Omnipod dash unexplained high BG

Soplewis12

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I have using omnipod dash for just under 3 months. As everyone knows lots of hard work & adjustments to date. Something strange has occurred over the last 3 evenings that my BG has suddenly risen within 2 hours of eating dinner. Prior to this was sitting at a comfortable 7.5ish but last 4 evenings its been between 15-21!!!
Discussed with pump specialist nurse today & she is as perplexed as I am. I did have a viral infection 2 weeks ago which maybe a cause. A low carb meal proved it wasnt my basal. I've been carb counting for years. Going to change my bolus rate and if that doesn't get results the nurse suggested extended bolus with evening meals. Anyone else experienced this? Any suggestions would me much appreciated.
 

In Response

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Have you tried changing your pod?
I wonder if it is something to do with your site and the way you are sitting in the evening.
If you blood sugars are managing fine during the rest of the day and night, it suggests there is something different after your evening meal and most people are more sedentary than other times of the day.
 

Soplewis12

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Have you tried changing your pod?
I wonder if it is something to do with your site and the way you are sitting in the evening.
If you blood sugars are managing fine during the rest of the day and night, it suggests there is something different after your evening meal and most people are more sedentary than other times of the day.
Hi, I did change pod (too many times) as correction also didn't work. The last replacement pod (yesterday evening) I put in my upper arm for the first time, previously tummy & lower back. I'm hoping this also might help. Thanks for replying xx
 

h884

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Hi soplewis12

I am an Omnipod user and find that I sometimes run high on the day I change my pod. I understand that this can happen. I am not sure if an increase in basal or correction doses is the best way forward. I have Pump Clinic appt on Friday. This is one of the questions I will be asking.

Will feedback on any help I get
 

Soplewis12

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Hi soplewis12

I am an Omnipod user and find that I sometimes run high on the day I change my pod. I understand that this can happen. I am not sure if an increase in basal or correction doses is the best way forward. I have Pump Clinic appt on Friday. This is one of the questions I will be asking.

Will feedback on any help I get
Thanks a million. The increase to basal hasn't worked, I've had 2 low BG's since 6pm tonight. It is very frustrating. Look forward to hearing from you after your clinic appt. X
 

Hopeful34

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It might be worth doing your basal check again with no evening meal, just to double check that.
I use a combo pump, and always use extended bolus and multi wave (so much of bolus prior to meal, and the rest for an extended time) all the time with food, as for me at least it's the best way, so again it might be worth a go.
Hope you can find a way forward, as it makes you feel rotten when bloods are high.
 

Soplewis12

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It might be worth doing your basal check again with no evening meal, just to double check that.
I use a combo pump, and always use extended bolus and multi wave (so much of bolus prior to meal, and the rest for an extended time) all the time with food, as for me at least it's the best way, so again it might be worth a go.
Hope you can find a way forward, as it makes you feel rotten when bloods are high.
Hi, I think your suggestion sounds like a good plan. I'll just have a salad for dinner tomorrow, I know it wont be carb free but a minimal amount & see how it goes. Only changed my bolus from 1:10 to 1:8 but too much. I've put my bolus teatime back to 1:10. I'll see what results are with minimal carb meal & if ok will extend the teatime bolus. The specialist pump nurse did say some patients require this if eating a meal with carb content of over 60g carbs. Thanks a million for your help x
 
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Hopeful34

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You're welcome. The only other thing that's just occurred to me. Is there any possibility you might have gone hypo after tea (the warmer weather can alter how quickly insulin works, or how much insulin we need), and the high's you're seeing are your liver releasing glucose to correct the low? Are the results you've posted from a cgm or a finger prick test?
 

Chas C

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if ok will extend the teatime bolus. The specialist pump nurse did say some patients require this if eating a meal with carb content of over 60g carbs. Thanks a million for your help x

Sounds odd, there is really no limit to use of the extended bolus, certainly not over 60g carbs. Many of us use extended bolus for every meal where its a low carb or a high carb. I have a standard setting that works for me dosing 20 mins before meal at 30% then spreading the remaining 70% over and hour and fifteen minutes (when my BG's are good and I'm well plus food is normal). I then adjust the pre-meal %, time before and length of bolus if I'm high/low before meal, ill, or meal is long acting carbs if its needed. But it is true to say if my BG's are low then I might dose 50% at time of meal and spread the other 50% over next 45mins.
 

Soplewis12

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You're welcome. The only other thing that's just occurred to me. Is there any possibility you might have gone hypo after tea (the warmer weather can alter how quickly insulin works, or how much insulin we need), and the high's you're seeing are your liver releasing glucose to correct the low? Are the results you've posted from a cgm or a finger prick test?
Hiya, libre sensor 2 but double checked with manual blood pricking test. I live in west of scotland & would love for it to be hot enough to affect my insulin levels, lol.
 

Soplewis12

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Sounds odd, there is really no limit to use of the extended bolus, certainly not over 60g carbs. Many of us use extended bolus for every meal where its a low carb or a high carb. I have a standard setting that works for me dosing 20 mins before meal at 30% then spreading the remaining 70% over and hour and fifteen minutes (when my BG's are good and I'm well plus food is normal). I then adjust the pre-meal %, time before and length of bolus if I'm high/low before meal, ill, or meal is long acting carbs if its needed. But it is true to say if my BG's are low then I might dose 50% at time of meal and spread the other 50% over next 45mins.
Thank you, I really appreciate all the help. Trial & error but I'll get there eventually ( I hope!)
 

h884

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Thanks a million. The increase to basal hasn't worked, I've had 2 low BG's since 6pm tonight. It is very frustrating. Look forward to hearing from you after your clinic appt. X
Hi Soplewis12.
I asked about this today but really did not get any help. The Doctor I saw acknowledged this was a known issue, the only suggestion was to correct. Sorry that is not really any help. As you say trial & error.
 

Soplewis12

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Hi Soplewis12.
I asked about this today but really did not get any help. The Doctor I saw acknowledged this was a known issue, the only suggestion was to correct. Sorry that is not really any help. As you say trial & error.
Thank you for feeding back. It seemed to resolve itself for a few days & then a massive high last night. I had the pod on my thigh & felt it pulling against my jeans earlier in the day. When I changed pod there was a kink in it.
I followed guidelines & took manual correction with pen & changed pod. Still too high 3.5 hours so took pod correction. Of course this has now caused frequent lows today!!!
I was really well controlled whilst on pens. Last Hba1c of 51 so this is driving me batty. Seriously considering going back to the pens. Better the devil you know.
Whinge over, lol x
 

h884

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Hi Soplewis12

No problem, sorry I could not be off any real help. My hba1c at the clinic on Friday was 52 which was down from when I started on the pump. I have found placing the pod on my leg can lead to to it getting dislodged. I am also much more aware of it there than on other sites. I do not think the absorption on the leg is as good which might fit with what you are describing.

All aspects of this condition are very frustrating, you think you have it licked and then things go awry again. Very very annoying. It might be worth speaking to your local pump team for some advice. I have found the pump team locally are very supportive.

Good luck, use all the support you can get. Let me know how things go
 

Soplewis12

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Hi Soplewis12

No problem, sorry I could not be off any real help. My hba1c at the clinic on Friday was 52 which was down from when I started on the pump. I have found placing the pod on my leg can lead to to it getting dislodged. I am also much more aware of it there than on other sites. I do not think the absorption on the leg is as good which might fit with what you are describing.

All aspects of this condition are very frustrating, you think you have it licked and then things go awry again. Very very annoying. It might be worth speaking to your local pump team for some advice. I have found the pump team locally are very supportive.

Good luck, use all the support you can get. Let me know how things go
Thank you for all your support. I have my 3 month review on Monday via video. It will be interesting to see how the other newbie pump users have got on. I'll let you know x
 
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