Pooling Insulin?

Hi all

I was coming along nicely at the end of my first month with my Ping, getting my basal rates for different time periods set up, getting used to infusion sets, etc. Then the last week I’ve been having intermittent highs all week which don’t seem related at all to food as my I:C ratios are very stable. I suspected infusion sites which is the weak link in my learning curve and a couple times I changed my site and there was, in fact, a problem such as bent canulas and bleeding. But other times there was no evident problem.

Then today I noticed lumps under the skin nearby my current site and the one I’d been using this morning. I took a bath (I always take very hot baths) and bingo, the lumps were gone! I’d gone up to the mid- 200s this morning and couldn’t get down much with corrections. Then I was 181 before lunch and took my lunch bolus and an added correction. I correct to 110 and 2 hours after lunch - and after my bath I was down to 75!!!

I had mentioned this happening before when I first started on saline. At that time people said it could definitely affect absorption which makes sense. But nobody mentioned how to prevent them (other than taking baths all day…lol). I’m wondering now if this has been happening all week and causing my highs. I put my site in my belly and I am using Insets. I tried and liked Inset 30 but just had 2 samples.

Any suggestions how to prevent this pooling?

Yep, three hours after lunch and my bath I am down to 54 and have to treat. Definitely pooling! Just need a clue as to what to do to prevent it!

Hi Zoe

Are you using sites where you used to inject when on MDI? It could be due to scar tissue build up or whatever the scientific name is. For the 1st 6 months after I started pumping, I avoided the center of my stomach used the outside areas, as the trainer said she felt denser tissue there from years of MDI. After 6 months I nervously tried to use the area again & it was better. So I suggest, try other sites. I think it is due to the insulin not dispersing in the denser tissue.

Also do you leave the old set in after hooking up the new, Walsh & others advise leaving it in for an hour or more, even up to you Duration of Insulin Action time, this way any insulin at the tip continues to absorb rather than spill out, I think it bleeds less too. At the beginning I remember taking it straight out & getting a drop of blood & clear liquid which I presume was insulin.

Thanks Annabella, I didn’t even think of that.

I only did MDIs for two years and I used all the parts of my stomach, but yes, I’m using my stomach now too and as you get older your skin does toughen up naturally. Sounds like I should give other sites a try.

No, I never heard of leaving the old site in after hooking up the new! I have only had blood a couple times, but I’ll read up on that as well. Thanks for your input!

Zoe, are you noticing trouble with unexplained highs when beginning a new site? I have trouble with highs with new starts and like Anabella said, leave the old site in until I am sure the new one is doing good. And I test and correct much more frequently with a new start, usually the first 3 to up to 6 hours I will tend to run higher than my normal with a new start. And they are crazy to get down too!

Actually, Korrie, I don’t seem to have problems right after the new start but a bit later which definitely muddies the water as to trying to find the cause. Like yesterday was typical. I changed the site at noon (canula was bent), did corrections and my numbers got into normal range by around 4PM and stayed there through bedtime. Then I woke up this morning at 195! (I don’t have DP and normally run under 100 in the AM). It’s always several hours or into the next day before I see problems.

But are you saying that it’s normal to have some highs sometime after a new set and if I correct it will come down and “act right” after that? Maybe I’m reacting too quickly and saying “It’s a bad set”.

I’m pretty frustrated and at a loss as to why this is happening this past week when I was doing well before that. It can’t be the set every time, can it? I think at this point if I correct and it still keeps jumping back up I’m going to assume something else is going on (like a low level infection I don’t feel) and maybe temporarily up my basals and just treat the highs without being able to confirm the cause?