Having to change inset nightly.

[krstn9@yahoo.com]

My six year old son is on a pump and his numbers are very unpredictable. Yes I know what else is new :) I found that the second day of the inset his numbers would be creeping up by the night time in the 400 plus. This was happening often so I now need to change the inset nightly. His numbers have been very good now but it is a bit of a commitment. I am just curious if this is something anyone else has had to do.

Kristin

mom to colby dxd 7/28/06 6 years old
brandon 9 years old non d

[Treysmom]

What kind of pump/set do you use?

Are you sure its the set, before you change it. We are still fairly new to pumping to so I'm not meaning to question here. I'm just trying to find out what you tried before changing the set.

[cgates]

I've never heard of that happening before. Something else is wrong.
I wonder if it's just a basal issue?

[Kaylee's Mommy]

you shouldn't be having to change a set out each night.. have you tried new boxes of sets.. it could be that the box you've got is bad... the set that you are using just isn't working for your son's body type or you need to adjust basals ... if he's steadily climbing to 400 everynight I would think its basals.. also, does he ever have ketones? kids on pumps develope ketones much faster than kids that aren't because they aren't using a background basal insulin.. so if there is something wrong with the site ketones will develope rather fast.. if he's not developing ketones, he's getting insulin and its not the site.. he just needs MORE insulin.. does he come down with corrections?

what pump and sets are you using?

[Mary Lou]

Like someone else asked, how new to pumping are you?

We were instructed to check for air bubbles in the tubing, and we usually find some significant ones every morning and night. If we forget to check, we often see higher than usual numbers b/c then the kids are getting air instead of insulin.

Just a thought...

[Ali]

Check with your Dr. I have to change every 48 hours but every 24 may indicate a reaction to the teflon and a steel needle might help or he may be one of those who will need to change very 24 hours no matter what the set. Check with your Dr. it may just be your sons biology with infusion sets, a reaction to teflon or somehting else. It is not unheard of. Ali.

[Abby-Dabby-Doo]

A site change will lower my daughters blood sugar, to the point she gets an uncovered snack or we lower her basal for a while (it affects her within 2 hours and we set a temp basal for 4 hours).
So here are my questions...
1- Are you changing the site and then around 24 hours later is where your child is then high? The site change lowered your child's b/s around that time, but 24 hours later when no site change is occurring your child's basals are wrong for that time?
2- Are you using Humalog and your cannula is clogging?
3- When you take the site out, are you looking at the cannula? Is it bent, or kinked?

This is a photo of a kinked cannula. We really struggled with wondering if the site was kinked, misjudged carbs, or carb ratios were wrong. We now use a different set.

http://quick.holdthatpic.com/images/165944.jpg (http://www.holdthatpic.com/)
Free image hosting by http://www.holdthatpic.com/

[krstn9@yahoo.com]

Hello Everyone and thank you for your quick responses.
We have been pumping with an Animas pump for about a year. I have to say that I am certainly not an expert at pumping but very experienced since, as all of you know, this is a large part of what our lives are all about.

He is on Humolog. This is not a decision that has come quickly but one that has been determined buy asking all the questions you intelligent Moms asked me. It seems to be a reaction in his body to the inset. We are using the round quicksets. They go straight in. I tried using the comfort that went in at a diagnal for better results to no avail. When I take the insets out, they are not kinked. I have spoked to the Endo and as one posters said that this is not unusual and does happen. I was just curious if anyone on the board had experienced this.

It can get scarry if I don't change because if I adjust a basal for a high it could be due to an inset. When I change the inset, he takes a dive.

Sorry for the long post....

Thank you for all of your input and wish everyone a few straight hours of sleep :) Kristin

[mom2jjm]

Kristin,
We are experiencing something simiar in using insets with our daughter, Mollie. We've been pumping with novolog and using insets for 2 years. We've had our share of kinked cannulas, but what we're dealing with now is not that. We went from being able to change sites every 2-3 days, to not even making it 2 full days from a site. We talked to our endo, and tried humalog, but that didn't help the problem any.

I finally started wondering if it was buildup of scar tissue from always having to use her butt cheeks for sites. The last two sites I've done I used her hip and her stomach, and no problems with the site going bad early.

I don't know, I would have thought if the problem was scar tissue, the site wouldn't work from the beginning, but who knows?

[Nancy in VA]

We were having to do them every 48 hours for a while, but we're getting back to almost 3 days now. I do think that location has a lot to do with it - I was getting higher numbers when I used her upper bottom instead of the fatty part.

[WestinsMom]

We use to have those problems and then we went to Sure T (a metal set) and we have seen a 180. It has been a few years now and we rarely, rarely have a set problem. If anything we forget its time to change and come close to running out of insulin!

I would look for a metal site to try.