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Re: [IP] Novolog vs Humalog
> Is it true that those patients using the MiniMed pump benefit more from
> Novolog (a buffered insulin) in terms of longer lasting sites? I was told
> that Disetronic users should see no improvement with Novolog because of
> minute delivery of basal insulin. Because insulin (either Humolog or
> Novolog) is moving every 3 minutes it has no time to crystalize in the
> tubing. In the MM pump, if Humolog is used, the insulin can crystalize
> lose potency because of the longer time it spends in the tubing without
I don't think your statements are true.
1. I do not believe Novolog is a "buffered" insulin. There is no indication
that it is on the web site (www.novolog.com).
2. My understanding was that before the modern infusion sets were developed
that buffering was added to Vesolin (sp?) to prevent reaction with the
tubing and crystallization. With the modern bilayer tubing that is now used
none of the usual insulins react in this manner with the tubing.
3. In recent times I have not heard of a documented case of Humalog under
normal conditions crystallizing in the tubing.
4. Have you seen any documentation concerning this increase tendency for
crystallization with a MM pump rather than a Disetronics? This sounds like
one of the wrong, but sort of logical, things that a salesman might repeat.
At the basal rates where there is a significant difference between the pumps
(less than 0.5 unit/hr) there is no difference in total insulin/tubing
contact time and the 3 min delivery is moving insulin less than 0.025 inches
every three minutes. This Doesn't seem like enough motion to improve on the
normal fluid Brownian motion.
5. The usual explanation for some people having decreased site-life with
Humalog is not the absence of buffering but a mild sensitivity that they
have to the (non-natural) insulin analog. Humalin and Velsolin are natural
insulins (exact same structure as human insulin) and Novolog and Lantus are
other analogs (different structures but not natural). People sensitive to
one analog may not be sensitive to another.
The bottom line is that none of the information you gave leads me to expect
that users of MM pumps will necessarily benefit more from Novolog than
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