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Canula changing highs

K

kkkk

Well-Known Member
Messages
185
Type of diabetes
Type 1
Treatment type
Insulin
New to pumping...and it may just be me, but my sugar level loves a spike after changing a canula - it takes about an hour or so to settle back to something decent....does anyone know the reason why that happens?

I'm trying to give myself an extra unit before I change it, and then temporary basal of about 20% for an hour and a half afterwards, and todays spike was one of the lowest it has been (partly as my sugar was fairly low when I changed it too)...even with all that I still give a spike of about 5mmol....it's bizarre as I am literally detached for no longer than 5 mins and I leave the old canula in for a bit as any extra stuff in that can sink in.

Is it worth putting the site in an hour before connecting it or is it just that the tissue takes a while to acclimatise to insulin absorption...any other great ideas for sorting it out? I've tried before meals, after meals...it doesn't matter when it always happens!
 
Are you ensuring there are no air bubbles before you prime? Remembering to fill cannula once you have done a set change?
 
Yep - I even flick out as many of the little ones as possible, and I check the line and I fill the canula (I'm still like the instruction book open as I go :))
 
Are you changing the whole set?

I've found that when I just disconnect my set, I have to do a canula fill and sometimes a small prime. It's not supposed to be necessary but it is. If I was not doing that filling and priming, I would miss out on a good chunk of an hour's basal insulin, which yes would cause a blood sugar rise.
 
The way I was taught to change cannula was to make sure I changed before a meal, this enables the meal bolus to go through and clearing any potential debris from the cannula insertion. Also to leave the old cannula in for a couple of hours at least. This enables the insulin left in the old cannula to be absorbed, it also acts as a safety net so if you have a good working cannula at change time and run into trouble with the new one you have can just use the old set for an emergency bolus whilst sorting out things.
 
I change everything each time...so canula, tube, vial or whatever that plastic insulin container is called...so it is all primed and the canula filled each time. I've tried insulin pre-meal on the old canula...then changed it over, I've also done insulin pre-meal on the new one too...either way I get a nice spike. I've even tried it in a nice stable part an hour or so before a meal....and I still get a nice peak. I think I am concluding that for the first bit of a new site I need to up my basal for a bit and do a little coverage with extra insulin. If you lot don't get it then it's probably me!!! :) I'm on a CGM - are any of you? I guess I notice fairly quickly that peak - but either way it wouldn't come down without the extra insulin...do you guys not get a peak at all...is it just nice and steady?
 
Spiker's on a cgm so is @Engineer88 . I find my goes up after 15/30 mins afterwards :(. Carbs does the same go for changing after a meal??
 
To be honest I have not checked the CGM around set changes, so it's possible I am getting a rise and haven't seen it. I'm off the CGM at the moment until I get a new batch of sensors.
 
I have watched my cgm after a set change and no difference in blood sugars. I did wonder if it was due to my changing cannula at the highest basal rate time ie before lunch, this thought was unfounded though as have had to changed before evening meal before now due to having to feed my dying father so things tend to become a bit waylaid so to speak.
I have noticed before though that if I remove the old cannula then I do get a spike.
 
Honestly this is something I personally havent ever seen - but then my bg doesnt change when I'm off pump for an hour either (bathing showering etc) sorry cant help really!
 
Perplexed by this. Could it be that the set change is still stressful for you and that's causing the spike?
 
Well....I spoke to the hospital about it and they were saying it shouldn't happen, and when I took out the bit from the canula to load up my data to diasend I noticed there was some blood in the tube/canula bit that goes into you. This is not the 1st time - I had one set fail probably because of blood, and I have noticed blood mixed in with the insulin when I have pulled old canulas out (so at least 3 in the last couple of weeks), so the hospital were saying to give the angled ones a try when I pop in to see them in a week or so as the blood thing shouldn't be happening (I am not the biggest of people and had to have a paediatric drip when I had my kids as they punctured me several times before concluding that a normal one wasn't going to work!) Also on a few of the canulas I have felt insulin go in when I bolus, and on one it hurt when it went in so I pulled that one out fairly sharpish! There is a level of stress with a set change, but not stressful enough for a spike I don't think...stress can also make me drop too - I was more stressed changing them on my holiday than I have been at home where I feel fairly relaxed about it all and the spike still happens! I am hoping an angled canula is the answer...for now I am going to try and find really fatty areas to put it!
 
If you are using a Vibe, the angled Inset 30 is virtually painless to insert. It has a very fine introducer needle and using the insertion device, it goes in nice and fast.

Sent from the Diabetes Forum App
 
Hadn't thought of that...I did notice myself shading and looking for a dark place to try and do the bolus the other day! I changed my canula last night as I was aiming to basal test, but that went wrong cos I went low in the night....so never mind. However I did go for the chunkiest part of my thighs, and theres no blood in the canula and there wasn't my normal spike, so I am hopeful that the angled ones will lessen my chances of hitting blood and stop that spike...so for now it is towards the back of my legs as a good place...well at least for this one :)

It is a big learning curve on the way insulin works in you when you are on a pump, I need to re-learn some of my data interpretation and when to adjust my basal going on my CGM - my diabetes even on injections was fairly changeable so hopefully the CGM will help me avoid starving myself all the time to get it right...otherwise I could see myself missing meals most days! (though I do appreciate it will still be necessary and is good to do)
 
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