Do you have problems on the third day?

Diabetes Technology Insulin Pumps
61

I am so glad I found this. I've suffered through quite the saga since switching to the T-Slim in November. My blood sugars went out of control for over 2 weeks for what are still mysterious reasons that my endocrinologist chalked up to my recent use of a new skin lotion containing essential oil of rosemary. They seemed to steer back to semi-normal (my basal rate increased by more than 100% - my total daily basal went up from 11 units per day to almost 35 units per day) after I stopped using that lotion but I am still at a way higher basal rate than I was in October.

The problem I'm seeing recently is WAY higher BGs starting after 48 hours of refilling my pump and changing the infusion site. What I ALSO see are tender lumps under the site after removing the old cannula - almost every single time. They feel bruised, are about the size of a pea and last for a few days. I keep switching back to my Animas Ping as my rates seem lower. Does anyone else suspect that the "force" of the T-Slim's delivery is not really up to par with other pumps, resulting in higher BGs?

I recently decided that after another full day of BGs hovering around 200-300 that my next refill would be with the Animas. I am hovering higher than "normal" after 48 hours but not nearly as high as on the T-Slim. The first 24 hours were fine & I was happy with my BG.

I am boggled, beyond frustrated and sometimes upset with my inconsistent results when previous to my decision to switch to the T-Slim everything was going fine and my HbA1c was 6.2. I'm dreading my next visit...

Anyway, my questions are:
- Is the T-Slim to blame for any of this?
- WHAT is the deal with the bumps under the infusion site I've never had before?
- Has anyone else suffered high BG using the T-Slim?
- Could my ENTIRE abdominal area where I insert the infusion set be ruined by scar-tissue (I've been using a pump for over 15 years)
- WHY is my basal rate SO MUCH HIGHER now than it was before if I haven't been sick?

62

Yes, definitely. I consistently have high blood sugars on the third day. I am assuming it is arising from general wear and tear.

63

I can go four days without any issues. But I live in AZ, and in Phoenix area I hear people complain that in the summertime the insulin can get too hot and loses potency on the 3rd day or so. Do you live in a warm area? Or do you keep the pump right against your skin? If so, you might want to use the belt clip to keep it outside your pants, or in a belt pouch like the ones from Angel Bear Pump Stuff.

64

This thread seems to be back from the dead LOL

I have never been able to get a set to work well on the third day. This was a problem from starting to pump and within 6 months I went onto a 2-day rotation. If I leave the set in for 3 days, I get rising BGs and also a big bump at the site (which I don't get if I change the set at the end of day 2).

There has been some research into the reasons for premature site degradation. Factors are reactions to insulin at the site (or rather to the preservative) - some people are more sensitive than others and the slight inflammation can affect absorption. Another major cause is the denaturation of insulin in the cannula and at the site. Reduced pH at the site (caused by carbon dioxide which is a natural product of metabolism) can cause the insulin to denature forming insoluble fibrils which then restrict the cannula and can impede absorption. The research showed that there are differences in susceptibility to this between the three rapid analog insulins. Apidra is about 40 time more likely to clog than Humalog - Novorapid (Novolog) is the least susceptible.

I was starting to find my sites degrading on day 2 and switched from Apidra to Humalog which greatly improved things.

Joel