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re: [IPp] Pumping Insulin - Lumps

From: "Michael" <email @ redacted>
<<in response to George's definition of lipohypertrophy & Sarah's
original message about lumps under Matthew's injection sites>>

...We know that at least 6% of OUR pumper population has some 
difficulty with this and that the side effects result in 
premature site failure and what appears to localized insulin resistance,
sometimes reddening, lumps, etc.... Many have solved the problem by mixing
insulins or switching to Novolog. The comment that it appears 
harmless may be true in the short term, but it definetly is harmful to the
pocket book to have to change a $15 set every day and a half when they fail
early due to a medical complication that is avoidable with proper 
diagnosis of the condition and a change of insulin vendors. This 
type problem has been reported by someone for most available insulins. ....

Michael - I agree w/ your original caution to Sarah about looking
at a different insulin for Matthew, and on the comment that this
"harmless" condition with early site failures is really only harmless
to the doctors who don't live with it every day.

My Luke is one of those in the 6% of the insulin-pumpers population who
had a definite problem with Humalog that was somewhat alleviated with
Humalog mixed with Regular, and apparently completely alleviated with
a switch to Novolog last fall.  Site failures are frustrating & they
worry us both about short-term problems (greater likelihood of DKA) and
long-term - how many minutes of life above a blood sugar of 300 does
it take to cause complications?  

We found that those lumpy areas formed much faster on Humalog & 
took a long time to heal up before the area could be re-used - about
double the time we see on Novolog.   And sites failed for no explainable
reason - the cannulas weren't bent, or other obvious things - and they
were at completely unpredictable times, generally in the 1/2 day to
2 day range, with blood sugars creeping up the whole time.  It was
not a fun time & we would have given up on pumping if Luke hadn't said
it was worth sticking it out.  

We still have periodic site issues, but they are always explainable -
like the one that pulled completely out this morning as he got out of
bed.  Sigh.  And his blood sugars are stable across 3-4 days.  It
makes setting basal rates much easier when you're sure that it's not
the site causing problems.

Sarah - good luck - we're thinking of you & hoping for a great start
for Matthew.  But if you see redness right around the cannula &
feel more lumpiness after a site change w/ insulin, I'd ask about trying

Shelly V, mom to Luke, 7, dx'd 10/99, pumping 3/01 + Trevor 11 & Kate 9

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