I seem to have trouble with my sites lasting for 3 days. It seems that I can only get 100 units before the site stops absorbing. I currently use about 40-45 units a day and I have tried everything to get it lower. Even metformin didn’t do much. My sites are crapping out after 2 days or 2.5 so I was wondering if anyone is pumping with u200. I read that it has been approved in Omni pod.
Not even sure it will solve the issue, not sure if the double concentration will absorb the same way or not.
My Tandem Mobi pump holds 200 units which is more than enough for me, I usually load it with 150 but I suppose I would only be loading 75 with u200 this might be an issue too, but I don’t know.
Cutting all the settings in half seems easy enough
I’ve been podding with U200 for three months, and I’ve been really pleased. Being able to deliver a smaller volume of bolus helps prevent tunneling but hasn’t eliminated it altogether.
I was previously using U100 Admelog, which I preferred over Humalog, which I found inconsistent and unpredictable, so I wasn’t happy about having to switch back to Humalog (the only U200 insulin in my province). But for whatever reason, U200 Humalog seems just as stable and effective as Admelog.
Oh, and you don’t cut all your settings in half. You halve your basals, but you double your I:C ratio and your correction factor.
Also if you ever resort to a U200 pen for a shot, you have to double whatever dose your pump suggests.
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One question and one idea… I know you said you tried everything. Have you done keto carnivore? I use about 15-17 daily without the carbs and I follow up my larger meal with a low impact walk to get more get more out of the bolus it really helps that insulin do its job.
Second I’ve been thinking about doing this myself. Pump for Basel and injection for meal. I notice a .5 unit on my pump vs .5 unit by injection hit DIFFERENT. Injection is like right to the point and pump feels like push me I’m coming. If you cut your units by using meal injection the site might last longer or be a ton more effective.
I’ve only done humalog so I speak to your actual question 100 vs 200. But I’m curious about what happens if change to meal injection…… I’m going to experiment next few days.
I tried keto and I really didn’t work out for me. I was able to do it for about 6 months. Also after reading Mastering diabetes high carb and low fat, I found a diet that works for me and it brought my insulin down dfrom about 60 units to 45. But I’m 6’3 200 lbs. 45 units for someone my size is actually on the low end. My issue is more about absorption because I have been pumping for 25 years.
The keto thing also makes me worry about heart disease. It runs in my family. So giving up fat and refined carbs seemed more like a more reasonable choice for me.
I recently had my heart and arteries checked and I currently have No heart issues, I would like to keep it that way.
Not everyone on keto will have heart disease, but there is a lot of saturated fat in animal fat.
I’m not even suggesting you or anyone switch to it, I’m just glad there are more choices.
I did an experiment way back where I ate a piece of dry toast and it took 1.5 units to come back to normal. Then I added peanutbutter to it and the added fat made me need nearly 4 units.
The mixing of fat and carbs cause me to have worse insulin sensitivity. And that is the core of Mastering diabetes. I’ve been able to keep it going for a year and a half.
If something better comes along, I’m all about it.
Just going through the process of trying different diets taught me a lot about metabolism that I thought I knew” I’m a biologist by education” I never truly understood it all. I feel like I have a better grip now but still there is a lot to learn.
Fasting is another nearly impossible concept that I have learned to do, but realize that switching to keto while fasting causes a huge spike when going back to glucogenesis.
It’s really all amazing
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I would ask docs about lipoatrophy or possibly lipohypertrophy - loss or lack or changes of/to fatty tissue.
The design of most pumps has us put infusion sets into areas where most people have at least some fat. If you’ve been super careful about exercise & food over the years, you may not have much fatty tissue! (Diabetes sucks in every imaginable way!)
Changing a site every 2 days can also be problematic if insurance limits your supplies to every 3 days, not 2.
Let us know how it goes.
I use new sites now that I have a mobi I can put it in places that are difficult to access. But since I don’t need to see it or pull it out, I can use my back and legs. But even new sites seem to have an absorption issue past 100 units. I’ve heard people keeping sites in for 5 days, but I have no idea how they manage that
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I have used Humalog 200 for over 7 years in my Omnipod. It was first prescribed because they thought I would need more than the 200 units the pod holds. But switching to a pump cut way back my insulin usage, I use about 45/50 units a day. But I liked it so much I stayed with the Humalog 200.
But I have been having a problem with tunneling for 1-2 years now. At first cutting back how much insulin with dosing helped. So switching to Humalog 200 should help you for a while, less volume. Now I am having a problem with any 2 units plus dosing through my pod. I can do small amounts here and there, but I have some pods last 3 days and sometimes 1 day, half of the time it lasts around two days. My doctor writes my script for one pod every 2 days for me and my insurance covers it with no problem. But the Omnipod is under Part D and the insulin is under Part D.
So this could be a problem unless you are willing to get your insulin under Part D. Medicare will not cover insulin for a pump from a pen. There literally is no code for it. And Humalog 200 only comes in a pen. It is likely to stay that way because of it’s double strength. In a vial someone could get too much insulin too easily. The pen when you key 1 unit, it gives one unit of insulin, it’s just half the volume. A vial would be wide open to someone drawing double the amount, plus I’m pretty sure it’s still not approved for a pump because of that same issue??? You literally have to reprogram some numbers in half and others get doubled. Doctors will prescribe it for it, my last two have, and insurance (Part D) has covered it.
Because of my tunneling issue I am now giving myself MDI shots for bolusing, I also use Afrezza, and I save my pump for a little over half of my basal. I am using Lantus twice as day shots for some basal. I have DP and I want the extra insulin in those am dawn hours from my pump. Right now that is working. In some respects a good thing, is when a pod goes bad I still will always have some insulin on board so my numbers don’t go as awry.
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Five days? I’m one of them. Not sure why. My average is 3 days, but when i first switched to tandem, i wanted to built up a small supply of spares. You never know when weather will delay supply deliveries, or an infusion set goes belly up too soon.
And i hate to waste insulin. Never know when the price of a $15 bottle of insulin will unreasonably go back to hundreds of dollars. (For some price never dropped.) If i hit 3 days and there’s still insulin in the pump, i keep going.
For what it’s worth, you can change infusion sets without changing insulin cartridges. I change my sites every other day (t-steel) but use the insulin in the cartridge until it’s gone.
Yeah, i get that, but again, trying to build up a backup supply of cartridges and infusion sets in case deliveries are interrupted for weather or other reason. Used to have an extra month when i was using Medtronics. Just about where i want to be. The limitation is really what insurance allows.
I’m using Humalog U-200 in a Tandem t:slim X2. I have a high insulin daily usage of around 100 units and with U-100, I was changing cartridges every 2.5 days. With U-200, I’m averaging 5-6 days between cartridge changes.
My major reason for switching from U-100 to U-200 was that my nighttime basal exceeded the pump’s maximum basal limit. With U-200, the pump is happy with delivering (half of) my nighttime basal.
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Hi Timothy: I’ve some issues with my infusion sites not absorbing well for the last few years. I switched to metal cannulas because I could take those out and stick them somewhere else, then tape them down. At the end of September, I decided to bite the bullet and go back on MDIs. That lasted 4 days. I couldn’t get my basal insulin (Lantus) to work over night or early morning. I was constantly at 14.5. It made me realize that I was never at 14.5 for extended periods of time while I was on my insulin pump, even if the sites weren’t the best absorbers. I decided to try using my pump just for basal and a pen for boluses, which I could calculate very accurately since I was still attached to my pump. Strangely enough, once I’d made my peace with this method, I found I’ve only had to use it with one infusion site since early October. I switched to shorter metal cannulas as well. Maybe try combining the two methods if you can. It seems to me that after 51 years of diabetes, I have a lot of sites that just don’t want to absorb a lot of insulin anymore, so using the pen to inject where my pump isn’t, works for me when I need it. Perhaps the extra strength insulin, which would cut down on the amount of insulin needing to be absorbed would do the same for you. Best of luck!
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