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[IPp] Humalog vs Novalog vs infusion sites

I know we have visited this subject before, but I was never clear on the
answer/opinions out there.  Has anyone out there had problems with very
visible old infusion sites on humalog, switched to novalog, and seemed to
get less noticeable "track marks?"  My daughter gets very red marks from her
infusion sites, and although I understand that the cannula is slightly
larger than a needle, I didn't really expect it to mark her in this way and
for so long.  Our endo said that the old sites were not from an allergic
reaction or infection, and that they were ok, but I worry about permanent
scarring.  Are these marks considered the norm when using sils?  Or are
there parents out there who are using the sils, switched to novalog, and had
smaller marks and quicker healing at the old infusion sites?

Our endo also told us that the silhouettes infusion sets were better for my
daughter due to small body mass and the whole angle issue (and pulling site
out, etc).  Even though the needle is longer than other sets, we use emla
cream and she doesn't even flinch.  I should also mention she refuses to use
her stomach area.  It's still too scary for her.  But that leaves very
little surface area to work with and makes the rear area look even worse.

Angela, mom to Ashley,4 (dxd 1/01), & Kristina 17 mo.

-----Original Message-----
From: email @ redacted
[mailto:email @ redacted]On Behalf Of Michael
Sent: Monday, April 29, 2002 12:13 PM
To: email @ redacted
Subject: Re: [IPp] clogged sets

> Wow, this describes almost exactly what has been happening to us
> lately! We use the MM 508 with the sil's sets. My son, Andrew, age
> 3, has night time basals that alternate 0 and 0.1 e/o hour. they are
> 0.3 during the day. Most of the time, lately, we've only been
> getting 2 days from a site....often times with numbers creeping up
> by the end of day two. I wonder if this crystallization is the
> problem. We also struggle with air bubbles in the tubing. Maybe i'll
> talk to the endo about Novalog. Thanks.
> Lisa Harris, mom of Andrew, 3yrs, (dx'email @ redacted) pumping 8mos. ~and
> Jamie 8 and Mary 4
> Barb,The crystallization can most definitely be seen in the cannula,
> if it is occurring.  It appears to be clogged and looks like opaque
> inconsistentlines.

Not likely, modern tubing inhibits crystalization and the modern
buffers pretty much prevent it.

More likely with bg's creeping up on day two that he is sensitive to

Approximately 6% of pumpers that use Humalog suffer some side effects
that appear to reduce site life to something like 36-48 hours, after
which bg's begin to rise and the site becomes very resistant to
additional insulin infusion. Moving the site appears to alleviate the
problem. The overall result appears to be a localized (at the site)
resistance to insulin that makes control very difficult. Mixing
another insulin, usually Velosulin however a few pumpers us regular,
seems to alleviate the symptoms and allow the infusion sites to
function as well and as long as using regular or velosulin alone.

If you check the ABOUT page of the web site, you will see the 6%
number for "mixers" and that most people that mix us 5 parts of
Humalog and 1 part Velosulin. Your next question will be "what is
Velosulin" :-)   --- It is a regular insulin that was developed with
specific buffers for use in insulin pumps. In most other respects it
behaves pretty much like regular insulin.

It is thought by one researcher that the sensitivity to Humalog is
brought about by a complex chemical interaction with the infusion
tubing and that mixing small amounts of regular or Velosulin with
Humalog somehow prevents the interaction or scavenges the offending
molecules. That research is not published. Novolog is chemically
different than Humalog and would probably not enter into the same
chemical interaction with the tubing.

Neither Humalog nor Novolog are true insulins, they are insulin
analogs. They differ in that both have certain amino acids modified or
switched in their molecular chains. In Humalog, the amino acids in
positions 28 and 29 on the insulin B-chain are reversed. In Novolog, a
single substitution of the amino acid proline with aspartic acid is
made at position 28 in the insulin B-chain.

So far a half dozen or so of our "mixer" pumpers have switched to
straight Novolog with good success. One person has reported that
Novolog does not see to work well for her. Since there are few users
of Novolog at this time, it is not known if there is a similar subset
of individuals that may have sensitivity to the composition of

email @ redacted
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