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email @ redacted

Subject:   New Humalog/Velosulin Mixer Experiences

Our son Thomas (5 tomorrow) started pumping with straight Humalog on 11/30/99.  We have had our share of difficulty since then with control (highs and lows and sudden swings between the two), crimped cannulas, pulled-out cannulas, blood in cannulas, apparent site degradation etc.  We still feel hopeful that the benefits will outweigh the difficulties, once we climb the learning curve.  

The day before yesterday we went to a Humalog/Velosulin mix in a 5:1 ratio as an attempt at remedying what appeared to be day 2 site degradations, that is, the insulin appeared to lose effectiveness or, worse, became inconsistently effective.  The results so far appear dramatic.  Toms' insulin requirement has dropped significantly.  Unfortunately, the immediate result was 4 lows in the first 24 hours, including a fairly obvious overnight low with rebound, one 40 and two in the 60s.  

We wonder whether others have experienced such a dramatic decrease in insulin requirements upon beginning the H/V mix.   On shots Tom had averaged 12.5 units per day, on straight H he was coming in around 10.5, on the first day of the H/V mix he needed only 9.4 and that included some post-rebound high blood sugar bolusing.   We don't know whether to take this as a very encouraging sign that our possible straight H absorption problems have gone away, or whether the mix may end up being too unpredictable for us.   As always, there is the third possibility of some other unconsidered variable(s) bedeviling us, but exercise and food have been very consistent, and there have been no apparent illnesses, before or after the switch to H/V.

We wonder too, whether the site degradation that folks have reported on straight H has played itself out in an erratic fashion.  With Tom, we seemed to get varying periods and degrees of absorption on days 2 and 3 as opposed to a steady decline in the effectiveness of the insulin.  For example, he would climb into the 400s, and despite boluses to bring it down would stay there for some time, but by waiting, and additional boluses using the unused insulin rule, we could eventually get back to the normal range.

Once we figure this out, we hope to share our experience with the list.  In the meantime, if anyone has any insights we would love to hear them and request that you send them to our address directly:  email @ redacted,  as well as the list.

Thank you,
Rob and Joan Zanger

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