For the past several days, regardless of what settings I put in my pump I am staying higher than 200. I’ve been checking my BG about every 2 hours. I feel like I’m constantly having to bolus to get it down. My basal is set at 3/u/hr. I will be switching to Omnipod on Tuesday when I have my training with my rep. I’m currently on Medtronic 630G. I’ve been through 300 units of Novolog in the last 24 hours!!! That’s with basal at 3u/hr plus correction & carb boluses. I’m HOPING we get this fixed when I change over to Omnipod. I’m REALLY wondering what in the world is going on. I’ve changed my site again (had to because I ran out of insulin at 1:30 this morning) so we’ll see if it was an absorption issue.
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So are you currently using about 2x as much insulin as you usually use in a day?
Are correction doses bringing you down at all?
I’m sorry you’re dealing with this.
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I have used 2x as much insulin as I’d normally use in a day for the last 24 hours. I have a temp basal set at 4u/hr as of this morning at 2:30am when I ran out of insulin (it’s 6:50am currently).
On 5/31 my numbers were as follows:
12:02AM - Tubing Fill
12:07AM - Cannula Fill
12:08AM - BG 234mg/DL
12:09AM 16.5U/BOLUSED
1:14AM BG 156 MG/DL
7:52AM BG 133MG/DL - 25U/BOLUSED FOR BREAKFAST
9:29AM - BG 162MG/DL - 25U BOLUSED FOR MORNING SNACK
2:20PM BG 142/MG/DL - NO FOOD SINCE 9:30 BECAUSE I WAS ASLEEP
2:44pm BG 206/MG/DL - 4U BOLUS
2:54PM BG 237 - 2.2U BOLUS
3:31PM BG 263 - 2.5U BOLUS
4:29PM BG 214 - 25U BOLUS FOR DINNER
6:09PM BG 151 - 19.7U BOLUS FOR REST OF CARBS (WE HAD PIZZA AND BREADSTICKS)
11:57PM BG 198 - 29.8U BOLUS FOR FOOD
1:48AM BG 146
2:27AM - TUBING FILL
2:32AM - CANNULA FILL
4AM - BG 182
5:47AM BG 208 - 5.5U BOLUS
6:09AM BG 207 - STILL NOT HAD FOOD YET -
7:06AM (NOW) BG 227 - ABOUT TO BOLUS FOR CORRECTION AND BREAKFAST)
When I tried the pump, after about 5 years I had a similar situation, and I would always try to inject in a different place…arm, thigh, hip(using a door mirror), and it was annoying, but seemed to work…you might want to look into u200 on the omnipod…seems like 3 units per hour won’t last 3 days with boluses
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And you aren’t sick or getting sick?
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Check your temperature too, see if you might be sick.
If nothing has drastically changed for you lately like diet or exercise, first things to look at are pump problems, being sick, and bad insulin (although insulin does not go bad frequently).
EDIT
Harold just beat me to it!
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Temp is 99.4
When I made this post this morning it was 227 at 7:08. I did a bolus of 10.2 because I was eating breakfast too. At 8:14 it shot to 331. Did another bolus of 6.8.
I currently have 7 units on board and am sitting at 322.
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You may be sick with something that doesn’t cause fever. You don’t feel any different than usual? No sick symptoms?
If it were Liam, I would first change the pump (if in doubt, changed it out) and then i would begin checking him for signs of sicknesses. And if necessary i would give mdi instead of pump to ensure he’s getting the insulin. Naturally lots of water.
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A temperature of 99.4 would be a fever for me, or at least a sign that my body was fighting something off. Definitely a degree higher than my normal.
Even if I think the pump is fine, I try to do injections if I’m over a certain number (for me, it tends to be “in the teens” or over about 230 mg/dl).
I also wonder if part of of the problem could be doing such large boluses through the pump. I sometimes find even 10 units through my pump really irritates the site. For that reason (plus the reason that the occlusion sensor on my pump seems extremely sensitive), I extend any boluses of 10 units or more out over 15 minutes.
Also, once you are high for an extended period of time, you can become really insulin resistant. That may be one reason you’re needing twice as much as usual. Having ketones can also make you really insulin resistant, which is one reason testing for them with highs that don’t respond to corrections can be helpful, because it can indicate that you really do need to pile on a ton of insulin and be really aggressive to get back down.
Or, more likely, it’s some combination of multiple factors I and others have mentioned.
Good luck in trying to get your blood sugar down.
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A few thoughts @egreen76
- Could your insulin have spoiled?
- Have you changed vials?
- Were the vials of insulin you are using from the same purchase?
- Have you done any basal testing?
- You’re bolusing via the pump. Is there a chance you have scar tissue there and it isn’t being absorbed properly?
- Have you tried bolusing in different areas using a needle and syringe?
- When you bolus greater than 7 units, Dr. Bernstein recommends you split the dose, so if you need 49 units, you would give seven, 7 unit injections, of course in different locations.
- Besides the need for more insulin, has anything changed in your life such as diet, exercise, emotion, stress, illness, sleep, …
I’ve used OmniPod for several years. The maximum the pod can hold is 200 units. You can’t refill a pod, like you can refill an infusion set. You may want to consider u200 or u500 insulin. The maximum wear time for a pod is 80 hours, three days (72 hours) plus an additional 8 hours before it will scream at you when it stops delivering insulin - even if you have any insulin left in the pod - until you change it, by putting on a new pod.
Or, you could do as I’ve been doing for the past few years, use both the pod and needle and syringe. I use the pod for my basal only. I was having trouble with absorption and found I had a problem called tunneling. When I would take my pod off it was wet with insulin and bloody. I had over-used my belly. I’ve since moved my pod off of my belly and only use the pod for basal insulin. I will bolus for food and corrections with a needle and syringe. I also went to a longer needle, trying to get deeper, beyond any scar tissue.
The best of luck to you! I hope you figure this out!
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So insulin came from 2 different vials. I finished off one night before last when I changed infusion sets. New vial this morning at 2:30am.
New site @ 2:30 this morning
Nothing new for at least 3 weeks. I’m being checked for continuous vertigo. Just had echocardiogram this morning.
The next bolus that needs to be done will be via syringe. I don’t currently have one with me. I still have 5.1u on board and at 299.
I have an appointment with my Dr in 20 minutes. We’ll go from there.
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Hope it resolves, or your medical team is able to provide an answer, not being able to get your blood sugar down is very frustrating. But you are doing the right things!
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So my Dr. is perplexed as to why I’ve been dealing with this just for the past 2 days because my BS was looking REALLY good!! We are going to switch me over to Fiasp to see if I respond any quicker to it. She gave me 15u at 11:30am with a syringe in my arm. I was at 256. It is now almost 1:30pm and I’m at 185. That’s the lowest it’s been (I think) in 48 hours. I still haven’t eaten anything since breakfast which was 22 carbs.
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It’s also worth mentioning something that no one else has yet, and I don’t know if this applies to you, but: hormones. Monthly hormones can have a huge impact on blood sugar. I often have to double my insulin doses and still end up correcting highs numerous times a day during the high-hormone weeks. There are several really useful threads about this topic here in the Women’s Health category, if it applies to you.
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@Jen Not sure if it would apply to me now or not to be honest and NEVER thought about it!!! I had a total hysterectomy including ovaries about 4 years ago. Previous to that I had been diagnosed with Polycystic Ovarian Syndrome. I know even with a hysterectomy the PCOS diagnosis is still valid as it affects metabolism and not just women’s monthly greetings.
Well a lot of people have made tremendously good suggestions as to what may have gone wrong and different things to try to fix it. But at this point it could be a whole mixed-up jumble. So let’s try to bring some order to it. First things first.
If your blood glucose is too high, you need more insulin.
That’s it.
There’s all kinds of things to investigate and reason out, but if your BG is too high, you need more insulin, and that’s always simple, clear, and unambiguous. Your body decides how much insulin you need, and it’s up to you to take it.
So take insulin. After 30-40 minutes you should see your BG starting to drop. If you don’t, then take more. Have some glucose tabs or other fast carbs close at hand, and be prepared to check BG every hour or two at the least, but keep taking insulin over and over until you get a response. Get under 200 so that you are out of immediate danger. You can try doing this with the pump, but the most reliable way to guarantee that the insulin is going in, is with a syringe—using a different presumably good injection site each time. If you’re taking a large insulin correction, you can even split the dose into 2 or 3 injections in different locations to reduce the possibility that you are hitting a bad injection site.
Ok, now it’s time for some diagnosis. You needed more insulin. Was it (a) because you weren’t getting the dose you thought, or (b) because your body actually needed a larger amount? You were right to try a different vial of insulin, and a different pump infusion site, because that helps rule out (a). It’s not uncommon for an infusion site to stop being effective. It’s much less common for the insulin to “go bad” but it’s relatively easy to test that by opening a new vial. And if you’ve been too high for too long, a syringe is a good way to make sure the insulin actually went into your body.
For myself, I’m actually inclined to think that my insulin requirement has changed rather than that my equipment or insulin has failed. If I relatively quickly zoomed up to 300, 400 then I’d think about equipment. But a more gradual drift upwards, meal boluses working progressively worse, waking up a bit higher each morning than the morning before, and so on, that suggests to me that my body just needs more insulin. Whether it’s hormones, stress, illness, change of the seasons, allergies, change in activity level, it doesn’t really matter. I start increasing my basal, little by little, until I’m back in my good range. When I re-read post #3 above, where you tell the times with your BG and dose, what I see as the big picture is you just plain need more. You set a temp basal of 4u/hr. That’s a good start. Keep increasing it bit by bit (while awake and you’re able to detect and correct if you start to go too low) until it’s enough.
Diabetes can be a real nuisance, can’t it. But remember, if your BG is too high, you need more insulin. For me, that simple saying from my CDE cuts through lots of confusion, and tells me what I need to do. Be safe, be well, and carry on.
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Wooohooo! FINALLY after almost 48 hours of fighting a stubborn high…I’m now correcting a low of 68 with it saying I’ll be at 55 in 20 minutes. 
MUCH easier to correct a low!!! Especially since I was watching and expecting it.
Thank you ALL for your suggestions and help through this today. I know I’ve been under a lot of stress since the 8th of May…it wasn’t anything new. Maybe it was - I have been fighting what they are calling Vertigo since the 8th when I fell while I was on my lunch break here at home…Alone…not fun!! I finally went to see my Dr. on the 11th when the dizziness was no better. I’d also had chest pains that day and that morning I was still having chest pressure so she made me go to the ER. Everything checked out fine. I was diagnosed with peripheral vertigo, given meclizine and told to use a walker for steadiness. I followed back up with my Dr. and she gave me a Dr.'s note to be off work for the next several days to allow for rest (meclizine does nothing but knock me out and I sleep all day & night). Was still no better after a week off. She referred me to a physical therapist and a cardiologist for the chest pain. Went to physical therapy once (due to my insurance and having to meet a deductible it was $100/visit) and couldn’t afford to continue. During that one visit while they were trying to recreate the dizziness he moved my head as far to the right as he could and my left eye went blurry. He mentioned there might be a chance for something called vertebral artery occlusion or something like that. It’s very rare. He gave me 2 exercises to try 3 times a day at home.
Fast forward a few days (still been off work) I go back to Dr. She is now trying urgently to get me in to see a cardiologist. She’s taking me off work for 2 weeks officially with a plan to return on 6/6 which technically would have me returning on 6/10 because I’m off Sun, Mon & Tues and then work Wed, Thurs, Fri, Sat.
Go to Cardiologist. He listens to me…takes notes at his computer…there’s no telling what else he looked at but the only “examination” he did of me was listen to my heart. He said he didn’t hear a murmur and he really didn’t think there was anything heart related going on. But to be on the safe side he would order an Echocardiogram and have me on a heart monitor to be worn for 3 days and returned to the office. I wore the heart monitor over Memorial Day Weekend and returned it that Tuesday.
Horrible highs began on Saturday. NOTHING had changed. Fought it Sunday. Woke at 2:30am yesterday morning due to pump being out of insulin. There was no way I was going back to sleep because I had my Echocardiogram at 9am. I don’t think the Echocardiogram went well. My heart rate ranged from 88 to 144 during the test and I was having chest pains again.
Went to see my Dr after test was over. She checked my blood pressure both laying down, sitting up and standing up. Everything was normal until I stood up and then my blood pressure dropped quite a bit. She says it doesn’t seem like it’s enough to justify the dizziness. I have a follow up with the Cardiologist on June 9th. She has referred me to an ENT because she’s beginning to think it’s Inner Ear related if it’s not cardiac.If we don’t get answers from ENT and Cardiologist the next step will be a Neurologist.
Maybe it was/is stress. Crisis has been adverted. That 30u bolus I gave (I knew I’d go low…didn’t think I go 25 minutes away from 55 low…but got that alarm) and the corrections I’ve made have me sitting at a comfortable 88. I corrected with ice cream and peanut butter. So I should be good the rest of the night I think. Now that I’ve been up almost 24 hours straight I think I’m going to try to lay down. I have my Omnipod training at 11am - can’t wait to go wireless!!!
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After being on Omnipod since Tuesday we are finding that I’m using at least 200u every 24 hours. That’s with basal and boluses. We’re still working to find my correct basal. We just increased me to 4.4u/hr today because I’m still no where near my target range. I have a feeling we’ll be increasing again tomorrow too. We are sending an order to my PCP for more pods…I don’t start seeing an Endo until July 7th, so right now everything is going through my PCP as the Endo is new to me.
Tonight I found my old medication list in an old purse from Jan 2019 when I was first referred to an Endo to get my Medtronic pump. The reason I’m not still seeing him is because I lost my insurance coverage in April of 2019 and came off ALL medication. I literally just got back on insurance and started trying to get my blood sugar back on track in April. In 2019 I was taking 90u twice a day of Lantus roughly 12 hours apart along with 15u of Humalog at every meal. I was not tracking at that time, so I don’t know how close we actually were to in range with that combination but I know I never had lows.
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Instead of going through a pod every day, you may want to get a prescription for one of the basal insulins and inject enough to cover you for 3 units per hour, then make the rest up with the pod. That way the pod lasts longer and your basal rate is still able to change when needed. The upside is when a pod fails you still have a good amount of basal insulin available to your body.
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So wow…I feel like I’ve been on a crazy roller coaster reading through your posts. I’m happy to see that things seem to have calmed down and that you have support for your new system as well.
I really love the line from bkh’s post. It’s something I have to remind myself about regularly, and has at times prompted me to adjust my basal, carb ratio and/or insulin sensitivity in my pump. I have a new Endo now so not so slightly freaked about changing those settings.
Just FYI in the event you ever find yourself without insurance again, or what you have won’t cover what you need. There is LOTS of help out there, including from the drug companies themselves. Just ask. The worst thing anybody can say is No.
Keeping my fingers crossed for you!
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