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Re: [IP] Velosulin Humulog mixture

Wayne wrote:
> About 2 summers ago I sent an experimental study to this
> list (which is in the archives) where I carfefully compared the
> duration of sites over 3 months with either pure H or a 5:1 H/V mix. 
> There was no difference in the length of time a site would last with
> me.  To see if the mix ratio were a factor, last summer I tried 
> using pure V for a month, but my sites still only go about 4 days. 
> Sometimes they seem to last longer ( record is 8 with H), but I more
>or less routinely change them at 4 days.

>    V does
> something to make sites longer.  If you are one then you should
> surely use the mix.  Its ymmv in this business  as we all know, and
> the placebo effect has very well documented medical effects.  If you
> think it works then go for it! -wayne

This is a pretty accurate statement and a good example of the 
knowledge you need to gain before trying a mix. Only a small number 
of people have irritation from Humalog (or any other insulin for that 
matter) this is almost always due to particular components of the 
buffer compound and not the insulin itself. If you suspect that you 
have a problem with site degradation DUE TO HUMALOG sensitivity, you 
can really only verify it by not using Humalog as Wayne did, for a 
at least couple of weeks. If there is no obvious difference in site 
longetivity, then mixing insulin will not help at all and will 
probably just complicate your life. On the other hand, if you see a 
marked difference in site longetivity, then you might benefit from 
mixing. It is not good enough just to try a mix -- there has to be a 
verifiable reason to do so. Wayne's results make it clear that for 
some (probably most) people, site life is not affected by the insulin 
they use. 

My daughters experience was quite the opposite of Wayne's and 
demonstrates why a control experiment is necessary. She switched to 
Humalog right after it came out and her doc gave her a bottle to try. 
The control results (as you all know) are much better with Humalog 
because of the faster response time. However, Lily's sites would 
routinely go bad after 36 to 48 hours. Her bg's would simply start 
going up. A high bg bolus would bring them down, but they would 
simply go back up again. Changing the site would eliminate the 
problem for another 1 1/2 to 2 days and it would start again. She 
switched back to Velosulin and the problem disappeared. She was again 
able to change her sites twice a week, ever third and fourth day, 
without any rise in bg's near the end of the change period. She 
stayed on Velosulin for a month and we watched the situation very 
closely because of the anamolus results with Humalog which had given 
her site life of only 1 1/2 to 2 days for the month she used it. We 
then tried the 5/1 mix and subsequently a 4/1 mix and found that both 
would provide the same site life as the Velosulin trial. She did not 
like the extend insulin activity with 4/1 and has stayed with 5/1 
since then about 2 or 3 years now.

As they say, YMMV. 

I reiterate, if you think you have a problem with Humalog, don't 
waste your time mixing unless you can demonstrate that NOT using 
humalog solves the problem. Lots of things can cause site problems, 
Humalog sensitivity is pretty low on the totem pole.
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