How do you guys go about identifying a site problem quickly:
-Is it because it “hurts”?
-Is it because BG values keep going up in spite of you keying in the right boluses? If so, how long do you wait to change sites?
I am a stubborn idiot and dont like to give up on a site right away. I usually will just keep compensating for the bad site with more and more insulin. bad site are very rare for me when i use my abdomen. I had more issues when I tried to use my thigh. I have found that my bad sites dont necessarily hurt either. Sometimes, a site hurts but my BG stays nice and normal. Go figure.
If I hit a vessel, it is intense pain and stays painful until I remove the site, has happened about 3 times in 4 years and then when I pull it out, it is a gusher. Meaing big time blood spurt.
Saturday morning I used the way right side of my abdomen and bgs have been on the high side since then so it is not necessarily a site gone bad, but a site where the absorption is not good, but since I got my bigger pump two weeks ago, I fill her up with 300 units and really, really hate to change the site, but I think I will take the insulin out of this reservior to fill up a new reservior along with an insulin vial, way too much work, but not liking these high numbers.
Answer is I just waited two days, but if it is intense pain about 2 minutes to a gusher.
Like Kathy, I hate giving up on a site. Mine usually don’t hurt and even when they have, my BGs were still good and I just dealt with the discomfort rather than change to a new site early. With me it’s always BGs that don’t respond to normal doses of insulin. If I have to correct twice in a row I’m pretty sure it’s a bad site. And yet, I will sometimes correct a third or fourth time before giving up! If I’m very active my BG might come down enough and I’ll think it’s working again but as soon as I slow down the BG rises.
I used to have numerous problems with Quick-Sets and one day I had to change my set 5 times. I’ve had far fewer problems with Silhouettes, and most of those have been when I tried leg sites.
I wonder if I hit a bad site today… I woke up to a decent 127, had a sandwich and bolused for it. Changed sets and now, mid-morning, I am at 246!!! :S
OK. 228 now, before lunch… I’ve only had water and coffee in the past hour… and bolused quite a bit when I saw the 246 before.
Seems like a bad site. 
Ok, at about 1:30 I was down to 119, so I thought that things had “settled” down… not so. I ate about 50 gr of carbs. What am I at now? 238!
Changing this set when I get home.
Those are the worst. Your blood goes high, but not insanely high. You finally get it to come down and you think everything’s okay, but it just starts creeping up again. What I hate most about that kind is I know some of the insulin has gotten through, but not how much. Once you change the set the IOB number in the pump isn’t reliable, and I never know what I should do. My CDE told me to do a full correction but I know that if some insulin got through, a full correction will send me low.
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My problem is that I usually can’t identify the problem!! At first I think I miscounted carbs, then I think maybe I forgot to bolus, then I think it MUST be hormones, then I realize the damn thing has hit a rough patch and change it. I hate those days! I usually figure out it out in 24 hours…which is WAY too long!
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I just had this happen last week. I stayed high all day. Not terribly high, but high none the less. I woke up at 145. Ate breakfast, and retested two hours later. Still 145. Didn’t eat lunch, and tested at lunch time. 135 or something like that. Tested later and I was 180. Ate dinner and tested afterwards. 196 and I stayed that way for about three hours. Did a correction, and came down to “normal” after another couple of hours. Went to bed and got up. Tested and I was at 155. AND my site hurt really bad. I had it on my thigh. It was painful. Put another site in and I stayed in the 140’s to 150’s for most of the day while tweaking basal and I:C.
Finally settled down around dinner. Yes, I am stubborn. I am also pretty new to pumping (seven weeks). After looking back, I must have been a little sick and my body noticed it. I also believe I had a bad site. That site hurt like Hell the second day, but it wasn’t red or anything. I am not sure what I could have done differently, since I changed out the site and still was high. At that point I just assumed I was sick.
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This makes me nuts! I seem to have a bad infusions ALL the time. maybe it’s P.E.B.C.A.K. But its a source of frustration/anxiety for me not knowing and having to wait for a big high. Sometimes a good site just hurts - I pulled a good one out and was so annoyed. I test like a madwoman the first 6hrs of a new site
To the designers of the infusion sets: Please work in a color change or some other indicator to notify the infusee that the insulin has leaked.
Bad site = feeling insulin running down my tummy - even though the occlusion alarm has never gone off. Or when pain does not subside. Or when I see blood in the cannula or around the canula. Or when skin around the site turns red and itches
I just went through 4 site last week that were all bad. I have never had that happen before. The last couple have been fine.
Ditto on all the below including being an idiot insisting a site problem is really my fault i.e. all the below mental gymnastics including I ate pizza, duh! I had a tough talk with myself and said as soon as my bs doesn't come down with one correction, change the site. With the Omnipod that is so easy the only negative is the cost in pods and insulin and the fear that the new site will hurt. I use my lower abdomen. Have tried back, hip, thigh, and leg but have no better failure luck with anywhere and I find the security of having the pod protected under clothing and where I can see what's going on reassuring. I also aim to change every other day tho sometimes I forget and the site is still working. My recent A1C was 8.3 so I'd like to know if anyone has found any 'magic' answer to minimizing this issue.
Even though I notice this is a very old thread, it's still a great topic.
My list of the things that make me question a site are an "all of the above" including:
Discomfort either from first insertion or starting later on
Knowing when I inserted that it probably "didn't go in right"
High blood sugars with no other explanation, especially if I correct them down and they go back up
Looking at my Inset 30- since it has a little window you can see part of the canula (which I love!) and so I can see things like a drop of blood, redness, or either too little canula (may be bent) or too much (may only be in a short ways)
I recently posted the question about how often people lose sites and discovering mine were way too frequent I reviewed my insertion technique and found I was doing something wrong. I now keep most sites for 4 days (what an improvement!). I think some of the problems I was having was with something (probably slightly bent due to wrong angle) were leading to poor absorption rather than outright failure. I also realized I was blaming the site way too readily because I'd come to expect failure. I won't wait too long, but now will give it a try to see if I can get high numbers in range before changing the set.
If It went down to 119 it should be fine. However, it could be a bad absorption spot or your body is going through something, I'd change it just to see what happens. if it keeps happening I'd assume its your body being rebellious.
Hopefully he's changed his site by now. (It being 5 years and all...lol)
I just sat down to the computer because I am grumpy that I just lost a pod to a bad site and I found this thread. I hate to give up on a site/pod too. I wait and test lots and up and up the insulin and if my BG doesn't go down I then change the pod/site. So, I go by BG or if I can feel that it's leaking or if oddly I can smell the insulin - it smells like bandaids to me. This is because I have had the reservoir leak and only the bottom of the pod is wet which I can't tell until I have removed it to change sites. It doesn't happen very often but it's so frustrating when it does - mostly cuz I am already high and then the pod change will raise my BG too so I have to compensate for that as well. I also, like mwags, like to have the pod protected but somewhere I can see it. I had just tried my thigh for the first time and just now changed it - but I think it was a leaky reservoir not a placement issue. Thank you for listening to my grumpy rant! And, for being there right when I needed this thread!! :)
Usually it's the pain that lets me know the site has gone bad. A shabby, throbbing, horrible pain!
I try to hold my own till I can get home to change it. Luckily it doesn't happen too often as long as I don't place my set on a muscular spot.
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With me, a bad site usually painful or itchy. Once, I got blood running back up the tubing, and that was a clearly bad one! My BG will often come down after a PP spike and then start going back up again, but it might be because my stomach is still not completely empty. So I correct with the pump, and if I don't see some effect within an hour, then the site might be bad. But on the other hand, I've had nights where I correct every 3 hours for 8-12 hours after a large dinner, and it does eventually come down. So I'm not quick to blame the site. But remember the pump companies always say to correct with a syringe if your BG is not coming down, and that really does make sense if you think it might be the site.
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LOL!!! WOW! I Did not pay attention to the date of this post at all! Well, if anyone is going through this problem I hope my comment helped a little. LOL! :-D