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Ok, I'm now at a lost of what to do, so I'm hoping someone might have a great tip to fix this!

In the past year, I have had a ton of problems with my sugars upon doing a insulin pump spot change.  I now dread changing my spot since I have to deal with a nasty sugar high EVERY time.  My sugars will be perfect when I change my site, but 3-4 hours after, they sky rocket into the high teens and twenties. (270 - 450)

I've been a pumper for 8 years and just made a switch to the Minimed from the Animas.  I've had this issue with both pumps which have different infusion sets. I've tried the quick sets and the comforts (which are not that comfortable!) I have 8 sites I use and continuously rotate every 4-5 days.

I've tried taking a bolus before changing my spot.  I've tried a temp increase in my basal for the next 2 hours. Nothing seems to work.  It's so bad now, that I have to inject with a needle after 2 hours of the spot change.  It just seems that it takes extra long for the insulin to start absorbing in the new spot.  After 6 hours it is fine and my sugars return to normal until the dreaded spot change is due again.  As well, I've started putting my infusion set into a new area on my body (thigh-side) which should not have any absorption issues, since there is no chance of scar tissue.

Anyone have a tip to fix this? 

Tags: absoption, changes, high-sugars, insulin, pump, spot

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Hi Desdemona- Depending on what infusion set you use with the minimed pump, you HAVE to perform a FIXED PRIME once you change your site. (Of course this doesn't explain why your levels are still high after taking a bolus before changing your site.) Just thought i'd share that tidbit about the fixed prime just in case that may help even a little. Good luck!
If you are only rotating to 8 sites, sounds like you need to use new "real estate" - that your absortption may be off. Have you tried other areas for insusion site placement? ALso agree that 4-5 days is too long for sites - I change mine every 2-3 dayss currently.
As other responders have said, you really should change more frequently.

Having said that, back to your problem. When I first started pumping I had a similar problem. My pump trainer suggested I would eliminate the problem by ALWAYS doing a set change just before a meal. That way, you get a greater amount of insulin to begin the absorption process. (She was right!)
Great tips. I will certainly try the every 3 days...just to see if that works. For the first 5 years of pumping, I use to do that, however, I guess over time I got lazy and 3 days, turned into 4, which turned into 5 etc...I have no issues with absorption after 6 hours of the infusion set being in, its just the first 6 hours are a nightmare!

Thinking outloud...Maybe if I put the new site in, take a unit of insulin, continue to use my old site, wait a few hours and than switch to the new site?

Oh yes Sophie, I do the fixed prime too.

The bolus before meals and spot change...I will try that too. I don't bolus much since I don't consume many carbs. I am 80/20. (80% basal, 20% bolus) most days. However, maybe I will try a heavier carb meal so I can bolus a bunch :} I can see how this might actually work..

Thanks for the tips!
Why use the old site just to switch to a new site within a few hours? Start with the new site and see if it makes a difference.

Hi Desdemona,

I always give myself a 1-2 unit bolus after a site change. Otherwise, I go high too. So once your set is in, the tube and inset are primed and active, try giving a small bolus, then check your BG levels at regular intervals to see how it reacts.

Good luck, Mike




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