High after pod changes....question

Today Matthew was a little high after his pod change (169). I was surprised because I know his basal is spot-on. (Unless he's growing again!)

I looked back in the logbook and every single time we've done a pod change in the last several weeks, he's been high afterward.

Yes, he is going through a major growth spurt and having a lot of highs right now, but I was really surprised at the pattern.

Does this happen to you? Do you bolus when changing the pod?

If so, how much?

Thank you!

(I know I've seen a thread on this, but a quick search turned up nothing.)

 

Actually, this is a common problem. The simplest thing is to eat something small and bolus for it after the pod change, alternatively you could just give a small priming bolus. I like the first idea better, because it is hard to know how much to give.

 

We try to plan pod changes around dinner time so he boluses soon after the pod change. That seems to do the trick for us. :cwds:

 

So you're not actually giving extra insulin, just making sure that a bolus occurs after the change?

 

Correct.

 

Okay. I'm going to try it! Thank you!!

 

My daughter tends to run high after pod changes as well. Sometimes quite high -- and stubborn to get back down. We now actually bolus 1 full unit after every pod change and also do a 30% bolus increase for 3 hours. It's helped, but we're still trying to perfect it. 169 would actually be a desirable number for us post-pod change.

 

Well, today is the first time I've really taken notice of this. I feel a little bad about that, there are just so many things to watch for.

This is a stubborn high....I rechecked 2 hours after dinner and he's at 300. Haven't had that in a while.

Wonder if it's was the pod change that started the rise, or maybe he's growing again. (The little stinker!)

 

Yes! We've had some serious highs. The problem we have is that the highs are several hours after the pod change. So even if I give extra insulin with the change, 4 or 5 hours Hana can end up in the 300 or 400s! The only thing that has helped is to not change the pod at night. We now only change it in the morning or afternoon so we can monitor her BS for several hours after and try to catch the rise. This has seemed to help. Last time, we had no noticeable rise in BS because we changed it at 2 in the afternoon. However, if we change it at bedtime and she goes to sleep, I check her at say 3 a.m. and she is 400!!

 

DD consistently was high 4 hours after a pod change.

We'd do pod changes after school. She'd be in range and two hours later, before dinner, be in range. We'd then be shocked with really high numbers after dinner. I now think that the two hour post pod change number was not a meaningful measurement for us -- it was simply reflecting the basal she'd been getting from the old pod.

We started doing a straight priming bolus and gradually increased the amount until we got to the current one, .80 u, with .10 u initially and the remaining .70 u delivered over the next half-hour or hour.

We also now do pod changes after dinner, which works well for us.

It took me a while to get to that as her ISF at the time had been 1:200!

 

Wow. Okay. I'm really going to have to track this.

I think something is going on, but gosh! Who knows?

Glad I'm not alone.

Oh! And for those of you considering the pod...this isn't complaining..we still love it!

 

When I brought this up to our CDE at our last appt., she said it isn't a pod thing - she said this can happen with any pump.

 

This is so interesting.

Matthew's afternoon/evening numbers have been excellent the past couple of days (finally!).

I'm so curious to see what happens tomorrow. If his numbers are good, I'm really thinking it's a pod issue.

May be back with more suggestions......

 

Same here, a meal or a snack. Seth will NEVER turn down a snack lol

 

Hahahahaha.....

I thought the same thing about Matthew!

 

We have had the problem off and on, but nothing really high or stubborn. With all of her other pumps, we actually had issues with her going low after changes, so for us it is just the pods. What we do is have her bolus a half unit, but only if she is higher than target anyway. She will do the correction and add the half unit. We do try to change before a meal or snack, that is what the trainer said works. I knew that some people had problems with this before we started on the pods, so that is why I asked about it.

 

While that is true, it does seem to be much more common with the Pod.

 

We ALWAYS had this problem and now when we change the pod and he is in range, we bolus an additional 1 unit right off the bat. When he is out of range, we do the full correction plus 1.25 units (unless it is near bedtime). We always do the additional 1 unit at minimum, even before bed, when we have a reliable dexcom, of course. Knock on wood but he tends to wind up around 110 most of the time now. He used to be in the 200's easy.

 

I put old insulin (that I was going to throw away in a pod). Activated it, all that, except not on my son. Once it was "live" I started bolusing in .05 increments, and it was 1.10u delivered before we saw our first drop of insulin coming out. We've been bolusing 1.0u directly following a pod change since I did that and we have not seen anymore highs.

I don't know if there is a magic 1u number, or if each pod/priming is different, but this has worked for us.

 

Oh my word. Wow.

You know, I do think Matthew's high was because of the pod. The 2 days prior to the new pod, his afternoon/evening numbers were perfect. (Finally)

The next afternoon, we changed the pod and he went high.

The next day (yesterday), perfect afternoon/evening numbers again.

I gotta think that points to the pod.

At tomorrow's change, I'm going to try bolusing with a snack right after. If he still goes high, I'm going to try a straight bolus next time. (But I'll start small)