I recently told you about our troubles with post pump changes highs. There was quite a response on Facebook, Twitter, and here on D-Mom Blog and I see that this is a common issue, no matter which pump you use.
I spoke with a pump trainer with 15 years of experience and she gave me quite a few tips and a good explanation of why this might happen for some people.
Remember that none of this constitutes medical advice and you should talk with your endocrinologist, CDE, or pump trainer to discuss any medical questions you may have. Please read the full disclaimer.
First she explained the body’s response to pump insertion. When you insert the cannula, the needle pokes a hole into your body. The body thinks this is an assault and the response is to heal it. This response can raise blood sugar levels just as any other event that the body finds stressful.
There is also some swelling at the site because of the insertion and this can cause temporary poor absorption.
She said that some people give a bolus either before or after to compensate for this rise in blood sugar and poor absorption.
Since this doesn’t happen every single time for us, she suggested that we keep track of which sites produce the high blood sugar and which don’t. Since some sites have better absorption in general than others, maybe we would only need that extra bolus when we put the pump on a particular site.
Because my daughter’s basal rate is relatively small (between 0.20 and 0.35 units per hour), it might be 15 or 20 minutes before she receives any basal insulin and it could be as little as 0.05 units). This might also be a culprit in the delayed high blood sugar.
We usually change the pump at 4:00 pm because that is a time that we are home every afternoon after school, but before activities. She suggested that we try changing the pump at dinner time because then she would get a larger mealtime bolus which would get the insulin flowing.
So here’s what I am doing:
- Making a notation of site location to look for patterns.
- Changing the pump at dinnertime and bolusing for her meal with the new pump site.
I’m going to give it a few weeks to see if we notice a reduction in post pump change highs and then I’ll let you know what, if anything, helped.
Post Pump Change Highs (Part 3) coming soon