I have been a type 1 diabetic for about 8 years now and have been on the pump for 7.5 years. Recently, in the last few months, I’ve had repeated issues with high blood sugars with no explanation, but after changing the site, things would go back to normal for a day and then be wacky again.
Its seems as though my body is reacting to the infusion catheter on the second day of having it at the site. When I remove the catheter, I do feel a hard nodule, which perhaps is pooled insulin? Has anyone experienced anything like this. I’m having a really tough time controlling my blood sugars dealing with this and am not sure what to do. I have considered going back to MDI but am afraid of hypos that would be likely be frequent with doing so.
Maybe try a different “flavor” of infusion set? I use the MM Silhouette ones and haven’t noticed a lot of problems. I like that I insert them manually too.
I agree with the others. I was having problems with my infusion set a month or so ago and asked minimed for some samples. They gave me 2 of each for me to try.
After trying the infusions sets I now believe my issue is scar tissue. I have started using my upper legs and love handles and my control has been much imporved. I would suggest trying different sights and seeing if they work better. Hopefully if you leave your possible scar tissue alone it will recover.
Scarring is my first thought as well. If you’re inserting in a “hard spot”, the absorption is likely slower, which means the insulin pools up at the end of the cannula – exactly as you described.
Depending on the type of infusion set you use, there might also be some tweaks. Stay away from parts of your body that bend or lean on other things (like when seated in a chair). Try a larger (closer to perpendicular) angle, or if you do use a perpendicular set, maybe you need a longer cannula. But avoiding scar-tissue and being attentive to site rotation would be my first piece of advice.
Also, just a thought, maybe a bad batch of infusion sets. My daughter started having problems with her infusion set kinking, where we would have to change it 3 times in on day. We have never had a problem like it before. First I thought we had a bad box maybe and switched to a new box, but we were having trouble with those also. I checked the lot numbers and they were from the same lot. I had one more new box from a different lot and have not had the trouble since.
All of these are good suggestions. I’ve been on a pump for over 15 years, I was an early adopter. I’ve found, for me, that I can never bolus more than 3 u at a time, and 2.5 is better. I always take any bolus as a 30 min square wave due to this. I don’t get the hard nodules when I change out the site and I don’t get the decreased absorption indicators.
Don’t eat until ~20+ minutes after you start your bolus/infusion, though.
I had this problem all summer long. Now that it has cooled down a bit, I am having no problems. My endo really didn’t have an explanation other than to say that it was probably an absorbtion issue. I think that it is just one of those diabetes issues.
marty
Just one more suggestion to think about if everything else dosen’t seem to make a difference. It could be the type of insulin? I had pretty much the exact same pattern when I used Humalog. I confirmed over and over the above things were not an issue. Tried different sets, put the site in an area I rarely used etc and still had problems. Got a sample of Novolog and it hasn’t happened since. I have also tried Apidra which doesn’t seem to be a problem for me either.
