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Re: [IP] highs after infusion set changes

At 10:45 AM 6/6/98 -0400, Kasey wrote:

>After changing Kayla's first infusion set, her blood sugar continued to rise
>for the next four hours and ended up over 400 before coming back down.  She
>uses the silhouette.  I left the old infusion set in for 3 hours after
>starting the new one and her blood sugar still went high.  I'm wondering if
>I'm not priming the canula enough.  I was told to prime a .5 unit bolus to
>fill the canula, but I think I remember a discussion about this a while back.
>Any suggestions?

According to the package insert for the Tender sets (same thing), it takes
.0075 cc of insulin to fill the space in the cannula. This is a .75 unit
bolus. If my BG is low when I change my set, I bolus .5 unit. If my BG is
normal or high, I bolus 1.0 unit to fill the cannula. More often than not,
the 1.0 unit bolus works best for me. I never bolus more than 1.0 unit to
fill the space in the cannula.

This is a small difference for many pumpers. If Kayla needs very little
insulin to move her BG (I think I recall you saying that a very small
amount moves her BG dramatically), this .5 unit difference may account for
the large rise she experienced.

It can be a little confusing troubleshooting this, if Kayla's basal rates
are still being adjusted. It might help to try changing her set at
approximately the same time of day, which will reduce the number of
variables you are dealing with.

Bob Burnett

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