Strange Pod Issue

[StewM]

I wonder if anyone had experienced something with a set change issue.

What’s happened. About 48 hours into my last Pod, my blood sugar started climbing as if my Basal needs spiked. I hadn’t ate in over 6 hours and saw a sharp spike, promptly corrected and went back to sleep. Two hours later, woke up covered in sweat. Checked my Libre. You could see the correction working but the minute the Bolus tailed off my Blood Sugar spiked sharply again, to even higher than the previous level. Corrected again, three hours later same story. When I get up for breakfast. My blood sugar’s below the previous peak but still high. I take breakfast with a small correction to.

I have to run a few errands, and use a reduced basal approximately 20mins into the walk my Blood Sugar drops in almost a straight line. I take some Dextrose and everything’s fine until Dinner.

Post-Dinner my Blood Sugar is stable for about three hours, but rising ever so slightly. Once my Dinner Bolus runs it’s course. Sharp spike again. I take a correction an hour later my blood sugar’s gone up another 5mmol/l. At this point I switch
Pods (probably should’ve done this earlier in hindsight). I take another correction*. An hour later my Blood Sugar’s risen again. Take another correction and finally my blood sugar’s coming down proportionate to my Bolus on Board.

Three hours later my Libre Alarm goes off. I’m mildly below target, think nothing off it. Switch the alarm off temporarily. 1 hour later I’m 2.9

Since then I’ve been incredibly sensitive insulin needing way less than normal and reverse corrections aren’t stopping the drop at all.

Crazy as it sounds. It looks like some of the Insulin that went missing yesterday is only being absorbed now.

Leading up to this I’d had two weeks of extremely stable control so I’m fairly confident all my ratios are where they should be.

Things that confuse me is if it’s a Pod issue, why was it seemingly only effecting the Basal at first. If it’s not a Pod issue, why did I suddenly become hyper sensitive issue when I switched Pods? Absorption seems to be an issue but I’ve never had anything like this from an overused site before? And again if Absorption was the issue why was it only effecting Basal initially?

*Btw I didn’t play fast and loose with these corrections just went the Bolus Calculator’s recommendations.

 

[Juicyj]

Tagging @himtoo as he is a pod user and I believe he has experience of this.

 

[himtoo]

Hey Stew ... that does sound a bit odd .........i have experienced lows with a long delay before going hypo
i have a rule that i always follow and many other type 1's i know either in real life or virtually use this rule too

at the first point of seeing an unusual spike it is a pod correction and then double check 2 hours later ...if no significant downward movement i do a pen correction then and wait another 2 hours and check again ( but the one thing i or others don't do is go back to sleep as we chalk this up to life with type 1 and the PITA that it can be )
so after 4 hours if pod and pen have not significantly shifted BG down this indicates a pod delivery issue as the correction is sort of replacing some of the basal that has not gone in ..................and then it is a pod change

 

[StewM]

Delayed reaction @himtoo that being the case, how would differentiate between a Basal issue and a Pod issue?

 

[himtoo]

Delayed reaction @himtoo that being the case, how would differentiate between a Basal issue and a Pod issue?

one of the trickiest issues because basal rates should be fairly stable assuming you have been pumping for a while ..if you are getting spikes like this perhaps it is time to revisit basal testing ..........

 

[JaneC]

Hey Stew ... that does sound a bit odd .........i have experienced lows with a long delay before going hypo
i have a rule that i always follow and many other type 1's i know either in real life or virtually use this rule too

at the first point of seeing an unusual spike it is a pod correction and then double check 2 hours later ...if no significant downward movement i do a pen correction then and wait another 2 hours and check again ( but the one thing i or others don't do is go back to sleep as we chalk this up to life with type 1 and the PITA that it can be )
so after 4 hours if pod and pen have not significantly shifted BG down this indicates a pod delivery issue as the correction is sort of replacing some of the basal that has not gone in ..................and then it is a pod change

I do pretty much the same as you after a pod change with rising sugar, this happens around 1 in 4 pods but I do find using the pen to correct can mask a dodgy pump for longer than I'd like but no alternative really. Totally agree about not going to sleep with a dodgy pod, I change mine around 6pm to avoid this but of course it’s not convenient for everyone.

 

[StewM]

Thought I’d reawaken this thread to ask this question, as it provides some relevant context.

So since this issue, I’ve seen a reoccurring pattern of this.

Between 36 hours and 48 hours into a new pod my insulin looses its effectiveness.
Due to the issue above I’ve been a lot faster at switching a new Pod in when issues occur (following Himtoo’s suggested method).
However then what happens is I become highly sensitive to Insulin for a period between 12 and 18 hours into the new Pod
- Example, after having a barely effective dose for dinner, I tried a correction which also failed, I then used a pen that fixed the problem quickly. However the first Bolus on the new Pod hammered my Breakfast as if I’d barely eaten any food.

This issue has been present before with the odd Pod before but it’s never happened with every Pod for a prolonged period of time until now. This all means I’m only getting ‘normal operation’ for a very short time on any Pod, and leaves me questioning if this Pumping stuff’s worth all the bother.

 

[Soplewis12]

Thought I’d reawaken this thread to ask this question, as it provides some relevant context.

So since this issue, I’ve seen a reoccurring pattern of this.

Between 36 hours and 48 hours into a new pod my insulin looses its effectiveness.
Due to the issue above I’ve been a lot faster at switching a new Pod in when issues occur (following Himtoo’s suggested method).
However then what happens is I become highly sensitive to Insulin for a period between 12 and 18 hours into the new Pod
- Example, after having a barely effective dose for dinner, I tried a correction which also failed, I then used a pen that fixed the problem quickly. However the first Bolus on the new Pod hammered my Breakfast as if I’d barely eaten any food.

This issue has been present before with the odd Pod before but it’s never happened with every Pod for a prolonged period of time until now. This all means I’m only getting ‘normal operation’ for a very short time on any Pod, and leaves me questioning if this Pumping stuff’s worth all the bother.

I'm still sitting on the fence as to whether I prefer pods to pens. Think the pods are double edged swords. I can exercise now by reducing basal by 80% one hour before, during & one hour after but the threat of low BG can carry on for up to 12 hours after exercise. When on pens I'd reduce my basal dose of lantus in the morning by 2 units, have my exercise & most times was OK for the remainder of the day.
Other benefits seem minor, e.g.no injections but you have a lump of plastic stuck on you.
Sticking in for now in the hope of omnipod5 with closed loop gets released to NHS in the next few years.