# Question - High BGs post set change - how to tell if coincidence??



## Twitchy (Sep 3, 2010)

Hello,

Well here are my first silly questions... 

1. How do you choose where to put the new cannula? I know it has to be 3cm or more from the last site, but do people tend to go along sequentially, or alternate side to side?... Just wondering if there are any pros / cons?...

2. How do you know if a high BG is due to a dodgy siting?  I changed the cannula this morning, checked my BG just as I had done it (7.2mmol), the again a couple of hours later (7.9).  So I assumed it had all gone fine... then this afternoon, my levels have been going haywire...15.3 before lunch (I had carb 'estimated' a snack before lunch though) and despite carb counting carefully & an additional correction of 3u, 2 1/2 hrs later it's 17.8!!  I've just done a 3.5u correction (I do have a cold, and it's been a hectic afternoon so I might have had a snack I forgot to bolus for ( I know, I know, how terribly stupid of me - it's chaos here with the kids at the mo!! ).  My question is, if the site was dodgy, presumably the BG rise is already marked at 2hrs?   Is there anyway for a site to start to 'go wrong' a few hours after inserting?...

Other than this blip I still love this thing...!  Got to try swimming tomorrow - fun!


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## Adrienne (Sep 3, 2010)

Hey you are doing great.

1.  We alternate from side to side.  I am talking about the tummy here.   This is purely to give the side a rest.

2.   Yes it is a possibility that the canula could kink inside hours and hours after set change but have you not literally just started pumping, like really recently.   Are your basals all set ok?   I am wondering if they are not and this is why you are going high.    Just a thought.

I am hoping you have more than 1 basal rate, I would hope possibly 4 maybe !


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## Twitchy (Sep 3, 2010)

Hiya...

Yep, really recently started...3 Days to be precise!  

At the moment, I only have the one basal rate... I've been given the pump but not the handset (it's an accu-chek combo) so I learn how to use the pump & don't cheat by playing with basal profiles or using the bolus suggestions etc on the handset or something...  Ho hum... mind you, it's probably good to have a slow start...maybe...!   Initially I was also told not to correct unless I was 15+, but I guess that was just while the old background insulin worked out of my system?  That's how I've interpreted it anyway! 

I have now been allowed to tweak the basal rate between 4-9am, as I get dawn phenomenon...unfortunately after 2 days of being ridiculously excited & testing almost 2hrly I didn't wake up for any of my alarm clock alarms last night, doh!  Hopefully will get it right tonight! 

I think I sussed out what happened earlier - a snack, toddler / baby / cat combined distraction & whoops no bolus... the shame!!


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## Ellie Jones (Sep 16, 2010)

Twichy

Some pumpers find that there BG rise after a set change, and found leaving the old set in situ for anything up to a couple of hours after they've swapped to the new set, over-comes this problem...

I actually swap sides on each change, easier for me to rember to change the complete set every other set change, right hand side indicates I need to change set + tubing..


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## bev (Sep 16, 2010)

Ellie Jones said:


> Twichy
> 
> Some pumpers find that there BG rise after a set change, and found leaving the old set in situ for anything up to a couple of hours after they've swapped to the new set, over-comes this problem...
> 
> I actually swap sides on each change, easier for me to rember to change the complete set every other set change, right hand side indicates I need to change set + tubing..



We always leave the old set in for a while after set-change and it makes no difference at all - Alex still goes high. So we set a temp basal of 130% for an hour and this does help.Bev


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## Ellie Jones (Sep 16, 2010)

I've never had a problem after a set changes so haven't tried out the theroy, but I know a couple who find this works for them...

If anything I'm likely to hit a low after a set change so have to check a hour after to make sure I'm not dropping...


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## donnellysdogs (Nov 4, 2010)

*Set changes*

I don't have problems on set changes, but enormous problems with cartridge changes.  I'm an accuchek pumper.

I always find that although I take out cartridges and warm them up, and they appear to have no bubble sin, I can guarantee that 5 hours after a cartridge change I will have my levels rising really high.  This is  despite banging the pump before, and during priming.

Since realising this, I now always have to do a reprime at 4 hours after a cartridge change.  I pre-empt what is going to happen to stop it happening.

It is a huge waste of insulin, but I have now been pumping 3 months and there is nothing I can do, but what I am now doing.


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