Always Double-Check Your Replacement Insulin Pump Settings!

I’ve had many replacement pumps in my years of pumping. To my recollection, I had:

  • 1 Disetronic replacement
  • 1 Accu-chek Spirit replacement
  • 1 Animas Ping replacement
  • 2 Medtronic Revel replacements
  • 5 or 6 Tandem t:slim replacements
  • and now, I’m on my second Medtronic 630G replacement.

So, as it should seem, I’m pretty well-versed at what to do. You know, upload the old pump if possible to save all of the history and settings. Once you have the replacement in-hand, go through the process of setting up the pump using that data you uploaded. However, I’m not usually one to look at the upload because my settings are simple and straightforward.

And, until this week, I have never missed a setting.

Rewind to Tuesday. I had missed the initial delivery of the 630G pump replacement because I had to take my daughter to her check up (which had gone well). I rushed to try to make it home so to avoid another hour-long trip to go pick it up, but alas, I missed them. And, at the time, I didn’t think I would be home Wednesday at the time they were going to deliver it, so we made the trip to go get it. Which, we almost didn’t, because UPS had some sort of problem releasing my package and I came thiiiiiiis close to almost having had it sent back, even though it was sitting right there in front of me. But, in a miracle event, somehow the UPS clerk was able to get it to release and we went home.

It was late, so I went through the settings to get it started up. I was more worried about whether I could save my 2-day old sensor than anything, which where the problem came in at. I rushed through my settings, forgetting ONE very important one.

For the last few mornings, I’ve been waking up with very high blood sugars. Wednesday, I thought it was my panic attack over the low I had to which I ate way more than I should have, but forgot to correct for after I started coming up. So, I was almost 600 mg/dL when I awoke and sick as ever.

But I came down within a few hours with some rather large boluses. I thought that would be normal since once I’m over 250 mg/dL, I typically need to add more to the dose.

I had been staying a bit high through the day, but I had been stressed a lot lately, and drinking way more coffee than water, so I thought that must have been the trouble.

Wednesday night before bed, I was high, but again, not terribly, so I took a bolus and increased my basal rate.

Thursday morning, I was almost 400 when I woke up, despite an increased basal rate and a bolus around 4am.

My day went relatively the same as Wednesday. My son had his summer reading camp awards ceremony that morning, and when I got home, it was full-steam into work-mode, with lots of coffee and Diet Coke. I still thought it was strange I was struggling to bring down some highs, but I mean, it could be anything, right?

I could be getting sick… It could be about the time for a mid-cycle bump due to ovulation… It could be that I really need some water in my veins….soooo many things!

So, last night, before bed, I took a bolus yet again for an almost 300 high (we had also eaten canteloupe and watermelon a couple hours before) that I thought should have been down by then, and I set a 125% basal rate, and went to bed.

This morning, I woke up sick yet again, and clocked in at 398 mg/gL. So, I uploaded my pump to see if I could spot anything at all that could be the cause. Then, that’s when I saw it.

I had a 0u basal rate.

I NEVER SET THE DARN BASAL RATE!

Again, I have had wayyyy to many replacement pumps in my life, and settings are crucial to set right away. Basal is almost always my very first one to set. I have NO idea how that happened. I’m still kicking myself. I mean, it’s set for sure now, but HOW ON EARTH!??? DID I MISS THAT!? Also, hoooowwww could I not realize that before? I mean, does that mean I, indeed, have too high of an insulin-to-carb ratio? So. many. questions!

So the moral of this story, kids: always have a check list. Always go back in and review those settings. Don’t think because you’ve done it lots of times before, that you’re impervious to a mistake like this.

Which leads me to a pump manufacturer request: Please make a plug-and-program option into your pump software? That would make switching over so much easier, and reduce human error such as this! Please, thank you 🙂