Needing Advice, Dr.'s don't even know!

As you have seen I just started pumping again after a 1.5 year break. Averages down 20 to 30 points first 3 weeks…then the problems begin. 2nd day into infusion set, 8 mil. cannula with Humalog. Pain coming from site during bolus on breakfast bolus (11) units. by the late afternoon my sugars had climbed to 265, and during the dinner bolus I had pain again, Sit down after bolus, all the insulin that was going me had pushed back out. The site being on my flank area. this happed a couple more time before I was sent an 8 mil. stainless canula because of canula allergies. Steel didnt work either 2nd day had to come out. the site was red and irritated, and bleeding something feirce. Dr. instructed me today the we need to switch to Novolog. Anybody out there had the same issues?

You've tried a steel infusion set and unfortunately that didn't work. Are you using IV3000 or Tegaderm? People can be allergic to them. They can also seal in bacteria! Don't use alcohol to pre-clean the site. Use a clinical disinfectant. It is possible that you are allergic or have become allergic to a certain brand of insulin. They are all 'contaminated' with nasty preservatives. So trying a different one might help. That quite high BG of 265 might suggest that your cannula depth is incorrect and insulin is a strong irritant in the wrong places. I got a bunch on my skin once and it became very sore. Correct depth is very important. Good luck with this one.

I was using the IV3000, but Accu-Chek and Dr. instructed me to stop. Accu check is send me a couple of things to try also....it will be a dressing to skin, then infusion, and another dressing. Along with the different insulin, hopefully something will work.

hum, i'm not sure it's the humalog, seems like if true allergy you'd have more like hives. were you using humalog on MDI's without a problem? sounds more like bad infusion sites/sets. maybe you're having an allergy to the adhesive too?

I've tried tubed pumps twice, didn't like them and will start on omnipod soon, but every time i took my set out or changed site mine bled too and I had a rash from the adhesives but it didn't have anything to do with the insulin. good luck. seems many have to try different infusion sets to see what works.

I also have allergy to infusion sets but it was not the cannula.
It was the adhesive that by the second day would work its way down the cannula to my skin. By the second day my absorption was reduced. It sounds like you have the same trouble.

This is what I did. It sounds like a lot but once you get use to it, it's second nature.

First I wipe down the area with skin tac after it is dry I apply a tiny drop of neosporin in the center. Then I cover it it with a regular iv3000 not the kind with a hole. Just the regular patch.(6x7 cm) Then I puncture my set straight through the iv3000 and into the spot of neosporin. Then tape the set to the iv3000.

The reason this all works is because the adhesive never touches my skin and anything that runs down the cannula will be stopped by the oily neosporin. It will also prevent infection if it does get inflamed a little.

I found the stainless cannula was even worse than the plastic ones as it allowed the adhesive to run along it even more than the plastic ones.

I have been using this method for more than a year and my sites never get inflamed any more when I take them off they look brand new. I don't get scars anymore either. I dont have painful sites anymore either.

I would try this before switching insulins. Insulin allergies have very different symptoms anyway. ( itching and hives and difficulty breathing)

I don't yet use a pump, but I went to a training session and found that Humalog could not be used. At the time, I just thought that was strange that only Novolog could be used.

Any of the three fast acting insulins can be used in a pump, Janina.

Second what Zoe said. Any of the three can be used, and I know people who use all of them. A good friend uses Apidra in her pump and loves it. Whoever told you otherwise has an agenda of their own. If I were to guess, it may be a manufacturer who has some sort of vested interest in recommending one over the other. But that's just a guess. In any case, it ain't so.

Hi Janina. I've tried all three the fast-acting insulins and Regular on a pump, and while all of them can be used, there are differences. (I'm now on MDI, but started on a MM508, getting updated pumps over the years.) It was maybe ten years ago that I was using Humalog and found that it clogged at the point where insulin enters the reservoir. My own opinion is that the clog might not occur if one used quite a bit of insulin, keeping the flow going -- I use only 25 units and under. I found Regular and Novolog to both work in a pump, but both are two slow in action for me. Apidra I love, but it's somewhat more temperature sensitive than the others. On a pump, the Apidra just didn't work well over 2 days in one site. (Now on MDI, I wouldn't give up my Apidra, though I'm really careful to keep it at a stable temperature.) Hope that made sense!

So, a few days has passed. I changed sets on Monday using Novolog, my averaged last couple days has been 130’s. Site will be 2 days old at 5pm today, with no pain. Accu-chek did send out IV3000 in case of Adhesive allergies. Doc says stay on Novo for few weeks. To your point on the clogging, I have a steady stream…Averaging 85 units total insulin per day.
I guess if things stay good it was the insulin…(confused).

Hi Jacky R. I'm glad you're getting good results! I ran out of real estate for wearing a pump (got thinner), but I really do miss it.

Yes, Zoe, we really are all different!

I've been using Apidra in my pump since I got it in 1/11 and it works fine for 3-4 days. Just shows we're all different!

i was told too that humalog shouldn't be used in pump, specifically omnipod, was also told humalog clogged in all pumps, both by pump reps and old endo. new endo said humalog was first used in pump and made for pumps...so...who knows. but many use it and seem to do fine.

I use humalog in my pump for over a year now, and absolutely no problems with it.

I should add, that training session was Dec 6 2010, so maybe things have changed a bit since then, as I pointed out I don't use a pump and am seeing them as more trouble and far too expensive for me when it would require me to buy more than double the insulin for the tubeless omnipod pump I had my eye on. So now I am hoping the pancreum will be a good one when it comes out. see pancreum.com