Pump Issue? Or something else?

Hey guys,

So after being on the pump for nearly a month now, I've had some pretty good days, along with some not so good days as well. The inconsistency has been extremely frustrating to be honest.

Anyhow, I've noticed over the past week or so, that after I eat and bolus, when I checked my blood sugar after 2 hours, it is usually in the high 100s or low 200s. Not so good. What tends to be the problem though is that, when using my CGM, I notice that my blood sugar tends to slow increase and then plateau. It won't really go up any higher, but it won't go down either. Eventually with a correction it will go down, but it takes a while for that to kick in too.

Now, this could be maybe a site issue (I've had 3-4 bent cannulas already) or maybe something else. Could I possible be getting insulin resistant? I've already adjusted my basal rates and insulin to carb ratios, but to no avast, have seen any major improvement.

Sorry guys, I'm just getting really frustrated with the whole pump thing. I didn't think it would be a "miracle" cure by any means, but I didn't think it would be causing all this trouble and frankly, anger from me at this point. Any ideas?

Thanks

I'm a T1 for 30+ years, switched to a pump about two years ago now.

I felt exactly the way you do at a month in, and also at 6 weeks, and somewhat less so at two months, and a lot less so but still a lot of angry head scratching at 6 months. The impulse to throw the thing through the window is considerably rarer for me now, but still comes up occasionally.

I think my biggest problem was that expectations weren't set accurately for how long it really takes for you to acclimate to the thing. All the enthusiastic testimonials and promotional materials from the manufacturers set some pretty high expectations that may be accurate for some people but not everyone. If someone had told me, "Look, it's not going to be all dialed in after two weeks or even two months, more like three or four," that would have saved me some aggravation and gnashing of teeth. By my timeline I'd say you're really just getting started. There just is a lot of tweaking and there are a lot of failure points where things can go wrong. Voids in the delivery system (bubbles!) was one of my persistent pet peeves and still is.

Some people do throw in the towel, and I strongly considered it a number of times. In the end I stuck with it and I do overall prefer the pump to the previous regime I was on. I would give it a while longer, but know that you're not alone in your frustration in getting adjusted. If you've got a good endo to work with it will keep getting better, but it does take a while.

My pump trainer did say it would "take some time", but it was a very vague answer at that. I guess I just thought the adjustment period wouldn't be so long. Being patient for me is hard, especially when I see that my numbers aren't that great. Although, my A1c was 6.4, when I was at my endo last Friday. So I guess it's going better than I thought? Lol

I do like my endo and they adjusted a couple things, but I'm trying to be a bit more proactive on my end. I will hopefully figure it out, but for the time being, I'm just trying to keep my sanity.

My 2 cents, have you tried any angled sets yet? If not, give it a try. Also try putting the set somewhere you didn't use needles. It only takes a couple of sets each to try these.
If you use a Medtronic pump you can just call the help line and they'll send you a couple angled sets to try for free.

I literally just called Tandem about my issue and she did mention the angled sets, for people who are a bit slimmer, like myself. I currently use the 90 degree, 6 mm, plastic cannula infusion set, and for the most part have been okay, besides lately. I might have to try to use those instead if it will help fix this issue.

Yeah--I'm totally fanatical about my numbers, and I hadn't seen 200-250+ in years, so when those kept coming up even a few weeks in it drove me a bit nuts. I had already mastered carb ratios and correction boluses on the lantus-novolog regime, so it felt like I was making a giant step backwards control-wise. I think my endo was a bit more cautious than I would have been about raising my basal levels to match how my body was responding--I wanted to crank the damn thing up! But when you consider that you're basically being continuously dosed by this silent little machine all day long, it's easy for all those little increments to put you in dangerous territory if you've set it just a bit too high. Particularly if you don't have a CGM, which a lot of insurance companies are mingy about covering (mine for instance).

try to be patient. If you can get a copy of the book "Pumping Insulin", I found it to be very helpful. I believe the author is John Walsh.