No Delivery Alarms: 10 Questions to Ask When You Hear that 'Beep Beep Beep'

This morning when I was changing my site, I heard that “beep beep beep” that none of us likes to hear. I looked down at my insulin pump and saw an error that I have seen before “No Delivery.” I know many of you have asked why this occurs, so I reached out to our 24-Hour HelpLine Team to learn more.

First, they wanted me to remind you that “No Delivery” alarms, while they may seem annoying at times, serve an important safety function. Next, they provided me with a list of 10 questions to ask yourself to help you identify what’s triggering the alarm.

10 QUESTIONS TO ASK YOURSELF WHEN YOU RECEIVE A NO DELIVERY ALARM
If the alarm occurs while priming:

1. Does my reservoir and infusion set have a secure and firm connection?
Make sure that it was a smooth connection when you were putting both of these together. If this is not connected correctly, the insulin may not properly flow from the reservoir through the tubing.

2. Could my insulin be bad or expired?
This is one of the main causes for a No Delivery alarm. If you have an extra bottle of insulin (preferably one with a different lot number) try using that to refill a reservoir with the new insulin to see if the error still occurs. Just because your insulin is not cloudy doesn’t mean it can’t be bad. If it occurs when you are wearing a set:

3. Does my infusion site hurt?
If your site is ever tender and you receive a No Delivery alarm, you may not be getting the insulin you need. If your site hurts, there may be a bend in the cannula underneath your skin, which is preventing the pump from delivering the insulin.

4. Am I using the right type and size of infusion set for my body type?”
As time goes by, our body types can change which means there may be a better suited infusion set for us. I personally used to wear a Quick-set and began to have site issues. So I worked with my doctor to try a few other options. I’m now using the mio, which has made a big difference (and it’s pink!).

5. Is the area of my body a site that is free of scar tissue?
If you have any scar tissue or areas of your skin where you commonly insert your infusion set, try inserting at another area so it doesn’t cause an unnecessary block for your infusion set. You can wear your site on the side of your arms, your abdomen, side of the thighs or your love handles.

6. Do I rotate the infusion sites enough?
Your infusion site should be at least 2 inches away from your belly button and 1 inch away from where you had your last set in. Try the “clock” method and “M” or “W” method to get into the habit of alternating site locations.   

7. Has it been longer than 3 days since I put on my last infusion set or
reservoir?
When you wear an infusion set longer than 3 days it can irritate the site and cause build up at the insertion area. If you use an infusion set like the Sure-T that uses a steel needle, you should only wear this up to 2 days.

8. Are there any bends in the tubing or kinks in the tubing?
If you wrap your tubing around your insulin pump or place it in a pocket, make sure there is not additional stress put on your tubing connection. If you wear your site under a belt line or in an area where your tubing commonly has pressure on it, this could also add additional bends in the tubing.

9. Is the adhesive or over tape still in place?
If you have a set that has its adhesive coming off and you decide to push it down with your fingers (I admit to doing this), make sure your blood glucose doesn’t go higher than normal because this could mean that while pushing down on the tape, your cannula may have shifted. This is also true for when you have put tape on top of your infusion set and try to take it off.

10. Is there insulin in my reservoir?
If there is no insulin in your reservoir this error can occur, perform a regular site change and make sure to fill up a new reservoir. When in doubt, change out your insulin, infusion set and reservoir (that’s what I did this morning, and it worked). If you decide to clear a No Delivery alarm the biggest precaution the 24-Hour HelpLine Team says to take is to keep a close eye on your blood glucose, because two unexplained high blood glucose numbers in a row can be a sign that you are not getting the insulin you should.

I hope this helped!

IMPORTANT SAFETY INFORMATION
- Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems.
- Successful operation of the insulin infusion pumps and/or continuous glucose monitoring  requires adequate vision and hearing to recognize alerts and alarms.

Medtronic Diabetes Insulin Infusion Pumps
- Insulin pump therapy is not recommended for individuals who are unable or unwilling to perform a minimum of four blood glucose tests per day.
- Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately.

Medtronic Diabetes Continuous Glucose Monitoring (CGM) Systems
- The information provided by CGM systems is intended to supplement, not replace, blood glucose information obtained using a home glucose meter. A confirmatory fingerstick is required prior to treatment.
- Insertion of a glucose sensor may cause bleeding or irritation at the insertion site. Consult a physician immediately if you experience significant pain or if you suspect that the site is infected.

Please visit http://www.medtronicdiabetes.com/importantsafetyinformation for complete safety information.