Could it be this box of pods?

Diabetes Technology Insulin Pumps
1

Hi all,

Been on the pod now since 11/2014 and am having varying degrees of success.I rotate between 4 sites and this newest observation has brought me back to this board.

So last night, at supper. I noticed that my BS was a bit higher than usual. Thought I had under counted carb for lunch, so I comped, and bolused for supper. I kept my eye on my dexcom and everything seemed ok. I took a nap after supper and got up about an hour and 1/2 later. BS was ok. I watched TV for a couple of hours in the living room and when I checked my BS, it was up to almost 400. (this is not normal for me at all). I bolused and drank water but nothing happened. Kept watching Dexom for decrease but kept seeing gradual increases. Finally I took an injection...Ok POD failure. I stayed awake until my BS was going down and woke to a normal BS. Was the end of day 2 on the pod. It was on my upper butt...

Changed POD this morning. Used POD from the same box.Now the same thing is happening. I am counting carbs carefully, based on food packaging and bolusing and my BS is gradually creeping up, not going down....Like basal and bolus not working....I just took another injection....

Thoughts? Could it be I have 2 bad pods in a row??

2

Hi, and welcome to the POD. I can only speak for me, but I need a lower IC ratio, i.e., it takes more insulin for each g of carb at supper for some reason. That was a programming adjustment I made after being on the POD a while that’s worked well. I also had to adjust correction factors, one for morning, one for day, and one for evening-night. I suppose it could also just be the Batch of PODs, but I’ve never experienced that issue.

3

I am on the omnipod and love it. But I had a box last year that I had 3 pods in a row alarm out. All the same batch number. Called it in and they replaced the entire box. Can you check the lot numbers and see if they are all from the same lot number. Could just be a bad batch, but my did alarm out.

4

Insulet is really good about replacing pods if they fail.
Do you have input from a CDE and/or diabetologist ? My CDE recommends an injection and drinking water when my BG stays above 300. For me: 3 units per 50 above 150, but it is very individualized; I change my pod. I was diagnosed Type I in 1986. Good luck--Ruthe

5

Personally, I think a CGM should be a requirement along with any insulin pump use due to possibility of issues like this. They should be sold as a "team" of devices rather than individually.

6

and both be covered or bring price down. costs about 5000.00 a year for my CGM, sigh

7

Assuming neither pod signaled a failure (i.e. you did not get a pod alarm) there are several other things that happen:

1) The notorious post-change delay. After a pod change some people experience a temporary delay in insulin effectiveness and/or delivery. Reports vary, many people do an extra bolus on pod change but one person a while back reported problems over the 12 hours after a pod change. I think she ended up stopping using the pod. In general if you have this problem you will see your BG going up unexpectedly after many, most or all pod changes. You can experiment with an extra bolus, either before or after the change.

2) Site problems, twice in a row. It's possible to have a cannula insertion issue where there is no occlusion alarm; all it takes is for the insulin to go to the surface of your skin not inside it. Check for insulin in the little, impossible to look at, window (an assistant helps when doing this :-) It's also possible for one site to behave differently to another or behave in an unexpected way, e.g. a long delay before the insulin gets adsorbed. Two such failures in a row are unfortunate but I'd try a third.

3) Insulin problems, but if you injected the same insulin that you are putting into the pod (the same vial, or pen) that isn't it.

4) A bad run of pods, like you suggest. Check the lot number, try a new box if you have one with a different lot number and, for certain, call Insulet to see if they know anything.

5) Changing reactions with the pod. It's weird but after I moved to the new pods I had a couple of months where they alarmed with monotonous regularity. This stopped, and it wasn't because I got a new batch of pods - I was using the same lot all the time.

I have another possibility which is very hypothetical based on (5); it may be that the PDM rather than the person is adapting dynamically to long term BGs and so on. It seems very unlikely that Insulet would program the pod to do this and not tell anyone, but I couldn't find a believable explanation for what happened in (5).

6) Changes in your own body resulting in a rapid substantial change to your IC ratio. If you were newly diagnosed I'd suggest your body might have stopped producing insulin, but given that you've been a T1 for 8 years longer than me that seems unlikely, however other changes are possible.

John Bowler

8

Thank you all for your responses. I changed the pod when I got home from work and all is well. I did call Insulet and they want me to return today’s POD & last night’s POD to them for them to examine and are sending me a return envelope. I’m confident this was not related toIC ratio as my IC ratio has been working pretty well. I do notice that I seem to have issues with POD placement on my but which is where it was last night. I wonder if laying on the POD in the bed could be affecting functioning or if the cannula could become dislodged while I’m sleeping. I do tend to move around in my sleep. I wear my dexcom on my stomach and I don’t have problems with that.

I have not ever heard a n alarm other than the change and expiration alarm.

I do drink the water when trying to get BS down and have found that helpful but it wasn’t doing the trick last night or this morning.o