Pod change highs
I know this topic had been discussed here in the past but my search did not turn up many matches. Please forgive my post if it's overly redundant!
I started on the O'pod system last July. I've had recurring post pod change hyperglycemia almost every pod change. It's characterized on my CGM by a long slow (about 8 hours) march from normal BGs up to about 180-200. Corrective insulin doses via the new pod seem to have a somewhat muted effect. In other words they seem to help but not very quickly and they often need to be followed up with another correction.
Once the pod settles in, at about 12 hours, things seem to settle down with meal and correction dosing acting normal again. So I reasoned that I'm getting a gap in delivered insulin and/or absorption.
I decided to start adding insulin with a separate syringe at each pod change. I started with adding three units and have found that I need 7 units at pod changes to pre-empt the post pod change hyperglycemia. I don't take a lot of insulin; my total daily dose ranges from 30-35 units.
I feel like this is a lot of insulin to add but I can't argue with success. I like the O'pod system otherwise and would like to remain with it. For a while I was starting to think that I'd have to drop the Omnipod and return to a tubed pump. Having an 8-12 hour high BG excursion every third day seemed like too much to me. I have enough user-caused hyperglycemia and don't need more caused by the pump itself!
Does anyone else have this problem? What have you done to work around it?
Replies to This Discussion
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Permalink Reply by HPNpilot on -
I too am very careful about eliminating all air from the syringe... tapping it with a pencil to get all the bubbles to the top and then inject the air back into the bottle and refill. It may take several iterations to get all the air out.
Then I pull out the syringe, invert it (i.e. needle is now pointing down), tap again several times to get the air up by the plunger and away from the needle, and fill the pod. Any air bubbles remaining stay in the syringe and don't get injected that way. I fill the pod slowly and steadily.
I don't seem to have much trouble with pod change highs. If I am above 100 or so, I may bolus 0.5 to 1 unit with the pod just to make sure it is primed well.
If I am normal or low already, I don't do this as I don't want to go low. -
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Permalink Reply by Terry on -
Your technique to rid the filler syringe of air bubbles is the same as mine. I note a few here claim to be able to remove all air bubbles. Try as I might, when I think I'm rid of all of them, when I turn the syringe needle down and tap the side, some bubbles are always left. But having them near the plunger rubber ensures that they don't load into the pod reservoir.
Thanks for reporting your positive experience with avoiding post pod change highs. I don't think I have a mechanical problem with my loading technique. I think it has something to do with my physiology resisting the initiation of absorption. I need to study this more!
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Permalink Reply by Alisonisayoshi on -
I don't have this issue but the trainer actually mentioned it can sometimes happen if I wasn't extremely caeful in removing air from the syringe. So I'm OCD about! Hope that rid bit helps.
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Permalink Reply by Terry on
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Alison - Thanks for responding. I don't think I have an air bubble problem as I'm kind of OCD about this too!
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Permalink Reply by Jen in CO on -
I use a temporary basal every time I change my pod and my son's (he's 7). For myself, I use a temp increase of 50% for 1 hour, for my son, 40%. If you are having this increase for 8 hours - maybe 20% increase for 5 hours?
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Permalink Reply by Terry on
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It's interesting that your temp basal rate tactic works for both you and your son. I like the concept.
I'm still faced with the early results of my experimentation with pod change boluses up to 8 units. If this fact holds true (I will test at each pod change.) then I will probably stick with what works for me.
Thank you for your response.
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Permalink Reply by Steve D on -
Terry -
As you mentioned, this is a VERY common complaint. The way I deal with it ongoing is I have a second basil rate saved in my PDM for change days. On the change days, the basil rate is literally double what it is on normal days, I find that this gets me down to normal rates on the change days ( every third day). Otherwise, I'd be bolusing every hour or so. Youll have to experiment to get to your optimal basil, but it is worth it. Good luck, and PEACE. -
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Permalink Reply by Terry on
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Steve - While you and Jen (above) use the temp basal tactic, you are using more insulin. How long do you set the double temp basal rate? That might be worth trying for me. I like that it is metabolically less drastic than the bolus I'm using now.
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Permalink Reply by Steve D on
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Terry - I just use the temp basil for one day....that works for me, it seems that the pod gets to being effective by day 2. What is the dogs name, if you dont mind my asking?
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Permalink Reply by Steve D on
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I see in your profile you have a "service dog" to warn you when you are going low...may I ask, did you train your dog yourself or did you get your pup from a third party service? Don't worry about being OCD about things, it is natural!
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Permalink Reply by Terry on
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Steve - I received my dog from a not for profit agency in the San Francisco Bay Area. Norm is four and one half years old and has been with me for two and one half years. It's definitely one of the best things to help with my diabetes that I've ever done. Aside from his low blood sugar alerting his emotional support is a major side benefit. Thanks for asking.
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