Sarah Howard
Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.
Sarah and her husband live in NYC with their cat Gracie. In her spare time, she enjoys doing comedy, taking dance classes, visiting art museums, and exploring different neighborhoods in NYC.
I have on so few occasions that I don’t make any adjustments. If the sugar rise was noticeable, I could do a correction if needed.
I notice a raise in bs when there is 20 U or less left in my pump, so an early site change actually helps correct that.
I found the same thing when I switched to the Tandem pump. Never had that problem with a Medtronic pump. I think the Tandem pump really does not know how much insulin is left, so I too change it out early.
I always give a bolus/prime when I change my site, even though I use tru-steel sets and they don’t recommend it. That really helps to saturate the site and mostly prevents BG rise after.
I do that as well. 0.7 u.
Not since I started filling the cannula with 0.5 units more than the infusion set instructions say to use and leaving the old site inserted until at least 4 hours after starting to use the new site. If I remove the old site right away after starting the new site, my BG almost always rises, but leaving the old site in during the first 4 – 6 hours of new site use along with the extra 0.5 units used in the “Fill Cannula” step usually prevents the site change rises.
I do often notice a rise and some sets seem to take awhile to start absorbing properly. I always fill the cannula with 1 unit instead of .3 and I try to change it shortly before lunch so I can push a larger bolus through.
On the contrary, I always notice a fall in BG levels after infusion site changes. I guess my antibodies are good at determining when a ‘foreign body’ is in place and it does its best to ‘reject’ that foreign body … i.e. the cannula. I already need to change my sites every 2 days due to the effects of my blood glucose levels rising within the period that I have an infusion set inserted. (Sometimes, when changing the site, I notice a ‘build-up’ of ‘gunge’ surrounding the end of the cannula which, I guess, limits the amount of insulin that’s being infused, even though my pump advises that the insulin is being delivered.
My BG #’s go down when it is time to change an infusion site because of clotting around the old site makes it harder for insulin to get where it needs to go, hence higher #’s. No clotting around the new site, so lower #’s.
I do a 1 unit bolus to help
I increase my basal rate to 200% for 2 hrs and do a .5 unit bolus after changing my site. This helps with the typical rise I get.
I answered “other” because, like others have commented, I offset the rise by giving an extra 0.5 unit bolus, which stops the rise I used to see.
For years my endo has had me filling with a little more than the priming tube amount. It has worked great.
I cange sites every three days unless there’s a problem. My
Bg usually dips a bit after a site change. A figurred it was because the insulin was newer. Good lord, what do I know?! I just do it and adjust……hope for the best, deal with the rest…..
“Hope for the best…deal with the rest”. ❤️
My blood sugar plummets about 4 hours after inserting a new infusion set. This has happened to me for the entire time I have used a pump, and through 3 different pump manufacturers. I try to change the infusion set two hours before a large meal and then decrease the insulin suggested by the pump by one unit. This sometimes works, but sometimes I still go low.
I almost always see a slight rise while the new pump is acclimating. I generally run a 35% basal increase for 2 hours and give myself 2-3 units of a bolus (depending upon what is going on when I’m changing my pump).
Generally, my BG levels do not change when I change a pump site around my belly area. I prime with .7 units in the cannula (as directed).
However, when I put the site in my thigh, my blood glucose levels almost always go up. I usually have bad luck with putting the sites in my legs. But, I don’t have many other options, so I keep using my legs.
When changing my site, i check various things. First, i check for kinks in the cannula. Then, i check my blood sugar often as it maybe due to more fatty tissue at the site.
When I move from a very insulin-friendly site to a less fatty location, I often see a rise in BS, and it remains fairly constant, though not as much an increase as when the site is initially changed. Of course, the opposite is true when I move from lean to fatty tissue. I’m thinking I should create a separate profile on my t:slim, one named “fatty” the other “lean” and raise the basil a bit on the lean. Any thoughts on that?
I rarely notice a rise unless the new site port fails for some reason, notably an undetected bent needle. A sharp rise in BG is then observed and another port installed.
I do a .25-.5 bolus before I change my pump site so no rise after a site change.
I gradually raised the cannula fill amount from 0.3 to 1.7u until I no longer saw the rise after changing sites. I also leave the old site in for several hours.
Maybe we can talk about leaving the old site in at the next Pump and Sensors zoom call.
I use corrective boluses and sometimes increase basal rates till the situation stabilises.
Sometimes I have a rise in bg because hitting some scar tissue. It drops after moving it again. Socks on supplies tho.
Sucks on supplies. Sorry was up all night with new sensor issues….
I only noticed this occurring this past time. Otherwise, they stay pretty steady, thankfully! 🙂
I answered occasionally but most of the time it goes low that’s why I never change my pump in the evening hours always in the a.m.
I try to bolus before removing the old site/pod to cover me while I’m off. I used to do that when I wore a pump that couldn’t get wet too, but since switching to the OmniPod I no longer need to do that.
Only when I hit scar tissue.
My body is not an insulin absorption machine. Usually if there is a rise in bg’s after a site change, it’s due to a poor site.
Since I have been using my Tandem T slim X2 pump I have rises after site changes. Never noticed this with my older Medtronic Paradigm pump.
I set Loop to my custom “site change” override, telling the AID system that I need 130% insulin for 3 hours.
Whenever a new site is put in the old site should stay in for a few hours to absorb the insulin, the cannula should be filled, and the site should be primed to get the insulin to start being used as soon as possible. The priming is done to get the infusion site to absorb insulin asap, the insulin needs to break up the clumps, the form that keeps it stable in the vial, and then the insulin comes in contact with more fatty tissue sooner than if no priming is done. Yes it is a hack never taught, and that’s a shame.
For me for the last 30 yrs I’ve used 1u to fill my cannula and 1u to prime the site, using soft XC sets.
The exact amount will vary from person to person and from site set to site set.
This should be taught to everyone who uses a pump, as I was 31 yrs ago.
I use a Teflon Cannula Set so instead of the Standard Prime of 0.7 U I always Prime a Full Unit, it all evens out
I often go low after a pod change, not high.
We often give Adam a corrective SQ injection while waiting for the new site to work completely. The endocrinologist suggested trying inhaled insulin for these corrections, saying there would be less risk of rebound lows/stacked doses. Adam has Down syndrome and he is not great with the inhaler despite practice so I’m never sure how much insulin he’s getting. Other suggestions?
I always bolus for a site/pod change to avoid the rise
I use 0.8 instead of the directed 0.7 for the cannula fill, and also bolus in the next few minutes — for food (or occasionally correction), whether I had intended to eat or not (usually I’m changing the site before breakfast, so it isn’t an issue). In the past, when I’ve noticed a problem with a rise after putting in a new set, it’s always been when I didn’t bolus for a while.
I have noticed a slight rise in my blood sugar levels an hour or two after a site change. I adjusted my cannula fill setting from 0.5 to 0.7 units. This seems to take care of it!
More often, I have a drop in my BGs after changing sites.
I’ve never noticed a big rose when changing my tubing it takes me only maybe 2 min. To change my tubing really not much of aa rise there is
I always experience a rise after a site change, and have started using Afrezza inhaled insulin to combat this once my bg reaches 200 after a site change. Brings it right down. Cannot take it before reaching 200 or I go low.
Usually experience a decline in sensor glucose after a site change. If it rises, that most often indicates a bad site, and lo and behold, a bent cannula.
With the release of DIY Loop 3.0, I can customize how much insulin is injected as part of the Omnipod pod change.