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:
There are a wide variety of Infusion Sets available. Many have an adhesive surface that sticks to the skin. Shown to the right is a Rapid set which has a small 90 degree needle thats easy to install. In this example, a paper covering is removed from the adhesive surface before placing it through the IV 3000 dressing on the skin.
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.
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.
Paul Schickling, RPh, CDE
My insulin pump is transparent and I can see it's heart and watch as the motor delivers my basal and bolus insulin. What I can't see is just as important. One might say the pump has an electronic "soul". You still have to guide it along, but most of its functions you do not have to think about. It becomes part of you, and the only evidence it is working is better glucose control.