Bad pod site or what?

[John58]

Started a new pod yesterday in AM. Struggled with some lingering highs all afternoon that I attributed to sitting on my butt all day (got stuck working on my computer all day). Knocked the high BG down by dinner, went to bed fine and woke to a low alert at 2AM. Low BG 54 and starving. Had 9 grams quick carbs (candy) and 3 graham crackers (30 g carbs). Bolussed for the 30 g crackers and went back to sleep. Overslept, woke at 9am to BG 262. Dexcom says I rose quickly to 250 range by 3AM and stayed there all night. So far this morning I’ve taken 7.5 units correction and have doubled my basal as a temp basal. Slowly dropping BG but not dropping as quickly as I’ve come to expect.

This pod is around the back about 2 inches above belt line. I’ve used that zone in the past with no issues. There does not seem to be any leakage.

Any ideas why my 3 unit bolus for a 2 am snack worked out so poorly? Is there a way to diagnose whether the site or the pod is causing the poor insulin absorption? I plan to get back in good BG range before I swap out the pod.

[CatLady]

How are you doing? Hope you changed out your pod—that’s one of the most important things I’ve learned on FUD.

[Beacher]

@John58

Any ideas why my 3 unit bolus for a 2 am snack worked out so poorly?

I usually find I need to double or even triple my insulin during the night, whether I’m compensating for overtreating or trying to bring down a high.

There’s a discussion here:

Are you insulin-resistant and slow to respond at night?

We have known for a long time that we (my T1D son) were slow to respond at night: from 45 minutes our response time to turning the corner goes up to 60-75 minutes. Over the past few months, we have also figured out that our CF (correction factor) doubles at night: we use twice as much bolus insulin to drop the same amount. It is not good for us because we are typically cautious at night with corrections: this CF doubling often causes us to be needlessly careful. We always thought that both of …

@John58

Is there a way to diagnose whether the site or the pod is causing the poor insulin absorption?

Inject instead. If that works, you’ve got a dud site.

[John58]

Well I gave those AM corrections more time and sure enough got back in range by about 10AM. I will look into the night time insulin resistance. Probably brought that on with a day of sitting at a computer…all my ratios are based on more normal days of being on my feet.

[ClaudnDaye]

I’ll repeat one of the quotes @Eric introduced to us, “if in doubt, change it out!” Sounds like possibly a problem pod to me.

[Trying]

Yes, I wish I could remember that when it is rea)y needed!!!

[Eric]

@ClaudnDaye

“if in doubt, change it out!”

Yep! And the nice thing is that they will replace the pod for you too.

[John58]

Swapped out the pod and went to upper arm, back in business! Not sure if it was the pod itself or the placement but swapping both did the trick.

[Beacher]

@John58

Not sure if it was the pod itself or the placement

Sometimes a site works and sometimes it doesn’t work so well. Recently I was thinking to myself that my arm sites were working really well, but then the last couple of arm pods have been both uncomfortable and poor absorbers. Even if I think I’m basically in the same insertion spot as a few weeks earlier, absorption can differ. I remember this inconsistency from tubed-pump days as well, so it’s not unique to pods, at least for me.