What to carry when technology fails
A pump failure or a dead phone is not an emergency if a backup way to dose and a fast sugar fit in your coat pocket.
A pump can fail, a phone can die, a sensor can fall off, and a pen can crack in your bag. None of that is an emergency if you’re carrying a backup way to get insulin in and a fast sugar to treat a low. The kit is small: it fits in a coat pocket.
- Carry a backup way to dose insulin: if you pump, that means insulin pens or syringes, because a pump stopping means no background insulin at all.
- Carry fast-acting sugar to treat a hypo (blood glucose going too low), like glucose tablets or a small carton of juice.
- Carry a finger-prick meter and strips, because if your CGM (the sensor that reads glucose continuously) drops out, you still need a number.
- Keep ketone strips if you can, since a pump failure can push ketones up fast and quietly.
- Know where to get emergency insulin out of hours: a pharmacy or NHS 111, not a wait until Monday.
A pump failure is not the same as a pen running low
If you inject with pens, a broken pen is annoying but slow to matter, because your long-acting (basal) insulin is already in you and working for hours. Basal is the background insulin that covers you between meals and overnight.
A pump is different. Most pumps hold only rapid-acting insulin and drip it in constantly to do the basal job. When a pump stops (a kinked cannula, a dead battery, an occlusion, or it simply falls off), that background supply stops too. Rapid insulin clears in a few hours, so within a few hours of a silent failure you can have almost no active insulin, and glucose and ketones start climbing. That is why a pump user’s backup is not optional, and why it has to be a pen or syringe, not a spare part for the pump.
What goes in the bag
The point of a backup kit is that you can treat a low and get insulin in without your usual tech. In practice that’s: a fast sugar (glucose tablets, jelly babies, a small juice carton), a finger-prick meter with strips and a couple of spare lancets, and a way to inject.
If you’re on pens, carry a spare pen and needles for both your rapid and your long-acting, kept apart so you don’t grab the wrong one in a rush. If you’re on a pump, carry pens or syringes plus a vial, because you may need to cover both background and meals by hand until the pump is back. Ketone strips (blood or urine) matter most for pump users, since a failure can raise ketones before you feel anything. Keep it somewhere it won’t cook: insulin doesn’t like a hot car or direct sun.
What to actually do when the tech drops out
First, get a number the old-fashioned way: finger-prick. A CGM that’s failed, warming up, or reading oddly is not something to dose off, so the meter settles it. If you’re low, treat the low first with fast sugar before you touch anything else.
If your pump has stopped and you’ve been without background insulin for a while, your glucose may be high and ketones may be rising. This is where you switch to pens or syringes to keep insulin going, and check ketones. How much to give by hand, and how to bridge from pump to injections, is a plan your diabetes team sets with you in advance: it’s dose-shaped, so it’s theirs to set, not something to guess in the moment. If you don’t have that plan yet, that’s the single most useful thing to ask for before you next need it.
What changes how much this matters
A pen user and a pump user have different risks from the same event. A short pump dropout at home near your spare kit is a shrug; the same dropout overnight, on holiday, hours from a pharmacy, is a different situation. Heat degrades insulin, so summer and travel change how you store the backup. And if you lean on CGM alerts to catch lows, a sensor failure quietly removes your safety net, which is exactly when a spare meter earns its place.
How it plays out
Examples, not instructions or doses.
You wake to an occlusion alarm and your glucose is 14 mmol/L. Because a pump holds only rapid insulin, you’ve likely had little background insulin for a while. You check ketones and use your pen backup as your team planned, rather than only fixing the pump and going back to sleep.
Your CGM peels off and won’t reconnect. You’re not stranded: you finger-prick to get a real number, and you keep testing by hand until you can replace it. The reading, not the blank app, is what you act on.
You find your rapid pen has leaked. Because you keep a spare pen and needles separate from your main kit, you swap to it and carry on, instead of skipping a meal dose because the tech let you down.
Worth paying attention to
Questions that make an appointment useful
When it's urgent
If your glucose is high and you have moderate or high ketones, especially after a pump failure, and you feel sick, are vomiting, breathless, or your breath smells fruity, this can be DKA (diabetic ketoacidosis) and it is a medical emergency. Get insulin in as your team planned and contact your diabetes team or NHS 111 straight away. If you’re vomiting, drowsy or can’t keep fluids down, call 999. If a low is severe enough that you cannot safely treat yourself, that is also a 999 situation.