Post-set change highs

paulpapa

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Hi everyone,

I've been going high after set changes for some time now and I'm still trying to find ways to fix this issue. I'm on a 640G with Mio Advance sets. I recently changed from Mio to Advance but it hasn't helped the problem.

To combat the post-set highs, I've been doing an extra bolus of between 2-4 units immediately after changing set in addition to any corrections for my inevitable morning highs I very often have.

Ideas:

  1. I was thinking about having an alternate basal rate for set change days so I can ramp up my basal, too;
  2. I was thinking today after having prolonged high sugars after my set change that maybe having some sort of extended bolus may help as my sugars stay high up to 6/7 hours after set change.
Just wondering if anyone else has this issue and if there's anything else I could try? Feel like it's ruining my sugars every three days...

Thanks,

P
 

Juicyj

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Hello @paulpapa Ok so covering the perhaps obvious here, do you check for bubbles and are priming your set before using ? are you checking your infusion sites for lumps ?

I use the 640g with sure t cannula sets and never have an issue with set changes but I am really careful about ensuring there are no bubbles in the reservoir and prime a few units through the set first before applying it to ensure it's a smooth changeover, if you're doing this already then it could be worth trying the sure t instead to see if this fixes it ?
 

porl69

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Hi @paulpapa I only get higher BGs when I use the tops of my legs and its usually for 5 or 6 hours after a set change and its only a few mmol higher. I have a temp basal of 140% for 5 hours BUT only after a set change in the tops of my legs. I guess it's trial and error and doing what works for you. When I use my stomach my levels stay good
 
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Helen46

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Hi, I use a 640g and up until recently used paradigm silhouettes. I was advised to go to the quick set and this had no significant effect. However, and there is always an however, I was then advised to completely change my sites. Previously I had the CGM above the waist and the infusion set below the waist and I thought I was doing a reasonable job of rotating. I changed the sites. Now one thigh has the CGM and the other the infusion set. Change legs when I change the CGM. AND it is much better. Took some getting used to especially when getting dressed etc but the theory was after 40+ years of injections the abdomen and above the waist was significantly damaged. Additional advice was to give bolus, have evening meal, check 2+ hours later and correct if necessary and then change the infusion set and do not eat until breakfast. Did this last night and woke at 6.1. Seems much better have been doing this for a couple of months. The CGM needs to be very firmly "glued" to the leg as it tends to get caught more but other than that give it a go. Helen
 
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porl69

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Set change last night......time for top of leg. 140% basal increase. 2 hours after said change and I was on a 25!!! Didnt come to single figures until 2am!
 

Helen46

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Set change last night......time for top of leg. 140% basal increase. 2 hours after said change and I was on a 25!!! Didnt come to single figures until 2am!
When did you eat? If you had no insulin is that the type of rise you would expect? Helen
 

porl69

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When did you eat? If you had no insulin is that the type of rise you would expect? Helen
Thanks for the reply Helen. The rise is due to whenever I place my sets in the tops of my legs. When I do a set change into my stomach then I have no issues
 

Helen46

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Thanks for the reply Helen. The rise is due to whenever I place my sets in the tops of my legs. When I do a set change into my stomach then I have no issues
Pleased it worked out...mine is the exact opposite! But my stomach has had a lifetime of injections etc.
 

porl69

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Pleased it worked out...mine is the exact opposite! But my stomach has had a lifetime of injections etc.

Same here, just the 49 years for me :hilarious::hilarious: (with the stomach)
 

himtoo

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why can't everyone get on........
Hi everyone,

I've been going high after set changes for some time now and I'm still trying to find ways to fix this issue. I'm on a 640G with Mio Advance sets. I recently changed from Mio to Advance but it hasn't helped the problem.

To combat the post-set highs, I've been doing an extra bolus of between 2-4 units immediately after changing set in addition to any corrections for my inevitable morning highs I very often have.

Ideas:

  1. I was thinking about having an alternate basal rate for set change days so I can ramp up my basal, too;
  2. I was thinking today after having prolonged high sugars after my set change that maybe having some sort of extended bolus may help as my sugars stay high up to 6/7 hours after set change.
Just wondering if anyone else has this issue and if there's anything else I could try? Feel like it's ruining my sugars every three days...

Thanks,

P
Hi
I find this happens to me as well so I do the following to help keep BG's below 8 in the first few hours post change

1- small bolus on the old site before change ( 0.5 to 1u )
2 - temp basal of extra 40% for 2 hours to get the new site kickstarted
3 - low carb food post change -- usually mornings -- so scrambled eggs is my preferred choice
 
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