Is it the site, or the pod?

Anyone else using Omnipod have that experience where the pod "sort of" works? As in, you seem to be getting SOME insulin, but not enough? Until very recently I'd thought this was a defective pod, but in reading some messages on here I learned there are sometimes site problems. My experience is that the pod will work okay for maybe the first day, but then it just seems to conk out and not deliver all it is supposed to. I ran into this problem today - the first sign was when I knew I'd had exactly 26g of carb for breakfast (the same thing I eat literally every day), dosed accordingly, and was 288 by lunch! Anyone have a good solution or explanation for this? I do rotate sites but is it possible to just have it on a bad spot?

There's been talk here that this may be due to the cannula inserting into scar tissue. This type of skin will have noticeably less absorption than in other areas. Many of us have found that it's a trial and error thing as to where on the body the pods work best.

I've definitely experienced this. I've seen people post that they raise or lower basals depending on the site. I haven't experienced that much consistency between sites. Sometimes they work, sometimes they don't - and it doesn't have much to do with scar tissue, since I don't put the pod anywhere near where I MDI'd for 18 years. ::knock on wood:: ive had better luck with the new pods with site consistency.

Like you, I don't put the pod anywhere that I was doing injections, and I really don't notice much consistency... sometimes one spot will be just fine, but the next time I use it, I run into problems. I am still waiting on the new pods so I hope they do prove to be a little more consistent!

I think what I'm seeing with my personal trial and error is that there's nothing consistent... I thought I'd discovered the holy grail of pod sites when I started placing them on my low back, but sure enough after several rotations I ran into this same problem there.

Had the same issue several times. End up using a needle, take about 3 times the normal amount and it’s like it snaps into place?! Then I don’t have a problem.

I had been using my back for the pods for about a year and all of a sudden they stopped working. I had been using the old pods on my arms and didn't like them being so visible all the time. I've been using the new pods on the tops of my thighs (which is totally doable with the smaller pod) and just tried my back again. Seems to be working, I dunno. But I still don't understand people who never have inconsistent pod days. It's the name of the game for me, but it's waaaaay better than MDI

Truth is you're shooting blind with each pod. Skin thickness, fatty tissue, muscle depth, blood vessel proliferation etc all affect insulin uptake at each site. Often one site won't work but 5mm away it works perfectly. The first few times it happened to me I documented readings and called tech support. Their advice is always the same - change the pod. Omnipod apparently recognizes this because they have replaced the pod every time for the last 2 years, no question.

If your BG continues to rise unexpectedly over 4 to 6 hours after activation, change it. Injections of additional insulin should be used very cautiously because there may be fairly large amounts trapped at the site. Eventually this insulin will diffuse into surrounding tissue and be available. If you have injected large bolus(s) via injection you run the risk of overdose.

You should always be conservative . A few hours of high blood sugar will not hurt you. Insulin shock is more likely to do damage.

yes, i worry about over-bolusing. thanks for reaffirming my caution

It could be a number of factors. I eat the same thing for breakfast every morning too, but stress, cycle hormone changes, or something seemingly random all affect my BG. I definitely see a difference in how my legs absorb compared to, say, my arms. But not sure that accounts for the same site BG variations.

Agreed! Whatever frustrations I have with Omnipod, they pale in comparison to injections. I always have to remember what an improvement this actually is! (and will be even happier when I have nice small pods)

I've had the same issue. As others have said, I too think it's a scar tissue/absorption issue. Frustrating sometimes but can happen with any pump.

Wow, this is great advice that everyone should read. I think a lot of people aren't aware of this and will often end up over-correcting using a combination of injections and Pod boluses. I have done it a few times myself, but through trial-and-error have learned that I almost always drop too far too quickly for it to be worth the risk.

With my first few boxes of new pods, I didn't have any post-change highs. Now I have them again Lot L40419. Maybe it also something to do with the site, but I also think the pods play a role.
I identify with Gary's post. I have never had any luck with increasing basal for a few hours and bolusing a couple of units with a new pod. Today my BG climbed for 6 hours. It hit 400's, so I injected to try and keep it out of the clouds. I am now 10 hours from the pod change and fighting a low. The accumulated basal and bolus start to lower my BG about 6-7 hours after the pod change. The hill drops for at least 3 hours.
I think if this starts to frequently happen again, I will turn down the basal at the change, and just let it drip. I will inject for about 6 hours. That way the accumulation won't take me off a cliff when it finally absorbs.

I experience the same issue. Since most insulin pumps are basically the same (with regard to the cannula), I believe that it is the site. I've noticed that scar tissue buildup definitely contributes to stifled absorption. I've also had the pod placed too closely to a blood vessel, and the cannula was occluded with blood.