1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2020 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Post-set change highs

Discussion in 'Insulin Pump Forum' started by paulpapa, Dec 5, 2019.

  1. paulpapa

    paulpapa Type 1 · Well-Known Member

    Messages:
    94
    Likes Received:
    76
    Trophy Points:
    58
    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
     
  2. Juicyj

    Juicyj Type 1 · Moderator
    Staff Member

    Messages:
    7,676
    Likes Received:
    6,306
    Trophy Points:
    198
    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 ?
     
  3. porl69

    porl69 Type 1 · Well-Known Member

    Messages:
    3,171
    Likes Received:
    3,729
    Trophy Points:
    198
    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
     
    #3 porl69, Dec 5, 2019 at 1:09 PM
    Last edited: Dec 6, 2019
  4. Helen46

    Helen46 · Member

    Messages:
    17
    Likes Received:
    9
    Trophy Points:
    3
    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
     
    #4 Helen46, Dec 5, 2019 at 10:18 PM
    Last edited: Dec 5, 2019
  5. porl69

    porl69 Type 1 · Well-Known Member

    Messages:
    3,171
    Likes Received:
    3,729
    Trophy Points:
    198
    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!
     
    • Hug Hug x 1
  6. Helen46

    Helen46 · Member

    Messages:
    17
    Likes Received:
    9
    Trophy Points:
    3
    When did you eat? If you had no insulin is that the type of rise you would expect? Helen
     
  7. porl69

    porl69 Type 1 · Well-Known Member

    Messages:
    3,171
    Likes Received:
    3,729
    Trophy Points:
    198
    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
     
  8. Helen46

    Helen46 · Member

    Messages:
    17
    Likes Received:
    9
    Trophy Points:
    3
    Pleased it worked out...mine is the exact opposite! But my stomach has had a lifetime of injections etc.
     
  9. porl69

    porl69 Type 1 · Well-Known Member

    Messages:
    3,171
    Likes Received:
    3,729
    Trophy Points:
    198
    Same here, just the 49 years for me :hilarious::hilarious: (with the stomach)
     
  10. himtoo

    himtoo Type 1 · Well-Known Member
    Retired Moderator

    Messages:
    4,675
    Likes Received:
    5,405
    Trophy Points:
    198
    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
     
    • Like Like x 1
    • Informative Informative x 1
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook