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RE: [IP] Continuing Humalog / Velosulin saga

Greg wrote:

> I have to admit I'm puzzled as to why you changed to "V" for the basal
> adjusting.  Why couldn't you just continue to use the H/V mix?  I would
> think you'd need to retweak again anyway when switching back to the
> cocktail -- I know I respond differently to H than R/V in the pump, not just
> in terms of time curve but also usage (my total basal rates are lower on H,
> not just shifted)

There were two reasons for the switch. 
First, Lily exhibited some  of the symptoms which are common to 
allergic reaction to H (this was a false alarm), the second was that 
the onset of H and it's dissapation are so rapid that testing every 
30 min to and hour would be required to get a good picture what 
happens as basal requirements change at night. She now goes from 
0.4 u/hr to 1.7 u/hr at 1:00 am. Missing that timing obviously 
could create a problem.  With regular insulin, several hours are 
available to make this measurement without wondering if it is the H 
onset/dissapation causing the effect. She was experiencing severe 
hypos due to the large shift in basal requirements and regular 
insulin provides a more stable baseline to work from. The basal shift 
has happend a couple of times as she has progressed through 
adolescence. So far the periods of stability have lasted 9 months to 
a year at a time. Lily started pumping at 11years old (now 15) and 
after the honeymoon was over (about a year) there was a big change 
about 6 months later. The most recent change was about 4-5 months 

The shift from regular back to H/V was easy, we just retarded the 
onset time of the basal change by 2 hours. After that, small (0.1 
unit) adjustments were all that were required to fine tune her rates.
> (My doctor and I discussed the cocktail idea, and decided against it for
> now.  We're going to wait and see if any "real" data comes along about the
> effects of mixing the insulins like that.  For now it just seems TOO
> experimental to us...)

Lily has been successuflly using a mix for about a year now.

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