Could this be a bad pod?

First, I want to say that I don't think it's a bad pod, but wanted to rule it out bc I don't know what it could be and I'm frustrated. :(

Yesterday I had a low when I woke up, not very low, but I was shaky and feeling terrible, which led to a little loss of control. So, I had two ginormous bowls of cherrios (the normal kind that just taste like cardboard, not sugary). I did 10 units of insulin through my pod (the largest bolus I've done before was maybe 3 units, my normal tdd is between 14 and 22 units depending on what I eat, so it seemed like a ton), but this is what my blood sugars looked like for the day:

7:30 52 cheerios 10 units
9:57 247 1.75 units
11:21 252 1.7 units
12:55 238 1.25 units
2:29 236 meat 1.7 units
4:39 242 2.3 units
6:13 267 6 units by syringe
8:00 202 almonds 2.0 units
10:06 87
11:39 123

This morning, I woke up and thought the horror was over, but...

7:18 111
10:47 229 2.55 units
1:44 224 2.35 units

The only calories I've had today were from heavy whipping cream in my coffee and the only calories consumed yesterday other than listed were the same, and I normally drink coffee with cream during the day without eating and basically flatline.

The corrections that I was doing were a bit on the low side, at first bc I was driving around on the highway with my kids, so I wanted to under-do the insulin, and then later because I felt like I was doing so many boluses on top of each other I was afraid that they would catch up with me. BUT I wasn't lowballing it that much -- I believe that 3 units would normally bring me down from 225 to 100ish. (It's been a while since I've tested it, but in the last couple of months I've had to correct for a 200+ and didn't have a problem.)

I was thinking it couldn't be an occlusion bc I *think* my b/s would be way higher than this and be rising if I didn't have some insulin coming in through the pod. The only insulin I've had by syringe was humalog at 6:13 yesterday, so I am sure I am getting some, or my b/s would not have been 111 this morning.

If I were not absorbing well from this pump site, wouldn't I have had more trouble overnight? Obviously I will change my pod when I get home, just in case. But I really want to know what has caused this, too.

I have NEVER had anything like this happen that I couldn't find an explanation for. Any ideas? I am afraid I broke myself with those damned cheerios. :( I have not eaten any grain whatsoever for the last two months. Do you think it could wreak that much havoc??? I could see messing me up for 12 hours, though I was surprised, but the next day?

Thanks for any thoughts you guys!

Sorry, those blood sugar numbers are hard to look at with no formatting. When I posted, it took out all the spaces I had put in to make nice columns. D'oh!

  1. what’s your usual correction ratio? If, 4hrs post correction, you have no joy, you’re meant to correct again, wait 4 hours & either change your pod or go to injections.

Well its a lucky thing I wasn't waiting four hours n between. Is that *really* the way its supposed to be done?

I think that I would have gotten rid of the pod earlier, except I initially thought the problem was that I was thrown for a loop by eating 3 months worth of carbs in on breakfast.

Your basal and bolus rates are probably wrong. Get with a diabetes educator and get a recalculation of what you need.

Good grief. What are you basing that on? So freaking unhelpful. I have been a type I for 20 years. I have a pretty good grasp of how to handle my blood sugar. If this were an everyday thing then sure, but the whole point is that this has never happened before.

not 4 hours, if you're really high, you need more insulin then a regular correction, if you have ketones it takes more insulin. If, within a 1 - 2 hour time frame, your blood sugars don't come down, take a manual correction and change out pod. I don't eat cereal but have heard that's a real hard one to manage, especially if you had with milk. That could be the problem too.

I had the same thing happen 2 pods ago. My numbers were in the 300s-eating very minimal carbs and had just changed my pod the previous day. Like you, I also had normal numbers in the morning. I finally changed my site and the cannula was bent. Who knows why it worked overnight (maybe the position of my leg-where the pod was-as I was sleeping provided easier flow through a bent cannula?) Also, I had some bad insulin. I left 2 vials in OH over Christmas and had a friend mail it to me (I’m in KS) My idiot brain thought the cold temp outside would allow for stability in shipment (didn’t consider the warehouse, delays, hot truck, friend not packing it on ice, etc). After spending 2 month with really wacky numbers I finally figured it out. I’ve been T1 for 12 years and always thought when insulin went bad it didn’t work-like, at all. I had no idea it could kinda work. Once I changed to a new vial it was wonderful! Sorry for the book-and the frustration!

also, since you were eating from a low, how did you come up with 10 units, was it just a guess, that too could have been the problem? i think a true serving of cereal may just be like 1/2 c. for some, so if you were just randomly eating 2 "ginormous" bowls plus milk, without measuring what you actual ate, you may have been way off in terms of carb count? just a thought?

Yeah, I understand that. At around 225 I normally would do 3 units, 200 2 units, 150 about .5 units. I did less than that partly bc I thought the 10 units was a pretty impressive amount of insulin and I when I started correcting it had not been so long, so I thought the ten units might still have a bit of a kick to it.

I don't normally eat cereal, either. I was looking around the kitchen feeling like I just had to get any carbs I could find, so I grabbed my kids' cereal. I did have milk over it, but I didn't drink the milk, so it was probably minimal. But I had more than enough cereal to bring up the low, obviously.

I wonder if there's any chance my insulin could be bad. It's hard to imagine bc it was fine the day before and it was just sitting in the normal spot it always sits in. But, if my numbers continue to be funky now that I've changed my pod, I'll toss it.

Live and learn about the partly working insulin. In 20 years I don't think I've ever had to throw out a vial. Last summer I left a bottle sitting in the sun in my pouch with my meter. When I got back to it, I tried to test my b/s (I had just eaten and was coming to do a shot) and the meter gave me a warning code that said it was too hot. Oops! But there I was, had already eaten, an hour from home at least and I had a bottle of insulin that was totally hot to the touch. I used it just in case it would work, assuming it would not, and it was 100% fine! I do think that cold is worse than hot, though.

The 10 units was a complete shot in the dark. Like I said, it had been a couple of months since I had had any grain-based food at all and I don't think I've had a bowl of cereal in years. But after the first couple of hours, I would have thought that the original mistake would have been behind me. Like, no matter how far off I was on that original guess at how many servings of cheerios I'd had, once I tested a couple of hours later and corrected, that would be behind me I think.

I am wishing now that I had done like 17 units of insulin to cover it, but I got in the car 20 min later to drive my kids to school, so I didn't want to err in that direction.

4 - 8 hours is the maximum length of time you should wait for your sugars to come down. The highs weren’t life-threatening. You weren’t following the sick-day rules. 24 hours + makes no sense.

You were very upset when someone suggested seeing a Diabetes educator. By your own admission, you don’t know how to determine insulin doses for carbohydrates. I think you should try it, as it won’t kill you.

The other thing I noticed is that you say you always wear your pod in the same site. You are meant to rotate your sites. You might have a build-up of scar tissue.

this is incorrect. anything over 240, typically, can cause ketones, ketones can happen very quickly too. also, it depends on the diabetic, if they still have any beta cells - producing cpeptide/insulin, etc.., if they're getting any 'basal' insulin. we're taught to check ketones at 240 and if we don't take action, this could lead to DKA. For those who keep tight control, as I do, correct anything over 130 and NEVER see 200's these high numbers feel absolutely horrible, I would have probably been throwing up at this point. Type 1 is different for everybody and we need to always be safe. What's high for you may be different for someone else and their body and how they process ketones and how quickly.

well, that probably was the problem. I would have, just to see, gone back to try and measure out what I ate, after coming out of the low. Thus, that 10 units worth of insulin probably wasn't enough to cover all that cereal - carbs. please try to use glucose tabs when low, they work the best. also, be careful driving when numbers high like that. IDK about you, buy my vision would have been very messed up, I probably would have been very sick to my stomach, tired and sick. TAKE CARE!

Testing for Ketones at 240 is advised to stop Drs getting sued. Correcting is a more practical thing to do. Not very many people carry a PDM & another meter that can test ketones. Urine ketone testing is 6hrs out.

I maintain, that while you might start producing ketones at 240, you probably won’t. If those were your average blood glucose levels, you’d have an HbA1c of between 10 & 11%: bad but not fatal over 3 months, much less 2 days. Yes, if you’re very tightly controlled you might feel rough, but you’d be very unlikely to come to any serious harm.

i'll disagree, that's your opinion..but thanks. my doctor's advice comes from caring for me and his patients, not to get sued.

he's the doctor who specializes in this field with a primary focus on type 1 diabetics. thus, he sees and manages this stuff everyday. i'm happy to put my trust in his advice, medical expertise and knowledge. thanks.

I don't know. I agree that I was probably off on my bolus bc I didn't measure, but I cannot imagine that my b/s would still be bouncing up like that so many hours later, let alone the next day. It do think, though, that the cheerios did throw me off somehow. Like, if I had not had them, but a couple of glucose tabs or whatever, I'm sure this would not have happened. I have recently gotten pretty good at having something better for me, not so insanely high in carbs when I have lows, but sometimes I just have a very hard time controlling myself when my brain believes with all of its heart that I'm starving. Today, sadly, I woke up at 51 again and I had three strawberries and was fine. I probably don't need anything when I wake up at 50ish, my guess is that just waiting it out for an hour would be fine bc my b/s normally rises after I get up a bit anyway. But when I had that one with the cheerios, I was very symptomatic for some reason and that just makes it so much harder for me to do the right thing.

Also, bc I eat so low carb (like <10 a day), if I'm going to eat carbs for a low, I'd like them not to be empty like glucose tabs are. When I was pregnant I would always have 4 ounces of milk and felt like that was a good way to get some nutrition. Now I'm more likely to have a bit of fruit.

As far as driving goes, I definitely don't feel worried about it in the 200s. My vision doesn't seem to be affected at all my transient high blood sugar. I think I have to be chronically high to get blurry. (Maybe someone has other info on this, I may be wrong, but that seems like my experience.) And sick to my stomach, tired, sick... those don't happen to me until way way higher than 200s. Like I have, many years ago, had very high readings, like "hi" that meant over 600 on that meter and felt fine. In recent years, I would say that I do start feeling thirsty when I'm high, like maybe starting around 300 or even 350, in a way that is not a normal non-diabetic thirst. But otherwise I feel fine.

I think when you get to a really high b/s, driving could start getting sketchy bc it's possible you could have a seizure. I have never had one, but I guess there's always a first time. But I would be shocked to find out that that was an issue at the blood sugars that I was having the last couple of days.

Anyway.... thanks for your well wishes!

I would open a fresh vial, fill another pod, find another spot, and throw the pod away. Maybe it is the pod. Maybe it is the spot. Maybe it is the insulin. Maybe it is you. I would just fix the problem.

Ugh. Definitely not the pod. I changed the pod a couple of days ago, using a new vial of humalog and its still happening. It’s like my daytime basalt just went berserk. I’m not ready to set them higher bc they were working perfectly for like two months and I can’t imagine what would make such a big difference all of the sudden, but I sure am feeling irritated at fasting all day and having blood sugars like this. For these numbers I should at least be getting to eat some chocolate cake.