I get bolus, but not basal. Does this happen to you?

Put in a new site last night. Bolused, had dinner and everything looked good when I went to bed. Woke up over 300. All day I’ve bolused to bring my bs down, but it would creep back up without eating anything. Finally changed my site this afternoon and all is good again. This has happend at least a dozen times since I started pumping a little over 2 years ago. I just don’t understand why or how to figure out the problem sooner. Does anyone else have this problem?

What kind of infusion sets are you using? Do you pinch when you insert or just go for it?

I use quickset, usually 9mm. I usually don’t pinch because I have a lot of fat where I use the 9mm. Where I use the 6mm, I sometimes pinch.

Maybe your Bolus for dinner was too little insulin, or your Basal needs to be adjusted.

Maybe talk to your doctor or CDE about increasing your basal rates.

I don’t think that’s it. Most of the time everything is fine and when it isn’t, a site change fixes it.

Elaine, how long have you been using insulin? I always wonder if long termers have lots of bad sites…scare tissue from years of injections.

28 years and I do have a lot of scar tissue. I try to avoid those spots, but I have built up a resistance to insulin

I, too, have scar tissue. Almost 15 yrs. on the pump. I’m 6’ and 153. I can remember when inserting was easy. The needle of my silhouette would slide into the skin. Now I need a hammer to puncture a hole, then glide it under the surface. When I have a good site, all basil and bolus values are right on. Other times it’s a guessing game. A couple of examples: 1-A new site can take up to 7 hours to work properly. 2-If I bolus more than 6 units, I need to use the dual wave. Either I’ll kill the site earlier than 3 days, or the amount over the 6 units “won’t take”. 3-When changing sites, I need to “fix prime” about 3 units. It seems that I need this amount to “get the site going”.
My endo thinks I’m nuts, but he can’t argue with my A1C. I’ve just completed a year with all under 6 readings. My last one was just 2 weeks ago at 5.5 We all need to do individual tests and trials to learn our bodies. I’ve been almost paranoid to find the things that work for me. This and other forums have been a great warehouse of knowledge to lead me into trying different things. Some work! Some don’t.
I wish you well. I’m sure you’ll get the answers you need.
Good Luck - Dick

Hi, Elaine! I was diagnosed with Type 1 about 15 years ago and have been on a pump for roughly 12. I’ve experienced the same symptoms you have – when I do, a site change seems to do the trick. I haven’t figured out how to tell in advance if a site is likely to go bad… I just get that inexplicable rise in bs. I try to bolus it down, but if after an hour it either hasn’t budged or has gone up, I know the site has likely gone bad.

Elaine,

A blocked site, following a site change is a frequent problem for my son and seldom a basal issue, at all. A kink in the cannula when the site is first inserted is usually the culprit for a rising BG following a site change. The fact that the cannula has bent extensively when it was inserted is usually very visible as it is still severley kinked when he changes a faulty site. Perhaps the bolus is sufficient to force the insulin through, while the smaller basal deliveries become restricted.

Cheryl

You all had a lot of good suggestions. Thank You! Today I tried the same spot on the opposite side with a 6mm instead of a mm and it’s working great. I guess I have a strange body type. Sometimes I can’t tell if I should use the 9mm or the 6mm. Again, thanks for your help.

Hi, Elaine!. I have experienced the same symptoms you have, recently as of this morning. I do a site change, and all is well. This happens with the Quick Sets more often than I would like. I change them out to a Sure T and all is happy in Mikeland. I have had one issue with the Sure-T’s, but it was because I hit scar tissue. I haven’t figured out how to tell in advance if it is a site issue or not. I normally have to go through the night and into the morning to tell (after giving a couple of corrections).

I tried to look for the answer, but I did not see how much preloading the site with insulin before bolusing. My sites need 2.5 units to keep the basal steady and keep the BGs from rising if I don’t eat. I can then bolus normally and my carb/insulin ratio remains the same. Unless you have a lot of experience changing sites, changing, then going to sleep can be a bit iffy.

I established my site loading number by documenting my changes and loading number and measuring BG for the following four hours to see if he BGs remained flat.

Good Luck!

I think you are right. It seems that some of sites need either a larger prime or an increased basal for a few hours. Then everything is fine.