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[IP] Re: Additional info on Humalog probs for Lilly

On Fri, 9 Jan 1998 email @ redacted wrote:

> Michael:
> <much snipped for the sake of sanity>
> > FWIW, the latest little "snag" for me seems to be related to undetected
> > hypos - quick onset (typically manifested by rapid pulse), very quick
> > rebound. These have begun sneaking up on me in the middle of the night,
> > sometimes during the day. Very interesting, but for now I am reminded of
> ####### #2  A- ha -- gotcha
> This is EXACTLY the kind of problem Lily was having. It was really 
> beginning to raise hell with her life.  The switch to the 
> Humalog/Velosulin mix seems to have tamed the problem.  I feel 
> satisfied enough with her safety at this point to reccommend it to 
> others.
> >
> Difficult to put into words, but:
> I returned to Velosolin briefly (two weeks) late summer (right about the
> time I subbed to this list). One of the first things I noticed was that I
> felt "smoother" -- very difficult to describe. With Humalog, I can actually
> "feel" the insulin kicking in. With Velosolin, it seems like it is more of
> a "controlled ride" - smooth, but unfortunately, I suffer from postprandial
> spikes with it. If I didn't have to bolus for meals, it would be great.
> For me, I think I actually got used to the "choppiness" of the feeling with
> Humalog, and over time I am beginning to miss the signals that I am
> starting to drop. I historically dropped quickly  prior to pumping *VERY*
> quickly - 150 - 200 point drop in 30 minutes was not out of the question.
> Lately I have woken up in the middle of the night with typical hypo signals
> - very warm, rapid heartbeat, etc. My BG was "normal" (130 - 150) but on
> waking I was around 200, sometimes higher. I am growing convinced that I am
> missing the hypo, waking up as my body rebounded. Since it takes about 15
> minutes or so for BG changes to be detectable, the test read normal.

Yep, Yep, Yep...... same problem here, occasionally when she went to bed 
late, Lily would be fine at say 10:30 (test around 100) and by 11:30 or 
12, 5 or six glucose tablets would go in and she would still rebound in 
the middle of the night.  

That's all gone away with the H/V mix.  It only took a littl V.
There have been no more (as in ZERO) of those episodes since she started 
the mix. She still is able to get the rapid onset to control highs and so 
on. There is no easily measureable diffenence in here body response to 
bolus for meals, etc.  She is a happy camper.
Michael <email @ redacted>

> This is all preliminary, but this "uncertainty" is a very frustrating
> aspect of Humalog. I have not grown completely tired of verifying and re
> verifying my basal rates (I do like the relative "freedom" of Humalog), but
> I am convinced that what we truly need is the "magic mix". I think Eli
> Lilly missed it on the first pass - close, but no awards.
> I am very, very interested in what Novo is doing. I know they are not
> sitting around just watching things roll by.