No insulin being delivered after pod change?

Hello. Our four year old son has had diabetes for just over a year now and we just started using the Omnipod about a month ago. We have been through so many pods!!! I can't imagine that this is that unusual?? We have had a few instances where after a site change, and then after the meal immediately following, his blood sugar would spike so high the meter wouldn't even register the number! It just said "HIGH". He would get no insulin at all and the pump would not error. I have read several posts on here about it being a priming problem, a site problem (it had happened at practically the same site), or just bad pods? I think I can chalk it up to a bad site at this point because whenever I moved the pod to a different site it did seem to work. So why didn't the pod error if the insulin wasn't delivered or if the cannula had a problem? My son is also very strong-willed and had made his mind up that he doesn't want to do site changes and has to be held down to do it while kicking and screaming. It's because of the click...it's simply the anticipation. Once it's done, it's no big deal. He says it doesn't hurt. So, in these instances of "bad sites" or bad priming, we have had to do two site changes in one day, which is so stressful for both us as parents and hard on my son!!! He knows he is supposed to go three days before another one. Then he has ripped a couple off (in the same day as a site change at that)!! So, I guess our biggest concern is these highs after site changes. We are afraid everytime we do a change, and he gets checked like crazy...not ready to give up yet. I love the idea of the Omnipod. It is easier as far a give shots go. Is is just the learning curve of starting it? Finding out what site are going to work and which ones aren't?? Or is there a certain way to hold the pod while priming to make it push out all the air?? I am remaining positive that we will figure out these "bumps in the road" and move on to smooth sailing. My husband gets very discouraged, and well, me too I guess.

One thing to make sure of is that the insulin is at room temp. The pods don't work as well if the insulin is cold.
2 of my kids use the Omnipod and one of them used to use the MiniMed. It seems that all devices have a learning curve and their own set of problems. It seems like lots of people have post pod change highs and they bolus before changing to avoid that.

Hi Judy, I feel your pain and wanted to share some things that we have learned in our year and a half of using the OP. Our daughter still does not like waiting for the "snap" of insertion, but it has gotten a little easier. I have heard that it takes a while for the insulin to start getting absorbed in a new site. The pod is working, but the body isn't using the insulin as efficiently. But, eventually, they start to work. There were a couple of times at the beginning when we gave her a correction with a syringe but left the pod on. After her bg came down from the scary HIGH reading, the pod worked fine for the rest of the 3 day period and we were glad to not have the expense of another wasted pod. These things are not cheap!

So, some pointers that helped me: Always use insulin at room temp. Flick the syringe and remove all air bubbles. Keep the new pod in the plastic tray it comes in when filling. (I guess it keeps it level or steady?) Push the insulin in very slowly - I slowly count to five as I am filling it. As far as the dreaded "snap", we just try to distract her and hope for the best. Like you said, once it is over, it is no big deal, but the stress leading up to it is not fun.

Also, some people like to give a bolus with the old pod right before removing it. Some people deactivate the old pod but leave it on for a while after they have activated a new pod in a new area. (I guess they think the old pod still continues to give a little insulin, even though it is no longer "activated"? We have never tried this method, as we are dealing with lack of real estate. Our daughter is 5.) What we do is to give a small bolus (0.20) immediately after we have activated the new pod - just to get it going. This seems to help in avoiding the post pod change spikes for us. But, as always with D, this does not always work. There are still times when we see numbers in the 300s, despite our best efforts to avoid them. But, that is the unpredictability of type 1, isn't it??

Anyway, hope this helps. Best of luck to you and hope things get a little easier...

Post pod change highs I think are one of the biggest problems with the pod. I don't know if other pump systems have the same issue or not. It can be VERY frustrating but you just have to keep working on it. We have them almost all the time, using the pod for 1 1/2 yrs now. However, this last time we gave our dtr the 0.20 to 0.30 "pod change bolus" and she went low, go figure..... Guess that one was working right away ;) There are various ways of doing this ie....bolusing with old pod before removing, giving an hours worth of basal up front w/ new pod (canceling the basal for that hour), just giving that extra little 0.20 to 0.30 after the change. I try to also gently massage the site when I am giving that "pod change bolus". I also think the more relaxed and soft their tissue is when the cannula is inserted the better results you may have. We always place the pod with the tapered end in an upward direction. Even if it's just a little bit up. Next time you take the old pod off, pop it open and you can see how the tubing is inside and at what end of the pod the air bubbles will settle. You can tap a syringe for 30 min and still have air bubbles that are so fine you can't see them but they will all settle in to one bubble eventually. Sometimes I will draw up her insulin about 3-4 hours before I insert it into the pod, stand it on end (needle up) to let any air I didn't get settle to the top so I can push it out before priming the pod. Try to stick with the new pod at least 6-12 hours before you decide to take it off for a new pod. Sometimes it takes that long for absorption to start or whatever is going on to improve itself. I know that seems ridiculous but..... There is also a recent discussion on the OmniPod Users group regarding this issue. Check it out for tips if you haven't already. Good Luck!!!!

i realize this is an old discussion...but we have only been on the pods now for 2 months and are almost to the 1 year anniversary of our daughters diagnosis (What a year!!)I would like to know if ya'll are still having the same trouble or how you have learned to deal with these situations. I feel like Insulet knows us on first name basis already...We have reported 20 pods at least (and I'm not exaggerating...its probly more than that)in the past two months.I was glad to find the momnipods group. I feel like ya'll will truely undrestand my fruteration with a 4 year old and all the pod changes!!! I could sign my name to your origianl post! We are there!!! Just got done calling in 5 pods from the last 3 days that have either alarmed or just given us HIGH readings...This is news to me that we should just keep it on and wait for it to start absorbing...do you normally treat the highs with a manual dose? or not ever? We love the pump WHEN IT WORKS but are seriously wondering if it just isn't for us!?! thanks for listening...

Beth, I get what you are going through. Sophia was dx at 4 1/2 and we were using the omnipod by 3 months. Same frustrations you are having we experienced. Sometimes I would wonder if it was even working at all. We had several consecutive months where we literally had a 50% failure rate per box. After 5 failures in a row (actual alarm failures) from the same box I refused to try the rest on Sophia and insisted they take the unused pods back and send me a new box of 10 and they did. At that point Sophia actually said “can you just give me a shot?” and I started contemplating switching to a tubed pump. Just hang in there because it got better for us and I hope it will for you too. It’s all trial and error and you just have to figure out which method(s) work for you.
Some things I do now 1) draw up insulin at least 1 hr before inserting in new pod and I draw up to the 200 even though she only uses the minimum. I get all the air bubbles I can see out and then stand it needle end down & tap so any left over bubbles settle up to the stopper. I prop up the syringe needle end down until I’m ready to use it. Before I insert the insulin I gently tap syringe so any other bubbles float up to stopper and push the plunger until a bead of insulin comes out the tip of the needle, insert and slowly inject insulin counting to five until I hear the pod beep. This way I know I’m not pushing any air bubbles in to pod. I obviously put remaining insulin back in the vial. 2) Priming, I hold the pod “butt end” up, tapered end down with the insertion hole tilted slightly higher than the opposite corner. I give it a lite tap to move any air bubble to the front of the tubing so it goes through first during the pumps prime (open a used pod so you can see how the tubing runs and if you have an air bubble in yours). I’ve never had one fail on priming doing this although they tell you to leave the pod lay flat when priming. 3) lately I bolus 1 unit of insulin with old pod and immediately deactivate. Sophia showers/bathes and then we put new pod on. Depending on her bg when new pod is activated I will give her the correction, up to 0.50 units if normal, AND temp increase her basal 100% for 2-3 hrs.
Tonight seems to have worked well so far. We are at 153 2 1/2 hrs after pod change but I still wouldn’t be surprised if its not up to 230 by midnight… It’s not unusual she will shoot up to 280 after a pod change. This is why I say leave it on and give it time to start working. By morning, after 1-2 corrections through the night, she will be in normal range. I treated a HIGH with a manual dose once when we first started w/ the pod but have not had a HIGH reading since. We’ve had plenty of 3-400’s and still correct w/ the pod and let it do it’s thing (unless I can see the cannula is bent, etc…in which I will then change the pod. I haven’t given a manual dose in 2yrs). I know it’s VERY frustrating but keep trying and good luck!!!

THANKYOU for all that information! I have one more question…we have numbers in the 400’s to HIGH would you still wait it out and let thepod do its thing…to me those are scary numbers!! But i can try to wait it out and see what happens next time. We finally got one working this evening! Yea!!! We are hopefully good fire a couple days now…so glad i found this group…hope y’all don’t get tired of my questions!!!

Beth, Sophia doesn't seem to readily produce ketones so that is one reason why I will ride out a high bg with corrections on the pod. You just have to see what works for you and just be diligent in checking numbers. Sometimes I will gently massage the tissue around the cannula insertion site when the bolus is going in. I don't know if that helps but it beats just sitting there wondering ;). Last night I did not increase her basal rate 100% like I usually do. I just gave her the 1 unit pre-change bolus and relied on the corrections of the new pod. 6:30p she was 170 (pre-meal). Carb bolus and eat. 7:00p I did not check her. Gave her the 1 unit and removed pod. She took her bath and we put new pod on at 7:45p. At 9p she was 153. I gave her 0.10u (half the correction). 11:11p she was 171. Again gave her half the correction. 2a she was 126 and 8a was 104. Last night worked rather well and I modified my usual routine just based on my gut instinct. The thing is, this could all change a month from now so you just have to keep modifying. I used to get mad when people would tell me "managing diabetes is an ART, not a SCIENCE" and I am finding that this is true to a large degree. This is a great place to be for support and questions. No one will get tired of them. Everyone is eager to help. I hope you have a good couple of days on this pod!!!