Second time on the pump (a retail warehouse career was a bit too hard on my old Paradigm pump). This is the first time I’ve noticed this, and I’m not entirely sure if I’m handling it properly.
Sugars were running very smoothly yesterday. SGs between 80-140 pretty much all day until it was time to change my infusion set. After completing the chnage my sugar has gone up very slightly but steadily (+2-3 mg/dL each sensor update). Correction boluses don’t seem to do the trick, but setting a Temporary Basal of 150% does cause SG to decrease, albeit slowly.
I’ve yet to hit 240 with this trend. I haven’t even gotten a HIGH PREDICTED alert yet, despite my SG inching as high as 231. I’m fairly sure the infusion set is good, so I’m hesitant to change it and waste a set if it is working properly. But is that what I should do?
Typically when I have an unexplained high, and I’ve done a correction bolus and there’s no downward movement after a few hours, I change my infusion set. I’ve learned the hard way assuming it was fine based on a visual check but when I pulled it out, the cannula was bent.
I’m fairly sure the infusion set is good, so I’m hesitant to change it and waste a set if it is working properly. But is that what I should do?
If you don't want to "waste" a set immediately, as an alternative you could do a correction bolus using a syringe. If that works then I think it would greatly increase the probability that you have a bad set insertion and should change it.
Are you still using a Medtronic pump and infusion sets? Although I’ve never tried it since I don’t directly pay for my sets, there is a possibility that Medtronic will replace your set for you if you call their help line and spend the time to have them walk you through their problem determination scripts. This can be a tedious process but if you need to economize then you might want to try going that route.
Are you monitoring your BG only via your CGM or are you verifying with a meter that your SG & BG essentially agree? Out of curiousity, which CGM are you using?
I agree with what has already been posted. I want to add that there are a million attributes to higher than expected blood sugar - typically for me but not limited to Stress, OTC meds, dehydration, a cold, extra anxiety, less activity, a little more inflammation, etc.
What I usually do is give the set a few hours and then switch it. you’ll be okay.
Thanks all for the excellent advice! I’ll try and answer everyone’s questions and let you know how everything turned out.
I’m using the Minimed 530G with Enlite sensors. If I’m just curious to see what my sugar’s doing I’ll use the sensor glucose only, but to give boluses for food and correction I use BG numbers from finger sticks.
It did end up that the cannula under the skin was bent, as my blood sugar did shoot up the next morning and pump corrections weren’t doing the job.
Once I gave a pen bolus and changed the set, things were back to relatively normal. I’m still in that period of “tweaking” basal rates so I did end up with a low that night but nothing severe, thankfully.
I really appreciate everyone’s help here. I’ve had T1D for 25 years, and some of the “rules” I’d learned to live are being rewritten now that I’m on the pump. All the data that I have access to can be overwhelming at times. I think I need to learn to not get too antsy when my glucose looks like it may start to get out of line and end up making things worse in the opposite direction, if that makes sense.
