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High BG 3 days into pumping

Discussion in 'Parents of Children with Type 1' started by wearingtaci, Dec 8, 2013.

  1. wearingtaci

    wearingtaci Approved members

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    Sophie went live on Thursday. She has been running a bit sweet,which we expected. Today right after changing her set she shot up over 300 and wouldn't come down. We changed out the set and the cannula looked great,no blood.kinks,or air bubbles. I didn't smell insulin.
    For the experienced pumpers,what else should we have looked for? Or could have done? The pump wasnt alarming.I felt bad having to change her out again so soon.
     
  2. StacyMM

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    Is she nervous about site changes? Perhaps the dread/anxiety was the culprit and it just needed more time? Or did you try a completely different site? For us, some sites work more quickly (arms and belly) and others more slowly (thighs). Or, was she climbing before the site change? Did you load the tubing and cannula completely?

    We don't usually jump to a site change without giving a correction a few hours to work, unless the kids can feel something wrong with the site...in which case we pull it immediately after putting it in.

    Good luck - it's always hard when you run into a complication right after starting something new!
     
  3. susanlindstrom16

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    Not sure I'd call us "experienced pumpers" (only 2 months in)- But are you guys in the stage where you are tweaking the basal rates? Maybe she needs a basal increase and its not related to the site?

    I'm like you though, I always think something went wrong with the insertion.
     
  4. Sarah Maddie's Mom

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    How long did you wait after correcting and before changing the site and then how long did it take to get her back into range?

    Most likely it's 1. your cartridge filling, tube filling or cannula filling technique, or 2. that you haven't yet got her basal rates right. Either (or both) would be perfectly normal for a pump start.
     
    Last edited: Dec 8, 2013
  5. Megnyc

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    Any ketones?
     
  6. misscaitp

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    Since you're on the t:slim I might have checked the luer connection between the reservoir and tubing leading to site. Also, most likely this early into pumping the settings (basal, I:C, Correction, etc.) still probably need fine tuning.

    Next time, if she shoots up due to a pump or site issue, it would be best to correct by shot if you still don't know the exact cause.
     
  7. Turtle1605

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    We have found that if my son goes above 300, the high is very, very stubborn. Especially at night. Basically, he needs more insulin than usual to get him down. For example...my son normally takes 1 unit to bring him down 100 points. Let's say he started at 350 and we gave him 2.00 units to correct they high. We see that two hours later, he is still at 300. We will then give him another 1.00 unit to see if that helps. If he is still at 300 or higher an hour later, we will resort to changing sets, etc. Unfortunately, we also have to do a lot of testing every hour or so until all of the insulin is finished working to make sure he doesn't go low.
     
  8. wearingtaci

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    We gave her 3 hours before I called the CDE(love her),she was still climbing at that point.The site she choose I would call love handles if she was chubby,but she isn't. It could have been the site,or the corrections finally started to work. An hour after the change she is down to 220,and we corrected again per the pump's reccomendation. Looks like it could be a long night for me.

    No
     
  9. Megnyc

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    Ok, then I would assume she is getting some insulin but not enough. That is good! If she is constantly high I would be thinking you have a basal issue. Your CDE should be helping you increase basals until Sophie gets into a decent range.
     
  10. wearingtaci

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    She loves the pump,but I miss the safety net of lantus already
     
  11. MomofSweetOne

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    I had a hard time moving from the Lantus safety net, but now not having Lantus is the best thing about pumping IMO. The CGM is a much better safety net. With a girl in puberty, you'll find basal needs are all over the place and the CGM/temp basal combination will serve you much better than Lantus. The basal needs at times of day became greater, too.
     
  12. mamattorney

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    I wonder if it took 2 days for the last of the Lantus to leave her body and the basals are just too low and you hadn't really seen it yet?

    I know that three days in got a 10% increase in basals all around, and then another couple of days in got an other overall percentage increase (10% again? I can't remember).

    My daughter is another whose highs are tough to bring down once they hit 275+, it usually requires a full correction plus a pretty high temp basal for several hours (175%) to do it.

    In the future, you can always try a correction by syringe if you think it may be the site.
     
  13. wearingtaci

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    Her dexcom is sitting in my room right now and I am trying desperately not to grab it and plug her into that too. This Friday she will have it,and between the cgm and pump,as a parent I am so much more excited about the cgm
     
  14. obtainedmist

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    It can be a bumpy ride for the first 2 months! It really took us that long to get the basals right, the insertion technique right, the cartridge filling & tube filling & canula filing technique right. It really does settle down as you perfect the problem solving techniques to figure out just what is going on. Have courage! :)
     
  15. hawkeyegirl

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    If she shot up right after changing her site, it wasn't a site problem. A site problem would take longer to present itself. :)

    Hope all is well today.
     
  16. sincity2003

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    I hope you had a good night. I agree with mamaattorney, she probably still had some Lantus in her system and now you're seeing true numbers based on basal settings.

    We are back on Lantus now, but I do remember feeling the exact same way you did about the "Lantus" safety net when we started, and it was a huge point of disagreement between DH and I (he had a hard time adjusting to not having long-acting insulin working in the background).

    good luck!
     

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