- advertisement -

high bg 4-5 hours after pump site change

Discussion in 'Parents of Children with Type 1' started by annaluvspink, Jul 16, 2010.

  1. annaluvspink

    annaluvspink Approved members

    Joined:
    May 20, 2007
    Messages:
    338
    This is the 2nd pump site change we've made since pumping with insulin and she has run mid-400's 4-5 hours afterwards. She usually runs mid 200's this time of evening (we haven't tweaked basal rates yet--she's only been pumping for one week). Last time she actually had small-mod ketones. We ended up giving a correction (like we did tonight) and also injected insulin w/ syringe. I've heard of this happening before--any suggestions? She's pumping w/ Omnipod (sorry haven't changed out my sign below yet).

    Thanks.
     
  2. Flutterby

    Flutterby Approved members

    Joined:
    Nov 11, 2006
    Messages:
    14,623
    how long was it between the old pod coming off and new one started and she was getting insulin again? Does she have ketones now?
     
  3. annaluvspink

    annaluvspink Approved members

    Joined:
    May 20, 2007
    Messages:
    338
    As soon as the old one came off, maybe a few minutes passed before the new one was inserted. We also bolused for dinner a few minutes after that. We haven't checked ketones (no blood ketone strips rx--yet :-( ). We did just give her a correction through the pump.
     
  4. annaluvspink

    annaluvspink Approved members

    Joined:
    May 20, 2007
    Messages:
    338
    I think I read somewhere that someone had this happen after site changes and that the increased the temp basal for a few hours before doing the site change. Has anyone heard of this before?
     
  5. Flutterby

    Flutterby Approved members

    Joined:
    Nov 11, 2006
    Messages:
    14,623
    It really depends on the person.. if you take a site off right away all the insulin that was sitting right at the tip of the cannula may not be delievered so some leave the older site on a bit.. if we've given Kaylee a bolus within the hour we leave her old site on for a bit longer, just to make sure all the insulin is absorbed. Do you need to fill the cannula on the omnipod?
     
  6. annaluvspink

    annaluvspink Approved members

    Joined:
    May 20, 2007
    Messages:
    338
    After the new site is inserted, the cannula is automatically primed. The pod goes through hundreds of self checks and will alarm if it detects something is amiss. She hadn't had a bolus in 4-5 hours before we changed it out.
     
  7. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

    Joined:
    Sep 23, 2007
    Messages:
    12,521
    How long were you on the first pod before changing it out?

    I'm asking because when we started pumping we thought site changes were really a big deal and we'd wait just a bit too long to do them and by then she really hadn't been getting good basal flow for maybe a few hours or half a day and then we'd see pesky highs and we always blamed the site when really it was that we were pushing the sites just a bit too long ;-)
     
    Last edited: Jul 17, 2010
  8. annaluvspink

    annaluvspink Approved members

    Joined:
    May 20, 2007
    Messages:
    338
    3 days. We've had great numbers all day. She did have an 84 blood glucose 1.5-2 hours after pod change/bolus for dinner. She felt low--so he treated her w/ 15/15 because she still had 1.5 hours of IOB. Checked her a bit later and she was 134. So, I know insulin is going in. Just weird how this happened last time we changed the pod---and it ended up working out just fine--she was 99 at wake up.
     
  9. annaluvspink

    annaluvspink Approved members

    Joined:
    May 20, 2007
    Messages:
    338
    We're sending in our first weeks' logs tomorrow and probably won't hear anything back from CDE until Tues. I will be curious what they will say....I know one for thing for sure, I can't wait to change that late evening/early morning basal!
     
  10. annaluvspink

    annaluvspink Approved members

    Joined:
    May 20, 2007
    Messages:
    338
    Hmmm...that is interesting! Maybe we should try changing the site a little sooner! Thanks for the idea!
     
  11. mom2two

    mom2two Approved members

    Joined:
    Jan 3, 2008
    Messages:
    1,486
    This has happen with us since day one! We either do a temp basal or give extra insulin when we change pods.
     
  12. Flutterby

    Flutterby Approved members

    Joined:
    Nov 11, 2006
    Messages:
    14,623
    did you do a correction to get her to that 99, or did she come down to that on her own?
     
  13. Skyefire

    Skyefire Approved members

    Joined:
    Mar 1, 2008
    Messages:
    1,083
    DS use to drop low for 4-5 hours after a site change, but the last couple of months he has been running high for 4-5 sometimes longer.

    Yesterday he had great numbers ranging 91-117, all day then we waited until supper time, changed the site and feed him. Correct for the meal with new site and the rest of the night he was 340 only dropping to 302 with 2 corrections.

    Then with the third correction he came down to 140.

    We have tried temp basals but with him I tend to find he goes low hours later and doesnt actually help with his highs. We always remove the old one right away, if it has been longer then 3 hours since last bolus.

    I might try leaving it on for a little while and see if it helps. But just wanted to let you know that you are not alone.

    Good luck
     
  14. coni

    coni Approved members

    Joined:
    Mar 23, 2006
    Messages:
    876
    We don't pump with the Omnipod, but we almost always see increased BGs after a site change. I do a 10% basal increase for 4 hours but check to see if she's in range earlier than that and back it down if needed. It's a pretty common thing from my understanding to see increases with site changes. Hope you can figure out some method to reduce the highs.
     
  15. sooz

    sooz Approved members

    Joined:
    Dec 4, 2009
    Messages:
    2,330
    We seem to have better luck with the pod changes and going high if we change the pod in the morning rather than at night. I dont know why.
     
  16. annaluvspink

    annaluvspink Approved members

    Joined:
    May 20, 2007
    Messages:
    338
    Thanks for all the input everyone! I can always count on CWD peeps!

    Yes, we did correct w/ extra insulin to get 99--3 units by pump, 1 unit by syringe two hours later...99 two hours later...gave 7 carbs (cuz she was sleeping)...136 at wake up. I was surprised she didn't wake up with the rapid drop :confused:

    Well, tomorrow is the next pod change and I'm dreading it. It's very smooth going, but I dread the bs later. We're going to change the pod at 3:30 pm---if I increase the temp basal, what is a safe, conservative amount? and for how long?

    Thanks!
    Michelle
     
  17. Mom to S&S

    Mom to S&S Approved members

    Joined:
    Jun 27, 2008
    Messages:
    227
    We had this problem when we started on the Omnipod. The rep told us it was a known problem in younger children (my daughter was three when she started it). It was like the pod didn't prime enough and with a low basal it takes time to work. The rep suggested giving uncovered insulin with the new pod. We would give a unit uncovered with every change. I think we started with .5 and worked up to 1.0. It is definitely something you have to tweak. Once we figured out the amount she needed, we never had a problem again.
     
  18. annaluvspink

    annaluvspink Approved members

    Joined:
    May 20, 2007
    Messages:
    338
    That makes sense to me. I was thinking that for some reason, not enough basal is getting in there. But, the last time we changed her pod, we bolused for supper right away thinking that would help get the insulin flowing in the cannula and we saw an in range two hour post prandial, but then we kept climbing after that (into 400's)---doesn't help that she should have a higher basal rate for evening time---I'm sure CDE will want to change that when she see our logs from this past week :cwds:
     
  19. mommylovestosing

    mommylovestosing Approved members

    Joined:
    Jan 10, 2010
    Messages:
    436
    Ella always runs high after a site change. Still trying to tweak the temp basal rate. Contemplating going to a bolus instead to fight it off...
     
  20. simom

    simom Approved members

    Joined:
    Jun 2, 2008
    Messages:
    226
    We are not pumping with omnipod - but we always do a small carb snack with bolus after set change to "get the insulin flowing" - this was recommended by someone on one of these boards and seems to help us.

    Is your child stressed out about the set change? Our son would get quite stressed out when we first started using sensor - we were changing set and sensor at the same time, once a week - and we would see what we determined to be a "stress spike" right afterward if we changed both at the same time. Once he became accustomed to the sensor change, we didn't see the spike anymore.
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice