I’m curious if anyone else is having trouble with high blood sugars on the first day of a new infusion set. I have noticed an issue with this, despite gradually increasing my fixed prime over time. I notice that on the first day of an infusion set it appears to take some time for the site to really begin to absorb the insulin.
What ends up happening quite frequently is that I change my site at my usual time in the morning, take insulin for breakfast, timing it as usual and eat. Then I go high, often quite high. I take more insulin, of course. At some time later, the insulin finally starts to kick in and I go low.
This was becoming a frequent enough pattern that I discussed it with my doctor, who had not heard of this before, but was not incredibly surprised.
I’ve been pumping for about 11 years now, using humalog since the beginning, so should not be getting such a delayed reaction. As I discussed this with my doctor, it suddenly occurred to me that this has been happening for somewhere about a year. Coincidentally, I also started to use the sil-serter to insert my infusion sets about a year ago.
When I started pumping, the sil-serter did not exist, so I was used to doing it manually. I have always preferred the silhouette infusion sets. I noticed the existence of the sil-serter some time ago and decided to finally give it a try. It’s so much easier! I was really impressed.
I have very sensitive skin. To insert manually, I lightly poke myself sometimes just a few times, sometimes a dozen or so times, until I find a spot that is painless and then slowly but steadily insert the set. Yes, I know how painful that sounds, but it works for me. The sil-serter finally saved me from this both in time and in the poking and prodding to find a painless spot.
Unfortunately, I am now coming to the conclusion that the sil-serter may be my problem. Despite the fact that the insertion is generally painless, the needle is inserted with such force that it actually comes out bent. I am now coming to the conclusion that this force may be bruising the infusion site and affecting the ability to absorb insulin for some time.
Or, perhaps it is just that when I insert slowly and carefully, I end up with the catheter somehow in a better spot or at a better depth. Either way, I have gone back to the manual insertion and am having far less trouble on the first day.
So far, this is just a preliminary result. I have not kept perfect records of this. However, now that I am inserting manually again, I’m even beginning to consider the possibility of reducing my fixed prime amount. I had been using 1.6 units for years. Recently, I had increased to 3.0 units as the prime. The infusion set is documented as requiring 0.6 units. That has never been enough for me to get the usual result from my usual bolus on the first day, so I increase it a bit.
Has anyone else consistently experienced this type of problem on the day of the site change? If so, what do you do for it? Have you noticed any difference between manual insertion of the infusion set or automatic insertion? Which infusion sets do you use?