problems with bottom and back

[tigger]

I moved from stomach to back a month ago but am having a lot of problems with high readings. I sorted the basal rate but what i seem to have is a trend of going high for anythimg over 35g carbs in a meal and staying there for a long time. I have a libre so am viewing this in full horror. I think one of these was due to an infected site but the others weren't.

I've tried increasing carb and correction ratios which helped a bit. I've tried bolusing earlier and only eating on the downwards trend which helps sometimes but other times results in hypos which i suspect may contribute to later highs.

Has anyone got any tips/ explanation? I'm using mios and have tried bottom, lower back, strip above the knickers. @azure @CarbsRok @tim2000s @noblehead

 

[azure]

I find my back doesn't work ( I tried in desperation once and it was like the insulin wasn't working). The above knicker strip works for me, but even the , I occasionally get an area that doesn't seem to absorb properly. I then move to another place on my bottom.

I'm not familiar with the sets you're using, but I use a different set for my bum than my thighs. I either use a longer Teflon cannula or a stainless steel needle. I think this is because the bum area is kind of fatter and also more 'solid'.

I've not noticed problems with boluses. I tend to bolus in little amounts anyway and often bolus separately for main meal and dessert. Could you also try altering the speed of the insulin delivery on your pump?

As a last resort, you could use a pen for the bolus (in your leg or tummy) When I firstbswapped to my bum, I got so tired sorting out the initial highs. I bolused with a pen to give myself a break from the highs. That worked well.

I do,find my bum is less sensitive/absorbing.

Hope you sort it. I know how frustrating highs are.

 

[himtoo]

Hi @tigger
how are you for upper stomach - ( just below bust )
I know I am a bloke but the general area is 1 I would never have injected in but on a pump seems to work as a site

the other area that works well for me is upper arms -- absorption is excellent.
it is just if you can find sites that suit the tubing to the pump without becoming a tangle.

 

[noblehead]

I moved from stomach to back a month ago but am having a lot of problems with high readings.

If your bg levels were fine when using your stomach but changed when you used your back then it points to poor insulin absorption, thb @tigger I've not used my back for a infusion site and tend to use my sides, stomach & arms, tried my legs before but with limited success.

 

[tigger]

@azure the mio is a 90° teflon canula. I've tried 2 different lengths with no great difference so stuck with the smaller. I did try a steel there a long time ago and it was amazing until it came out overnight and i went to 21. After that i couldn't find a way to insert them that wasn't very painful.

@himtoo i'm currently breastfeeding so don't want tubing in grabbing distance. I may resort to that at some other point. Do you insert on the front/side of arms or the back?

I still haven't tried my arms. I have very bad memories of injections there as a child and also i'm concerned about knocking into things as it's taken me a while with the libre to get the hang of walking through doors.

I don't know if it is absorption as if i stick to low carbs i can manage a perfect day. If it was absorption wouldn't i be high all the time?

 

[himtoo]

Hi @tigger
if I look straight down my arm with it by my side and call that the top , that makes the outside of my arm one of the sides.
so using that as reference I would tend to use the top side and the underside of my arm if that makes sense,

as for absorption I would agree about the carbs having an impact but it seems to be for me that sometimes absorption gets worse by the third day after insertion , sometimes it takes a few hours at the beginning to settle down.

perhaps with breastfeeding your basal rates and carb ratios need further tweaks ??
Have you spoken with your pump DSN ??

 

[azure]

I used to use a 30% longer Teflon cannula in my bum, but wouldn't go back to that now I have the steel needle. I've found it so much better for smoother sugars. My bum as a site has also lasted longer with the steel than the Teflon.

I know you had the steel come out, but could you try again to see if it made any difference? I use a 6mm steel cannula and haven't had much pain at all unless I hit a very sensitive area. I find I need to avoid a little line where they seem to jab into my muscle as I move, but apart from that I'm ok.

Arms didn't work for me, which I found really surprising. It was also really awkward.

I think absorption can be strange in the bum area, so I don't think it's beyond the range of possibilities that a larger bolus doesn't absorb properly. If it was me, I'd maybe stick with my bum and use a pen to either do the whole bolus elsewhere, or just the 'extra' over the bolus amount that you know works ok for you.

Cool you're still breastfeeding

 

[CarbsRok]

Perhaps try an angled set! I know using my back or bum causes major issues with basal increases needed so tend not to bother any more just using my tum starting just below my ribs and working across then going down the levels so to speak.

Bolus in the bum ...... have you tried splitting the bolus so not to much in one go? Might work but have no idea really.

 

[tigger]

Thanks for the suggestions. I'll try an angled set and see if that works. I've been holding off based on the inserter looking a bit like an autolet and not having the confidence to manually insert when i can't see.

The sets did work well for the first 2 weeks and my basal reduced. I was surprised by this as i'd seen lots of posts on here about basal needs rising for the bottom. I also tweaked the carb ratios down as i was hypoing a lot. But then it all suddenly changed and started going really high after meals. Either i found a really good spot in the beginning and need to relocate it or something else changed.

Baby turns 6 months on saturday so i'm on a relatively stable stretch although my requirements will probably increase once we introduce food. The dsn is not very experienced so i tend to come here for advice.

The new set seems to be fine for the first bolus and then go badly for lunch and supper. I also find that breakfast works better even though i used to be much more insulin resistant in the morning.

 

[azure]

@tigger Im still breastfeeding but I found there was a kind of hormonal change (I presume) around 7 months approx. I didn't go low so much and I needed a little more insulin. Just something to bear in mind in case that's contributing at all. I think your body's reaction changes as baby's demandS and needs change, and I think that might affect sugars.

 

[iHs]

Because I did most of my big dose background insulin in the side area of my bottom, inserting sets is a bit of a no go no matter whether it's 90 or 30 degree or steel needle. I am ok with steel needle sets top back part of my arm and just put a piece of tape over the top to stop it coming out.