U-500 and Animas Ping

I have just switched to the Animas Ping from a Deltec Cozmo. Since the cartridges only hold 200 units of insulin, my doctor has written me a perscription for U-500 insulin. That will allow me to go 5 days on one cartridge. Yay!



Has anyone else used U-500 with this pump? On the setup screen, how do you set the ISF? If 1 unit of insulin lowers my BG by 9, I would need to set this to 1.8 (9/5). Since the Ping only allows you to enter whole numbers, should I round up to 2 or round down to 1?



I would love to hear from anyone else who is using U-500.



Thanks,



Ned

There’s value in knowing how other patients handle this situation, but has your doctor offered to help with these calculations? If I were in your shoes starting out on an unconventional regimen, I’d be writing up a list of questions for my healthcare team in addition to doing online research.

I hope this doesn’t come across as preachy…I just think it’s important to take advantage of all available resources, online and off. Best of luck to you!

An interesting discussion of U-500 is here. Ihave to tell you, U-500 has a longer duration of action that even R, lasting upwards of 24 hours. So there is some tradeoff involved with using U-500. U-500 will also be a very poor bolus insulin. Your basic concepts about adjusting your carb factor and ISF are correct, rounding up will lead to a more conservative dosing, rounding down will be more aggressive. And you really need to make a number of other subtle adjustments that require some expertise. I would strongly advise consulting with a CDE before attempting to make this switch. If you forget something, you do run the risk of injecting 5 times more insulin than you should, a rather bad error.



A key reason for moving to U-500 is that injections over 50 units with U-100 have a lot of variability. U-500 can be more predictable. From what you have said, I gather you are using about 200 units/day. If you have about a 50/50 basal bolus split, one option might be to use U-500 as your basal insulin taking two shots a day and then using your pump for bolus. In this way, you could use a normal rapid insulin in your Ping and have it last 2 days, you would get a good insulin bolus for meals since your meal injections are less than 50 units and you can still take advantage of the U-500 for your basal which at 100 units/day requires large injections.



In either case, I would strongly recommend that you consult a CDE in making any switchover to U-500.

Thanks for the response. I did get a good laugh from it. I live in NY and have been to some of the best doctors, endocrinologists and others. However, I can count on 1 hand the usefull advice I have ever gotten from them over the past 25 years. Same with my father who has been managing his diabetes for 60 years.

Yes, I am cynical and yes, it is a sad statement on the current state of our medical care. Perhaps if there were more diabetic endocrinologists, the situation would be different. But it is not and I have to survive, in spite of what doctors do and don’t know.

And, to answer your question, my doctor (GP) didn’t even know there was such a thing as U-500. Neither did my endocrinologist.