Desperate

I am so disgusted with my control I am almost considering taking injections instead of a pump. My fiasp doesn’t seem to be working as fast as it should . My bloodsugars go up immediately Fter food… I just don’t know. I think it might be my absorption although I have had my infusionset in my love handle and it still absorbed slowly. I have a diagram that says it’s fast absorbing in that spot. Any suggestions?

Are you pre-bolusing for meals? And how big are your boluses? Larger boluses can have a delay in absorption compared to smaller ones.

I usually bolus 5-10 minutes before recently. Previously I never needed to do that unless I was high. I am eating small amounts of food because of my gastroparesis. I have been feeling sick the last few days due to gastro. Fiasp is supposed to fix after meal highs and I feel it’s not working the way it should.

What is your normal carb intake for meals?

33-60 grams of carb. At supper I always do a dual bolus.

I don’t know that Fiasp is any different in that regard, other than it supposedly being faster.

Change infusion site. That might not be a good one for you. You could have some scar tissue there.

How are your basals? Did you get your basals right, prior to working on the bolus? I often see this often when my basals aren’t right.

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I sometimes get a little overwhelmed when my diabetes is not under control. My gastroparesis is acting up too. I am feeling a little better as I couldn’t eat much yesterday and was able to watch my sensor hourly for lunch basal. I panic when my bloodsugar goes up to 10 mmol after eating and I know I shouldn’t. Thanks for defending me from insensitive humans.

If using a cannula-type set, switch to a steel needle type such as Contact Detach or Sure-T (for Medtronic–same as Detach, different connector)

If I started to use a steel cannull what difference would that make? I am thin.

it MIGHT make a difference in absorbtion. Cannula sets are notorious for 3 things: causing more tissue trauma, tunneling, and kinking. I nearly stopped pumping more than 10 years ago because of all the issues I had with cannula sets and that includes HIGH BLOOD SUGARS! What have you got to lose? You can call tech support for FREE SAMPLES. Takes nothing but a phone call.

Dave - How often do you change sites? Do you ever just move it to a new site, tape it down and prime while keeping the set and cartridge in service?

Usually about 3 days. I have moved them if they hurt where I insert them because I hit a nerve but that’s about the only reason I would move one. I always put an IV 3000 over them anyway so it doesn’t matter that the adhesive is ruined by moving the Sure-T to another spot

Don’t you have to change the steel cannula every 2 days? I recieved a government grant that covers my pump supplies. I don’t know how much out of pocket I would have to pay. I suppose I could look into it.

Don’t you have to change the steel cannula every 2 days?

No you don’t. Many years ago when sure tees were marketed for kids they said they should change them every 2 days because they have a stronger immune response. My wife wears them for 5 days lots of times without any problems. Try not to make up a problem in your head from old information

I /have/ to change sites every 2.5 days - I notice a significant degradation in absorption (most of the time) after 60 hours in any site. I’ve also noticed that /for me/ the “love handles” are an absolutely terribly site! I get a lot of bent cannulas there and terrible absorption even when they go in straight – not to mention, the area tends to be uncomfortable for me. As for Fiasp, I noticed a fast start-of-action, but overall not a significant reduction in highs - in fact I saw several very stubborn highs when using Fiasp. I’ve had much better success with Apidra, though Fiasp seems to work well for me for corrections after higher-carb meals.

my absorption remains fine for 3 days

Like Dave44, I made the switch to metal infusion sets and have never looked back. I thought they would cause more pain, (when I first started pumping 27 years ago, all we had was metal and they did hurt). These “new” ones are so tiny, I don’t even notice them. I am on the thinner side and yes once in awhile I hit a bad spot but like Dave said, you can just pull it out and put it back in. I try and change every 3 days but I do go 3.5-4 days with no issues. And I go longer sometimes because of the amount of insulin still left. Hate to waste it. But I use so little and there is a minimum you have to put in and if I’m not eating a lot, I may carry over an extra day.
Ask for a couple sample sets and give them a try!

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If I know I am eating say over 40 carbs I try to prebolus about 30 minutes prior to eating. Of course I don’t prebolus that amount of time if I’m starting at a 120 or lower BG level. I will then take insulin right before I eat and delay part of it. And it does matter what I’m going to eat. I also split the bolus about half fast acting and half over the next hour or so. This seems to work for me not to go into the 200’s after eating. I still will climb sometimes into the 170’s and 180’s part of the time. But it’s a work in progress of figuring out how much to split what I’m taking.

I find it’s easier to try to stop the climb in the first place than to try to get my BG’s down after the fact. You just have to remember to actually eat on time and eat carbs to what you took. Plus if you wait too long to eat and are not eating a fast absorb carb meal, you might end up eating a quick fix.

And then I will have the days where my BG’s are high for no apparent reason, usually it’s just a day but sometimes 2, where I am not eating except maybe nuts, but taking insulin all day and eventually I drop and sometimes pretty fast.

There are the identifiable reasons which are, maybe fighting getting sick, fighting any infection, in my case doing too much and I have a back issue, so inflammation, pod in a new spot that doesn’t work as well, suspicion of insulin that might not be working as well. (it does turn out that insulin isn’t always what it should be) So there are tons of reasons while short uncontrolled levels might happen.

Steel works much better for me, no kinking issues and a lot less irritation etc. I almost never get the dreaded occlusion warning insulin suspended etc. I’ll never use a plastic cannula again unless they drastically improve it. It could be your gp is wreaking havoc also, my digestion often does usually I crash first and then spike later.

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