#1734 Defining Diabetes: Priming

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1734: Defining Diabetes – Priming
Host: Scott Benner
Guest: Jenny (Diabetes educator and co-host)
Date: January 11, 2026

---

Episode Overview

This episode expands the "Defining Diabetes" series by focusing on the term "priming," a crucial but sometimes overlooked aspect of insulin pump therapy. Host Scott Benner and co-host Jenny explain priming in plain language, sharing practical insights and personal anecdotes to help listeners—particularly those new to pump technology—understand the concept and its importance in daily diabetes management.

---

Key Discussion Points & Insights

1. The Motivation Behind “Defining Priming”

• Scott admits he’s never personally dealt with pump tubing or priming, as his daughter has always used Omnipod, a tubeless pump.
• The topic was prompted after Scott saw a parent on TikTok priming pump tubing and realized many listeners might find this terminology confusing.
• Quote:
  “Managing diabetes is difficult, but trying to do it when you don't understand the lingo, that's almost impossible.” (A, 00:10)

2. What Is Priming? (02:48–04:49)

• Jenny’s Definition:
  • In traditional (tubed) pumps, priming is the process of filling the tubing and cannula (the part that delivers insulin under the skin) with insulin to remove air.
  • Air, not blood, can remain in the cannula after the insertion needle is removed; this air must be pushed out to prevent gaps in insulin delivery.
• “You have to actually fill the tubing to begin with… At the end of the tubing is your cannula… Once you remove that needle… what's now in the cannula? Air.” (B, 02:51–03:52)
• “Each cannula length has a specific priming dose that you have to put in… If you don't prime, you end up missing that amount of insulin… kind of a black hole into the future of insulin.” (B, 03:57–04:48)

3. The Importance of Proper Priming

• Consequences of Not Priming:
  • Not priming properly results in a missed dose of insulin, leading to potential gaps in basal delivery and higher blood glucose.
  • This is compared to air in household plumbing that needs to be flushed out.
• “There’s a gap. So we prime the cannula, fill it with insulin, so that as the basal starts dripping, it's absolutely dripping underneath the skin. There’s no gap.” (A & B, 04:25–04:49)
• Scott’s Analogy:
  • “When I have to shut the water off at my house… then I turn it back on, and you have to open up the faucets to let the air out. This is the idea.” (A, 04:50–04:58)

4. The Difference with Steel Needle vs. Flexible Cannula (05:11–06:00)

• Steel Needle Cannulas:
  • These work like a thumbtack; the steel needle is the cannula itself.
  • Once tubing is primed and insulin is seen at the tip, it is inserted under the skin—no further priming needed.
  • “With a steel needle cannula… you don’t pull the needle out. The cannula is the steel needle… so there is no priming with a steel needle.” (B, 05:11–05:36)
• Flexible Cannulas:
  • Require priming after insertion because the inner needle is removed, leaving hollow plastic that can contain air.

5. Step-by-Step: The General Priming Process (06:00–07:12)

• Tubed Pumps:
  • Fill the tubing first before insertion.
  • Do not fill tubing while the cannula is already under the skin.
• Omnipod (Tubeless System):
  • The priming process occurs automatically inside the device, not manually by the user.
  • The pod pushes out air and primes the cannula after insulin is loaded and just before insertion.
• “Omnipod, you're right… it does it itself. It's an automatic process.” (B, 06:00–06:19)
• “And that clicking is the actual fill and priming of the cannula.” (B, 07:09–07:12)

6. Practical Tips and User Anecdotes (07:15–09:56)

• Scott’s “Tap-Tap” Trick:

  • After priming an Omnipod, Scott pinches and taps the pod to clear any excess insulin from the view window, to prevent skin irritation and help see the window clearly.
  • Jenny finds this habit amusing and notes she's never done it in her 20 years of Omnipod use.

• “Every time I do it, I feel like you're supposed to be like, I've never in the 20 years… No. Is it 20? 20 years? Oh, my gosh.” (A & B, 08:35–08:48)

• Jenny’s Pump Journey and Historical Context:

  • Started with Animus; switched to Omnipod when it launched in 2005, motivated by her triathlon participation and need for waterproof, tubeless design.
  • Insurance coverage played a critical role in her decision.
  • “As soon as it was out on the market… It was covered by my insurance, thankfully.” (B, 09:25–09:34)

7. Takeaway Messages

• Priming is essential for ensuring there are no air gaps and insulin delivery is consistent.
• The process differs based on pump type (tubed vs. tubeless; steel vs. flexible cannula).
• Automatic systems (like Omnipod) have simplified priming, but knowledge is still critical for understanding and troubleshooting.

---

Notable Quotes & Memorable Moments

• On Learning Diabetes Lingo:
  “Managing diabetes is difficult, but trying to do it when you don't understand the lingo, that's almost impossible.” (A, 00:10)

• On What’s in the Cannula After Needle Removal:
  “Once you remove that needle… what's now in the cannula? Air.” (B, 03:48)

• On Missing Insulin if Not Primed:
  “If you don't prime, you end up missing that amount of insulin until you've delivered enough bolus or basal… which can create… a black hole into the future of insulin.” (B, 04:04)

• Analogy with Home Plumbing:
  “When I have to shut the water off at my house… and you have to open up the faucets to let the air out. This is the idea.” (A, 04:50–04:58)

• On Omnipod’s Automatic Priming:
  “It does it all for you, which is why you have no clue how to do it.” (B, 07:15)

• On Diabetes Parenting Habits:
  “I think Arden does it only because she saw me do it.” (A, 08:35)

---

Timestamps for Important Segments

• 00:10 – Scott introduces the "Defining Diabetes" series and the importance of understanding diabetes terminology.
• 02:48 – Jenny provides the technical explanation of priming.
• 03:57 – Explanation of why priming the cannula is crucial.
• 04:50 – Scott compares priming to clearing air from plumbing.
• 05:11 – Differences between steel needle and flexible cannula priming.
• 06:00 – Omnipod’s automatic priming process described.
• 07:15 – Scott’s “tap-tap” trick and user habits.
• 08:48–09:34 – Jenny’s Omnipod adoption story.

---

Tone & Language

Scott and Jenny maintain a conversational, friendly, and accessible tone. Their exchanges are peppered with humor, practical wisdom, and personal stories, making technical details feel approachable and relatable for listeners living with diabetes or supporting someone who is.

---

Summary Takeaway

Priming in insulin pump therapy ensures proper delivery of insulin by eliminating air from tubing and cannulas. The specific steps, and whether the user must perform them, depend on pump type and infusion set design. Understanding priming is foundational for safe, effective pump use, and this episode demystifies the process with relatable examples, practical tips, and a reassuring, patient-first perspective.

Transcript

[A]

Welcome back, friends. You are listening to the Juice Box Podcast. Managing diabetes is difficult, but trying to do it when you don't understand the lingo, that's almost impossible. The Defining Diabetes series began in 2019, and today we're adding to it. Go to juiceboxpodcast.com up in the menu, click on Defining Diabetes and you'll see a complete list of all the terms that we've defined so far. If you're living with type 1 diabetes, the after Dark collection from the Juice Box Podcast is the only place to hear the stories that no one else talks about, from drugs to depression, self harm, trauma, addiction, and so much more. Go to juiceboxpodcast.com up in the menu and click on After Dark. There you'll see a full list of all of the After Dark episodes. While you're listening, please remember that nothing you hear on the Juice Box Podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your healthcare plan or. Or becoming bold with insulin. I wish I could tell everybody what we're laughing at as we start this episode of Defining Diabetes, but I can't. That's between Jenny and I. I think this one's going to be a short one. I just needed to define priming, and I realized this never made it on the list because Arden has an omnipod and has her whole time. And I just watched somebody the other day on. Who was I watching? Oh, I had. You don't know TikTok, but I had a woman named Marley.

[B]

I know it. I just don't. I don't TikTok.

[A]

I don't TikTok. I think it's a pretty good indication that you're not on TikTok. Marley is the mom of this little boy named Bane who was diagnosed really young. Right?

[B]

Okay.

[A]

I had her on the podcast recently, so I was making a TikTok to, you know, kind of connect with her so people could tell she was on. And I looked through some of her videos and there she was priming tubing and, like, holding it up, stripping. I think it was her, by the way. If it wasn't her, I'm sorry, it was somebody. She's holding it up. It's stripping out, trying to assess if it's working cannulas, you know, little stickers with, like, cannulas on them. And I went, I don't know anything about this stuff.

[B]

As you've never used. She. Arden's only ever been Omnipod and has never used anything else.

[A]

Never. I was like, I don't understand. I mean, I understand what you're doing. I'm not an idiot. But like, I hands on, don't know what it is. So.

[B]

Right.

[A]

So priming defined is.

[B]

So priming defined is. You talk about tubing, right? There is in tubed pumps, it's a little bit different. In Omnipod, I can describe the difference. But in tubed pumps, you have to actually fill the tubing to begin with, in which case, at the end of the tubing is your cannula, which is what goes under the skin to deliver the insulin. Right. So you're filling the tubing first, watching for drip. Drips to come out of the end of the cannula. But in all except steel needle cannula, the normal plastic, flexible cannulas, once they are inserted and you remove the insertion device, a needle gets pulled out. That's what delivered the cannula under the skin. So what does that mean? Yes, you saw drips coming out. But when you remove that needle from the interior of the cannula, what's now in the cannula? Air.

[A]

Oh, I was going to say blood, but I don't know why, but air. Okay. Oh, okay.

[B]

Underneath. Right.

[A]

Okay. And then so you have to prime it out, push insulin through.

[B]

Every time you put that under your skin, then there is a priming key on your pump. It encourages you. This is priming time. Each cannula length has a specific priming dose that you have to put in. So based on 3 millimeter, 9 millimeter, 6 millimeter kind of cannula, there's a certain dose of insulin that you have to prime that cannula that's now sitting under your skin, but it's hollow, it's empty.

[A]

Okay.

[B]

If you don't prime, you end up missing that amount of insulin until you've delivered enough bolus or basil has dripped in enough to fill the space, which can create, as you like to call it, kind of a black hole into the future of insulin. Right, Right. There's a gap. So we prime the cannula, fill it with insulin, so that as the basil starts dripping, it's absolutely dripping underneath the skin.

[A]

There's no gap.

[B]

There's no gap.

[A]

When I have to shut the water off at my house to fix something in the toilet, and then I turn it back on, and you have to open up the faucets to let the air out. This is the idea.

[B]

Similar idea exactly. Yeah. And as I said before, you know, even tubed pumps, some users, myself included, I could never use the little flexible cannulas when I was using a tubed pump.

[A]

Okay.

[B]

I always use the steel needle cannulas. The steel needle cannula is kind of like a thumbtack. It gets popped right underneath the skin. And you have primed the tubing. You've watched for the drips to ensure that it is coming out. You pop that under your skin, but you don't pull the needle out. The cannula is the steel needle. And so there is no priming with a steel needle.

[A]

There's no priming with a steel needle. Okay.

[B]

Because once you pop it under your skin, the cannula is the steel needle in which you've already watched the drips take place before you put it under your skin.

[A]

So then in either scenario. God, I hope I get this right. You fill the tubing.

[B]

Yes.

[A]

Then you prime the cannula once it's inserted. But you don't have to do that with the steel.

[B]

Correct.

[A]

But you do have to fill the tubing with the seal, but you still.

[B]

Have to fill the tubing. Absolutely. And you always fill the tubing without the cannula under your skin. You never want to fill tubing with it under your skin. Right. Now, Omnipod, you're right in terms of it doesn't technically do priming yourself, but it does it itself. It's an automatic process.

[A]

That's the clicking.

[B]

It is. So once you. When you have it laid down and you filled it with insulin. Right. What it's actually doing there is it's pushing the little valve at the bottom of the cartridge inside the pod. It's pushing it up to meet the back of the insulin amount that you filled it with. That's its almost fill tubing, if you think about it. So it's getting rid of air in the cartridge. But then once you put it on yourself and. And you hit deliver or insert cannula. Right. I have to think of the words they use. Insert cannula. It does that clicking. And once it clicks, it has inserted the cannula under your skin. The needle has been retracted. You get the little pink square on the top of the pod to indicate that that's what happened. And that clicking is the actual fill and priming of the cannula.

[A]

Okay. So in my mind, so it does.

[B]

It all for you, which is why you have no clue how to do it.

[A]

I mean, she's like, dangling it up. It's dripping. I was like, I've never been through this in my life. I could change an omnipod. I'm going to say if you put a vial in front of me, a closed pod, and a human arm, if you gave me those three things, I think that I could get a pod onto somebody and inserted in less than 90 seconds. I've done it so many times, like, almost with my eyes closed. Yeah, yeah, yeah. I mean, the priming takes the longest amount of time, and there's a little. So there's. You put it in, it primes. Right. And it's like there's a little clicking with that. Do you do the tap, tap at the end of the priming to clear the. Oh. Jenny just looked at me like she doesn't know what I'm talking about. So after the pod primes, you pop off the needle cap? Yeah, I always pinch the pod at the back and then smack it in the center over my finger a couple of times to knock any loose insulin out of the window. Because it keeps. Cause it helps. You know what I mean?

[B]

Because the viewing window then doesn't look like it constantly is wet.

[A]

Right. And your skin doesn't, like. Because if there's too much in there, you can get, like, almost irritated from it as well. Like, all that insulin's just laying in there. Plus, it's hard to see in the window. I do that Art. I realize I. I think Arden does it only because she saw me do it.

[B]

Probably it's a habit now to do that. No, I don't do the tap, tap now. Every time I do it, I feel like you're supposed to be like, I've never in the 20 years. No. Is it 20? 20 years? Oh, my gosh.

[A]

Really?

[B]

20 years that I've used Omnipod.

[A]

Wow. Were you right from the beginning with it?

[B]

I used Animus, and then Omnipod came out in 2005. And once Omnipod was out, I had a friend who actually, I was in the stage of deciding on a new pump, and at that time, I'd started doing triathlons, and I was kind of really to the point of irritation with having to disconnect all the time and whatever with the swimming part of doing triathlons. And she's like, just wait, Jenny. She's like, there is this pump coming out that you won't have to do that. There's no tubing. It's waterproof. Blah, blah, blah. She got me connected with the clinical rep for the area where we were living. And then as soon as it was out on the market, I. It was covered by MI Insurance, thankfully. So.

[A]

Wow. That makes knowing that timeline changes a little bit even the story I have about Arden getting on a pump at first doesn't fit here, but. Yeah, because Arden, we put her on a pump right before she went to kindergarten because it was in our head that we didn't want her to. We didn't want a stranger to give her shots. Actually, I think that is exactly what why we did it.

[B]

Yeah.

[A]

I don't even think we understood how valuable the pump would be when we decided to get a pump. It wasn't until we really started paying attention to it that we knew. Okay, all right, I'm sorry. This was great. I really appreciate it. Thanks so much. Yes. See ya. Okay, well, here we are at the end of the episode. You're still with me. Thank you. I really do appreciate that. What else could you do for me? Why don't you tell a friend about the show or leave a five star review? Maybe you could make sure you're following or subscribed in your podcast app. Go to YouTube and follow me. Or Instagram TikTok. Oh, gosh, here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page. You don't want to miss, please. Do you not know about the private group? You have to join the private group. As of this recording, it has 74,000 members. They're active, talking about diabetes, whatever you need to know. There's a conversation happening in there right now, and I'm there all the time. Tag me, I'll say hi. If you'd like to hear about diabetes management in easy to take in bits, check out the Small Sips. That's the series on the Juice Box podcast that listeners are talking about like it's a cheat code. These are perfect little bursts of clarity. One person said, I finally understood things I've heard a hundred times. Short, simple, and somehow exactly what I needed. People say Small sips feels like someone pulling up a chair, sliding a cup across the table and giving you one clean idea at a time. Nothing overwhelming, no fire hose of information. Just steady, helpful nudges that actually stick. People listen in their car, on walks, or while they're actually bolusing anytime that they need a quick shot of perspective. And the reviews, they all say the same thing. Small sips makes diabetes make sense. Search for the Juice Box podcast, Small Sips, wherever you get audio. If you have a podcast and you need a fantastic editor, you want Rob from wrong way recording. Listen, truth be told, I'm like 20% smarter. When Rob edits me, he takes out all the like gaps of time. And when I go and stuff like that, and it just. I don't know, man. Like, I listen back and I'm like, why do I sound smarter? And then I remember because I did one smart thing. I hired [e-mail].