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Thread: How much do numbers vary with a new site?

  1. #1

    Default How much do numbers vary with a new site?

    When you change out a new site on the pump, do you see very different basal and I:C needs?

    We're three days after going on the pump and last night we changed out, instead of being steady all night she went up all night. I'm pretty sure that means the lantus is finally out of her system and I need to reset all the basals a touch up, but should I look out that when we change the site the next time they could be set too high?

    We're on small amounts, of course, so a little makes a big difference.

  2. #2

    Default

    Our I:C's and ISF do not change that much.

    To deal with site absorption differences, I have roughly three basal profiles that are all similar. Profile A is our basic profile that we use the most. Profile B is the SAME as A, except it is 0.05 lower across the board. Profile C is the same as A again, except it is 0.05 higher across the board.

    When he's high across the board we simply move to the higher profile. This means I also have to choose between changing profiles, and actually changing the profile shape. The profile shape does not change that often, either. Usually if he's high across the board changing the profile does the trick.

    Example:

    Profile A: 0.35 (8am-1pm) 0.5 (1pm-8pm) 0.45 (8pm-12a) 0.3 (12a-8a)
    Profile B: 0.3 (8am-1pm) 0.45 (1pm-8pm) 0.4 (8pm-12a) 0.25 (12a-8a)
    Profile C: 0.4 (8am-1pm) 0.55 (1pm-8pm) 0.5 (8pm-12a) 0.35 (12a-8a)

    (We can name the profiles on the pod, so we actually name A "low" and C is named "High".)

  3. #3

    Default

    We do not see any differences when we put in a new site.
    Mom to J., age 10
    Dx 2007 @ age 3
    Medtronic pump and CGM (4/2008-6/2013)
    Tandem t:slim and Dexcom G4 CGM (current)
    CGM in the Cloud 7/2014

  4. #4

    Default

    Quote Originally Posted by saxmaniac View Post
    Our I:C's and ISF do not change that much.

    To deal with site absorption differences, I have roughly three basal profiles that are all similar. Profile A is our basic profile that we use the most. Profile B is the SAME as A, except it is 0.05 lower across the board. Profile C is the same as A again, except it is 0.05 higher across the board.

    When he's high across the board we simply move to the higher profile. This means I also have to choose between changing profiles, and actually changing the profile shape. The profile shape does not change that often, either. Usually if he's high across the board changing the profile does the trick.

    Example:

    Profile A: 0.35 (8am-1pm) 0.5 (1pm-8pm) 0.45 (8pm-12a) 0.3 (12a-8a)
    Profile B: 0.3 (8am-1pm) 0.45 (1pm-8pm) 0.4 (8pm-12a) 0.25 (12a-8a)
    Profile C: 0.4 (8am-1pm) 0.55 (1pm-8pm) 0.5 (8pm-12a) 0.35 (12a-8a)

    (We can name the profiles on the pod, so we actually name A "low" and C is named "High".)
    Do you notice these differences depending on where you put the pod?

  5. #5
    Join Date
    Mar 2006
    Location
    Parkland, FL
    Posts
    4,293

    Default

    We have a need for significantly LESS insulin for 4-8 hours after insertion of a new site (and even more so if we open a new vial of insulin). This is one of the reasons we try to avoid putting in new sites at bedtime . We simply put in a 20% basal reduction to accomodate. Once we see the numbers going back up, we take it out, and things usually are back to normal. As with everything else diabetes, though, your child may have a completely different need...
    Marisa
    ~~~~~~~~~
    Proud Mom to:
    Mia DOB 8/25/01, dx 10/08/04
    Pumping Animas since 5/16/06
    Apidra since 6/22/09
    Little sister Ciana DOB 3/01/03, rebel
    Happily married to Erich since 5/28/00

  6. #6

    Default

    Thank you, I'll watch and adjust. And then watch. And then adjust. And then watch. ... . good to know it is a factor but that there are tactics.

  7. #7

    Default

    Have you tried leaving the old site in for a few hours after you change it?

    Sometimes there is a pool of insulin under the site that is not absorbed yet. That may be your problem right there. I usually do leave my site in for a couple of hours after the change because I experience this problem.

  8. #8

    Default

    Quote Originally Posted by danismom79 View Post
    Do you notice these differences depending on where you put the pod?
    Not really. The differences even happen from day to day... there is no pattern for placement. I was hoping once we rotated better to the legs, that these issues would go away, but they have not yet.

  9. #9

    Default

    We have been pumping for one week today. In total we have done 4 site changes (bad luck with a few- dog pulled and kinked cannula and one that would not reattach). We have not seen any different #'s with site changes.
    Candise-mom to 4
    Spencer 13, Heaven 12 dxd 2/6/09- pumping pink MM522 - quicksets, Grant 9, Gracie 7

  10. #10
    Join Date
    Sep 2006
    Location
    Michigan
    Posts
    3,112

    Default

    We used to see slightly higher numbers after site change until I changed his "fill cannula" to .4 instead of .3. Only a tenth of a unit makes a world of difference.

    I would caution you to be very careful raising basals across the board. That all adds up after a few hours. I learned that the hard way.
    Lynn
    Mom to Nathan
    Born 5-22-03
    Diagnosed 2-7-06
    Pumping with Cozmo

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