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Re: [IP] To H or not to H

At 04/04/98 - 04:42 AM, Bob Burnett wrote:

>Some potential issues to be aware of re: Humalog:
>1)  Many users need to change their infusion sites more frequently than
>with Regular (often at least every 2 to 3 days, compared to 3 or more days
>with Regular). This *can* be more expensive, or simply prove inconvenient.
>No one seems to know why this is the case, but for many people, the
>infusion sites seem to lose their effectiveness after two days. This is not
>the case for everyone, though. Some users report no "early site loss" with
>Humalog. This is a subject of endless discussion on these lists.

How do you tell when a site has lost it's "effectiveness" and needs to be

>2)  Humalog appears to remain less "stable" at temperature extremes than
>Regular. It freezes at a higher temperature than Regular, which means you
>need to watch it when you transport it in one of those "insulin cooler"
>packs, for example. Humalog seems to be really fussy about high
>temperatures. This may not be a factor for you, depending on where you live
>and what your lifestyle is.

That would probably not be a major issue up here in Western Oregon (we
worry about moss than heat). My home, work & cars also have air
conditioning for those warmer days of Summer. I don't do a lot of outside
recreational stuff and I use a treadmill indoors for exercise (no excuse
not to do it... like its too hot, cold or rainy). 

>3)  Since Humalog has a very rapid onset and short life span in your system
>it is important to time your meal boluses properly. High fat, or slow
>digesting foods might prove a challenge - the insulin will peak and then be
>done, often well before the meal is finished breaking down. "Square wave"
>or multiple, smaller boluses over time can help to deal with this.

I suppose this would be just a matter of experience with how various foods
react. I'm getting some carb-counting books to help me. The "square wave"
function seems to be pretty interesting. We'll see how I react to it all.

>There is a slightly higher risk of DKA with Humalog if your insulin supply
>is interrupted. Again, this is due to the fact that it is gone from your
>system so quickly. More frequent monitoring of your BG levels might be
>necessary to guard against this.

Although, this is a general risk for all pumpers, but I can certainly
understand why it would be even more so for Humalog. I think I recall
reading that there is some sort of alarm if the pump is not able to do its
job (for whatever reason). Does this work as advertised?

>4)  Some users have reported "sensitivity" to the Humalog. Lilly makes you
>aware of this in their product literature and notes that this may be true
>with any insulin. In my particular case, it appears that I am very
>sensitive to Humalog. We are terming this an "allergy", though we do not
>know of any definitive way to test this, other than discontinuing the use
>of Humalog.

I've been using Humalog for about a year now... no adverse reactions yet...
but then, I'm just using it occasionally not all the time. I can understand
that using Humalog exclusively might cause reactions that may not show up
during occasional use.

Thanks for response. I'll have to discuss this more with my doctor. I have
a feeling that my endo didn't want to come right out and recommend it
because it was not "officially approved"... but it was pretty obvious that
he wouldn't oppose it either. However, maybe a mixture of R and H might be
a better approach.


Insulin-Pumpers website   http://www.bizsystems.com/Diabetes/