Omni pod location related to High BG

Hi my daughter (14 yr) was recently diagnosed (Jun '20) as T1. I think overall we are doing well. She has the Dexcom g6 & omnipod dash. Both have positive & negatives. My question is: does anyone have high blood sugar issues when they have the pod on their thigh? Both times we had an issue. I know that the placement is good, we just cannot get the levels down. We are trying to change the location to prevent scar tissue buildup. Does anyone have a suggestion?
Thank you. It is much appreciated.

here are the best spots for a injection, pump infusions set, or Pod.

good luck

infusion sites

FWIW, my daughter didn’t get good results there, either, so she stopped trying. She still injects there, if the pump’s off for whatever reason, but unfortunately it does limit the amount of real estate she rotates through on a regular basis.

I don’t want to discourage your efforts but I’ve been pumping for 25 years and took injections for 30+ before that. I primarily use my abdomen for my (TSLIM) infusion sets - rarely but occasionally other spots; for my Dexcom I alternate been abdomen, thigh and upper arm.
I’m not saying I don’t occasionally hit some scar tissue but hopefully your daughter has a long time to go before she needs to worry too much about that. As you can see from the diagram @joe provided there are lots of options she can choose from to find which work best.

Thank you for help. I have read a lot of your post that has a lot of helpful information. It is much appreciated.

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Thank you for letting me know that it isn’t just us. May I ask how old your daughter is? My husband and I are spending a lot of time navigating during the menstrual cycle. We did good this month keeping her #'s under 230, but now we are working on the following week. Her #'s seem to stay high and then week 3 they go down & we have to change her basal. It is like a vicious cycle. Was wondering if your daughter is at the same age that is dealing with the same issues? Thanks again for all of your help. It is definitely a frustrating time.

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Thank you so much for your reply. Learning from experienced T1 is so helpful & I am very grateful that you are willing to help out. It’s been 7 months and just when you think you have it under control, you get thrown a curve ball. It’s so frustrating. May I ask what you do when you bolus for pasta or rice? We have noticed that if we bolus for all at meal time, she will go low. We see that her #'s go up at approx. 3 hours in(glad to have dexcom for that) So we bolus at 2 1/4- 2 1/2 hours later. Tried the extended bolus on omni pod once & not sure if we did right. It seemed that there was not enough insulin at digestion time. Any suggestions is much appreciated.

Hi Jeannine @jfrancise , I have never used an OmniPod so I can’t offer first-hand thoughts on that, but I have used three MiniMed insulin pumps and one Tandem pumps.

Regarding the pasta meals your daughter will eat, I agree with you that the Extended Bolus is usually the best way to go. But when my glucose level is relatively low before I begin eating, even a well stretched out extended bolus will cause too much of a drop - similar to what your daughter experiences. On those days - for pasta or pizza - I give a very small bolus at the beginning of my meal, and then watch my CGM and when the “rise” is consistent, but before going up too fast, manually put in the balance of the meal insulin.

Another point, now that your daughter has been using insulin for 7 months, don’t be surprised if you find it necessary to make adjustments in her basal rates, and her insulin-to-carb ratios for meals. Seven decades of keeping myself active by injecting/infusing insulin have taught me that just about the only thing that remains constant in effective diabetes management is our ability to be able to change our therapy as our bodies change.

This may sound odd but I don’t eat much pasta or rice so I can’t recall details! Wait - recently I did have a Chipotle Sofritas burrito bowl with brown rice and my numbers following were great. Brown rice is supposed to have a relatively gentler effect on blood sugar than white, so i guess it’s a good thing they were out when my husband went in. I wish there was a definitive answer I could give you as to how to handle various circumstances but it’s really a matter of trial & error and observation to find what works.
I see @Dennis gave you some input - he’s an excellent resource.

Hi Jeannine @jfrancise! The female cycle is a bit of a roller coaster. Ladies are more insulin resistant when they are ovulating and on pms. I have to up my basal insulin when I am ovulating, then drop it until I am on pms (when I increase my basal). Then I drop my basal again until ovulation.

I have only been a diabetic since March of last year, but I have finally gotten the rhythm of it. I just takes time and repetition. Hang in there, you guys are doing great!

Thank you very much for your response. We are experiencing a lot of changes with her basal and bolus. Especially during menstruation and the week following.

Thank you so much for your response. It’s nice to know that we aren’t the only one experiencing this.

Thank you. We are definitely doing a lot of trial & error right now.

Hi, @jfrancise! Our daughter’s 12 (Dx’d at 6) and not yet menstruating. But she’ll start soon, so we’re grateful to you, @homeschoolingmomof5, for the info! It takes a village…

Hi @jfrancis. I switched from Minimed (new Medtronic) to Tandem about 10 years ago. Both allow you to set multiple profiles which you can turn on and off as needed - is that an option with Omnipod? I’m not familiar with that particular pump.

Hi,

My T1 son is 6. Diagnosed 11/2018. We also notice his blood sugars aren’t as well controlled when his Omnipod is on his thigh. I know as far as absorption of the insulin the abdomen is the best but of course we need to alternate to prevent scar tissue. My coworkers daughter is 13 with T1 and also shared how significant her sugars change during her cycle. Hang in there. We are on a closed loop system with the Riley Link. Regular Omnipod (not dash) and Dexcom. We are so grateful and are sleeping at night again. https://getrileylink.org/

About 40 years ago, I mapped my Injection sites giving each location a number or letter to regulate or influence site rotation for injections and now pump infusions. It soon became clear to me that some sites would work better than others.
I now have Profiles pregame In my pump to provide more or less insulin depending on how well a particular site uses insulin.

I met a classmate with diabetes when I was in junior high. As best I recall MDI didn’t start until late in my college years - at least I didn’t start them until graduation. My friend’s mother used a Sharpie to mark her legs for site rotation - she showed me 5 numbered marks and I guess injecting somewhere around each of those numbers worked.

My daughter (13 yrs old) also has the same problem when she puts the Omnipod on her thigh. She was diagnosed at 11 but only started using the Omnipod in August. She’s a softball player and we switch off between the back of her left arm and her left thigh. She ripped the Omnipod off her right arm when she was pitching her screwball and she’s a stomach sleeper so she doesn’t want to wear it there, also not a good placement when diving back to a base. It goes on her left thigh when she doesn’t have field practice. She always goes high for the first 4-8 hours after placing the pod on her thigh. We, of course, correct the heck out of her and then she goes low. It ends up working well for her after this initial time. My super non medically based belief is that her thigh is very muscular and it takes a little longer for the insulin to take effect. Is your daughter an athlete too? This doesn’t help out your daughter but maybe it helps her know she’s not alone.

Hi @AliG. You share that you “correct the heck out of her” it sounds like you may be stacking insulin, something I’m sure we have all done: taking or giving a dose we believe will bring the numbers down, seeing no response, then adding on more. I’ve done it plenty of times and just as you’ve discovered I dropped precipitously when it finally caught up. Unfortunately insulin just needs time to “get revved up and do its thing” - adding more doesn’t help and you simply have to wait.
From my time on the Forum I’ve found most members to be pumpers, so what I’m about to say may sound odd and counterintuitive in today’s environment: but some people do quite well and sometimes better on injections than on pumps; and some athletes prefer to take MDI so as not to interfere with their chosen sport. Admittedly not everyone can get the control they need or want without a pump, but it may be do-able - some of us on the forum managed for decades before making the change. It may be something to consider, at least during softball season.