So Jennifer do you just do a temp basal then, with no pod change bolus? And how long do you do the temp basal for? We have been doing a 2hr +30% basal but sometimes my daughter’s numbers spike later. We were actually thinking of boosting the pre-change bolus. [we do a 0.5 bolus on the old pod, wait and then do the temp basal on the new pod–all just before dinner.
I do not do a pod change bolus when I change the pod after dinner. My daughter is four, and I feel it is just too risky to do it after she’s eaten her big meal for the night and she’s about to go to sleep. Of course I check her overnight but it’s just too scary for me, and I absolutely HATE treating her in the middle of the night. I think it’s such a violation of her precious sleep!
Also, the last few pod changes her BG at the time of change has been very good, like in the 80-110 range…so I’m too scared to give a bolus with that number!
I generally do a .35 basal (as opposed to her normal .25 basal after dinner) for two hours. There is no rhyme or reason for this number or time…I literally just plucked it out of thin air…like so much with D! I feel it’s just a help to get the pod going. High basal rates definitely accumulate in her, so I’m hesitant to do too much…If she has gone high, it’s usually only somewhere in the 200s (even high 200s) because she’s only missed her basal (which is so low anyway overnight) and her BG is usually good coming into the pod change. If she goes high I just correct her. Sometimes the first correction works, sometimes I have to do it all night. Again, no rhyme or reason as to why some pods take longer than others. Usually by the third correction if it’s THAT kind of night I add 10-20% to the correction and it seems to take care of it. Not much sleep for me that night though 
There are just so many variables it’s hard to say. I think location of the pod has a ton to do with it. When we put it on her back, it works fantastic (almost too good). When it is on her bum facing “in”, she notoriously has high numbers.
If it were me with D, I would probably go for the extra bolus, stay up a little later and have a snack if necessary. But I just can’t put my daughter at that kind of risk.
A lot of people seem to bolus with the old pod. That never used to make sense to me because it obviously doesn’t help the new pod get working, but I see now that at least you have three or so hrs of active insulin while the new pod gets up to speed.
Sorry for the long reply but there are just no easy answers with this stuff!!! I have learned so much on this site, I don’t think we would have been nearly as successful with the pod if not for everyone here. No matter how good drs and nurses are, it’s us who are actually in the trenches who can figure things out the best!
After reading all these comments we changed our routine and have seen some good success.
We are still doing a change bolus of 0.5u and a temp basal of +30% but we do it all with the new pod (so after the change) and we do it right after dinner. Done three changes this way with good BG afterward.
A caveat. A couple of days ago my daughter fell while running cross-country (cut her face up and chipped a tooth). Her pod was on her stomach but looked ok. That night her numbers climbed into the 300s. Pod looked ok and when we did a correction. Morning numbers were high but not extraordinary. Then at 9:30a she called from the school with BG of 455. We gave an injection and changed the pod. Did the +30% temp basal but no extra bolus. She ran for cross-country and did her normal routine. Later she went low. Then around 9:30p her pod started falling off. We had to do a second pod change. This time we only did a +20% temp basal and no bolus. At 12:00a she was 56. The cross country running has a lot do with the low number but from now on we will only do the 0.5u bolus plus +30% 2hr temp basal if the pod is changed at dinner. Otherwise a new plan is required.
We also had highs with our 3 year old. We found that leaving the old pod on for a few hours with a 50% increase in basal for the first 2 hours has eliminated the highs.
I’ve been having problems with this on and off. At the moment, I decide whether or not to take an extra bolus depending on my blood sugar when I do the pod change. If I’m lowish, no bolus. If I’m normal or high, I do about 1.25 u, then I program a temporary basal +30% for 3-4 hours on the new pod. This seems to be working for my in-between-meals blood sugar.
My problem is that I seem to always spike really badly with the very first bigger meal that I eat on a new pod. I just can’t seem to wait long enough or take enough insulin… My blood sugar still goes up over 300 most times, but only with that first meal, even if it is the next day (after a good, controlled overnight). Does anyone else have trouble with this?