Unble to control BG levels - any advice

Hey there! Im 19 years old and have had T1D for about 9 years. Im currently on the Omnipod and Dexcom g6 system. My control is usually pretty good but for the past 2 days ive been averaging 220. I changed my pod thinking it was bad but it has had no effect. Ive restricted my diet heavily the past day or so and am till sky high. Any advice or tricks to get this back under control?

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Did you use new insulin, not from vial as the bad one?

Could be bad insulin.

Try injection by pen or syringe to see if injected insulin is working as expected.

Call omnipod for possible podd replacement.

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i agree with mm1 on trying a new vial of insulin, could also be scarring/tougher area, rotation is ok? i seem to have lots of issues with omnipods in my arms, abdomen not so much

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Do all of the above and… you could be coming down with something and this is your body’s advance warning.

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Is it the Omnipod 5, or the Omnipod Dash?

I’m assuming it’s the 5, since you mentioned the Dexcom too.

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Have you tested for Covid? Even if you don’t have symptoms, it can mess with your numbers.

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Are you taking any new meds? Any steroids in particular will shoot your BG sky-high.

As others have mentioned, illness – even an undetected infection – can raise bg a lot. If your exercise level has dropped, that can matter a lot.

Beyond that, just be aware this this is far from the last time you will see unexplained bg excursions. You just have to adjust, as you are doing, but perhaps more aggressively with insulin. This necessity is the main reason that t1dm requires such extensive patient involvement.

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No new insulin, currently on Fiasp (which has been awesome btw for anyone wondering about it). And I did replace the vial because i feared the previous vial may have denatured.

No new meds yet, but quest did give me a call after i posted this stating my ACTH was 3x the normal limit. I’m pretty sure based on my current understanding of ACTH and Cortisol that it may be contributing to hyperglycemia. I’ve gotten my time in range to 96% the past 2 days by doing a 25% increase temp basal on the OmniPod. Thank you for sharing the advice regarding infections! It certainly can increase glucose but my labwork doesn’t indicate an infection yet.

I don’t use any site that has been used within the past 2 weeks. So I think my rotation should be decent. If that’s not enough time between sites then i might have an issue lol.

Omnipod 5! Have you had any issues with their algorithm?

I used Fiasp for awhile until it stopped working for me. It worked very well until it became like injecting water and didn’t work at all. Other people have had the same problem with this insulin.

Have you tested for COVID? I had it in '22, and the only symptoms I had was high bg’s. In fact, if my friend hadn’t called me to tell me he caught it, apparently the day before he and I got together, I wouldn’t have had any reason to test. My blood sugar ran high for about 5 days, but I had absolutely NO symptoms of COVID.

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I don’t use it. I don’t like their algorithm.

Tandem has a baseline basal that it uses, and it adjusts from there. That makes sense to me,

The O5 does not have a baseline basal, it just constantly adjusts. So it seems more reactionary.

If you know you have higher or lower basal requirements at certain times of the day, it seems that it’s better to start at the higher or lower basal amounts, and adjust from there.

sounds more like contraindications, for me, any antibiotics etc usually affects my glucose (hyperglycemia)and could also affect the dexcom, although it usually is not affected

For whatever reason Tandems algorithm never really worked for me. I went from an average BG of 190-200 and an in rage average of 35% to an average BG of 122 and an in range average of 96% with the Omnipod. From what i can tell based on others and my own experiences is when you first start the Omnipod it takes about 5 days to learn your body to make its own schedule. Its worked fairly well for me. My biggest complaint with the Tandem pumps was the pain from the infusion sets. The Omnipod has been painless 8/10 times and has been working really well!

Good to know… I never knew that Fiasp had this issue! Ill have to watch it closely and see if I’m becoming resistant to it. Thank you for the heads up!

I took one of the test kits from CVS and it was negative. Thankfully lol. I’ve had it 6 times so far so I’m hoping the antibodies will have me covered a little longer!

:star2::star2::star2: for that m. It aggravates me that diabetes has become ubiquitous with diabetes mellitus, basically Latin for honeyed siphon (excessive sweet urine), when there are 4 additional diseases diabetes Insipidus, insipid or tasteless siphon (excessive nearly pure water urine).

Diabetes is just a word that describes the common symptom of all 7 diseases, polyuria, excessive urination.

Are you using finger stick or Dexcom for insulin dosing? I find the Dexcom too inaccurate for insulin dosing.

John