Hello, just wanted to vent a little about highs after pod changes. I came home from work around 6 30 last night and my husband and jacob had changed jacob's pod around 430. I have told my husband many times about the issue with pod changes and he feels he handles it fine he does a small bolus after and does not do the temp basal i recommend i usually do 15-25 % increase for 1/1/2 hours post pod change more if needed. well he was 146 at pod change he gave him .75 and then shortly after that let him have a clementine with no bolus. at supper he was around 220 and it seemed like he bolused correctly but majorly pigged out ham, rice, bun and then cake which he bolused for separately. at bed time snack he was 264 i bolused slightly more than the pdm recommended and tested one hour later 364! he came down slowly over the next hour with two more small boluses of .5 and lots of fluids i put him to bed at 1030 at 313 i assumed his pod was working because he was coming down and he had negative ketones X 2. his pod change was at 4:30 and this was 1030 so if he had an occlusion i would think he would be putting out some serious ketones. needless to say it was a stressful night luckily jacob was happy to stay up watching tv and was in a good mood. but ready for bed! does anyone else have these issues i think it is an absorption problem or sensitivity issue post pod change he does tend to over use his belly but we do rotate. the worst is i feel that i am more educated about jacobs D and my husband does not acknowledge this. he said when he was 364 after bed time snack you mustn't of given him enough of a bolus for his snack not admitting he overfed him and did not do the temp basal. i think after a pod change it is best to go lighter with eating. i don't blame my husband just try to education him but he takes it personal, I don't hold jacob accountable because he is an active part of his D team but i don't make him the key player yet but i think i am going to have to have him step up more when his dad is home with him. just wanted to vent like i said sorry this is so long, any input on how to better manage post pod highs? and husband not on board with the plan! thanks! amy
Arden hasn't experienced "pod change highs" since she switched her insulin from Novolog to Apidra.
You can read about the switch on my site -
http://www.ardensday.com/main/2011/2/2/apidra-v-novolog.html
http://www.ardensday.com/main/2011/6/28/apidra-blog-ptii.html
also Apidra is FREE until 4/30/12 -
http://www.ardensday.com/main/2011/10/11/free-apidra-from-now-until-43012.html
I've been on the pod for 5+ years now & Type 1 for 31 years so am quite different from your son in many ways. After struggling with post change highs for a long time, I've arrived at the following strategy: 1. I ALWAYS change right after breakfast (bolus with OLD pod) to avoid sleepless nights in case of a problem. 2. check sugar every hour or so until I feel it is definitely working; if it's high at all, I assume pod isn't yet working, so I bolus with needle & start drinking ALOT of water.
3. If I eat lunch I bolus with another needle if my sugar is around normal. I don't eat if my sugar is high. I'm still assuming the pod is not ready to function properly & continue with the water drinking. Usually, after about 5 hours the pods seem to be working just fine. For me, I decided it was better to keep my sugar more in control by using needles for a few hours than to risk going really high using the new pod & hoping. I can't imagine how hard it must be to take care of a child with all the diabetic issues. I admire your devotion. Maybe you & your husband could attend a session with a diabetic educator together. Good luck.
So just to chuck one into the mix - I have been on the Omni for 6 months but have been on a Nav CGM for 3/4 years. As Annecy said above - I am an adult and therefore different in many ways to Jacob. However, I do change my Pod mid morning - sometimes mid morning - I work in a healthcare friendly enviroment and therefore people understand. Using the CGM I can see the trend and work with that in term of bolus. I tend to leave any in take of carb for at least 2 hours, then go forward as normal. Compacting new pod with bolus doesnt work for me. But thats just me. It must be so hard with a little one. Gos
hi scott, i never would of thought of this one on my own we will consider it, if we end up making the switch down the road i might need some more advise since jacob's endo didnt have alot of experience with the omnipod, i'm not sure how they would handle switching to aprida but we'll see and move foward with it if need be, i'll have to do more research thanks again and happy new year! amy
I'm an old timer. 53+ years so far. I've been using the pod for 2 1/2 years and read a thread here about bolusing with the old one before changing it. I do a 0.50. I change mine in the morning before I eat. It seems to work for me but like it has been said everyone is different.
My situation is quite different...I'm an adult with D for 35 years, type 1, I have been on the pod for a year now. I change my pod prior to breakfast. I had experienced highs both the night prior to and the morning after pod changes. I use humalog. After researching the issue on Tudiabetes, I started doind a temp basil the night before of 15%, I do an additional bolus of 1. and a temp basil of 25% for the first 5 hours. I do eat my regular breakfast and bolus accordingly. This usually works for me. Good luck. I hope you can find the same comforting answers to problems I have found on Tudiabetes. I can assure you the information contained here is far superior to any I've recieved from my endo. I usually confir befor making changes, but she agrees the information contained here is wonderful.
i agree with you about getting more practical advise here than from the endo team! more experience is gained from living with diabetes, i'm sure some endo's are great but sadly jacob's team doesnt have alot of experience with the omnipod, but like others have voiced here it is a self managed disease. we have tried a variation on your suggestion and will continue with that, unfortunately with jacob in school it is not possible or practical to change his pod in the morning so it is ussually around 4 pm that we do pod changes the temp basal and the small bolus seems best maybe we will try doing the small bolus with the old pod as a new variation to try, thanks for the input! amy
We have been experiencing similar issues wth the pod changes. Every third day (and some times earlier) has beome a day of anxiety, concern and often frustration. For first three months after starting on the pod, life was wonderful except for occasional insertion pain. My daughter was using only stomach sites. Then we switched from Humalog to Apidra because the canula insertion marks were not fully healed even after 3 months. The switch to Apidra is helping with the insertion marks which indicates that her skin was reacting to Humalog. The BG contol has beome worse though with Apidra. The wonderful Insulet CDE came to our house and spent hours helping our daughter get used to alternate sites using dummy pods and a variety of tapes. We are now using arms, back, and upper stomach. However, we have had numerous highs (200-400) after pod changes even with pre & post bolusing. Will try temp basal increases to see if that helps. It seems that all the hard work of maintainig good glycemic control gets thrown out the window with a pod change. I could live with this if it were a 10% or so event, but it is happening almost every other pod change.
I wonder if similar issues exists for tubed-pump site changes.
glad to have somemore input on aprida, i feel your frustrations! the temp basaling does seem to help jacob as long as it is done when i am not home! isnt it ironic people without diabetes think you swich to an insulin pump and it is like an artifical pancreas, i mentioned to my nurse manager about jacobs issues and she looked at me like i was nuts and said he has a pump doesnt he even doctors that i work with think the pump regulates his blood sugars itself! how frustrating is that! i try to educate people but it isnt their child so they really dont care. but anyways, how old is your child maybe a growth spurt is going on. i suspect there is less issues with tubed pumps but my son in no way wants to switch, if they overuse a site there is probably issues but not like wiith the omnipod, well hang in there and hopefully if we all keep talking and sharing we can help find some answers. working with the insulet CDE is a great idea they have seen it all and know how to tweak things better than most endos. Hang in there! amy
oh crap! really? will check out your posts!
we have found our endo is learning with us about omnipod and they have actually implemented many of the tips i have read about here and other places within the doc!!
we have had these same issues!, we do low gi meal after pod change, we bolus one unit with change, try like hell to have a normal bs before pod change, and sometimes add in a little correction bolus with sub q for good measure.
this is purely diffusion time right? there is a science behind this! isn’t there some physics equation we can use to figure out the exact amount of time it takes for the pod to get going and thus the exact amount of extra insulin it will take to offset?
and another thing? how much time does the old site continue to leach insulin from the fat into the bloodstream?
my two cents?
upper stomache? maybe we should try that? got a pic? i will show to kennedy, it is hard to convince her of new sites, but perhaps a pic will help!
we have to domafternoons as well due to school, thatngives us from 4 or 5 to bedtime to be normal!
we do need a dexcom bigtime, dont we… i cried when i read your diagnosis story…