So I injected Humalog w a syringe for lunch yesterday and my numbers were good…but I got a dime sized, bright red welt at the injection site that lasted 16 hours or so. It was not itchy or anything, but it never looked like that back on insulin pen days. What the heck?
Could it be lipohypertrophy?
Try it for a month and see if it feels better.
i will discuss it with my endo at my next visit.
Anecdotally I wouldn’t think so. It was fresh skin that I never really injected into all that often. And it has had very few pumps there…
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I’ve been re-reading you guys’ discussions about site problems with the Omnipod. I’m definitely becoming a believer in the “max bolus at one time” theory (thanks, @Beacher). My last pod made it all 3 days plus 5 hours thanks to you guys, Flonase, pinching up and pushing down during insertion, and all my boluses were 5 units or less. Now I’ve had to change out my current pod after 30 hours due to blood in the site and stuck numbers. I went through my bolus history and realized I had bolused 6 units all at once for lunch and that’s when the numbers got stickier.
While I’m here, here’s my current pod change routine for anyone whom it might help now or in the future…
- I draw an X on the old pod with a Sharpie (so I don’t remove the wrong one since I leave the old one on if I have a pooled bolus in the site. I’ve had the pooled bolus leak out before and that led to a long night of testing and not sleeping.)
- I soak the old pod’s adhesive in baby oil gel since I have dry/sensitive skin and an apparent skin allergy to the adhesive.
- I spray two sprays Flonase on a new sandwich bag while wearing it like a glove. I wipe it all over the anticipated new site. (I do this b/c Flonase is designed to spray up, and my sites are typically not anywhere you can spray “up” on. The baggie doesn’t absorb the Flonase, and allows an even and full distribution of it rather than a mist of large or small droplets which take forever to dry and don’t cover evenly.)
- I load the new pump with insulin, etc.
4.a. I use a tissue to soak up any insulin droplets in the new viewing window after priming. This helps keep the viewing window clear from the start, making it easier to tell later if my site is leaking. - I start the new pump on the Flonase prepped site.
- If I have time, I leave the old pump in place for an hour or so. Then I use Dawn dish soap on the site to remove the baby oil and adhesive.
- Apply neosporin to my oft-bleeding cannula site and hydrocortisone to the rest of the adhesive affected area.
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@daisymae I have hypothyroidism which became Hashimotos after I became T1.
I currently take Levoxyl 200mcg Mon-Fri and 400mcg Saturday and Sunday as well as 5mg (I think this is MG not MCG) liothyronin or aka Cytomel. I believe the Levoxyl is for T3 levels and other for T4.
I’ve also recently, past year or so, had my testosterone levels plummet down to dangerously low levels. Normal is 250 to I believe 1,100, I was using Androgel and my levels were around 340 or in that range but about 8 months ago I sweating all the time, gaining more weight and always fatigued. Went to the doctor and that’s when I found out that I dropped to 62. That number has my Urologist worried and he had me double the amount of Androgel and 4 months later it went to 89. Now he’s got me on clomiphene citrate and I go back for a follow up in May.
It’s really sad that I was healthy, in the best shape of my life and had plenty of energy and BAM T1 hits and its downhill from there.
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I don’t mean to discount your numerous health challenges, but you also turned 50 at the same time. And the simple fact of aging is something we easily forget when we look at our accumulating health issues.
Many of us the other side of 50 can look back wistfully to a time when we were in the best shape of our lives and had plenty of energy. Certainly for myself, 50 (give or take a few years) was a turning point when it came to fitness, energy and stamina. Into my forties I used to go on half-day hikes or bomb around off-road on my bike several times a week and still get my day job done. Now I sit at my desk all day and wonder where I found the time. And the energy. I think, “That couldn’t have been me. That was someone else’s life.”
So, yes, you have a number of things going on, but don’t forget you’re aging as well, and that’s not an insignificant factor.
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Just great… Glad to read this. I thought I had already reached this stage with 40 then 45… There’s more??
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@Beacher that’s a very valid point although happening in flash like it seems to have done wasn’t something I was prepared for,is anyone ever prepared for it? Lol
The one I feel is the worst is the lack of sleep. I track all that with Samsung Health and I’ve averaged under 4 hours a night. Just once I’d love to be able to sleep 6 full hours, is that too much to ask? 
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Last night was a low point. I bawled my eyes out for 20 minutes out of frustration at this disease. I’m working hard to make impactful changes and the energy being expended is not being reflected in how I feel physically or in any of the BG’s I’m registering.
Now, today is oddly going as perfectly as Diabetes can…and I hesitate to say that lest the Diabetes Gawds smack me down later today. My blood sugars are the best they’ve been in at least months, if not years, this morning. I’m becoming a huge believer in (1) Drying any primed insulin drops out of the viewing window before applying the pod…my window is dry and clear on DAY 3 which has not happened in years, (2) Careful Flonase application to my site prior to pod placement and (3) Not bolusing more than 4 units at any one time (i.e. extending larger amounts for an hour after I deliver the initial 4 units). Novolog seems to be a champ, too.
Thank you to everyone, especially @Eric for his reassurance on the Novolog change. These tips may not be the silver bullets for all my issues, but they are certainly getting me headed in the right direction. It is so nice having a site last 3 days, knock on wood.
You guys have made all the difference in finding these changes to make. I never would have asked my IDS CDE about tunneling linked to bolus size if it weren’t for you guys (@Beacher). She certainly supports that notion linked to site blow-outs.
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Do you want to work through specifics of what happened last night?
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I really appreciate that. I’m standing by to see about some of my trial and error changes that are in progress on the hormonal month scale.
Ultimately, I think my basal programming overnight/morning on “work days” is way off. Since I cut wine out of my evenings last month for good, I’m seeing my true basal needs now since they were probably artificially low before due to wine. The merry-go-round of female hormones makes basal adjustments tricky due to changing resistance every few days for me. I have made two rounds of basal changes that are so far helping (knock on wood). I’ve reduced my breakfast carbs and that’s helped.
Trying to distinguish between a bad site (which I had a TON of due to the adhesive allergy and site blow-outs due to too much bolus at one time, I think) and a hormonally resistant day is really difficult. They look the same on the Dexcom graph and can react similarly to changes (i.e. like a manatee trying to maneuver quickly…it just doesn’t respond that quickly or gracefully. Btw, I think manatees are adorable.)
I think my other underlying problem is nerves about basal changes in light of the hormone stuff. I have to just Woman Up and do it, I suppose. Any change I make has to be viewed in the context of where it fits in the month…and if this would be a dangerous change in week 1 vs week 3 or 4.
I have elected not to start birth control since the one that was recommended to me from a blood sugar standpoint has some pretty ugly lawsuit history over blood clots and strokes. Due to my family’s cardiac history I’m not going near it.
I think this will take a few (or more) months to get back in the saddle, but good sites (and good COMMUNITY) is the most important stepping stone in that direction for me.
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Are you able to remove some variables?
Getting your prescription changed to allow pod changes every two days? I assume your endo is aware of your site issues, so this shouldn’t be too much of a problem to get adjusted. And committing to changing every 2 days for a while to try to remove as many issues as you can with site absorption.
Doing some good basal testing - meaning planning to miss a few meals at at scheduled times until you are comfortable with your basal numbers. Like if you want to do daytime, you plan on skipping lunch. If you want to do evening, you plan on skipping dinner. You don’t need to do them all the same time, but planning them out and doing a few of them is a good sanity check for basal.
If you aren’t already doing this, trying to record carbs per day and keeping them fairly consistent until you get a handle on things. I am not a proponent of restricted diets and eating the same thing every day, but just to get a few data points it can be helpful.
And on top of this, trying to keep it in the frame of mind of weekly hormones I imagine adds an extra level of complexity. 
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Thanks, @Eric.
I am currently tracking all BG’s, Dexcom trends, carbs, calories (need weight gain), steps per day, basal, meal boluses and correction boluses. Just having that data all on paper now for the last two weeks is helping my anxiety on changes significantly. I can see the data and feel confident that I’m not jumping off a cliff by making X change.
I am trying to add calories each day, but I’m only able to break even on work days to what I burn. On weekends I am active enough that I can really add calories without (additional) blood sugar issues. I’m eating more protein than I normally do…so trying to remember how to count that above certain thresholds for bolusing is dusty in my mind. And trial and error, too.
I have a good supply of pods and could change more frequently if necessary…but having this one last all the way to 3 days AND having good numbers on Day 3 is GLORIOUS. But yes, I might change more frequently if it appears necessary. My pump change process is messy (baby oil soak on adhesive) and time consuming (two hours all told) in an effort to protect my skin. That plus work plus little league plus Life is a lot.
I think my main hurdle is the revolving female door of hormones as related to my basal rates. If I can get my basal dialed in better, I have a feeling my meals will inherently work better. Having to limit my boluses to 4 units (plus extended bolus for additional insulin) throws a monkey wrench into my meals. On work days, I typically needed 7 units for lunch and 6 units for dinner. Now I need to reconfigure my meals (oy) or rejigger my timing of boluses. Which takes us back to my general anxiety about the feeling like I’m in a foreign country with a language I don’t speak concerning my blood sugar…since my old markers and controls that I used to use to see how it was working for the day (or not) are not well established right now, it feels like a lot more of a game of chance than it used to in my heyday of good control.
What is the difference between now and then (good control). It is not totally pump related, is it?
My site issues have cropped up in the last few months…so I imagine the skin allergy development has a lot to do with it. But otherwise, not entirely sure. Aging? Not changing basal rates frequently enough? Getting lax in logging everything?
It always seemed to me in the past that the closer to controlled my blood sugar numbers were, the more easily they stayed in range if that makes sense. It feels like I’ve exited the orbit of good control and I’m still not pulling all the right levers to get back down in the atmosphere. I think it will all come together (hopefully soon) and I’ll do my best to stay on top of it and engaged.
It took me about seven years to feel fully proficient on shots…when to increase my Lantus for hormone resistance and what to look for in the patterns. Almost everything I did was expressly contrary to the advice the endos would give me. But it worked and I did it and didn’t care if they agreed.
I feel like these four years on the pump are all training in order to feel truly proficient in my own care again. There are so many levers you can pull when pumping, I’ve been doing “watchful waiting” on a lot of situations to make sure I make the right move. Maybe it won’t take a full seven years to feel proficient on the pump this time…I hope not, anyway!
The other thing is fear of lows in the last few years as I’ve had little little kids. My kids aren’t as little now so I have more time and brain-space to really tune into my own care again.
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Anything you can attribute to lifestyle, like changes in activity level, diet, or stress level?
That makes sense. Bringing a 150 down to 100 is much easier than bringing down a 250!
Was the carb calculator you used MDI easier? Did you use a calculator that factored in BG corrections differently?
There is no rule that says you must use the calculator that is on the pump. You can use any one you think is easiest. (I don’t even use one, that’s the easiest for me)
This 
is usually one of the best tactics to getting good control. 
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If you don’t mind using a syringe (or pen) you could use that to take 5u somewhere else, then use the pod for the small remainder. That will mean any IOB statistic from the pod will be wrong for a few hours, but at least you’ll be able to take your bolus and get on with it.
If the baby oil takes too much time, have you tried the Unisolve medical solvent? I don’t know whether it would bother your skin but if not, it should be reasonably fast.
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I think unisolve was one of the adhesive removers I tried at a friend’s recommendation. Totally burned my skin. Eeek.
Injection for work day boluses is a good idea!
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