I use the Tandem Tslim pump. Has anyone ever noticed that periodically an insertion sight will go “stale” on day three? Almost as if the insulin is not getting in like it used to on the first two days?
A few times (including today) my number just keeps creeping up even though I am bolusing to correct it. I know there are like 32 factors that can influence blood sugar but I am normally very steady- many times I have 95-100% in range days, but then there are days like today that are just a complete mystery to me. I am looking for the cause.
Having to move the insertion site is the reason I switched to the TRUSteel infusion set. I can be any time from initial insertion to “out of insulin” point. My endo said it’s not “scar” tissue as we often hear but probably cellular hypertrophy which can cause the insulin resistance like a type 2. It goes into the interstitial fluid and then gets absorbed into the blood stream by some cellular mechanism so that could be reasonable. If you don’t use the TRUSteel you might consider it. It’s easy to move and re-insert (with some waterproof tape.)
Welcome to the TuD community! I have been using insulin pumps for a long time and have seen the symptoms you describe many times. The problem is like related to two different mechanisms. Your insulin pathway (infusion set, reservoir, and connection) is compromised or your tissue is not absorbing like it should.
What you describe has happened so much to me that I’ve called it “third-day fade.” It caused me to stop using the Ominpod pump altogether after 5 months.
You should consider trying to find new sites. In any case, watching your CGM like you describe, is the prime way to detect and counteract the occurrence. I have little patience for this and will change an infusion site early, if necessary. I usually go 3 days but changing on day 2 or even day 1 can avert hours of unnecessary hyperglycemia.
Be aware that your infusion set may be leaking (the set/reservoir connection possibly) or you may have under-dosed your last meal. I dose not only for carbohydrates but also 50% of the protein grams and 10% of the fat grams.
I am so grateful to you for discussing this. It’s something I’ve noticed but didn’t realize it might be my infusion set. That’s something for me to try
Terry, thanks for your thorough response. I tend to bolus as aggressively as I can. Sometimes I feel like I am fighting my pump because I use the ConrolIQ which aims to keep glucose at 110 and I am more interested in gunning for 90. (My Endo calls me overzealous!)
My other battle is that I had a full Pancreatectomy (hence my username) removing Pancreas, Gall Bladder, Spleen and Duodenum- and one of the results is a slow-emptying stomach. So I can’t bolus too hard up front or its off to hypo land hehe. My numbers literally take 3-4 hours to climb from some meals.
Hi Mimi, thanks for jumping in. I would say 1 out of every 5 times, by day 3, I notice at least some degradation. Not all of our bodies act the same having the canula inside.
It is inconsistent, because I have had times I waited until day 4 to change because it was still going strong and I hated to waste the insulin being thrown away from my pump tank at the time of change.
I totally understand that you rightfully desire a blood glucose level < 110. I don’t think shooting for a “normal” blood glucose is overzealous! I would call your ambition as normal.
Your situation is more complicated since your full pancreatectomy. I share some of your challenge as I was diagnosed with an exocrine pancreatic insufficiency (EPI) just over a year ago. I take pancreas enzymes with each meal. Things are getting better now but progress has been slow. For many months this health condition held me hostage near my bathroom.
Yes, I have T-slim X2 pump and it’s one of the options for an infusion set. I had problems with bent canulas using the Teflon ones which is why I went to the steel one, not only is there no bending upon insertion, they can be relocated as needed.
Terry4,
I am glad for your progress, in part, it sounds due to Creon. Digestive struggles are so hard and I celebrate your progress.
In a world where Big Pharma takes a lot of (well-deserved) heat, I must give credit where it is due, Creon is my sole source of digestive capacity (apart from Saliva and stomach juices) Were it not for Creon, I LITERALLY would struggle to even live. So, as a 700 Creon/month user, I am here to say Thanks to the people who came up with the idea that pig enzyme could solve a human problem.
I used true steel infusion set back when I had a Medtronic pump. Prior to that had kinked cannula constantly. Worked great so when I recently went on tandem pump asked up front for the true steel. My third site change I tried a place I saw on YouTube but didn’t seem to be working. Just plucked it out and moved and worked just fine. Just don’t like the two patches and also the little tabs get caught on things. I usually put an op site on it.
