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Re: [IP] Mixing Humalog with Regular in the pump
> I heard from a friend that mixing Humalog with Regular insulin can
> help sites last longer and can help prevent high's that occur after
> a site has been in for 2 days. Can some of you please enlighten me
> on the following:
> + Is this a common practice?
> + How do you know for sure if you need to do this?
> + How much Regular do you use - is there a formula?
> + Any other info I should know about this?
> Thanks for your info and advice in advance!
You have asked about two different things that are unrelated.
High bg's after site change are sometimes related to insulin loss
from the OLD infusion site or damage to the site itself when the old
set is removed. If the old set is removed before all the insulin that
has been infused into the site is absorbed, some may leak out when
the old set is removed -- I've actually seen this happen on my
daughters tummy -- a bead formed where the old site had been. AND...
second, if you damage the tissue as you remove the old site, local
absorption can be hindered. What works for us is to leave the old
site in place 2 hours or more for Humalog and 4 hours or more if a
regular insulin is being used. This gives the insulin plenty of time
to be absorbed before you "rip" out the old set. YMMV
------- 2 ---------------
Humalog / Velosulin mix
There is a relatively small percentage of pumpers that seem to have a
sensitivity to straight Humalog. The explanation is long, technical,
and still unproven, but involves an interaction between the Humalog
itself and the infusion tubing. The end result is that the infusion
site deteriorates prematurely causing bg's to start rising within as
little as a day and a half after a set change and usually always by 2
days. We have found that mixing a small amount of Velosulin with the
Humalog seems to eliminate this problem. My daughter used Velosulin
for some time before Humalog came out and routinely changed her set
twice a week every 3rd and 4th day. There was never a problem with
site deterioration. When she began using Humalog, her sites would not
usually last beyond 36-48 hours. With some experimentation we
determined that 5 parts of Humalog and 1 part of Velosulin would
allow her to use the twice a week change regimen without any problem
yet give her the speed of Humalog. If you look at the statistics on
the ABOUT page of the web site you will see that 5-6% of pumpers now
use a Humalog/Velosulin or Humalog/Regular mix. Most primarily for
this reason although the same technique allows you to tailor the
absorption time curve for the insulin for your own needs if you have
gastro problems or something like that. There is some science that
supports the mixing of H&V but it is not published. If your physician
would like more info on it, contact me privately an I can put him/her
in touch with those working on the science.
To verify that H sensitivity is causing short set life, you can
switch to Velosulin or Regular for a week or two and see if sites
last 3-4 days. If they do, an H/V mix may also work for you. Discuss
this with your endo and have them contact me if need be for
reasurance or more info.
4600 El Camino Real - Suite 206
Los Altos, CA 94022
Tel: 650 947-3350
Fax: 650 947-3356
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