Do you have problems on the third day?


We've heard some buzz about this and wanted to check it out directly with The People: do you notice a difference in your blood sugars on the third day of using a pump insertion site? Manufacturers recommend changing your insertion site every 3 days, but some people report consistently experiencing higher sugars on day 3. Do you?

I don't regularly have problems on the third day but a fair number of sites perform at a B- level that third day. It usually occurs if there is some bruising on the insertion.

Maurie

I suffer from set fade on day three...my fasting numbers exceed my target settings.In years past I would run a different day three basal profile but it was unpredictable so I just started doing small corrections on day three watching my CGM...My Endo aways asks me why I do so many manual boules...

Not at all. I generally aim for four days. I don't always make it, but it's usually because I don't have enough insulin left to make it through the night without an alarm, or I have a kinked canula which occurs at various days. I don't even notice a decrease in effectiveness at the fourth day.

Absolutely not. And I wear a pump set for 4 days consistently with little difference between Day one and Day four. Even do five days occasionally without problems.

My biggest problem, after ten years of pumping, is placement of the set. Running out of places!

yes I do, right now I'm trying to hoard supplies, so I'm trying to go every 3 days if I can, but I'm usually sorry if I do. funny when I first started pumping, I didn't have a problem at all.

Not for me & I usually wear my set for 4 days. I often have more problems with day 1, days 3 & 4 can be the best. As with everything with my diabetes it is not predictable, depends on the site.

I’ve never had trouble on day 3, but the couple times I’ve accidentally left it longer, I’ve noticed a precipitous drop in absorption. For me, it’s like my insulin absorption falls off a cliff on day 4. But yeah, no problems with three days.

I don’t usually notice anything. If my blood sugar is high, it is probably from something that I did, or didn’t do. I sometimes feel some stinging during a bolus, but I think that is more site specific than having an infusion set placed for three days. On occasion, I have put some extra insulin the the reservoir to get by until I can change the site; usually with no problem.

This is a great topic.

I also stretch my site to 4 days, sometimes 5, but by then the site begins to get sore, so I change it only for that reason. I switched to Sure-T's a couple of months ago, and they recommend changing every 2 days! Ya right!!

Day 3 is no different for me than days 1 and 2.

if i have problems it is on the first day not the third by the end of the third day it is usually performing well.

So interesting to read. I can't believe so many people can leave their site in for 4-5 days!

I definitely have problems on day 3, and I always have. I used to just leave sites in anyway and bolus a bit more, but in the past year or two I haven't been able to wear sets past 2 days without having them often stop working completely. I'm pretty sure I have an allergy to the cannula and/or adhesive—sites often get itchy after one day and are red, itchy, and hive-y when I remove them at the end of two. Sometimes sites get so itchy they only last a day.

I need to try Contact-D sets again but keep forgetting to ask for them when I order a refill. Last time I tried them I had a bad experience (about 50% of them bled and/or just didn't work), and they recommend changing every 2 days, so I wouldn't be saving anything there. I think absorption would be better, though. I think sites not working well for me right now is contributing a LOT to my level of control ... I've just been too busy lately to deal with it all.

Even getting to the third day was proving a problem for my wife; after 5-years on an Medtronic pump. She aims for very tightly controlled blood sugars. By day 3, the pump wasn't providing those. Sometimes, it would fail completely, with blood sugars suddenly climbing.

I always got trouble on day three but discovered it was mostly about the insulin getting unstable. My pump rep told me that Humlaog would only last 48 hours when taken out of the orginal glass cartridges. My solution has been to fill the pump reservoir with just enough insulin for two days and change both cannula, the tubing, the reservoir and insulin every 48 hours. Made the trick for me.

I´ve heard Novo Rapid is more stable and better for pump use, - but it doesn´t work for me, so Humalog there is.

I'm out to day 5 here and there's some turbulence overnight but I've seen that quite a bit lately. Yesterday I didn't but here we are again today. Time to swap it out. I don't worry about sites that much. It was also 90 degrees on Monday and I'd run about 3 miles...

That's one of the problems we found with the pump; especially once summer hits.

And, here's the thing... it's not like it suddenly stops working after 48 hours. I'd think it's gradually losing it's strength.

It just seemed like there was already enough variables in keeping tight blood sugars, that trying to recalibrate doses every day based on whether it was day 1 or day 2 of the pump, just didn't make sense. E.g. my wife's basal dose had to go up 0.05-0.1 units per hour by day 2, quite often.

Yes I do too...my b-sugers are higher and won't come down as it should after bolus. If I fail to remove after 3 days (time flies ;o)the insertion site will start itching and inflame, form a hard ball under the skin.
So I recommend a change every 3/4 days!

I can't say that I've noticed this but I wonder:

Is it a "problem" to use more insulin to achieve the same target? What I mean is, say my lunch kept my BS high for longer than normal. Putting aside the longer elevation, is there a health issue with hitting another bolus to correct?

I always correct highs (taking into account the IOB, of course). The less time spent at a high number the better. But if I find I'm correcting all the time after certain mealtimes or times of day then I will look at making a change to dosing. Better to aim to turn out right the first time than always have to correct.