Last year, I wrote about how I “pre-soak” CGM sensors for better first-day BGs. That’s something I started doing years ago whenever possible.
Similarly, in the last few years, I’ve also changed how I change my pump sites with similar goals of improved outcomes, whenever possible.
What I used to do (i.e. for 12+ years):
- Pull out pump site
- Take shower
- Put in new pump site
- If the pump site didn’t work, spend all night high, or the next hours high while I debated whether it was just “slow” or if I needed a second new site. Ugh.
What I decided to start doing and have done ever since (unless a site gets pulled out by accident):
- On day 3 when I decide to change my pump site, I do not take my “old” pump site out before my shower.
- After my shower, I leave in the old pump site and put the new pump site on. Which means I am wearing TWO pump sites.
- Put the tubing on the new site etc. as expected. But because I have the old site on, if I start to see BGs creep up, I can do one of two things:
- 1) Swap tubing back to old site, give a bolus or a prime on the old site, then switch tubing back to new site. (I do this if I think the new site is working but “slow”)
- 2) Swap tubing back to old site, ditch the new site, and then insert a second “new” site (or wait until the next morning to do so when I feel like it)
- Otherwise, if BGs are fine, I pull the “old” site out once I confirm the new site is good to go.
Is this method perfect? Nope. Does it usually help a lot when I have a new site that is kinked or otherwise a dud? Yup.
To me, it’s worth keeping the old site on for a few (or even ~12) hours. I know many people may not like the idea of “wearing two sites”. But it’s not wearing two sites for 3 days. And if you find yourself having a lot of kinked sites – that’s why and when I switched over to this approach.
YDMV, always. But hope this (post-soaking?) of pump sites, like the idea of pre-soaking CGM sensors, is helpful to someone else.
2 thoughts on “How I change pump sites”
I do the same 😉
Leave it for 8-12 hours, just n case…
Yea, “kinked sites” have been my main reason for the occasional crazy high BG. The other has been “local resistance” when I used 100% FIASP. (Not happening now when I mix the FIASP with around 30% Humalog into reservoir.)
I try not to switch sites right before going to bed.
I now prime with 0.7 IU for the 6 mm cannula, used to prime 0.3. This does not *feel* super optimal (adding more unannounced insulin), but between the actual “priming of the tissue”and the safety provides by CGM and loop, I have not seen any resulting lows, but smoother operations post-site-change. So, aside from not *feeling* right, it might be helping, and isn’t hurting.