My son is a teenager and takes large amounts of insulin to cover increased hormones and a large volume of food. He is quite thin but eats a lot, as teenage boys often do, thus he pumps 100+ units a day (basal + bolus). Since this is a tremendous amount of insulin to absorb through his infusion set I requested Humalog 200 so we can dose 1/2 the amount. Does any have any experience with Humalog 200?
I use it! I’ve heard it’s better than the U-100. I’m not sure about that but It was originally thought I might have to change my pod every 2 days because of my usage so they prescribed the 200. It turns out my usage went down so much it wasn’t necessary.
But I liked it so I stayed with it and only use about 25 measured units of it or really 50 units of insulin a day. Which brings me to the point it can be confusing for people at times who aren’t used to it. Please be aware of that if you switch from using the pen and pump at all.
My endo that put me on the pump is the one that originally prescribed it. When I moved the endo here originally wrote the prescription for 25 units a day of U-200, but it can’t be written like that, it still has to be written as 50 units of insulin. When I have talked to the mail order pharmacy staff before, they completely understood, but this last time the lady I talked to didn’t have a clue and then wanted to half the prescription when I tried to explain it to her. Because you fill up a pod or reservoir by volume. So as soon as I mentioned I put 80 units volume into my pod for 3 days her understanding went out the window.
And Humalog does not want to hear it’s for a pump, I guess it’s not “approved” for it. So if you talk to them for any reason just don’t mention that. My endo that prescribed it said she did so all the time and she was a type 1 herself. It only comes in a pen.
The other thing is it’s helpful to have someone familiar with programming helping you with programming the initial pump numbers, you don’t have to, but at first it’s a little confusing. Everything is virtually doubled. So on the I/C programming if I take 1 unit for 7 carbs, I have to put 1 unit for 14 carbs etc. 1 unit for 25 correction is 1 unit for 50. Once you have all that information in then you’re good to go.
So far in my search, the only site that makes sense to me, on the topic of U200 is this one (and look who it is written by!) https://integrateddiabetes.com/double-your-pump-volume/
That’s a really good article @Dave44 and I forgot to mention the very important halve all your basal rates!
I think in your son’s case, it makes sense to move up to a U200 insulin concentration. Although you didn’t say what brand if pump your son uses, do you know if that pump allows for U200 use?
@Marie20, does Omnipod formally approve of U200 use in its pumps?
I’ve never used concentrated insulin, beyond the U100 kind. I know from a few threads here that people are often confused about the concept.
Ten units of U100 or U200 or U500 are all equivalent insulin doses. The liquid volume of each of those 10-unit doses is different. U200 is one half the volume of U100 and U500 is one fifth the U100 volume.
Where important safety mistakes are made is when someone uses, for example, a U100 syringe to draw up insulin from a higher concentration insulin vial. This can and has led to insulin overdoses.
Sorry to veer somewhat off-topic here, @Yifat. I just wanted readers to think about the safety aspects of using insulin of a different concentration than what the equipment was designed for.
Larger volume insulin doses are slower to perform. Halving the volume of insulin your son uses for the same meal dose will likely give him better performance. I would try it if I were faced with that situation.
Sorry, don’t know anything about Humalog 200. I am pretty insulin sensitive. But I do listen the Stacy Simms at Diabetes Connections and her son had the same problems. They went with injections of Tresbia for his basal and bolus through the pump. He also does keep a low dose of basal going but the bulk of his basal is through a long acting insulin injection. It might be something to talk with your medical team about. With some of these newer basal insulin’s, there is a lot of freedom on timing of dosing so he won’t lose a lot of that pump flexibility he might really love and need. Good luck with whatever option you try out. Let us know how the experiment goes!
I’ve never hear of this. I want it.
Thats a lot of insulin. He really needs this stuff. I use that much on occassion, but not consistently. I am 175 lbs female in her 30s.
Is Humalog 200 more expensive that normal Humalog?
Is this a way to cut costs by only using one vial where you might have used 2?
I don’t know @Mohe0001. I get whatever insulin I need for the same co pay? But they only put 2 pens in a box of U-200 versus I think it’s 4 of U-100?
I use the Omnipod pump and also use ~100 units of insulin per day, so I am changing my pod roughly every two days. I looked into U200 insulin awhile back (I think I was on Novolog at the time but now use Humalog), and the cost difference was substantial so I did not make the switch, but I know many people are now pumping U200 so I might have my endo look into this again.
I’ve been using U-200 in my tSlim x2 for about a year now. I’m type 2 and was going through a cartridge every day and a half. With the U-200 I can go 3 days. It’s a small pain that it only comes in pens as to fill the pump cartridge I have to draw it from the pen with a syringe. Getting all the air out is a challenge, but doable.
As others have said, dosing can be hard to wrap your head around if you’re used to 100. Even my endo had trouble with the first prescription ordering a 90 day supply. You use the same amount of insulin but half the liquid volume.
I think there is a 400 too.
However I’ve been taking the same carb ratio my whole life.
Even when I was 21 and super active eating 3500 calories a day, and super thin, I was still taking the same insulin about 1 unit for 20 g of carb. I only eat 2000 calories now but still 20 to one. I can’t imagine why he needs so much insulin , but I guess he needs it.
I’ve been using it the last few years and it has been a game changer. Starts working in 5 min or so. I used to need over 100 units a day so was always changing reservoirs. Now I can easily go 3 - 4 days between changes. Way better than the U-500 we tried for a while. Way too slow onset and duration. My insulin requirements, not just the volume, also diminished. Love the stuff - just wished it was approved for the pump to avoid the yearly hassle with the insurance company.