March 16, 2003
Insulin Analogs, Insulin Pumps
Question from Baltimore, Maryland, USA:
My three year old daughter has just begun pump therapy, and her pediatric endocrinologist wants her to be on U-50 NovoLog, but the manufacturer has not done any studies on mixing U-100 NovoLog with any of their three diluents and is hesitant (to say the least) to recommend any of them. The endocrinologist wants us to stick with NovoLog because we know NovoLog. We can predict her blood sugars almost flawlessly. We have given 110% of the last year to learning how her body responds to this insulin and really don’t want to start all over with Humalog.
Are you familiar with using U-50-NovoLog in a pump? If so, are you aware of any problems that may have surfaced? Are potential risks associated with using an unstudied diluent/insulin mixture mild, moderate or dangerous? Worst case scenario: we can’t get U-50 NovoLog or we see problems arise, what next? Do we even have a choice?
Answer:
I have no experience with U-50 NovoLog but have managed many young children on insulin pumps with undiluted insulin. You may want to check with your daughter’s endocrinologist to see if diluting the insulin is absolutely necessary. Many pumps will do 0.05 unit/hour increments in basal rate, and it is also possible to set the pump to do “0” unit per hour basals if lower average basals are needed.
LAD
