When our four and a half year old son started pumping about six months ago, we chose to use NovoLog when we started, but his diabetes team requested that we change sites every two days even if they are fine due to potential long term tissue damage. With the new studies, is this as important? Should we not worry too much when we go three days? Typically we get a low reservoir if we go three days anyway, but we still aim for every two days to comply with the team’s request.

You should discuss this with your son’s diabetes team and figure out what works best. Catheter size irritation is very individualized. Some kids and adults do fine with changing every three days, and some need changes more frequently. Most people do not have problems using Humalog since it is a buffered insulin product, just a different one chemically than Novolog. If you are having no problems with catheter occlusions, alarms or losing glucose control towards the end of your catheter runs, then I’m not sure I would recommend changing anything that you are doing at the moment.

SB
Additional comments from Dr. Larry Deeb:

I have some wonderful pumpers who really pay attention and help me decide on advice. If you are really well managed and look at the blood sugars, you will see a rise on the third day in glucoses when the sites start to go bad. Many patients have demonstrated this to my satisfaction. It seems to me silly to go to all the trouble of using the insulin pump and have impaired control a third of the time.

LD