April 8, 2007
Insulin Analogs, Insulin Pumps
Question from Hartford, Connecticut, USA:
Please discuss the duration time of Humalog. My six-year-old son has had diabetes for approximately four years and has been on a pump for two and a half years. I have always found the duration of Humalog for him, following a bolus, to be at least four hours, but have been told by my son’s APRN (Advanced Practice Registered Nurse) that the insulin from a bolus of Humalog is “all gone” in three hours. A review of previously asked questions on this site corresponds to this information.
In Pumping Insulin, 4th edition, Walsh and Roberts, the kinetic versus dynamic action of insulin is discussed, whereby the dynamic action of Humalog continues to lower blood sugar for five to six hours following a bolus. Should I make an adjustment to the DIA (Duration of Insulin Activity) setting on my son’s pump to account for the dynamic activity of insulin?
Answer:
This is a good question. There is a lot of debate as to what the best “duration of action” setting is for different children with Humalog and NovoLog. In our center, in very young children, we have used a duration of action of up to four hours, and as the children get older, we bring this down to two to three hours. For your son, I would use whatever you think works best. Doing some after meal testing can help you determine the optimal duration for the insulin.
LAD
