I’ve been on novolog and using a pump for the last 7 years and have very rarely had a problem with the pump, and never had insulin go bad on me, despite heat or leaving the pump on for 3-4 days in a row. I jus switched to humalog last month because of insurance reasons. The results were pretty much the same, until I reached the end of the bottle. I woke up last Wednesday with a bloodsugar in the 500s and very high ketones. My original thought was that I must’ve kinked the tubing or something…I took a large correction bolus, noticed the ketones were going down, and thought it must’ve been a fluke! I was feeling fine most of the day but then I started getting very sick, throwing up and ketones were high again, my number was 597.
“my site must’ve gone bad” I thought, so I changed my cartridge and site. Ketones were still high when I went to bed, but my number was on its way down. Woke up in the morning and ketones were at “medium” and number was in the 200s. During the day the ketones went away but my numbers stayed high. Through Saturday morning my numbers stayed in the 200s, but then spiked to the 400-500 range despite taking frequent correction blouses. I’m usually very sensitive to insulin so this was very strange. Saturday afternoon I decided the bottle must have gone bad somehow. I switched to a new bottle and changed sites, number finally came down to 131.
Now I’m nervous, it’s the next day and my numbers are on the rise again. What else could be wrong? Could my humalog be bad again, from a new bottle? It’s been pretty hot out, but I’ve been keeping my bottles in the fridge or in the air conditioned house, and never had a problem before. Is humalog less stable than the novolog? It’s just so weird this happened on my first bottle!
I'm just gonna tell u this....................The Humalog makes me go higher than the Novolog does. It just has so my dr put me back on the Novolog and wrote a letter to my insurance company thaT i COULDN'T TAKE IT B/C IT MADE MY NUMBERS WAY OFF. gOOD LUCK!
I've never seen this with humalog and have been on it for 7 or so years, but maybe just the switch could have contributed. I'm with Doris, if something is working and all of a sudden it isn't then it has to be the switch to a different insulin, if you're not sick otherwise, then I would get a letter from your endo to get this fixed soon.
I've had a lot of problems with insulin losing its effacacy. I blame some of them on "crystallization", where the insulin seems to clog up the (teflon) catheter. This problem seemed to be a lot worse with Humalog (I switched to Novolog). When it happens, it leads to the kind of problems you describe - only a new bottle or in the worst case a new batch from the pharmacy helps. Right now I'm using almost exclusively steel needle sets, which seems to be helping.
When you have a problem like this you should switch to a syringe, this will give you feed back about your pump, is it the pump or bad insulin. When you develop Diabetic ketoacidosis your body becomes insulin resistant and it can take a massive amount of insulin to correct BG and your blood pH can take days to drop back to normal range. I guess what I'm really trying to say is it's not a good time to test a infusion sight or your insulin. I would agree with what others have said about Humalog crystallizing and causing pump issues, and it does appear that your minim insulin requirements where not met at some point. I can also say there are times when something goes wrong and we never figure out what really caused the problem...Humalog is the most popular insulin on the planet and and a lions share of pumpers use it without any problems.
I agree with John about syringes. If my glucose is very high (over 200 for me) and I HAVE NO IDEA WHY, I will switch out my pump completely: new cartridge with insulin from a new bottle and new tubing. THEN I do the correction. If that doesn't begin to make a big difference in a downward manner within 2 hours, I switch to the syringe for correction, leaving the pump for basal delivery. Honestly, I hate using Lantus, so this is a little weird, but seems to work for me.
I used humalog for years, as the military did not carry novolog and switched when they began to have it. I really saw no difference between them at all. Also, when glucose gets that high, it takes a lot more insulin than my regular correction ratio to bring it down.
Additionally, the heat can affect a great deal more than the quality of the insulin. We were without power all weekend with temps over 100 and I was so consistantly low, that I ran a temp basal of .2 for 48 hours and cut my bolus to 1/3. Heat really tears me to pieces.
I find that once I enter into KETOACIDOCIS it is very difficult to keep sugars down Ketones cause insulin resistance to skyrocket. It takes me 3 times my usual insulin to keep my sugar normal. It takes your body a while to eliminate ketones, so even a small event of say over 200 will set you back again. It is like a nauseous roller coaster that you can't get off of.
It may or may not be the insulin too. I don't know but Ive take both Humalong and Novolog and they work pretty much the same for me.
I just keep a very close eye on my sugars for at least a day after I have an event
like you had. I test every hour even thought I have a CGM.
I had my canula come out once in such a way that I could not see it. My came up to around 350. It took me several hours of nauseousness to get it in range.
I looked back at my pump the next week and saw that I used more than double my normal daily insulin for the 2 days after that. And my daily rates don't vary much at all. I am right around 35units per day. and those two days were 77 and 70 .
