There's nothing quite like the horror of having an insulin pump suddenly go postal at eleven o'clock on a Saturday night. The buttons that don't respond to touch, the motor that spins wildly, the shrieking alarms. It's almost enough to induce a panic attack!
Although insulin pumps are the treatment method of choice for both Amy and I, they are machines. Which means that sometimes they go kaputt. Unlike Amy who rocks an Omnipod, I don't have a box of back-ups at my disposal to switch to. When a tubed insulin pump (Medtronic, Animas, or the dearly departed Cozmo) fails, it's a pretty straightforward fix, but not without its share of anxiety.
Of course, according to Murphy's Law, an insulin pump will usually die at the most inconvenient moment. The last time my insulin pump died was in 2005 (knock on wood), while on vacation at a cabin in rural Central Oregon. I was changing my reservoir and in the middle of priming, my pump's motor suddenly didn't recognize how much insulin was coming out. After rewinding a couple of times and having half a reservoir of insulin spew all over the kitchen counter, I admitted defeat.
So what's a PWD to do?
Luckily, it was a Tuesday afternoon, and I was able to get a prescription for Lantus and syringes faxed to the local pharmacy within a couple of hours.
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But what if it were the weekend or what if my vacation was somewhere overseas?
Animas and Medtronic both have fairly cut-and-dry recommendations for what you should do if your insulin pump suddenly becomes a very expensive paper weight:
- First, call the manufacturer right away. They can usually overnight a replacement pump, so chances are you won't be without your pump for longer than 24 hours.
- Always keep a prescription or a bottle of long-acting insulin handy (and bring it with you when you travel!). Make sure to keep the prescription up-to-date, as they usually expire after six months.
- Write down (or print out) your insulin pump settings, and remember to update this if you make changes to your basal or bolus settings.
- For those traveling, you can also investigate loaner programs, such as Medtronic's Travel Loaner Program and Animas's Vacation Loaner program. (These keep you pumping with a basic model until you're able to get a more permanent replacement)
If you don't think you'll have access to a 24-hour pharmacy, your safest bet is to always keep a pen or bottle of Lantus or Levemir handy. In some cases, even NPH can be used. Unopened bottles and pens can last for months if they are kept refrigerated.
Remember that switching from your insulin pump's basal profile to long-acting insulin isn't an exact science. But Gary Scheiner, CDE at Integrated Diabetes Services and a type 1 PWD himself, has this advice: "If you don't have a backup pump, it is necessary to take long-acting insulin IMMEDIATELY. If your basal program has a significant peak/valley, NPH might be your best option. If not, glargine is usually best. If using NPH, take 80% of your total pump basal insulin as a single shot of NPH. If using glargine, take 110% of your total pump basal as a single shot."
When FedEx does arrive with your brand-spanking new insulin pump, don't get too excited. Long-acting insulin stays in your system for many, many hours. "Remember to let the long-acting insulin wear off before resuming basal delivery with your new pump," Gary says. "Wait at least 12-14 hours after taking NPH, and 20 hours after taking glargine."
An insulin pump malfunction is certainly one of the most annoying and nerve-wracking things that can happen to a pumping PWD. But luckily, it's only temporary. You can even think of it as a pump vacation! (Life with diabetes is all about finding the silver lining, right?)