I am a week out from total knee replacement surgery and doing reasonably well. However, I am finding that I need to replace insulin pumps more frequently—I use Omnipod Dash—because I don’t seem to be absorbing boluses very well after Day 2. (Luckily I have a few pumps stockpiled and I am also hoping Insulet will send replacements when I call them about this.) I have also noticed that even when I am absorbing insulin well, my insulin needs seem to be all over the place but I am guessing this is pretty typical post-op? Any thoughts or suggestions greatly appreciated!
6 Likes
Sorry to hear you needed surgery. Hoping the recovery will go well for you!
Are you taking any steroids?
Are you using NovoLog or Humalog?
During times like this, it might help to use injections for the boluses, and just let pods handle your basal for you.
Or at least let the injections handle the bulk of the bolus, and use the pods for the fractional amount. Like if it is 5.35 units, let the pod do the 0.35 part and inject the 5 yourself.
4 Likes
Thanks for responding so quickly, @Eric . 
No steroids or heavy-duty pain meds, for that matter. I use Humalog and generally do okay with it.
I was considering doing this but think I may need to replace my old Luxura HD pen with a Kwikpen Junior. Something seems to be off with the dosing mechanism.
1 Like
@CatLady,
I am not sure it is related to your surgery, this might be totally unrelated, but have you seen my posts on the differences between Humalog and NovoLog in a pump? I can hunt for the posts if you are not familiar with them.
I hypothesize that under normal conditions for you, it might not be very noticeable. But when exacerbated by the surgery, you might be seeing the “Day 3” effect with Humalog!
The “Day 3” effect is a big deal with Humalog. There are many studies that were done with it, and I have found a lot of them and posted them before.
Pens always seem so sketchy to me! I am not very trusting with them. And the needles can get clogged too.
To me, syringes are so reliable!
I have a million 1/2 unit syringes. Good stuff, the BD brand. I can send you some if you would like.
2 Likes
Thanks for reminding me about that!
I also think I am just underestimating how much extra insulin I actually need while I am recovering. This is the first time I’ve had to deal with an extended illness since my diagnosis (yah, I know, weird)
1 Like
Everything is amplified! 
Highs are higher, what is normally 1 unit suddenly needs to be 2 units. Stuff like that.
It was like that for me when I had Covid.
1 Like
Inflammation will cause the release of cortisol which will make one more insulin resistant. Best course is to increase insulin, basal and bolus.
If really high consider doing an intramuscular injection in the deltoids, works faster.
This is what they did for my nondiabetic wife after an open heart surgery. Her nurse explained to me that BG will spike after r major surgery.
4 Likes