Note: this technique should only be used in an emergency. Also, you should be quite familiar with your basal and bolus rates to ensure your blood sugar control and safety. Finally, my pump is a Deltec Cozmo, so I'm not sure if this would work with other pumps, as I'm unfamiliar with their functionality.
So, here's what happened: there were leftover sandwiches from a meeting in my office yesterday. My blood sugar was about 90 mg/dl and I decided to grab half of a turkey sandwich on wheat bread. Because my blood sugar was trending downward, I ate the food before delivering my bolus. When I looked at the pump and discovered it only had 0.50 unit of insulin left, I went to change the set and realized that I didn't have an extra vial of insulin with me.
It was 1:00 p.m. and I had another 4 hours of regularly scheduled work ahead of me. (I could have explained the situation and gone home, but since I recently pulled out a site and had to leave early, I didn't feel like explaining another diabetic complication to my coworkers.)
I remembered that the pump will continue to deliver basal insulin even when it indicates that the reservoir is empty. It isn't really empty, just low. So, after I bolused the 0.50 unit, I set a temporary basal rate for 2 units per hour for the next 2 hours. Since my normal basal rate during the day is 0.50 units per hour, in effect I delivered an extended meal bolus of 3 units over 2 hours.
Basically I tricked the pump into delivering insulin to cover the meal. My blood sugar peaked at 150 mg/dl about an hour after eating. Ninety minutes later it was down to 100 mg/dl, so I ate some yogurt and extended my temporary basal rate for another hour. By the time I got home to change my set and eat dinner, my blood sugar was steady at 136 mg/dl. Everything worked out.
The moral of the story, however, is that I need to be better prepared and carry more pump supplies with me at all times. It's good to have emergency plans, but hopefully you never need to use them!
Read more blog posts from Kelsey on her insulin pump:
When Your Insulin Pump Fails...
