Pump Safety Features

Get the Most Out of Your Insulin Pump: Pump History, Reminders, Insulin Limits, Lock-Out

The power of an insulin pump made me nervous at first... as a parent, I worried: what if my young son played with the pump buttons and delivered insulin when he didn't need it? what if he delivered too much insulin when he was away from me? would he remember to deliver insulin for meals, and to check his BG a few hours after meals? I found the antidote to all of my mom-worries in these safety-conscious insulin pump features.

When we first got an insulin pump for our then 3-year-old son, the learning curve was steep for us. In the beginning we simply used the pump as a high-tech syringe, continuing to perform all the same tasks we did when we were injecting his insulin. But as we got a few useful features under our belt, we wanted to learn how to get more from the pump. These are some of the helpful features that moved us past the “high-tech syringe” stage, making our battle with the diabetes dragon easier, improving our family's quality of life, and giving us the power to better manage our son's blood glucose, ultimately resulting in a lower A1C.

Waltzing the Dragon also has articles on other pump features that have offered the same benefits.

They're linked below under More Ways to Get the Most from Your Insulin Pump.

Pump History & Apps

The Pump History feature of your child’s insulin pump keeps track of all the actions taken by the pump, automatically and manually, including the date/time and amount of basal doses, boluses, Total Daily Doses, alarms, primes, and suspensions of pump functioning.

If your child can’t remember if she bolused for lunch… check the pump history. If you get unexpected blood glucose results… check the pump history for clues. If you changed the basal rates and can’t remember when and by how much… check the pump history. Can’t remember if it’s time for a new infusion set?… check the pump history for a “new set” record, or for the date and time that the cannula was last filled. Unlike injected insulin programs, use of an insulin pump provides an automatic record of everything that occurred with regards to the pump… Handy!

Note that if your child’s pump model includes an integrated blood glucose monitor, you can also consult the monitor history for information about past blood glucose readings. Some pump companies offer data software that integrates results from both the insulin pump history and the blood glucose monitor log, so you can see all the relevant entries in one record on your computer or mobile device. Or you can use third-party software like Diasend, Tidepool, or Glooko to view the glucose data, print summary reports and analyze trends.

Reminders

Does your child have a habit of forgetting to bolus for lunch at school? Are you interested in the 2-hour post-prandial (post-meal) blood glucose reading, but keep missing the check at that time? Most insulin pumps have a feature which allows you to set a Reminder which will alert you at a certain time of day (ex. 12:00pm), or when a certain length of time has elapsed since the last bolus (ex. 2 hours after the last bolus), with a reminder to check blood glucose or to bolus (if it was missed).

Tips from the Trenches

We have a recurring 2:30pm reminder set on our son’s pump to prompt him to check his blood glucose during what are often busy afternoons at school when this important check could easily be forgotten.

Also, when he is at school, he is solely responsible for bolusing for his lunch. Since lunch occurs at a the same time every school day, a 12:30pm reminder to bolus would fall just after the start of lunch, catching a missed lunch bolus (and prompting him to complete it) before it wreaks too much havoc with his blood glucose. ~Michelle

 

Tips from the Trenches

When my son goes on sleepovers and knows that he might forget to check his BG because of all the excitement, he will use the reminder feature to help him remember to check before bed. If he is a “sketchy” number at bedtime, he will also set the reminder for the middle of the night so he can be woken up by it to test again. ~Danielle

Insulin Limits

As a safety net, most insulin pumps allow you to set an upper limit on the amount of insulin that can be delivered at one time. There are also settings to restrict the amount of insulin delivered across multiple boluses over a 2-hour period, and over a 24-hour period, as well as an hourly limit on basal delivery.  For a child who is in the early stages of learning to operate their insulin pump on their own, this gives parents some peace of mind, as the amount of extra insulin their child could accidentally deliver is restricted to the maximum limit set. When the limit is reached, a warning message pops up, which may alert you (the parent) of the need for damage control. And allow you to avoid a potentially dangerous low blood sugar situation.

Limits can be restrictive, however. If you find that your intended boluses too often hit this upper ceiling, it may be time to change the settings to allow for higher insulin limits.

Tips from the Trenches

When our son started delivering his own insulin at school, away from our direct supervision, we were worried about the potential for him to mistake .8U for 8U and deliver a catastrophic amount of insulin. So we set the maximum limit for a single bolus at 1U higher than the largest meal bolus we typically gave (in his case, his maximum dose is set at 4.0U), which prevented him from delivering tons more insulin than usual. While he could still make a mistake, we felt better that if the mistake was large, the pump would give an error message, prompting him to turn to an adult for help. And if he ever has a meal which exceeds that maximum, we can simply deliver the extra as a separate, normal bolus.  ~Michelle

Update: Ten years later, we have the Max Bolus set at 15U... things sure do change over time!

Lock-Out Feature

If you want to prevent an unauthorized user from pressing pump buttons (and potentially delivering an unintended bolus), most pumps include a Tamper-Resistant (Lock-Out) feature. If you lock the pump each time you finish using it, then pressing pump buttons will have no effect until you “unlock” the pump. This feature is handy for young children or developmentally delayed individuals who wear an insulin pump. It was also an important safe-guard in the eyes of the staff at our young son’s school – they wanted to make sure that other students could not put our son at risk by tampering with the pump.

Tips from the Trenches

Locking the pump seemed like a hassle at first. But we have found that once we established the lock/unlock habit, it didn't take much extra time and effort (just pressing 2 buttons simultaneously), and offers a huge benefit. ~Michelle

Tips from the Trenches

When Paul was three, we came into his room about 2 hours after he was put to bed in order to check his BG. We noticed his pump was laying beside him and not in its usual pump pouch. After looking through the pump’s history, we discovered that Paul had given himself multiple boluses of insulin (playing with the pump) while he was trying to fall asleep. Luckily his BG was still okay and it just involved us having to wake him and give him juice with sugar mixed in to quickly feed all that extra insulin. Even though we had discussed with him many times the dangers of him touching his pump, it just took one time of not listening and it could have been a potentially fatal outcome. Needless to say, we locked Paul’s pump at night religiously for the next couple of years! ~Danielle

The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.