Ideas please - currently having a few difficulties

[ElyDave]

So, longs story short etc

Sunday - full set change, cannula (90degree, steel), tubing (70cm), new cartridge. All changed after my long run in the morning.
No pain from cannula either on insertion or after

From late Monday onwards control started to deteriorate, can't really take any account of Monday as it will be affected by the previous days long run. No significant change in diet, still around 70-100g carbs a day.

My thoughts and solutions so far
- exercise - slowed down the running, but I've been walking more - unlikely to have a significant effect
- stuff on hands - more attention to handwashing, but would not affect more than one or two readings
- bad cannula position and poor absorption - changed cannula last night, woke up this morning at 8.5 (normal is less than 6)
- change basal profile this morning - increased by 10%, Aberdeen has been notably cooler, but the offices are pretty warm, no evidence of any colds etc

Last thing on my mind is just a bad insulin supply and if it's no better then I'll change cartridge tonight.

Anyone got any other thoughts?

Cheers, Dave

 

[masonbason63]

Maybe a possible bug or short illness starting ? Very rare to get bad insulin, I know your very fit could just be the exercise it can affect us one day to another

 

[ElyDave]

Maybe a possible bug or short illness starting ? Very rare to get bad insulin, I know your very fit could just be the exercise it can affect us one day to another

Yes, that could be the case, but on historic experience, that would account for normally one day of after effects, this is now 4 days later.

 

[masonbason63]

I'd then do a complete change and relocate cannula opposite side of body

 

[CarbsRok]

It could just be that your basal needs have changed or the wind is blowing in the wrong direction. There are very few people who have a static basal and it's work in progress all the time.
Weather is cooler as you have mentioned so this could account for the change as could an infection that hasn't surfaced just yet.

 

[azure]

My first suspect is always a bad site - either some cannula issue or poor absorption. So changing the set and insulin is always a good start. I also check all the 'connections' just to make sure nothing has come loose or is on askew (I once had a set that somehow loosened itself from the pump - I think I knocked it somehow).

I don't know how long you've been pumping, but sometimes a move to a different body area for the site can help.

 

[iHs]

My basal is eeding to be increased due to high bg levels. It's probably because the weather temperatures are changing an it's not as warm as it was. The way to know if the set is faulty is to either give an increased bolus by pump or large temp basal for 2hrs and then if nothing happens, take set out and replace . The other is to give bolus by pen. If pen works, then problem is the set.

 

[Spiker]

I'm not sure what pump type you have but maybe worth changing the cartridge as well as the set. With the Vibe there was (well still is as far as I know) a problem with some faulty cartridges that would stick and underdeliver. Or it could be a technique issue with cycling the cartridge after inserting it and before use. Given the problems occurred after your full change, some aspect of the consumables or the set seems the likely cause, and you've already eliminated most of those.

 

[CarbsRok]

Is the increase in basal right across the board or just breakfast/rising time?
My personal view is if you had faulty insulin or a set/delivery problem then your blood sugar would be a lot higher than you have stated.

 

[Applenerd81]

Stress/illness if all other factors are Ok. Pen bolus can usually confirm.

Also, I remember a while back Dave that you mentioned you use very little insulin - it may be that you need to use more now (end of honeymoon period?)

 

[ElyDave]

Thanks for all the replies/suggestions always good to get some reassurance and draw on the experience of others

Went for a run yesterday which had the usual effect and pre/post dinner readings were both good. This morning a little higher than usual at 6.5, but overall in a better place.

Seems that the increased basal has done the job, I may do some basal testing over the weekend if I get a chance just to confirm.

 

[RuthW]

I had a few days of higher blood sugars recently. I upped my basal rate by a total of one unit a day. I was wondering if it was insulin resistance due to weight training but it didn't fit in terms of timing. A few days later I was back on my lower basal rate. I am pretty sure now that it was a change in the weather! We had a few days of cooler weather and that was it, I think.