Well I did my first pod change today and 2 hours later I had spiked to 260. After searching around on the web, I’ve found this to be a common occurrence not just with OmniPods, but with most other pump/infusion set changes as well. There’s lots of advice out there…Give a bolus before the change, give a bolus after the change, run a temp basal for x number of hours…Do you all have this same problem and what advice do you have for dealing with it?
Thanks,
Tony
yes and I found the answer to be just bolus before changing.=]
Tony,
I’ve found that a bolus of about a unit right AFTER changing works best for me. I’ve noticed occasionally when I take a pod off, especially if I just bolused, a little drop of fluid will leak out of the old site, which I’m under the impression is left over insulin that hasn’t been absorbed. Hence the bolusing after changing. It seems that the amount to bolus really depends on the person, but my hypothesis is that it has to do with how long since your last bolus (and thus how much insulin at the site that hasn’t been absorbed yet.
Happy podding!
Same here, but I observe two additional details:
Recently I’ve gotten very frustrated by this and am planning to spend some time on the phone next week with Insulet customer service and my trainer - My spikes are much worse than just 198 BG, more like 250 and up - and that is just not tolerable for me.
I agree with Eric. It depends on the site. I too have a hard time keeping good control when pod is placed on the thigh. Takes about 6 hours to get things back to normal even bolusing after change. I do not spike hardly any when it is placed on my arms and abdomen area. Keep testing and keep a log and even graph it so you’ll know your trends.
Thanks for the replies, everyone. It looks like I had a bad site. I gave it about 18 hours with frequent correction boluses, but I couldn’t get back down under 200 or so. I switched sites on Sunday morning (back to the trusty old abdominal area) and gave an extra 1/2 unit from the new pod and was back in range within a couple of hours. I’m disappointed because the upper arm seemed like a real comfortable site.
Don’t assume that your arms are always going to be bad just from one trial. For example, 3 days ago I used my lower back site (upper-butt, really) and could not get my BG within range no matter what I did. So that night I changed pods and put it on my arm (my favorite spot). This morning was my time to change, so I put a new pod on the upper-butt site that had not worked 3 days ago; today, I’ve had no problem with BG.
My point is, sometimes a cannula is just in a spot that doesn’t absorb, or maybe too much air gets into the reservoir during filling, or… who knows… but a site just doesn’t work. That doesn’t always mean the area will always fail.
Today I tried something new that seemed to keep me from spiking. When I placed the new pod this morning, I did a temp basal of +40% for 8 hours. In addition, I also added an extra unit to each of my first two meal boluses. My BG was a bit high before lunch, (but not really what I’d call a “spike”) and the rest of the day it stayed within range. I did not give extra bolus at dinner and just checked (2 hours later) to find a BG of 124 - I’m happy.
So it looks like a temp basal increase coupled with extra bolus at first meal helps me control the new-pod spikes.
Yeah, it’s really a hit-and-miss kinda thing when you place pods or regular sites anywhere but the abdomen. When I first started the omnipod, i tried my back. That day I had the same problem - constantly high no matter what. So I gave up on that one. Saturday I put one on my back again and it worked fine. I changed to the other side of my back last night and it’s working pretty good, although I am having to take my meal boluses an extra 10 mintues before I normally would. Otherwise my basals seem to be ok there. Just keep trying! My arm is actually my favorite spot right now, but if the back keeps working, it may soon become my second-favorite! 
Take care Tony!