I’m curious to find out if other people have trouble with high bg right after you change the pod. Today when I changed my pod my bg was great it was at 110. I then had a low carb lunch and my bg shot up to 277 (may still go higher). My last pod change was the same way. I went into a panic the last time thinking maybe the canula didnt really go in straight or there was another problem. I was so ready to change the pod but I wasnt home so I had to wait. By the time I did get home several hours later it was starting to come down but I wonder if this is something I should just start to expect.
This time I am not going to panic, I’m just going to keep working on it until it comes down. But I’m wondering if this is something others experience or if it is only me.
I do find that my sugars go up. I wait until the pod runs out of insulin to change it and I believe that it sometimes doesn’t realize it’s out. It could just be that my body takes a while to adapt to the new spot though. I’ve found that for me a small bolus (I use 2 units, if you’re more insulin sensitive you could probably use much less) right after I change pods helps keep me fairly stable.
Angelia -
Yes, I have the same problem every pod change. I suppose (like Rebecca) that the new location just requeres some time to start to absorb insulin. The way I deal with it is to give myself a bolus just before the change, then another right after (new pod). Of course, I need to take a few bg’s through the entire process, which is a bit of an inconvenience, but this entire disease is no walk on the beach! I also try to change my pod as late in the day as possible, even just before bed, so there is no activity (food or excercise) for at least 7 hours. It’s not only you!
Its not only you. Iv had it happen with infusion sets as well… I tend to like to 1. do any needed corrections right before a set/pod change… 2. usually give myself an extra bolus of .5 to 1 unit after the new set/pod is running, AND possibly a temporary basal of 10% for up to 3 hours (idea being is that it will end shortly after the pre-change bolus should have peaked)…
When the TBR ends… check your BG again
it should be back in line, as long as theres not a meal/bolus in the middle of it…
If its slightly high, you can either try correcting it out again, or another period of TBR (temporary basal rate increse)
if it is really high… Inject a correction and consider yanking the pod/infusion set…and starting again
(your idea of really high may vary, im thinking anything over 275)…
as always YMMV, but hopefully you might find that this suggestion could work for you
I’ve always wondered if some of the recently injected insulin doesn’t absorb when I pull a pod off. Sometimes I see a little insulin like liquid at the old infusion site. I have been trying not to bolus right before changing sites, so the questionablilty of insulin from the old pod not being absorned isn’t there.
Mine usually does. So, I bolus 0.5u after each pod change and it seems to help avoid that post-pod change high.
This is not just an OmniPod thing – this will happen on every pump. There are a few things at play:
- You get pooled insulin at the old infusion site – pulling out the set may push some of that pooled insulin that has not been absorbed yet from reaching the blood stream
- Depending upon how long it takes you to switch pods, you do not get any basal insulin. This can be a bigger deal than you might realize.
Taking a bolus right before you change the pod may help, or it may not – since you might experience the pooling.
Taking a bolus right after you put a new pod on should help – if you bolus what you missed as basal+what you think your BG has risen. The priming process only gets the insulin to the end of the cannula, basically, nothing hits the bloodstream until the basal starts to deliver.
as you can “see”, you’re preaching to the choir. I resolved this issue by changing my pod just before bedtime. I always give myself a bolus of either .5 or 1.0 unit depending upon my BG reading at the time.
My variation of the technique everyone seems to use is to change my pod right before I eat, if possible. (Since I am almost always getting ready to eat, it’s not hard for me.) That way I prime the new site with a unit or two. I’d be afraid to dose without eating but I do notice a spike if I do not bolus.
This problem seems related to priming. Make sure the pod is properly primed before using it. Lots of air and insufficient priming could be the cause. You could be “pumping” air for a while. It seems that some people here didn’t have that problem because they delivered a small bolus after the change, essentially “priming” the pod. Just make sure to consult your CDE/endo to find out how much of a bolus is not too much.
I’ve had this same issue with the pod since day 1, which was 12-15-2008. Only it took me a lot longer to finally figure out what my problem. I worked with my CDE for a number of weeks trying various ‘remedies’ for the post pod high that always happened. What I finally ended up doing is: change the pod just before breakfast or lunch, never at night as I’m alone most of the time, after the basal has started with the new pod I give myself a ‘bolus’ of 3 units of insulin and that usually keeps my blood sugar stable.
This is just my opinion, but I think there may be an issue with the programming of the pod itself. Here is my reason to question that. My CDE said that in his practice he has seen this issue with BG being high after a pod change from many of his patients. One day he took a pod, filled it with 50 units of insulin, let it remain in the plastic container that it comes in and put the pod through the priming process as the PDM instructs. He then removed the pod from the plastic container, turned it over (like it had been placed on the infusion site) and hit “start” when the PDM instructed him to do so. The PDM doesn’t know the pod wasn’t actually inserted into a person’s site, my CDE wanted to see just how long it actually took for a “correction bolus” to start delivering. He was quite surprised to see with his own eyes that the insulin did not come dripping out right away. He tried this experiment several times and it took anywhere from 5 to 15 minutes for the pod to deliver insulin.
He is not saying the pod is a poorly designed insulin management system, just that there is this ‘kink’ that needs to be addressed probably by software programming. No system can be perfect and I still love my OmniPod and would not trade it for anything else.
Maybe if we have insulin left in the pod to be replaced, we should bolus a bit out of it before we remove it.
Hi Anngelia -
I guess I’ll add my voice to the chorus! I’ve heard that you can also go high after a pod change because of the shock to the system that is involved in placing a foreign object underneath your skin. Your body can resist it for a little while or cause a minor adrenaline rush that raises your blood sugar.
I have this happen every time I change the pod. Usually I just give a bolus of 2.25 u (I played around till I had the right number) with the old pod right before I deactivate it. Then I change to the new one immediately (ideally with less than 5 minutes in between pods to minimize any lost insulin).
I hope all of the suggestions here have helped - even just knowing that you are not alone!
Interstingly, I also use the bolus number of 2.25 unhits just before my change and it seems to do the trick. i guess its just extreme coincedence between myself and Lindsay.
I’ll have to try the 2.25 bolus. I tried taking 1.5 and still 2 or 3 hours later was at 300+ When I got the 300+ reading I took another correction bolus and raised the basal rate up 95%. I never had this happen with my Animas pump but you can raise the basal 200%. Sometimes when I had a really high BG I would run 200% for a half hour. Used to correct whatever the problem was. I guess I’m just going to have to keep playing with it until I figure out what works. But I really appreciate all the suggestions. I’m just going to keep trying them one at a time until I get it figured out.
Good luck, Anngelia…one adventure after the other…
Hello - I just want to THANK YOU all for your sharing and your input. Our daughter is 11 y.o. and was diagnosed Juv. Type 1 on Oct 11 2007. She has been on the OmniPod since July 2009. I have recently joined this website to have some of our mysterious questions answered by those that have walked before us!!!
Britt is extremely in touch with her physical body and is incredibly responsible about her Diabetes. Britt has been telling us for the past 2 months that she always experiences high BG’s after changing her pod. She feels it takes nearly a full day to get back into check… We have started really looking at the pattern - SURE ENOUGH - she was 100% right!
This is one of the questions that we were looking for some input on!
Thank you! We plan to try some of the suggested ways to head this off on our next pod change.
Thank you again!!! Wendie
Four factors: #1–bolus after pod change; certainly this has been our experience as well, and we give our 13 year old T1 a 0.5 unit bolus after pod changes.
#2–if you just ate before a pod change, give yourself at least 1 hour, and preferably 2 hours before a pod change, to let your insulin bolus absorb, then change the pod.
#3–in warm weather, the insulin tends to degrade a bit faster, so by day #3, you might notice higher blood sugars. We will add some “overage” to carb counts of at least 10-15% to compensate for this on day #3.
#4–sometimes by day #3, the catheter might get a little local skin and subcutaneous tissue irritation, and you might not be absorbing the insulin well from that sight. Might be time to change the pod early to a new sight if this happens, and it can be noted through the pod window, being more red and swollen, or subjectively feeling more tender at the catheter insertion site.
Hope this helps you all.
I usually bolus 1 unit 30 mins before changing. This helps ease the spike so its not a spike, but more of a little hill
Janice, when do you use .5 or 1? We're also trying this formula w/ our son Santi 3yr old. We measure BG before changing POD. If BG is between 100-200 (his target), then we bolus 0.5 after POD change. If BG>200, then bolus 1.0. Is this what you're using?