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Re: [IP] New thread - unexplained highs - how do YOU change sets?



Bob,

I usually base my change times on the ability to be home where I have time,
space and refridgerated insulin.  That is not always before meals (I usually eat
little or nothing for breakfast and drive 65 miles first things in the morning
so an AM set change can be problematic during the weak, lunch I'm teaching or in
an office on campus, and I'm home at dinner time 5 nights out of 7, but would
have to make my husband and sometimes others wait many nights if I took the time
to change a set then).  Weekends of course are often easier.  When I don't have
insurance I keep my sets in as long as possible and I certainly base my changes
on when the set runs out.    I've been on a pump for a long time (17 years) so I
haven't had a regular meal schedule in years although I often try to eat 2 or 3
regular meals a day.  I do, however, have small ocasional snacks.  So the
boluses from those may or may not coincide.  The long absorption of Velosulin
means that I tend to loose bolus insulin for as long as 2 hours after it was
taken.  In other words, before a bolus sounds great if I can eat at home,
unrushed and won't keep anyone waiting.  First thing in the AM is great if I
don't have to drive a long distance and if I have access to a place 2-3 hours
later where I can redo a bad set.  After dinner is great b/c I have 6 hours to
make sure the set works before I go to bed and I am most likely to be home.  In
other words, I guess I'm just not that consistent -- and the lack of consistency
has never been much of a problem.  The only time I have had consistent new site
problems was the 4 week period during which I changed them first thing in the
morning every time.  Go figure :-)!

Bob Burnett wrote:

> Gang:
>
> After re reading many of these posts concerning unexplained highs after set
> changes, I am confused.
>
> I have *always* changed sets before meals, therefore any bolus was taken
> after I changed my set. I was taught to do this during my pump training. The
> thinking here is that a bolus after your set change helps to clear any
> tissue away from the end of the needle or cannula and helps guarantee good
> insulin flow to the site. You do have the added benefit of not having to
> battle the BG rise from carbs you have already eaten if there are any
> immediate problems with your new set. A simple BG check right before eating
> should let you know if things are o.k. with your new set.
>
> However, after reading about users who leave the old set in after changing,
> it seems like many of you change your set *after* a mealtime bolus, which
> seems to explain why insulin leaks from the site. It takes time for the
> insulin to be fully absorbed after a bolus.
>
> So .....
>
> Am I confused, am I simply mis reading this, or am I the only one who
> changes *before* mealtime boluses and doesn't need to leave the old set in
> to avoid the high BGs after a set change?
>
> Bob Burnett
> mailto:email @ redacted
>
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