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Re: [IP] Regular insulin in Pump
I used Humalog for about 14 months, then switched back to Velosulin a
little over one year ago (I also used Humulin).
I had to make the following adjustments when returning to Velosulin:
1) Re adjust basals - I had to change the amount and the timing. Since V
does not act as quickly as Humalog, I needed to program my basal changes
about 2 hours in advance of when I wanted to see the change begin to take
effect. With Humalog I only made the change 1 hour in advance. It was a
little tricky managing my dawn effect, since it tends to "move and float
around" anyway. This was probably the trickiest part.
2) Changed my insulin / carbohydrate ratios to accommodate the different
characteristics of the insulins.
3) Changed my high BG adjusting bolus - timing and amount. Again, with V,
I don't expect to see the drop in my high BG as soon as I did with H.
Though, with very regular exercise (4 X a week, very active), the lead time
with V can be very similar to that of H.
4) Modify my thinking on the "unused insulin rule". Since V lasts longer
than Humalog, I need to be more cautious when bolusing, if I've still got
some insulin remaining. This was less of a problem / issue with Humalog.
I'm not "quick on the trigger" when bolusing anyway, but I needed to be
more conscious of this when I switched back.
5) Bolus in advance of meals, snacks. Depending on my activity level and
pre meal BG, this lead time with Velosulin can be anywhere from 20 minutes
to 1 hour - can be tricky. With Humalog, the timing for me was anywhere
from 15 minutes *after* the meal (only if very low to start with), to as
long as 45 minutes in advance. Typical timing with Humalog was 5 - 15 minutes.
The change involves some re learning of things, but I found it to be fairly
straightforward. Give your self time to adjust, make the changes in a
predictable, logical fashion and it will start to make sense again.
For those of you who read all the way through this and were waiting for me
to say it ... YMMV <g>
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