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Re: [IP] Pump sites going bad after about 2 days

> My 6y.o. son Luke's sites seem to go bad at the 1.5-2
> day interval in the past 2 weeks.  He's been on
> Minimed 508 pump since 3/5/01, and has been using
> QuickSet infusion set since 4/8/01, primarily in his
> buttocks as we are letting his abdomen rest from hard
> duty in March.  When his blood sugar shoots up
> indicating that there's a problem, the site looks fine
> (not infected), the cannula is straight & the infusion
> set is not clogged, and the pump is fine.  Sometimes
> we can go 3 days but the average lately is 2 days. 

This is a common symptom of sensitivity to  humalog and site 
corruption.Chat with your doctor about using a Humalog Velosulin mix. 
Most "mixers" use 5 parts Humalog an 1 part Velosulin. It is possible 
to verify this sensitivity by switching entirely to Velosulin for a 
week or two and observing how long the site lasts. Typical site life 
of 4 days or more (not recommended) should be achievable. My 
daughter uses a 5:1 H/V mix and changes her sites every 3rd and 4th 
day. On straight Humalog she can get 1.5 - 2 days max before her bg's 
shoot up. Approximately 5% of our forum members currently use an 
insulin mix (see the ABOUT pages of the web site).

Questions have come up periodically about mixing Humalog and 
Velosulin or regular insulin to reduce or eliminate infusion site 
corruption / loss. There is substantial ancedotal evidence that this 
mix solves the immediate problem however WHY is not clearly 
understood. Current science indicates that the underlying problem is 
related to lispro chemistry and the presence of lispro monomer in the 
tubing. What is going on in the tubing set appears to be an 
interaction between lispro, the tubing  and any human insulin in the 
formulation. It is believed that the addition of Velosulin competes 
for lispro monomer and that the lispro-insulin heterodimer is more 
stable than the lispro-lispro dimer. 

Any persons working on this problem or physicians seeking additional
information / explaination for patient treatment should contact me
privately by telephone or e-mail and I will provide contact
information for the folks doing the investigation so that you may
obtain a better understanding of the science behind this. The
information may be limited as there are intellectual property
considerations that have not yet been resolved.

email @ redacted

> The unplanned changes are really causing us concern
> for his control as well as just a rollercoaster of
> emotion.  Any hints/clues/advice would be appreciated.
> Thanks,
> Shelly, Luke's mom, Luke dx'd 10/15/99, pumping 3/5/01
email @ redacted
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