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Re: [IP] Humalog vs Regular

> The remaining paragraphs are "common sense" types of things. Make sure your
> insulin stays cool, etc. This is written as a recap of advice from Eli
> Lilly. No where in the article does he mention "Humalog going off through
> being shaken around in the heat" as John Neale thought he observed.

Sorry if I've sown any confusion here. My comment about "shaking it
around in the heat" was my own interpretation of what might be
happening. If the situation occurs more often in the summer, and IF it
is not related to the infusion site, then it would seem that the heating
of the insulin would be the most likely explanation, and shaking insulin
is generally bad for it. But JW did specifically suggest this.

What do pumpers do that injecters don't? They absorb the insulin through
one spot for many days, rather than 4 different spots each day. And they
carry it with them the WHOLE time, so it's exposed to all the body's
movements. And the insulin is stored in the medium term in a plastic
cartridge and plastic tube, which might affect its stability, rather
than a glass bottle. The Disetronic pumps have a glass cartridge. Do
these pumpers find similar problems I wonder?

I have another private email from John Walsh, I've asked if I may
forward the whole email to this group, but he's not yet replied. In the
email he says:

Regarding uptake vs. degradation, in working and talking with hundreds
of pumpers, I have almost never seen any problem with uptake and Humalog
(it's rare to begin with and site problems would not change between use
of Regular and Humalog). However, I have personally seen a lot of
particulate matter in Humalog reservoirs and in Humalog bottles when
pumpers and others were having control problems. Particles indicate loss
of stability which points to the buffering as a
likely problem. ...the problem corrects when new insulin is used, and
insulin from the bottles, at least, does not work well when injected.

John is a high profile pump advocate, who has written some excellent
books on diabetes and pumping. If his experience differs from the
experience of others here, I think it's important we keep level heads,
and open up some lines of communication. His views are open to
development, and will no doubt be included in future revisions of his
book "Pumping Insulin".

If anyone here has experiences about Humalog losing its effectiveness
unexpectedly, I would encourage you to email him at
email @ redacted

Mary Jean, I agree. My current "best guess" is that there are two
seperate problems here:
1) Humalog can occasionally and randomly go off when stored under less
than ideal conditions. This doesn't always happen, but happens much more
readily than with Regular/Velosulin
2) Some people find that sites go off much faster with Humalog. Again,
this happens for some and not others.

You can test which is happening by changing the infusion set, but
keeping exactly the same insulin in the cartridge. If the bg's go backto
normal, the site was giving the problem. If the bg's remain high, it is
the insulin that needs replacing.

I've looked at a few left-over bottles of Humalog I have lying around,
and have found some of these particles floating around. They were very
very tiny, and I needed a good clear cross light, but they were not air

I've never observed medical research before, and I'm surprised how
little coordination and communication there is here. Is pumping still
such a minority activity, that there is no impetus for the
"professionals" to work out in detail what's happening? Is it right that
we should be forming our own vague ideas about what might or might not
be happening here? Just a few musings...

mailto:email @ redacted

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