Insulin used with a pump

(orange_mms) #1

First, let me say that I am on injections. I use Humalog 3x's daily and levemir @ bedtime. I currently am not interested in getting the pump. Who knows about the future though.

I was wondering when you're on the pump, what type of insulin is being delivered? Is it short acting only ? Is long acting being used at all (through the pump or injected)?

Sorry if this seems like a silly question. I am not familiar with the use of a pump. I searched this site before posting this topic, I did not find an answer. So I figured I'd ask those who are experienced in this process.

 

(hcole) #2

The pump uses only short acting insulin, but delivers it as a basal slowly over 24 hours, so it acts more like a normal human pancreas:)  I don't have one, but hopefully soon!

(tess) #3

Hi, The pump uses fast acting insulin only 24/7.   They are great.  Mini Med has a continuious glucose monorting pump.  However you must check to see if your insurance pays for the sensors.  Have a great day.  Claudine

(tess) #4

Thank you so much for the correction about the type of insulin delivered  by the pump.  It was my understanding that the insulin was fast acting....however I could easily be wrong.  It is delivered by basal.  Agains thanks.  Claudine

(joe) #5

[quote user="orange_mms"]

I was wondering when you're on the pump, what type of insulin is being delivered? Is it short acting only ? Is long acting being used at all (through the pump or injected)?

Sorry if this seems like a silly question. I am not familiar with the use of a pump. I searched this site before posting this topic, I did not find an answer. So I figured I'd ask those who are experienced in this process.

 [/quote]

The answers you were given above are the most typical.  Most pumpers (me included!) only use short acting insulin, the pump works by giving you tiny amounts of short acting (to take the place of your levemir shot) and a burst at meals (to take the place of your additional humalog shot).  The truth is that sometimes, for some people,  you actually mix insulins in the pump reservior.

some pumpers mix a little bit of long acting insulin in with the fast acting, in their pumps, the thinking is like this:  if your pump only delivers short acting insulin, and you have some "problem" such as a ripped out site, an occlusion, your pump gets run over by a garbage truck, etc, or you simply "like" to disconnect your pump for reeeeeeely long intervals, you could have a problem with very high sugars and even DKA in 3 hours.   3 hours.    Truth be told - pumpers are more likely to have problems with DKA than people who take levermir or lantus.

some folks are prone to occlusions and some like to disconnect for longer than an hour.  For them, it's way better to either mix insulin in the pump reservior or take a separate shot of lantus or levemr in addition to the pump therapy.

just wanted to offer another point of view - hope this doesn't confuse things for you.  I have had my pump on for 3 years and love it. I use Humalog or Novolog in mine and I was on shots for 29 years so I have a lot of experience with freestyle needles.  I do not have any problems with the pump, or DKA, but I have read a lot about this therapy and the pros and cons.

cheers.

(orange_mms) #6

Thanks so much for the information , I appreciate it. I've learned something new today, lol.

(Doug D) #7

Really Joe?  I hadn't heard of that. I just use the Humalog and haven't had any DKA issues. Do a lot of pumpers do that?  I always just keep extra needles and a bottle of long acting insulin just in case although I've been lucky and haven't had to use it yet.  I guess I learned something new too!

(hcole) #8

[quote user="Joe"]your pump gets run over by a garbage truck[/quote]

Haha!  That is a random example...are you speaking from experience here?

(poodlebone) #9

I have never heard of micxing long acting insulin in a pump.  I'm pretty sure you're not supposed to mix the newer insulins with anything, although it was always okay to mix older "human" insulins like NPH + Regular.  I can't imagine how adding long acting to your reservoir would help.  It would totally mess up I:C ratios and corrections because you wouldn't be getting just short acting.  Personally, I would never, ever recommend doing that to anyone!

I use Humalog in my pump because that's what I used while on MDI.  I always have my current open vial with me and a couple of syringes.  In 4 years of pumping I've never had a set fall out without me knowing it, I check my BG frequently and now have CGMS.  My worry about DKA right now is zero.

(kiwispinner) #10

I use humalog.

(ajax) #11

When you keep a bottle of long acting around just in case, how often do you replace it?

(joe) #12

you can't mix levermir or lantus with anything - it's very dangerous to do so because it will change the protein chain and it will absorb FAST, just like a shot of fast acting.

People mix the Humalog or Novolg fast acting in the pump with R (insulin Regular) or another medium/long acting insulin, I don't think it's N, but I could be wrong,  I'll look it up.  The mixing is a protection from quick onset DKA.  less thatn 10% of pumpers mix.  It's a really good idea, for example, if you go on a swimming vacation, and you want to disconnect for 2-3 hours to go in the water or spa/jacuzzi.  You could do a hybrid therapy - you could take 50% of your basal as lantus - then you can disconect and go swimming for hours and be at a automatic reduced basal rate, plus you will not have high spikes/DKA issues.  it's only one example.

haha regarding the garbage truck...   I did get my pump caught in my fall protection gear last year on a job (construction) site and it was nearly crushed =)  good thing they are very strong!

 

(joe) #13

[quote user="ajax"]

When you keep a bottle of long acting around just in case, how often do you replace it?

[/quote]

the expiration date is printed on the bottle.  it's usually about a year, if you keep it in a refrigerator.  I take a bottle with me sometimes when I travel... then it's a month and then... garbage.

(melg125) #14

The pump uses only short acting. It gives a constant flow of short acting insulin in very small amounts just like a "healthy pancreas" would in a non-diabetic person. There is no need for Levemir (or Lantus) because the pump gives a constant basal rate. My baby has been on a pump for 6 months. She uses Novolog. I love it because It can deliver half units(.5), or quarter units(.25) and even as small as one twentieth of a unit (.05) of novolog for the most precise blood sugar control.

The downside to this is that if the pump "malfunctions" or she is disconnected from her pump longer than an hour or two she is at risk for DKA much quicker than if she were on levemir or Lantus.