Wondering if anyone had experienced a consistant string of "No Delivery" messages? 

I have had them from time to time over the 7 years I've had my pump and attributed them to damaged tissue at the infusion site.

But today I have had them at almost every bolus.  After the first, I changed cannulas and used a different site, but I am still having problems.   I usually only get through .1 or .2 units before I get the "No Delivery" alarm.

I am using a paradigm 512 which is at the end of its life, so I am beginning to suspect the merchandise, but was wondering if anyone had discovered another reason for these errors.  

Any help is appreciated.

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Replies to This Discussion

I have only gotten two in my 2 years with the MM. They were both in the early days before I switched infusion sets and I think that they were due to kinked cannulas. With the Sure-T, I have never gotten a no delivery alarm.

How are you blood sugars? If you are really getting too little insulin, then your blood sugars would have gone up too? Did you switch to injections?
i use the MM 722 and when i do get them it's normally after bolusing + if i ignore it and bolus again it gives me the same message. i just change the infusion set + it normally works. maybe it detects there's a kink or block in the tubing :/ <3
I've only had my pump (Paradigm 523) for about 6 months, but I've had a few No Delivery messages. Also would have unexplained highs that might be fixed for the first while after changing sets. One of my educators suggested I try a Sure T infusion set (small needle instead of a cannula). It's worked like a charm! Two No Delivery messages were fixed by straightening tubing more where it attaches to the actual infusion point.

I've been diabetic for 30 years, so I think cannulas didn't work for me because of scar tissue.

Hope you get it figured out!
Thanks to all for the input. I usually just resume the pumping and re-bolus. Its never really affected my sugars, because I always hear the alarm and make sure I've gotten the correct amount of insulin. But I am wondering about the soft cannula's affect on my tissue. Kristin and Miki, it sounds like you are pretty happy with the Sure-T. May I ask if you can feel the needle more than a soft cannula? Have you found that the needle affects the healing process? I am, in no way, head over heels about the soft cannula, but am pretty active and am not too crazy about another adhesive pad.
I am happy with the Sure-T. I switched about 6 months ago. To answer your questions:

- Do I feel the needle more than a soft cannula?
Most of the time, no. But sometimes if it is in the wrong spot I will get a sharp pain that I don't remember getting with the Quick Set or the Silhouette. I think it must just depend whether it is close to a nerve. I haven't found a pattern, but the good news with the Sure T is that you can MOVE the infusion set without replacing it (re-insert and tape down)... more on that below. I have bruised from the Sure-T a few times. Also, I am more intentional about NOT laying on the Sure-T than I was with the Quick Set. That might not be necessary, but psychologically, I don't like the idea of laying on a needle. Maybe I'll get over it.

- Healing process
I have found that the Sure T sites heal A LOT faster. I'm not sure if it is because it is only in for 2 days or because the cannula is different. The cannula is thinner than the plastic cannulas. I have a lot less marks on my skin since I switched.

- The second adhesive pad:
I didn't like this at first, but actually i have found that it doesn't bother me. The second adhesive is there for detachment and it's basically just like a sticker. I put the two pretty close together. All together it is not much bigger than the space that Silhouette took up on my skin. But this can be a disadvantage of the Sure T ( for example if you have problems with the adhesive sticking.

Other things that I like about the Sure T:
- I can MOVE the infusion set whenever I want. If I realize that I did not put it in an ideal place, I'm not "stuck" with it for 3 days. I pull the infusion set out and clean it with alcohol and clean my skin with IV Prep (to have the stickiness) and I re-insert (my doctor even OKed this) then I tape it down with strips that I cut from IV3000. I usually leave the second adhesive pad in place and just move the needle around it. So I usually get 6 days out of a single infusion set.
- Insertion is MUCH easier and rarely painful. If it is painful, I pull it right out and re-insert elsewhere.
- No worries about kinked cannulas.
- I used to have problems with highs after changing my infusion set, but not anymore. I just prime the set before inserting and I'm all set (no need to prime after insertion as the needle is filled and nothing is removed).

Another possible con:
- It's hard to insert in hard to reach places because there is no inserter. You can basically only put it in places where you could give yourself an injection. My husband sometimes helps me insert it on my back or the back of my arms. He did not like to insert the QuickSet, but finds the Sure T much less intimidating because the needle is MUCH smaller than the Quick Set insertion needle.
Thanks, Kristin. You've definitely bolstered the Sure T case. I have always used the silhouette with a manual insertion, so it doesn't sound like there are many things to get used to. Perhaps I will have to give them a try!
Great explanation, Kristin! Now I know I can move mine w/o fear and continue to use. I've only moved the second adhesive patch. Do you ever refill your reservoir?

I've only rotated around my abdomen, but it doesn't bother me in the least to sleep on it. Might "feel it" (the needle) if it's pushed on, but it's not painful.

MUCH less marking on my skin from Sure-T than QuickSet.

Personally, I think Sure-T should be the first infusion set used by educators and doctors!
I have a MM722 so I can get almost 300 units in a full reservoir, which lasts me about 10 days. Then I refill. It's very rare that I change the infusion set and refill at the same time. I just change the tubing (up to the point where you disconnect and leave the rest in .

I agree about the Sure T -- glad that you are enjoying it too!

I am a little late to this discussion, but I would like to thank Kristin for your comments on the Sure-T.  I just started pumping in August 2010 and basically had no problems with the Silhouette.  However manual insertion was sometimes hard for me when it came to 'hard to reach' places.  I tried the Sure-T on the recommendation of a friend here on TuDiabetes and it works beautifully.

 

I have a question about changing the Sure-T every 2 days.  Is that something that is a personal choice or is it accepted practice on the recommendation of Medtronics?  Also, is it OK to re-use a reservoir if your supplies are getting low while waiting for your next shipment?

Mayumi, I was told by my diabetes educator that leaving the Sure-T (or any other insertion device) in longer than recommended can cause "tunneling" which is some kind of problem with the skin and it's ability to absorb properly.  She said it may not be evident for a while, but the idea is to prevent the problem from starting.  I like Kristin's idea of reinsertion.  Not sure about reusing the reservoir.  I've wondered this, too.

I know some people who reuse reservoirs and have had no problems. I tried it once. But I don't feel confidence about it. Reservoirs have some lubricant that determines how easily is slides and I wonder how quickly that wears off. I guess using it twice shouldn't be a problem.

 

I experienced the negative effects of leaving infusion sets in too long. I used to leave mine in for 6 days and I have a ton of scar tissue.

 

Relocating the Sure-T is not something that I think that Medtronic would advise because it is not sterile when you re-insert. But my doctor said just to clean with alcohol and re-insert.

I have had to relocate a sure-t when I put into a sensitive area and then because the adhesive doesn't work as good I put a ReliaMed Transparent Thin Film over it so it will stay in place, works for me.

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