- advertisement -

Using Regular insulin in the pump

Discussion in 'Parents of Children with Type 1' started by Chippy28, Jul 26, 2011.

  1. Chippy28

    Chippy28 Approved members

    Joined:
    Sep 24, 2008
    Messages:
    190
    Hi all! Saw my endo today and because I suspect that I am allergic to something in all the analog insulins (Novolog, Humalog, and Apidra), he asked me to do a one month trial of regular insulin to see if I am having the same infusion site reactions. Anyone use regular insulin in the pump? Any advice? My endo stated that there wouldn't be much difference between Novolog and regular since I am using the pump, but I am a bit skeptical.:eek:
     
  2. Lisa P.

    Lisa P. Approved members

    Joined:
    May 19, 2008
    Messages:
    5,380
    But he is having you change the duration, right? :confused: And adapt because of that?
     
  3. Lisa P.

    Lisa P. Approved members

    Joined:
    May 19, 2008
    Messages:
    5,380
    Are you using the regular in the pump for basal insulin, too, or just bolus?

    Is Apidra a log insulin?
     
  4. Chippy28

    Chippy28 Approved members

    Joined:
    Sep 24, 2008
    Messages:
    190
    Nope. He said it wouldn't matter, which surprised me.


    Yes, regular will be used in the pump as both my basal insulin and for boluses as well.

    To be honest, I don't know what Apidra is classified under, but my endo lumped it under "analog insulin" when discussing it with me. Maybe someone else can explain the different classifications of insulin.
     
  5. Lisa P.

    Lisa P. Approved members

    Joined:
    May 19, 2008
    Messages:
    5,380
    I don't have first hand experience but I know some have used regular with MDI and some with the pump here.

    But this really seems odd to me, the pump is just an injection system. I can see, I guess, how basal insulin might even out over time? Once you were using it around the clock it would act kind of "the same" but at the beginning of any changes it would take longer to "take effect" and if you turned off basals or made a temp basal it would take longer to see the change?

    But for a bolus, how could timing not be affected? My understanding is that the logs average a 4 hour duration (which varies in different people) and regular is more like 6 to 9 hours? How can you not be stacking if you switch insulins without switching duration of insulin on board?

    Seems there's a miscommunication somewhere -- maybe he didn't understand your question? Maybe you didn't understand his/her answer? Maybe I'm missing something? I hope. . . . . do you find this endo normally completely blows it like that?
    :confused::confused: I definitely wouldn't follow those instructions until I got an answer that made sense to me!!

    Hopefully someone here will chime in with better info than mine!
    :D
     
  6. Chippy28

    Chippy28 Approved members

    Joined:
    Sep 24, 2008
    Messages:
    190
    Lisa, that is what I thought! I could understand the basal not being affected possibly, but what really concerned me was the timing of the bolus. It is quite possible that he misunderstood my question because I don't believe English is his first language. But then again, it is possible that he just meant for me to not change the timing during this one month trial as to take as many variables out of this change (my A1C was high so we are increasing my basal rates again). As for his decision making, I usually only see him twice a year as my A1Cs have always been around 6.5 and only reason to see his was to check my A1C and to get a Rx. I have handled all basal changes and tried to deal with my allergy issues without much input from him. This is the first time that we have really sat down to address the issues that have become progressively worse in the past 3-4 months. I guess the 7.7 A1C really caught his eye this time around.:rolleyes: Thanks for the input though, I really appreciate knowing that my thought process isn't completely skewed!:p
     
  7. Lisa P.

    Lisa P. Approved members

    Joined:
    May 19, 2008
    Messages:
    5,380
    Well, or we're both really skewed!

    I'm sure you can progress on this course using your own sense and a heap of caution, of course.

    I know there are some folks with insulin allergies here, and I know several folks have a good working knowledge of Regular, so hopefully someone will log on to the board soon that has some direct knowledge and can advise!
     
  8. Lisa P.

    Lisa P. Approved members

    Joined:
    May 19, 2008
    Messages:
    5,380
    Are you positive allergies is an issue? Have you tried the logs on MDI to see if you get the same issues? Just curious. :)
     
  9. sarahspins

    sarahspins Approved members

    Joined:
    May 5, 2009
    Messages:
    2,205
    Just throwing in my 2? here... pumping regular will probably NOT offer you any relief. If you are allergic to "something" in the insulin it's most likely one of the preservatives. Unfortunately, ALL modern insulins (analog and otherwise) use similar preservatives. That your doctor doesn't realize this is somewhat concerning. There have been a few isolated cases where people have been allergic to specific analog insulins (the insulin molecules themselves) but those are rare. Generally it's some sort of phenol allergy.

    I react more strongly to all insulins when they are infused vs. injected.. past a small welt on MDI I usually don't notice any problems, but on the pump that small welt just continues to get irritated and eventually will cause a site failure. I am currently only able to keep pumping with the help of an RX steroid cream. The next step would be mixing a small amount of injectable steroids into the insulin in my pump.. but my doctor is not too happy with that idea, so I doubt it's something she'd agree to easily.

    Be prepared for your control to be absolutely HORRIBLE pumping regular.. that stuff is so slow, that it could be downright dangerous for your doctor to suggest that you wouldn't require any duration changes!
     
  10. TheFormerLantusFiend

    TheFormerLantusFiend Approved members

    Joined:
    Sep 10, 2006
    Messages:
    4,925
    I started using Regular about a month ago because I was hoping it would kick in slower and last longer than Novolog, because I keep going high hours after I eat supper. Unfortunately, the Regular seems to act in my body exactly the same as Novolog. It kicks in within 15 minutes (if not faster), is mostly done within three hours, and I see no effect past four hours. On the plus side, it's cheaper.
    That is not the official story, but after complaining about it, I found out that I'm not the only one it works faster in- it's different for different people in terms of how long it stays in the body. Somebody telling me his experiences said that for him, the Novolin brand Regular (sold as Novolin R) and the Humulin brand Regular (sold as Humulin R) worked differently. He suggests that might work for me too but I haven't broached the topic with my endo and I'm not sure I will.

    The instructions that come with Regular warn against using it in pumps, but that's what people originally used in pumps- pumping is older than common usage of analog insulins.
     
  11. Ellen

    Ellen Senior Member

    Joined:
    Oct 22, 2005
    Messages:
    8,240
    My son used Regular in the pump for some time. He definitely had to adjust insulin for basal (as I recall) about an hour before he wanted bg to change, and wait longer periods of time depending upon premeal bg before eating. You may want to get one of John Walsh's first pumping insulin books where Regular was the insulin used/referenced. (Of course we also now know pre-bolusing is a very good idea even with the 'logs depending upon premeal bg.)
     
  12. Chippy28

    Chippy28 Approved members

    Joined:
    Sep 24, 2008
    Messages:
    190
    Nearly positive. In the past year, I have tried pretty much every infusion set available, multiple different adhesive tapes beneath the set, multiple different barrier wipes, and benadryl spray in every possible combination that I could think of and I still have these issues. I wear my Dexcom 24/7 and I have (*knock on wood*) never had any allergies associated with their tape as well as any other additional tape used to help secure it. What really clued me into the fact that this might be an insulin allergy occurred about a month ago. I had an extremely stubborn high that I decided to treat with an injection in my thigh. The next morning (about 12-15 hours later), I woke up with a itchy welt on my leg exactly where I had given my injection.

    Sarah, thanks for sharing your experience, I really appreciate the input. I am definitely afraid that this might not work, but my endo wanted to do a one month trial just to rule it out just in case as he said having such an allergy is quite rare. He has been practicing for nearly 35 years, is highly respected in this area, is often involved with research and sits on multiple committee boards, and doesn't shy away from new technology. He mentioned that he put his first patient on a pump in 1981. He appears extremely competent to me and came highly recommended. At this point, I am so frustrated that I am deferring to his expertise as everything I have done has ended in failure. I will definitely be paying careful attention to how my body reacts to regular and hopefully my control won't be any worse that was it has been in the past 3-4 months especially since we aggressively increased many of my basal rates today. I guess I'll just cross my fingers at this point!

    Jonah, this is really interesting! I can only hope that I experience something similar. I used Apidra for about 8 months and found that it's duration was quite similar to Novolog in my body, so I can appreciate that some insulins may work differently than expected.

    Ellen, thanks for the info. If everything works out well with the Regular this month, I will definitely try and get my hands on one of those books!
     
  13. deafmack

    deafmack Approved members

    Joined:
    Sep 22, 2006
    Messages:
    3,209
    I am curious. Have you been tested for extreme insulin resistance. The reason I am asking because there is another person on another message board who is type 1 and has extreme insulin resistance. She uses U-500 in a pump. U-500 is Regular insulin but instead of 100 units per ml it is very concentrated and has 500 units per ml. I am just throwing it out there. Also could the allergy come from not the insulin but the material in the infusion set itself, etc. Have you tried going to a metal needle infusion instead of a plastic canula type of infusion set. Just an idea though. The reason I am thinking of insulin resistance is because if your numbers are still high that might just be a possibility besides the allergy.
     
  14. Chippy28

    Chippy28 Approved members

    Joined:
    Sep 24, 2008
    Messages:
    190
    Nope, not insulin resistant. My numbers have just been all over the place, both highs and lows, because the inflammation at my infusion set makes it difficult to predict how much insulin is actually going to work when I bolus as well as making my sites go bad at random. I could have days of beautiful numbers, followed by days full of lows, followed by days where I seemed to be stuck in the high 100s to low 300s. There was really no rhyme or reason to my numbers unfortunately. I have tried both types of both metal and plastic infusion sets as well as multiple different kinds of metal and plastic sets. It doesn't seem to make a difference unfortunately.

    Also, this may be just a coincidence or it may be related, but about 2 years ago when I started seeing these allergy issues, I had a sinus infection and was prescribed amoxicillian, a drug that I had taken many, many times as a child. Unfortunately, this time I had a horrible allergic reaction that required steroids. Like I said, I have no idea if this is somehow related, but I do find it interesting that my immune system has become hypersensitive to a few things in the past few years.
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice