Have you Auto-offed your pump?
I just read a lengthy story about the auto-off feature in Minimed insulin pumps and the effect it had on one family's life because pumps are shipped with the auto-off feature disabled.Do you know about the Auto-off feature?
If I tell you that it was originally called the Deadman's Switch, does that help you understand it's potential importance.
This setting ensures that if you don't do anything with your pump (that is bolus, set a temporary basal, check the remaining insulin, etc.) then your pump will turn itself off after a certain amount of time has passed. On my pump (Minimed 512) this is a hard setting to find. It's buried under the Alarm menu under Utilities.
I have it set to 11 hours, which is probably the shortest setting I can safely use. I generally use my pump first thing in the morning and late at night. Most of the day, I will be interacting with my pump every 2-4 hours. In the nine years that I've been using a pump, this feature has never activated.
So what's the story I read? To my eyes it indicates what might happen when you have a novice pumper with (I think) inadequate training and no-one to monitor them closely while they are getting used to the pump. It's not an easy read.
This investigative article by The Seattle Times reads as a report against Medtronic Minimed because the court records were sealed so that other pump users don't have an opportunity to learn from the mistakes made here.
If you're reading blog post and you don't know about Auto-off, please talk with your diabetes team about this feature and whether it makes sense for you to use it.
posted by Bernard @ 9:19 PM
3 Comments:
I did not agree with the lurid tone of the article - the use of Auto Off as a required safety feature is not clearcut. As I understand it, the kind of coma Sylvia had is really rare and people on MDI can't turn off their insulin delivery. Aren't highs from stopped insulin delivery much more dangerous? And one thing the article did not explain is why her family did not call paramedics when they were unable to contact her for three days. I also didn't see any evidence that Sylvia herself didn't know about the feature. I think what happened to her is a tragedy, but I wouldn't blame the pump.
Lili
I agree that this isn't a clear cut case against Minimed, or the person who trained Sylvia, or even the family. And the article makes it sound like at least the first two of these are in some way guilty.
You may be correct that the coma she had is rare, but how might that be determined for sure? If any of us had a low and it wasn't treated and our pump continued to deliver insulin then who knows what state we'd end up in.
For me the story illustrates that people with pumps need to be correctly trained and monitored closely until they get used to it. In my case I wore one with saline for a few days to get used to the controls before I switched over to insulin (Regular in those days).
But I posted this note partly because I think the Auto-off feature is useful and worth activating.
If I didn't do anything with my pump in 12 or 14 or 18 hours then I'm pretty sure there's something up and I'd rather it turned off (and it does alarm in the same way as it does when you suspend it) than continue to deliver insulin to me.
I'm also troubled by the fact that the case outcome was sealed. That part really disturbs me and was my second reason for putting up a pointer to it.
This article kind of ticked me off. It was sensationalism. Anyone who uses insulin has a chance of a low, and with long-acting insulin you can’t shut your insulin off if you happen to have a low. You have to have other measures in place to help deal with this possibility.
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