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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!

Hi Dawn,

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.

Insulin Pumpers
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