For the past two days no matter what I do I can't get below 200. It's driving me crazy because I am doing everything I did before when I was in the 90's and 100's.
I changed the pod once already but I still seem to be having a weird absorption issue. I had it on my arm and that was a disaster, now back onto my abdomen. I see the cannula is in.
What could be going on? Now that I am on a pump I really want my numbers to be normal or as normal as possible. This just frustrates me!
Thanks!
Linny,
I applaud your enthusiasm and desire for immediate great results with the pump.
I really can't answer what could be going ob. Are you calculating carbs correctly? Any sign of infection or illness that could be elevating BS? Are you sure pod filled correctly? Have you called your Insulet trainer for advice?
I can tell you that I have been on the POD for 6 months now and my AIC is not what is was when I was doing MDI. I am seeing my endo next week and looking for answers. I read a book, called Think Like A Pancreas which has helped me considerably. You ,might want to read that if you haven't already.
Who is working with you on your pump settings? An adjustment may be in order. Diabetes is a disease where treatment needs to be reviewed and changed as need be. I was getting pretty good readings and then for no reason, seemed to be running high. I made adjustments to my IC ratio and correction factor and have been better over the last few days.
Since you are new at this, you might want to talk to your endo. Just be patient. From what I hear and have experienced, it takes some time to get the settings right.
Yes, Thanks. The weird part is I was having great sugars from the moment I put on the Pod in the beginning of March. We have been tweaking it because I was going low after meals and in the middle of the night, now I'm going high!
Can't see the new Endo until September, if you can believe that. He only sees new patients once a week an he is very popular. For now, my CDE is helping me.
Thanks for your help!
Hi Linny,
The nice thing with the pod over mdi is being able to set different basal rates. In his book, "Think Like a Pancreas", Gary Scheiner addresses basal testing. He has a Website as well, IntegratedDiabetes.com. These are a few pages on his site that speak to basal testing:
http://integrateddiabetes.com/basal-testing/
http://integrateddiabetes.com/Articles/insu/basal%20insulin%20for%20friends%20with%20diabetes.pdf
You mentioned you changed the pod, did you change the vial of insulin?
When I first started, I had to do much of the same things and it even happens now, all of the sudden things just aren't ... status quo. I've done what you are doing, checking sites/locations of the pod, all the various rates/calculations for basal and bolus, and then changing the vial. I've been pleasantly surprised a few times when it turned out to be that the vial I had been using had for whatever reason, lost some/all of its potency. Not happy to have to toss the partially filled vial, but to finally have a reason for the change in numbers.
Just to throw it out there, I've noticed that I need to make some adjustments too, when the seasons change from hot to cold or cold to hot. If you live in a climate changing area, you might be faced with something similar in the near future.
Keep us posted!
What it sounds like is that you need a deep look into this by your doctor or diabetes educator. I know that my first few months with my Omnipod, we adjusted it all over the place on basal and correction/carb amounts. Seems the body does change a little with this pump, and you have to flow with the change. But don't do it alone. Take your BG readings and meal history to your provider and let them hash out the numbers for you.
Thanks. It's a pretty new vial, a couple of days out of the fridge. I think I am just panicking. After all Ive been in the 200's-300's and beyond for years, my average BG now is 138.
Thanks, Scott.
what strikes me about your high issues is summed up by your post above that starts with "yes thanks the weird part is" it sounds to me like the tweeks were tweeked too much just my opinion of course , but sounds like they went a little too far to stop the lows , but they always treat the lows first due to the danger of them , now have to edge them down a little , if you are comfortable with correction boluses see if the sugars will respond that will tell you if something more untoward is going on or not
Hi Linny - I HATE when that happens. Quick question - could some of the highs be caused by you being so stressed out that you are high? Has happened to me before. Not suggesting you don't need to dig deeper and look more closely, just thinking the stress might be bumping you up a bit.
Good luck to you.
I have noticed that BG levels are affected by different sites. My arms are the most efficient and the abdomen area doesn't seem to absorb insulin as well. When rotating sites between the arm and abdomen I will compensate for the difference in absorption efficiency by setting a temporary basal increase. For example I normally can add a 12 hour 25% temporary basal increase to achieve similar BG results between the arms and abdomen area.
If I see unusual highs in the 225 plus range I will add a manual injection. This gives 2 paths for insulin to absorb into the blood stream and BG levels will drop quickly. Keep in mind by adding the manual injection your reverse bolus and IOB will be skewed until the manual injection is gone.
My last 2 quarterly A1c have been a 5.6. Much better than I ever achieved in 20 years of MDI.
You definitely want to consult with your professional medical personnel before attempting any of this.
I changed my correction factor and that has helped somewhat. I think you are right that to compensate for the lows they have now set me too high. I know there is a period of adjustment with the pump and it is my first time pumping. I've read the Think Like a Pancreas book and Pumping Insulin. And I have a friend who has been pumping for years, she is a great resource.
I see the CDE on Friday and I'll bring in my reports as well as my food log (though I'v been so stressed by this that I have neglected my food log for days!). I haven't been eating anything out of the ordinary or haven't eaten before while on the pump.
I know I shouldn't expect perfection at the get go but I am so excited by the pump and what could be.
All your replies are incredibly helpful - thank you!
Ah, sticky highs. Here is my opinion about what happens:
Our body continuously releases glucose into our blood stream; it has to do that because we need energy continuously. The body of a NonDiabetic continually releases insulin to allow the glucose to be adsorbed. We T1Ds have to inject insulin instead; this is the basal dose.
When we get stressed, possibly just by an incipient illness that we don't even notice, our body releases more glucose to provide energy for dealing with the stress. NDs produce more insulin in response, T1Ds either need to do the same, by increasing the basal dose, or need to remove the stress.
If we do neither we get a sticky high. That's because a correction bolus takes about 4 hours to act and, over that period of time, our body has released a whole load more glucose that we haven't got the insulin to handle!
I typically handle sticky highs by multiple corrections spaced about 2 hours apart, but that only works for me because I have a 2 hour insulin action time, so I end up stacking the corrections. A more logical approach is to use a temp basal *and* a correction then avoid stacking the corrections by waiting 4 hours before doing anything else.
The easy way to do this while fasting is as follows:
1) At least 2 hours and preferably 4 after your last meal do a blood test and correction bolus using the PDM calculation.
2) Wait 4 hours, don't eat ;-) Do another blood test and correction, but now take the correction bolus, divide by 4 and use that as an increase to your basal for 4 hours; i.e. do a temp basal which will deliver exactly the same as your correction bolus over the next four hours.
3) Check again after 4 hours. You have apparently double-dosed (notice that this is like what I do with my short action time) but really what you have done is correct for the previous 4 hours of too-low-basal and anticipate the next 4 hours!
Once you get the number from (2) you can eat again, immediately, but don't do another meal bolus (or eat) for 4 hours; until you get to (3).
We need to keep up the temp basal as long as the stress continues. Since we aren't likely to know when our body stops responding to it the only thing to do is test frequently; I'd say at least once every 2 hours. Don't be tempted to correct until after the end of the insulin action time programmed into your PDM (and take care if you do what I do!)
John Bowler
Thanks for that thoughtful reply!