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.