Sometimes I feel like I should start another blog call Diabetes Mysteries, because there’s so many subtleties and nuances to this disease. Diabetes is picky little diva, isn’t it? The latest mystery on my mind is pump infusion changes, and the obnoxious high blood sugars I’ve been having with them.
I love most everything about having a pump. It’s given me greater flexibility with sports and my general lifestyle, and of course it’s king in terms of convenience. But pumps, being machines, aren’t perfect, and diabetes being….well diabetes….certainly isn’t perfect and lately I’ve had some trouble when I switch out my pump pod. Namely, I see my blood sugar soar for the first few hours after I change my infusion site.
I’ve read about other folks dealing with this many times before, and I’ve heard dozens of my customers (endocrinologist, nurses, CDEs) also complain about this issue. My own CDE recommended I bolus one unit before changing my pump, to give myself a little insulin on board that’s already at work so there’ s some coverage while the new pump starts infusing.
But that’s what is so weird about the problem: when you insert a new pump, you’re technically getting insulin right away. So why do the highs occur in so many people? It’s almost as if your body has to get used a new batch of insulin over the course of a few hours before it starts working properly. Someone once told me that it takes a little time for the insulin to be absorbed in a new infusion site and actually get to work.
Whatever the reason, it’s annoying to deal with the prolonged high, and often results in me “rage bolusing” until I crash out with a low. Although I try not to change my pump near bedtime (this is unsafe because if you get a faulty infusion site, there’s a danger of going extremely high while you’re sleeping and not being aware of it. I’ve actually talked to more than a few pump users who hit DKA this way. When I do have to change my pump at bedtime, I keep the CGM super close by), but sometimes a situation calls for it (e.g. super long work day and not getting home until 10pm), and I’m stuck with a buzzing DexCom for the first few hours of sleep, plus the anxiety of wondering if I do have a faulty cannula.
Has anyone every successfully combatted the pump-change highs? Would love to know any tips!