High BG and wondering why

So my morning bolus didn’t work as well as I expected (even with some walking around after breakfast) and my BG has been around 190 all afternoon despite corrections. (Some exercise finally moved my BG into the 120 range.) I use the OmniPod pump (2 days so far on this one) and am wondering if there might be an absorption issue at the site. I am well-hydrated and don’t feel sick. Also, I don’t recall bumping into it on my thigh. At what point do you bail on a pump/pump site and switch out? Any thoughts? Thanks!

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I usually swap out a pump site as soon as I start getting those thoughts in the back of my head that I may have a site issue. If several corrections in a row aren’t doing their job, I’ll slap a new site on most times. If you wanted to test whether it was the site or something else (surprise insulin resistance or whatever) you could always try a manual injection. If that works but your corrections weren’t, it’s pretty much definitely a site issue.

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I suppose insulin resistance could be in play (and so needed bigger corrections) but that little voice makes me wonder…

Usually my intuition/spidey sense is pretty accurate :wink:

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I’m gonna consider the fact that me having my obvious blood sugar struggles (all the time lately) probably makes it poor form for me to give advice here…but it’s not stopping me…I bail on pods if my blood sugar is climbing and I can’t reverse it. Being stuck at a higher than preferred bg is typically a different issue for me to be solved. But if two corrections don’t work when given enough time, I will usually change it.

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@jen has some good guidelines on that, hopefully she will see this thread!

As for us, we have changed sites several times to find out that the resistance problem is still there. So now, after 2 failed corrections, I always try a manual injection before switching. It has lowered our site changes a lot.

@CatLady, could you be coming down with something?

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If I start wondering whether it might be a site issue, I change sites. I’m quite liberal at changing sites, probably more liberal than most others… Two corrections that don’t work (not necessarily in a row), more than about half a day spend high, any irritation at the infusion site plus unusual numbers, or a site being more than two days old will all prompt me to change. I also always change sites before changing basal rates, as often changing sites solves the problem.

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Thanks for all your replies and support! I bolused for 15 grams of carbs for supper last night and had a nearly normal response. Overnight was fine, too (though a slight rise at 6 am that did respond to correction). So that leads me to conclude that I was dealing with insulin resistance and that I need to bump up my activity level and/or modify my insulin dosing.

@Jen and @glitzabetes, I totally like the “if in doubt, change it out” strategy you recommend! :+1:t3:

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If I’m climbing or stuck high with a pod despite corrections, I do an aggressive correction with a pen. If that works, I change the pod. If it doesn’t work, chances are it’s resistance and I continue with rage boluses to get things in line.

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