Replies to This Discussion

Permalink Reply by christy on March 3, 2013 at 6:16pm

I've heard of others saying this. I haven't seemed to experience this problem, but I can't say I'm doing anything different or special. I think like a lot of things, everybody is different. Hope you find a solution that works well for you.

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Permalink Reply by still_young_at_heart on March 3, 2013 at 6:50pm

I tend to run a little high 2 hours after breakfast and can bring it back down before lunch with a simple correction. Acidrock has said that he bumps up his basal (he calls it running hot) when he changes sites and finds that that keeps his blood sugars in range. You might just take an extra 1/2 unit or even a full unit with your meal and just watch carefully over the next few hours.

Maurie

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Permalink Reply by acidrock23 on March 3, 2013 at 7:33pm

Maurie is correct. I had the suggestion from Ginger Vieira, who doesn't pump but knew someone with whom she'd discussed the idea. The theory is that the insertion is traumatic and impairs absorption of insulin for a while. While it's impaired, like if you have steroids, stress or other BG "boosters" a basal boost will counter the BG boost. I like basals b/c they are "softer" than taking an extra unit or two as Maurie suggested but, in the end, at .8U/ hour, that's a unit or two anyway. W/ a basal though if I do 1.6U/ hour instead of .8U, I can turn it off when I perceive the site to be working when my BG is sitting where I want it to. This is obviously easier with a CGM but a couple tests would cover it too.

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Permalink Reply by Korrie on March 3, 2013 at 7:33pm

I also will run high after a site change, doesn't matter what infusion set I use, the location of the new site, or the time of day I change sites. I just automatically correct with a bolus, for me around .8 to 1 unit moderates the spike. At times I need to do a additional correction at 2 hours if I feel I am still trending upwards. Usually within 4 hours, I have stabalized and will begin to trend downwards if my sugar is elevated, or will maintain in my target ranges. And I have seen others post similar problems on other forums, so this does not appear to be an abnormal occurance, with most people noting they either increase basal or add a bolus to cover the spike in sugars with the site change. Good luck!

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Permalink Reply by JeffC on March 3, 2013 at 7:55pm

There's actually no reason to take the old infusion set out right away, you can leave the old one in for 4 hours and bolus for breakfast on the old infusion set if it's still working and put the new one in at breakfast so it's warmed up for lunch.

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Permalink Reply by rick phillips on March 3, 2013 at 8:20pm

I have the same issue and I agree with Jeff C below. I keep my old site in while the new one gets warm and switch about 3 to 4 hours later. Here is another trick a CDE told me once that works occasionally. Upon change push about 5 U and then set up normal basil for about 2 hours before you check. This implies that you dose for breakfast in the old site, before you remove it. You have to be very careful however, because this has driven me to an unexpected low. I gave it up because it was not working the best for me. If I was not low I was high, so I found the idea of placing a new site and not using it a better alternative.

Let me know how it turns out, this issue drives me nuts.

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Permalink Reply by Matt7571 on March 4, 2013 at 4:12am

Thanks everyone for the feedback... I will definitely try some of these options (use the original site for 1/2 a day before swapping to the new one, or adding a temporary basal for a few hours while the new site sets up)

Most of all, I'm pleased to hear that this is more common for others and not just something happening to me.

Thanks again everyone - I appreciate it

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Permalink Reply by JohnG on March 4, 2013 at 8:20am

My infusion sites are best when new, I do prim a little more than recamended but by day three I can usaly run a 110% temp. I usaly get 3 days but compleatly reject the steel sets (Sure-T) in about 24 -36 hrs.

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Permalink Reply by S Woodward on March 4, 2013 at 11:41pm

If you are not adding a few units after inserting the infusion set there may not be enough insulin surface area to get affective absorption of the dosed insulin. I been on the pump for 16+ years and I add 2.5 units to the new infusion site even though the infusion line and needle have been filled before injecting the infusion set.

I came up with the 2.5 u # by tracking bg post infusion site injection and seeing no change in bg. This mean, like with basal testing, steady bg before, no meal or dose to adjust bg, and measuring for several hours. If I done add the extra post new set, my bg will rise and the I:C ratio will be way off.

Some CDE's call this extra insulin a pool to set the site or prime the site.

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Permalink Reply by Matt7571 on March 5, 2013 at 5:19am

Thanks S Woodward for the information - that is interesting and something I haven't heard of before... so just to be clear, you prime your infusion set before inserting it, then you instantly bolus 2.5 units after the insertion of the site to create a pool of insulin to help the site set up?

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Permalink Reply by Stress on March 5, 2013 at 6:49am

My Endo told me to do a temp basal on days that I change my site. For me a temp basal of 75% for 4 huurs seems to work. Before that I was always high (200+) 2-3 hours after changing.

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Permalink Reply by S Woodward on March 5, 2013 at 11:18pm

Right after the infusion set is connected I bolus 2.5 and add whatever needed for a meal. I stay away from temp basal to cover set change, it seems to take several hours to get back on track with the temp basal for me. It is best to ry it w/o eating a meal and starting with a BG in range and not changing.

It has worked for me, hot you can find a way to feel as you are under control again.

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