Last week was Diabetes Camp Week! It was AWESOME.
My kids blood sugars were the best they have been in months. Why is that? I didn’t change basals (amount of insulin that is continuously given via the insulin pump) or I:C ratios (Insulin to Carb ratios ex. 1 unit insulin for 14 grams carbs) or ISFs (Insulin Sensitivity Factors – amount of insulin given to correct a high blood sugar)? Yet their BSs stayed between 78 and 176 while at camp. That mystery is for another post. This post I want to share a problem I hadn’t run into before – well I had but I didn’t know why until now.
At camp on Thursday Sugarboy’s tubbing became detached from the cartridge of insulin in his pump. He didn’t know how long it had been detached before he realized it. Someone (he can’t remember if it was his group leader or a medic) told him to just plug it back in. Don’t get to upset with the person – I have done the same thing.
After camp we went to a water park. We ate dinner before and Sugarboys BS was 227 so he dosed for his dinner and corrected. An hour or so later he wanted nachos for a snack. He had just eaten and dosed so I let him dose for his nachos without checking his BS. At home he was 358. I thought we had not dosed enough for the nachos so I corrected him. At bedtime he was HIGH GLUCOSE. Huh?
I thought perhaps his infusion site had gone bad so we put a new one on. His pump said he still had 46 Units of insulin available and it was late so I decided against a new cartridge of insulin and to use the old tubbing until I replaced the insulin in the morning.
Thus, I ran a prime (push insulin through tubbing to remove any air). While priming I noticed a bit of blood come out of the tubbing. Huh?
Seeing the blood I decided to remove the cartridge to investigate. Huh?
There was no insulin in the cartridge – just 46 units of air. Thus after the insulin that was in the tubbing was used for dinner, nachos and attempted corrections my boy wasn’t getting any insulin. Turns out while the tubbing was disconnected insulin drained from the cartridge (makes perfect sense). Thus plugging back in without priming and checking the cartridge is dangerous. I did share the occurrence with the medical director of the camp and she assured me that she does instruct the medics to send the camper to the infirmary so proper procedures are followed. It was an honest mistake that even I have made. Which explained why in Feb of this year I found a cartridge filled with air when I thought Sugarboy’s site failed. At that time I didn’t make the connection that the disconnected tubbing caused the air filled cartridge – thus I called Animas and explained the air filled cartridge and they believed the cartridge was faulty and sent me a new box of cartridges.
New cartridge of insulin was installed with new tubbing and site and Sugarboy was within normal ranges in three hours. He was negative for ketones. All was right in the world of diabetes (at least in our home).