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[IPp] Crystallization / Novo /Humulog

I have been watching the recent threads regarding crystallization and
thought I'd throw in a few comments.  While not common, we do know that
Humulog can crystallize.   The problem seems to be less frequent on pumps
that deliver insulin every 3 minutes..... the thought process is that the
constant movement of insulin every 3 minutes stops the crystallizing process
from occurring. On pumps that deliver in .10 increments the infusion rate
for our kids is generally much less frequent. For example,  if the patient
is on a .10 basal rate, the pump only infuses once an hour. On .20, twice
and hour and so on. This lack of movement is believed to be one of the
causes of crystallization.  To overcome this, there has been field studies
by one of the pump companies working with CDE's /MD's to study a buffered
Humulog. No results have been posted but the belief is that the FDA was not
willing to approve this without significantly more testing.  So, how do we
stop crystallizing?  Maybe those that are on pumps that deliver in 0.1
increments could dilute if they are experiencing crystallizing. Why? Because
it will double to infusion rate, increase the movement of the insulin in the
tubing and lessen that chance of the crystallization. The person that is on
0.2 per hour (2 deliveries per hour) will go to 0.4 when diluted 50/50 and
now get 4 infusions per hour.  
In regard to Novolog, I agree with Michael and the others.... watch blood
sugars carefully after the switch. I noticed a 15% reduction in need for
insulin after the switch and it seemed to be more predominant at night. Not
a good thing!    In regard to diluting Novolog, Novo offers no dilutant.
When I inquired why, I was told that diluting was primarily used in Peds and
that their new insulin is not approved for Ped use.  So, what can we do?  We
diluted our 5 year olds Novolog using Lilly's dilutant....... it worked for
us.  Oddly enough, she did not see any benefits of Novolog and since our
insurance is unwilling to cover Novolog (Blue Cross), she is now back to
diluted Humulog.
Craig..... dx 33 years ago, dad of Emily who started pumping at age 3.
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