Hi!
I am an Omnipod user and I have a question regarding high BG. I was 136 this morning and calculated my actually sweet cereals to be about 60g of carbs and instructed the pod to inject. It calculated about 8 units but 2 hours later - 371! Why didn’t it lower it? Was I too high to start off wirh?
A few things could have happened. And probably more that I’m not mentioning.
And some of this will depend on how long you have been a T1? There is what we call a honeymoon period for possibly quite a while. That means you might have been producing some insulin and this time you didn’t.
Next, was it a new pod? Because sometimes they don’t work right. Whether it’s the pod itself or the site with an Omnipod there is no way to know. But when I get a reading out of whack, I re evaluate if I actually did the right amount of bolus,what was in the meal to maybe cause a delay or is it the pod? I’m pretty quick to change out the pod if it’s within the first 12-24 hours of wearing. You call them in and they send you a replacement and will reemburse you for the insulin if you pay for it.
There seems also to easily be a problem if you disburse too much insulin at one time in many people. So sometimes it’s better to do a delay for a second dose, but even better to do part of it as a prebolus.
It could be your insulin to carb ratio is off, if the doctors set it, they have a tendency to start out light on settings.
What did you eat with the sweet cereal? Because if there was anything high fat, it delays the absorption of carbs. Your insulin is used by the time the carbs hit. Some people even have to dose a much smaller amount for proteins. I just had pizza yesterday and 4 hours later I started climbing.
Plus we can change our needs, Especially in the morning when DP (dawn phenomenon) or FOTF (foot on the floor) can come into play.
Next, it could be totally unrelated to your meal and be FOTF, which means it will probably happen again. I’m watching my BG climb right now from 80 to 143 and I didn’t eat. I skip eating in the am because it’s hard to control. This works for me, not necessarily what others choose.
Less sleep will make you insulin resistant, higher fat food the day before can make you insulin resistant etc.
Did you prebolus? I know this was a delay in the climb, but doing some insulin as a prebolus helps keep the numbers down better, unless it’s a high fat meal.
So in other words there is no easy answer. But re evaluate your carbs, was this meal different for some reason? I would take a correction dose once I get past a certain number. Keep an eye on the pod to make sure it’s not that. Sometimes flukes happen and we never figure out why.
Oh and do you have a CGM? Because if you don’t, really try to get one. It helps keep better track of what’s going on.
If you’re that high 2 hours later my guess would be you didn’t get any insulin. But don’t listen to me, I’m not a doctor.
If this was high carb and high sugar, it will spike bg quite quickly. If you ate just after bolus from omnipod, the insulin isn’t totally working yet. Even a 15 minute wait would help, but 60 high carbs without protein/fats to slow digestion will aften give a quick rise.
So some options are:
Wait longer after bolus. If you are using CGMS, its easy to catch when insulin kicks in. If not, do bg checks.
Include fat/protein with meal, eat before cereal.
Check if your bg normally rises after getting up. This is common for many, and with pump typically program a higher basal rate. Have you skipped breakfast and observed how much your bg moves?
Speaking for myself, it’s hard to respond in any useful way without knowing more about stuff like:
When did you start using insulin to cope with diabetes? What type of diabetes are you dealing with? T2? T1 since childhood? LADA T1? Something else?
How long have you been using the Omnipod? What has your experience with it been like?
Are you using a Continuous Glucose Monitor (CGM) of some kind or only using a Blood Glucose Meter to monitor your BG? If you use a CGM, which one?
How were your current basal & bolus settings selected? How confident are you that they work well (enough) for you? Have you done basal and/or bolus testing?
What time of day was this? Could a periodic metabolic variation such as Dawn Phenomenon be part of what you experienced?
Essentially, why on earth were you apparently so surprised that two hours later your BG was 371. What previous experiences lead you to expect a different outcome?
This is a great compilation of things that can happen. Totally agree with your list and I appreciate the thought you put into each item.