My son had a big problem where...after he changed his pod he would go high for up to 10 hrs. At first I thought it was stress causing the high since he was stressed at that time...well.. later.. pod changes were not as stressful so I wondered if he was just slow to absorb in a new site. So..we started correcting right after a pod change and even increasing basal temporarily... well.. that didn't work and things kept getting worse so I called our Omnipod Pump instructor. Here is what she said:
Some people have sensative skin and just the canula insertion stresses the area. So... correct first w/ the old pod then don't do anything to the new pod for about an hour even if he is running high. Let the site rest. She said if that didn't work she would have us try something else.
Well...it works!!! He has had 4 pods changes that he didn't get crazy numbers after! Turns out... my trying to get his numbers down by repeat corrections and increased insulin...was the opposite of what he needed.
I wanted to share this incase anyone else was having this problem. :)
Interesting. I was told earlier by this group to always correct with the old Pod before changing to a new, and I was not opposed to that since I usually have more than enough insulin left to do a 1 or 1.5 unit before a change. Many of us have to bolus a little when we change, but this just confirms that using the old Pod for that bolus is the best thing.
I also noticed if I change RIGHT after I bolus, I seem to get a lot of seepage of the bolus when I remove the old Pod. Now I try to bolus at least 30 minutes before the Pod change so that does not happen.
I’m glad that you found a solution that works for your son!
That is good to know too…yes sometimes if he boluses right before taking it off it looks like a mosquito bite and maybe some comes out? Not sure but I see how waiting a bit could be a good idea… we will do that too next time.
That is exactly what I have had to do since going on the pod in 2005, and sometimes I even go on shots for 12 hours until I am sure the new pod is delivering. It’s a pain, but it works!
Hmmm… so you are saying that the first few times we give him a dose after a pod change…no insulin is even coming out yet?? There might be air only or it isn’t pushing the full amount? So… if this could be the case… that is kinda scary. He would get as high as upper 300s and say check for keytones.
But… on the other hand… then the new method wouldn’t “fix” the problem…it would make it worse. Or…only some pods are not priming fully and some are so it is hard to know?? In all of the above cases though… pod changes every three days could be an unpredictable mess?! I wonder if this is a problem they are working on.
Today for the first time when I changed my pod I did a correction before I took the old pod off. I got better numbers this time, not perfect but better. I think I will be trying this again next time. I think I need to tweak the numbers but it seemed to be working.
Hi Gil -
I am not sure I understand how a pod could not be fully primed…does this mean we have put the pod on before the double beep? how can this happen?
I’ve noticed that two out of three changes, I will run high right afterward. I’ve started giving 2 u from the old pod. If I notice I’m going up, I’ll either send out a correction bolus or I’ll have a little something to eat and factor in the correction with that. I’m glad your son’s pod changes have been so successful. I’m still trying to get the hang of it.
In response to the issue - how can the pump NOT be fully primed? My 4 year old daughter is on the Omnipod, and after starting in January had ridiculously high numbers after changing pods…sometimes. Like 400s, as if she was not getting any insulin at all. In talking with my CDE who is incredible, we tried an experiment…to activate a pod and bolus, but not put it on her body…to see what insulin came out right away. Well, I did that and I was shocked. I did a .5 bolus and nothing came out…but the cannula did fill with insulin…so I don’t think the pod was fully primed! So basically an additional bolus was necessary to get ANY insulin at all…because my daughter is so small and gets such a small basal and bolus generally, it took a while for the pod to kick in (i.e., fill cannula with insulin and start getting any) which explains the highs for several hrs after. So my new method now is to give a .75 bolus with the NEW pod right after insertion, do a higher temp basal as well. This works great 75% of the time. Other times the pod must have primed correctly, and she goes low…other times that is not even enough. Interestingly enough, my CDE tried the same experiement and the pod worked perfectly, insulin came out on the first try. If anyone else doesn’t mind wasting a pod and insulin I would be curious what your results are.
So like everything else with D, there isn’t always a clear answer. And with the Omnipod, which I love dearly and will be a customer for life - unfortunately the hardware issues are still being worked out. But that was just our experience!!
Jennifer - Thank you for reitterating my question! I dont understand how this can happen. Great experiment you tried, I’m surprised I never tried that! gonna next time I change pods!
Just ran across this. I have the same issues. Will try that on the next one. I usually change mine every 2 1/2 days. Trying this I will need to change every 2 days because I exhaust the site at 2 1/2 days and stop absorbing insulin correctly. I will not be able to bolus properly to compensate for the wait time.
I have the same issue at every change, so I bolus from the old just before the change, as they suggested, and it seems to work so it is now standard procedure for me.
Another thing I’ve found that helps these pod change highs (assuming they are in fact due to air bubbles/improper priming from air bubbles, which seems true in my case): I hit the syringe against the counter before filling the pod to get all big air bubbles out. Then you are left with some small foamy bubbles. Aim the syringe straight up so those foamy bubbles gather at the top of the syringe and push out those bubbles from the syringe. They come out like foam and kinda sputter. You know the bubbles are all out when the insulin comes out of the top in a spray with no bubbles. After doing this, I haven’t had any pod change highs.
Just thought I would chime in here - there does seem to be an issue that some people experience highs with any site change (pod or regular pump). This happens to our son all the time. Apparently, the body tries to reject the cannula and then goes high. You will have to play with your bolus to see what works but for us this is what we do. Prior to pod change, we test and make any necessary correction with the old pod. We then change the pod and once the new one is in place, if he’s under 200, we do an extended bolus of 0.50 at 50% for 3 hours. If he’s over 200 (remember, we corrected with the old pod) we do a full unit (1.0 unit) for 50% for 3 hours.
We then test every two hours to make sure that he’s coming down. We get a full three days out of our pods using this method.
We have been doing kinda the same thing… Always check and correct w/old pod first… then change but we wait one hr to do any corrections w/the new site. Leaving it “rest” other than the reg. basal rate…seems to make it less “stressed”. Then after that hr…we correct w/ the pod and if over 200 we to a temp. basal rate of 50% for one hr. This method seems to be working for him. His pods are lasting 3 full days now and sometimes he has up to 30 units left even… The nice thing is the doctors gave him a perscription for pod changes to be every 2 and an 1/2 days so we are doing great on pod supplies. The freedoms he has now that he is on the pod has really made the difference in his…and my life. Wouldn’t change using the pod for anything!..well…short of an artifical pancreas!
Hi Steve,
What I mean is that after the pod is activated, it is primed by delivering prime bolus several pulses (you’ll hear the clicks). This is to expel the air from the cannula and fill it with insulin. The problem is that the number of pulses in this “prime bolus” is just an estimate, on the safe side. That means that there’s a possibility that there’s still some air in the cannula. Therefore, the first several bolus and/or basal pulses may be shooting “blanks” (air). Eventually, the cannula will fill with insulin and it will work fine after that. That’s what I suspect could also be happening.
Most people here are suggesting delivering one last (extended) bolus before changing pods, because they suspect the new site may take a little while to start absorbing the insulin. I think that’s a great idea because it will solve problem whether it is caused by (1) the new site or (2) not enough priming pulses.
the hardware issues are still being worked out. But that was just our experience!!