Woman, 53 years of age, type 1 diabetes, has been wearing an insulin pump for 18 years. Recently changed insulin pumps. Not only upgraded on a certain brand, but now has a totally different brand. We did not change settings when she started with her new pump. She called to let me know her glucose levels were higher since she has her new pump.

She told me she has had this experience before. She has learned her body has to adjust to new pumps.

I recommend she wear her CGM for the next few days, correct as needed, but also make sure she’s documenting her food, activity, boluses, etc. And we would review.

Sure enough…we did have to make changes in her settings. This didn’t happen overnight. We had some adjusting and assessing to do, but we did it and voila…Disaster Averted!

Lessons Learned:

• Not all pumps are the same. Check with pump manufacturer specialist to find out the differences in insulin delivery between the pumps. Not that one is actually better than another, but it may be for a particular patient, or it’s just good to know.
• When pumps are changed out, sometimes patients go to or from a tubeless to a system with tubing or vice versa. Or infusion sets may change. There are a lot of factors that can make a difference.
• Don’t assume just because settings are working well for a patient with a particular system, the same settings will work when the system is changed. Together, you and your patient may need to reassess and make changes to make the new system work.
• Listen to your patient when they tell you they think they know their problem.