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Why do working sets suddenly fail?

Discussion in 'Insulin Pump Forum' started by MushyPeaBrain, Aug 8, 2016.

  1. MushyPeaBrain

    MushyPeaBrain Type 1 · Well-Known Member

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    So after starting to have some issues with my sets I gained some weight and overall it's made a huge difference and sets are comfy and work well again.

    From time to time though during pumping I get the weird situation I have tonight and wondered if anyone else does or knows why this happens. So I did my set change Saturday lunch and set comfy and working very well with great BG. Sunday evening hubby and son decide they want MacDonalds as a treat so I have one too. I know my carbs using their website and set big temo bsal and take large bolus. All seems to be going well and I even have a slight hypo.

    Then late evening my BG starts to rise to 11.8 so I take a correction. Still rising to 13 and I'm feeling very rough as rarely go above 9. Take further correction but nothing is working. Now at 14.6 and still rising. Now each time this happens I always think at first it's the meal but as the hours pass, my BG gets very high and no correct does anything I end up changing set. New set works straight away and correct high BG so basically previous set seems to suddenly fail - but why?

    Sat here with this exact issue now and debating changing set. Also feel like never eating takeaway or high carb meal again as this is when it usually happens if it's going to fail like this.
     
  2. donnellysdogs

    donnellysdogs Type 1 · Master

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    I think you have pretty much answered your own questions really..

    Putting on some weight helps.. Believe me I know! My muscle has now gone and now back on pump after 14 months off it.... Just skin now, must be some fat extra but have climbed back up a stone in weight to what I was 14 minths ago.. The extra no muscle has helped.

    Personally high carbs are a no no for me but do you take into account the fat / protein as well?

    It would be pure fluke for this to happen each takeaway or high carb meal... Do you do a dual wave? Perhaps this would help? Since going back on pump 5 days ago I've had to do dual waves even for my green salads!!

    Certain food affect me for 15 hours. However, my colon is pretty much defunct without meds so thats my reason for some foods affecting me.

    I really do not think if this haooens every high card/fat meal that it is all down to a bad set.....
     
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  3. rockape37

    rockape37 Type 1 · Well-Known Member

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    I don't have an answer just a suggestion.

    Once you have done a set change before you throw it away reconnect the set you have just removed assuming you have also changed your reservoir and depress the plunger to see if insulin is flowing through ok. (obviously this isnt going to be attached to you).

    As already mentioned Dual wave may help. I was told to use Dual wave on doses of 10 units and above which is pretty much 98% of my bolus's.

    The delayed bolus will help the remaining insulin be absorbed better.

    Regards

    Martin
     
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  4. tim2000s

    tim2000s Type 1 · Expert
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    @MushyPeaBrain, I wonder whether it has anything to do with set changes too. Things like maccyDs are a PIA and I find that the only way I can handle them is to dual wave bolus with normal amount for the lot plus a further 50% over the next three hours to control it.

    It sounds as though your body struggles to handle these types of food efficiently (as does mine) so you may have to change how you dose for them.
     
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  5. CarbsRok

    CarbsRok Type 1 · Well-Known Member

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    The set hasn't failed it's just the way your body has reacted to all the fat in the food you ate. You need to learn to give the correct type of bolus for junk food as I call it :)
     
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  6. MushyPeaBrain

    MushyPeaBrain Type 1 · Well-Known Member

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    Thank you for all the replies! It's not every takeaway but maybe a third of them. So when I'm going to have one I start +180% or more basal a good half hour before eating and continue that for 6-8 hours. I also bolus about twice what I would normally take but most of that is upfront and then a little about an hour later.

    Please can you remind me which a dual wave bolus is? I will try this next time. I will also try the tip about reconnecting old set to see if flowing ok.

    The thing is I have given it over 6 hours to bring BG down and it doesn't even slow it so I change set when getting near 20 and then new set brings BG down straight away. Surely if it's the food type this wouldn't happen? I don't often eat takeaway or high carb meals so is it possible I can't handle them?
     
  7. noblehead

    noblehead Type 1 · Guru
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    A Dual-Wave bolus is just splitting your bolus dose as you would on MDI, so you bolus a % upfront and deliver the remaining dose over the time you want it to be extended.
     
  8. CarbsRok

    CarbsRok Type 1 · Well-Known Member

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    Yes it will happen because the all the extra corrections you have added hit home hence you are under the impression it's the set.

    On the very rare occasion I have fish and chips I have to bolus as soon as I eat rather than 30 mins before, this stops the hypo due to slow food absorption then anything from 6 to 8 hours later I use an increased basal of +30% for another 4 hours this stops the highs for me.
    Bottom line is though you need to find out what works for you as everyone is different.
     
  9. donnellysdogs

    donnellysdogs Type 1 · Master

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    Other than that.. Just don't have takeaways!! It is possible to have nice other treats instead..
     
  10. tigger

    tigger Type 1 · Well-Known Member

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    @CarbsRok fish and chips are my bugbear too! I must try your formula next time.

    @MushyPeaBrain how does stress affect your levels? It's possible that you're getting stressed because you're going high and believing your set doesn't work and then when you change sets the stress goes and your bs drops.
     
  11. MushyPeaBrain

    MushyPeaBrain Type 1 · Well-Known Member

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    @tigger stress doesn't cause me too many issues with BG as my life has always been full of it and I can deal with it pretty well. I'm calm until my libre shows straight up arrow and is hitting 17 or more at a fast rate. Then of course I am anxious and stressed which won't help. Most times I manage the same takeaways really well and don't go past 10 so it's weird that just some sets seem to do this. Also I always have stress with any set change so have to use temp basal to allow for that. Now I have the libre I know my patterns very well so can spot when things aren't right much faster thankfully.
     
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