehave. Mechanical problems cannot be solved by giving more bolus insulin. Assuming they can may easily lead to an unnecessary hospital bill. It's critical to recognize when the pump, infusion set, reservoir, or insulin is the source of high blood sugars. Below are some of the problems pumpers have encountered and how to deal with them:

Infusion Sites

For sites, most pumpers prefer the abdomen, but anywhere that has padding will do. The abdomen usually gives the fastest and most consistent absorption. You should stay at least 2 finger widths away from the navel for good absorption, and above or below the belt line. The upper buttocks, thighs and back of the upper arms also can be used. The buttock area often works best for young children because it is a large skin area that is out of sight. An area you can easily see is best when first starting on a pump or if you are having site issues.

Insulin & Dressings

Insulins and tapes for pumps

Novolog, Humalog, and Apidra are all approved for pump use. Because it was the first rapid insulin available, many pumpers started out on Humalog and continue to use it successfully in their pumps, although some problems with Humalog stability have been noted.

Tapes, skin preparations, and transparent dressings can greatly aid safe pump operation.

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