Why do I get .......

[flash]

Why do I get a no delivery on a bolus and the basal delivery is OK ???

Flash

[Funnygrl]

If you get a no delivery warning, the basal is NOT delivering. Often it takes a bolus to "catch" the occlussion, or whatever is causing the warning, because a larger dose of insulin is being given.

[flash]

I get the no delivery on the bolus not the basal which means the basal is delivering I guess

Flash

[camjen1]

Well how are your numbers in between meals? If they are higher then norm then it's obvious you aren't getting your basal either.

It's hard to get a bolus to set off a no delivery because it's a smaller amount then a bolus and is pushed a little here and there and not all at once like a bolus.

[Funnygrl]

Flash- did you have pump training? Can you call your trainer? Have you read the manual?

[flash]

Why wouldn't I recieve a no delivery on a basal delivery like I do on a bolus delivery ??? I realize that it's a slower delivery
but still if it's not delivering it should give a no delivery warning regardless of how slow the delivery is. This makes me think that the basal delivery is working while a bolus delivery isn't working.

Flash

[JediSkipdogg]

Flash, there are a few reasons for this.

The basal is given at a MUCH slower rate. Therefore less pressure is needed with each "burst" of insulin every 3 minutes. Occlusion alarms occur when the pressure required reaches a certain point.

Many times to reach the "breaking" point of an inclusion it takes about 1-2 units of insulin. That's why an occlusion alarm is 90% going to happen on a bolus. Since most people 1-2 units takes about 1-2 hours and even then, it can still "difuse" into the body as it's absorbed at a much slower rate maybe making that time period longer.

That's why when a true occlusion occurs it may be hard to determine how much insulin you have not been getting. Generally, if you have one, check everything, and go again, you may need to test your BGs every hour for the next 4 hours to make sure you got the correct amount of insulin.

I hope that helps some.

[Injecto]

Ditto

What Jedi said above is exactly what I was going to say (well, in my own words :) ).

[Funnygrl]

Jedi said the exact same thing I said....

If you are convinced your basal is running when you get that warning, and don't change it, you risk going into dka.

[lilituc]

Flash- did you have pump training? Can you call your trainer? Have you read the manual?

The short answer is "no." I refer you to this thread: http://www.diabetesforums.com/forum/pumping-insulin/16444-new-722-a.html

[flash]

I don't think that training has anything to do with my question. I want to know why I can't get a definite yes or no answer from mini med. If the basal is not working because I recieved a no delivery on the bolus then the pump should alarm no delivery like it does on the bolus. I realize that the basal is a slower delivery does that mean there would be no occlusion with the slower delivery or like those who said that the basal is not working as well ..............

[JediSkipdogg]

flash, read my post above. It has nothing to do with the pump. It has 100% to do with the delivery rate of insulin and when these pumps are set to detect an occlusion by a certain amount of pressure being required to "force" the insulin into you. Page 138 of the Minimed 522/722 manual...

Occlusion detection
When occlusion is detected, the “no delivery alarm” will occur. The occlusion alarm is triggered by an average of 2.77 units of “missed” insulin. This table shows occlusion detection for 3 different situations when using U100 insulin.

Rate --- Minimum time before alarm --- Typical time before alarm --- Maximum time before alarm
bolus delivery (1.5 u/minute) --- 92 seconds --- 116 seconds --- 162 seconds
basal delivery (1.0 u/h) --- 2.2 hours --- 3.09 hours --- 4.47 hours
basal delivery (0.05 u/h) --- 37.4 hours --- 59.2 hours --- 87 hours


So using the above table if you are on a 1.0 u/hr basal rate all day long. And you eat dinner and give 5 units and it happens that there is an occlusion at that time it will alarm you in about 2.5 minutes. BUt if you skip dinner, you could be going without insulin for 3 hours before you know that it occluded.

[Funnygrl]

I don't think that training has anything to do with my question. I want to know why I can't get a definite yes or no answer from mini med. If the basal is not working because I recieved a no delivery on the bolus then the pump should alarm no delivery like it does on the bolus. I realize that the basal is a slower delivery does that mean there would be no occlusion with the slower delivery or like those who said that the basal is not working as well ..............
You can get a definite yes. The error says NO delivery. As in NO insulin is being delivered.

[flash]

Thank you Jedi, for all your work and time ..........

Flash

[JediSkipdogg]

Thank you Jedi, for all your work and time ..........

Flash

Not a problem and I'll say what you want to say....yes, it sucks that you could go 3 hours of a basal and not get insulin. I've had it happen. It's crazy the next few hours after trying to figure out what you truely need to give. But if they lower the detection level (which on the Animas you can do, not sure about the others) then it may pick up too sensitive and go off if you give a large bolus (since you would be pushing more insulin into the same area at once.)

[KAnderson]

Flash - also remeber that what you are experiencing is exactly why you never want to change a set after dinner - you could easily go until breakfast before finding out that you have a problem - basal rates aren't going to give a delivery alarm soon enough. Giving a meal bolus after changing ensures all is well.

Ken

[flash]

Thanks for the reminder ........

Flash