Can you pump with REGULAR insulin?

[duck]

Like the title states, can you use REGULAR as opposed to Novolog or Humalog? What are the ramifications, you think? Obviously, R will act a bit slower, so I'm thinking basals will need to be adjusted, and boluses (boli?) will need to be planned a bit better.

Any input?

[JediSkipdogg]

I would say yes, but it would be extremely tough. Pumps have been out for 10+ years, so I would assume Regular was used in it at one point. However, anymore it would be hard to say what you would need to calculate for basal rates and what you have to do if you need to make changes.

[Tony]

Before Humalog and Novolog R was approved for pumps and probably someone out there is still using R in their pump. I would say your better off with Humalog or Novolog.

[am1977]

I agree :dito:. I have heard somewhere :dontknow: that it's possible to use Regular in the pump. However, I know I've also heard that a faster acting insulin is more effective and better in controlling blood sugar levels, so I'm not sure why someone might opt for Regular (unless it's a cost issue).

[camjen1]

Any input?


Yeah, I wouldn't want to go there!

[spike]

Like the title states, can you use REGULAR as opposed to Novolog or Humalog? What are the ramifications, you think? Obviously, R will act a bit slower, so I'm thinking basals will need to be adjusted, and boluses (boli?) will need to be planned a bit better.

Any input?

I started on Velosulin, which was quite similar to regular. Basals needed to be adjusted a couple hours before the desired effect would kick in. Boluses had to be taken well before eating to prevent high post prandials. It wasn't nearly as cool as with Humalog, but I still got better bg's from pumping then, than I did with MDI. The very DAY that Humalog was available in my area, I got my first few vials of it. Nice improvement! :)

[playgtar]

Can you use the Novalog insulin from a pen in a pump? Transfer it from the pen to the vile, and then fill your pump resivor?

[lelggren]

Can you use the Novalog insulin from a pen in a pump? Transfer it from the pen to the vile, and then fill your pump resivor?
Yes, you can :) One day, one of the educators that I work with, she had someone donate 4 boxes of humalog pen cartridges (I think like 5 cartridges/box) and she couldn't give them out to patients, and so she gave them to me. All was well because they weren't opened or anything like that. But, I don't use the pen. I use a pump. So, what I just did was I filled my reservoirs from those humalog cartridges. It worked really great! And, I didn't have to buy insulin for a while :)

[playgtar]

Yes, you can :) One day, one of the educators that I work with, she had someone donate 4 boxes of humalog pen cartridges (I think like 5 cartridges/box) and she couldn't give them out to patients, and so she gave them to me. All was well because they weren't opened or anything like that. But, I don't use the pen. I use a pump. So, what I just did was I filled my reservoirs from those humalog cartridges. It worked really great! And, I didn't have to buy insulin for a while :)

Ah.........yeah, that's what I did. I was just afraid I'd catch some flack for doing it. They told me it was the same. I just finished the sample pens they gave me and was on my first "perscription" pen when switched to a pump. I had 4.5 pens left. I didn't want to waste it. My co-pay wouldn't mind it either.

[duck]

Ah.........yeah, that's what I did. I was just afraid I'd catch some flack for doing it. They told me it was the same. I just finished the sample pens they gave me and was on my first "perscription" pen when switched to a pump. I had 4.5 pens left. I didn't want to waste it. My co-pay wouldn't mind it either.

I do the same...my pens are my back-up, and I'll fill almost-empty vials with them before I refill my pen prescription. I try and make sure the vial is not close to expiration, though, as I don't want to chance even a fraction of the insulin being expired...

[parrotletzoo]

I've used Regular in my pump before instead of Novolog and I kept my basal rates and insulin to carb ratios the same. The only differencie I really saw was that R takes longer to effect bs to correct (obviously) and is slower to respond when suspended for lows or during temp basals. etc. My control was not as fine tuned for the week or so I used regular in my pump but in an emergency it can be done. I order my insulin online, waited too long to order and managed to break my last vial of novolog so I purchased a bottle of R OTC. I use minimed paradigm 512 and under PRIME MENU you can change insulin types from humalog/novalog to Regular if need be.

[duck]

I've used Regular in my pump before instead of Novolog and I kept my basal rates and insulin to carb ratios the same. The only differencie I really saw was that R takes longer to effect bs to correct (obviously) and is slower to respond when suspended for lows or during temp basals. etc. My control was not as fine tuned for the week or so I used regular in my pump but in an emergency it can be done. I order my insulin online, waited too long to order and managed to break my last vial of novolog so I purchased a bottle of R OTC. I use minimed paradigm 512 and under PRIME MENU you can change insulin types from humalog/novalog to Regular if need be.

Well that's a cool feature for the 512!

I'm pondering switching to R and using Symlin. I don't want to bring up the topic of my "driving anxiety" drama, but I wonder if part of that is because of the much more agressive profile of the *log insulins. Also, since the pumpers on Symlin have to basically "tone-down" their fast-acting insulins, from what I can tell, they are making their pumps mimick the "R" profile when they started using Symlin...

Hmmmm...did any of that make any sense? :hmmmm2:

[spike]

Well that's a cool feature for the 512!

I'm pondering switching to R and using Symlin. I don't want to bring up the topic of my "driving anxiety" drama, but I wonder if part of that is because of the much more agressive profile of the *log insulins. Also, since the pumpers on Symlin have to basically "tone-down" their fast-acting insulins, from what I can tell, they are making their pumps mimick the "R" profile when they started using Symlin...

Hmmmm...did any of that make any sense? :hmmmm2:

If you have widely varying basal rates, you'll have to push them forward a couple of hours so that their effect with Regular will take place when you want it. IIRC, I used to lead by either 90 minutes or 2 hours when I used Velosulin. I'd hate to have to go back to that stuff!

My lowest rate is .4/hr. My highest rate is 1.1/hr. If I switched to Regular, I'd have to change the starting times of my basals to make up for the slow onset of Regular.

Why do I get the feeling you are taking a step backwards, to accomodate Symlin? :)

[duck]

If you have widely varying basal rates, you'll have to push them forward a couple of hours so that their effect with Regular will take place when you want it. IIRC, I used to lead by either 90 minutes or 2 hours when I used Velosulin. I'd hate to have to go back to that stuff!

My lowest rate is .4/hr. My highest rate is 1.1/hr. If I switched to Regular, I'd have to change the starting times of my basals to make up for the slow onset of Regular.

Why do I get the feeling you are taking a step backwards, to accomodate Symlin? :)

If anything, I'm taking a step backwards to accomodate this irrational $^%&* driving anxiety...Only when I am driving in a car do I feel like "it's coming to get me..." Since I can over-analyze ANYTHING, I have come to the conclusion that it only happens when I am low...or dropping in blood sugar (I could be 300 dropping 50 points an hour, and that will do it). And it's not as prevalent in the AM as it is in the PM, after I am more "awake". So it could also be caffeine-related, as I am known to consume a lot (which, BTW, is getting shut off PDQ).

It could be any number of things, and I could be completely off-base and grasping at the wrong straws. But in reading Bernstein's book, I am also wondering if I need to cut back on my overall insulin uptake as well, so Symlin may be a step in that direction, and it may work well for me if I decide to take a shot (no pun) with R in the pump.

[duck]

Oh, I vary from .8 to 1.1 in my basals, so not too much crazy variance.

[spike]

If anything, I'm taking a step backwards to accomodate this irrational $^%&* driving anxiety...Only when I am driving in a car do I feel like "it's coming to get me..." Since I can over-analyze ANYTHING, I have come to the conclusion that it only happens when I am low...or dropping in blood sugar (I could be 300 dropping 50 points an hour, and that will do it). And it's not as prevalent in the AM as it is in the PM, after I am more "awake". So it could also be caffeine-related, as I am known to consume a lot (which, BTW, is getting shut off PDQ).

It could be any number of things, and I could be completely off-base and grasping at the wrong straws. But in reading Bernstein's book, I am also wondering if I need to cut back on my overall insulin uptake as well, so Symlin may be a step in that direction, and it may work well for me if I decide to take a shot (no pun) with R in the pump.

I apologize in advance for asking this--what's happening when you are driving? Are you getting a lot of lows, OR, are you anxious about being low, without BEING low? I used to freak out when I was MDI, because I had so many killer lows I was afraid I'd not wake up some morning. The paramedics used to warn me that they'd seen diabetics have heart attacks from the adrenilin rush from severe hypos. I'd sometimes drop 100 points in 5 minutes flat. seems impossible, but it's oh, so true! Thank God for my pump! No more paramedic visits.

I guess all of us know that if we low carb we can reduce insulin usage to the point where we can more easily maintain a "steady state" bg. But it's hard to pass up "real" food! :)

[duck]

I apologize in advance for asking this--what's happening when you are driving? Are you getting a lot of lows, OR, are you anxious about being low, without BEING low? I used to freak out when I was MDI, because I had so many killer lows I was afraid I'd not wake up some morning. The paramedics used to warn me that they'd seen diabetics have heart attacks from the adrenilin rush from severe hypos. I'd sometimes drop 100 points in 5 minutes flat. seems impossible, but it's oh, so true! Thank God for my pump! No more paramedic visits.

I guess all of us know that if we low carb we can reduce insulin usage to the point where we can more easily maintain a "steady state" bg. But it's hard to pass up "real" food! :)

I've been getting weirded-out driving...

http://www.diabetesforums.com/chit-chat/7554-driving-anxiety.html

In my ongoing, never-ending analysis, it started *right* before my son was born...Which would have been about when I literally stopped working out (a momentous event in my life, I used to be RELIGIOUS about it)...Also, about two years into Humalog. The first time I ever had this sensation was when I owned the itty-bitty blue MGB, and I was on I-81 passing a semi...All was well and then right when I was getting past it, I get this discombobulated, disconnected feeling like my head was coming loose or something. I pulled over, a little freaked out, and checked...my sugars were 164 (I remember the reading), down slightly from an hour earlier. I had just started Humalog.

Anyway, it got reeal bad when I made that post, but that was easily one of the worst few days I had had in the last couple years. So as far as "anxiety" goes, I had a lot to deal with...but this **** is ruining me. I LOVE to drive. LOVE IT. There's a part of me that is starting to ask "why me? Why this?" My wife would not believe me when I told her about it, she looked at me like I had just said "I've been dating Roseann Barr.." She said something to the effect of "You've done things driving a car I didn't think could be done outside of NASCAR..."

I see others here complaining about anxiety, and it seems to be tied into going low, or getting lower. And I am just wondering if the *log insulins are contributing to my issues...

[spike]

I've been getting weirded-out driving...

http://www.diabetesforums.com/chit-chat/7554-driving-anxiety.html

In my ongoing, never-ending analysis, it started *right* before my son was born...Which would have been about when I literally stopped working out (a momentous event in my life, I used to be RELIGIOUS about it)...Also, about two years into Humalog. The first time I ever had this sensation was when I owned the itty-bitty blue MGB, and I was on I-81 passing a semi...All was well and then right when I was getting past it, I get this discombobulated, disconnected feeling like my head was coming loose or something. I pulled over, a little freaked out, and checked...my sugars were 164 (I remember the reading), down slightly from an hour earlier. I had just started Humalog.

Anyway, it got reeal bad when I made that post, but that was easily one of the worst few days I had had in the last couple years. So as far as "anxiety" goes, I had a lot to deal with...but this **** is ruining me. I LOVE to drive. LOVE IT. There's a part of me that is starting to ask "why me? Why this?" My wife would not believe me when I told her about it, she looked at me like I had just said "I've been dating Roseann Barr.." She said something to the effect of "You've done things driving a car I didn't think could be done outside of NASCAR..."

I see others here complaining about anxiety, and it seems to be tied into going low, or getting lower. And I am just wondering if the *log insulins are contributing to my issues...

I read the post you provided the link for. Sounds somewhat similar to the panic attacks I had that began about a year or so before my diagnosis in '78. I have no idea what started them, but I can tell you the feeling of helplessness and impending death was overwhelming. Each attack, I was SURE, absolutely POSITIVE, I was going to die. Those attacks persisted for many years. I went to the ER a few times and one of those times the doc presribed Valium. I tried taking it, but I don't do well on drugs (don't like how they intefere with my feelings and thinking). I would break a pill in half and that's as much as I'd take in one day. Valium was hardly the correct drug for whatever ailed me, and eventually I just stopped taking it. I never took it regularly, anyhow...

At some point, I decided that I'd take up flying, and from the day of my first flight, my panic attacks stopped! And that's after more than 10 years of problems with anxiety. I've no idea what started them in my late 20's and no idea to this day why flying caused them to stop. Because I'll never forget the indescribeable feelings I experienced, l give my assurance that I DO know roughly how you must have felt. No one who hasn't experienced a full blown panic attack can fathom the sheer terror one experiences. The fear is off the charts. I hope that you find the solution, be it meds or whatever. I have NO CLUE how one goes about resolving panic attacks. My story about flying curing my attacks seems to me as bizarre as the panic episodes themselves were. Inexplicable.

[duck]

Thanks man, at least I have some hope it will go away.

[condensr]

If you have widely varying basal rates, you'll have to push them forward a couple of hours so that their effect with Regular will take place when you want it. IIRC, I used to lead by either 90 minutes or 2 hours when I used Velosulin. I'd hate to have to go back to that stuff!

My lowest rate is .4/hr. My highest rate is 1.1/hr. If I switched to Regular, I'd have to change the starting times of my basals to make up for the slow onset of Regular.

Why do I get the feeling you are taking a step backwards, to accomodate Symlin? :)

Spike, do you not use any lead time for your basals on your pump now? I was instructed to give basal changes a 1-2 hr lead time in my pump, as Novolog actually peaks 2hrs after administration. Seems to work for me..

[spike]

Thanks man, at least I have some hope it will go away.


:) That was kinda the point I was making. Even if it lasts for a few years, that doesn't mean (even though it SEEMS) that the anxiety attacks won't stop. Like I said before, I don't know what started it, and I'm even more perplexed as to why such a terrible affliction went away. I know it was the flying, but I don't know what about the flying that created a permanent fix. And I'm not trying to imply that all anyone needs to do is find a hobby! :) I'm just offering my experience as an example of "truth is stranger than fiction". I had expected that I needed to have my head examined, because I knew the panic was self induced. I've lived it, yet I have no inkling of why I was panicking.

Have you read any books on the subject? I don't recall if I bought or borrowed anything on panic disorder. That was before the internet, so any info I would have gotten would have been from books.

[spike]

Spike, do you not use any lead time for your basals on your pump now? I was instructed to give basal changes a 1-2 hr lead time in my pump, as Novolog actually peaks 2hrs after administration. Seems to work for me..

Well, since I pretty much perfected my 10 rates per day years ago, I can't tell you precisely what lead time I'm using. My day rate is less than half my 2:30 to 4:30 rate of 1.1 Because it works pretty well, I expect that whatever rate is running each hour, effects my bg for the next hour. I don't think (but I might be wrong) that I need a 2 hour lead time.

If you have a Pumping Insulin book by Walsh, please let me know what it says (only if it's current enough to cover Humalog). My Walsh book is from 1995, so it's obsolete for that type of info. It's good for things that don't distinguish between R and Humalog.

Sorry I can't be more definitive. You surely asked an excellent question, and rather than trying to blow smoke (I try always to be totally honest), I prefer to find out what the current philosophy is on basal lead time. so let me know. Thanks!

[~MADSCOTSMAN~]

I am currently on a MM Paradigm 511 and have been for around 4 years (Warranty up in 7 months, and eagerly awaiting upgrade). Until the last 6 months or so I was using Humalog insulin. I was having to refill my insulin resorvoir every 20 hours because of the high amount of insulin I was taking (resistance, body mass,...etc). After complaining to my new Diabetes Educator here at my new job at a local hospital, she recommended I change to a new type of insulin called Humilin R 500. This is a very concentrated regular insulin that is 5x more powerful than normal Regular insulin. It has been great so far and I am noticing that I am needing less and less insulin. With the Humalog, I used to have my nightime basal rates set to give me twice the rate of insulin much as my regular daytime basal rate just to be at a decent number in the AM. Now I have had to reduce my nightime basal rate to less than half of my daytime rate. I also now give smaller boluses and basal rates because of the higher concentration of the insulin (Go through less batteries, refill resorvoir every 3-4 days, boluses dont take 10 minutes to enfuse=less wear on the pumps mechanics). I still have the anxiety and difficulty with trying to give my blous 30 minutes before eating without knowing exactly when I will eat, or what if I dont get to eat on time, or wht will I eat. This also has saved my insurance company alot of money as I would normally get 6 bottles of humalog at a time with one refill at $65-70 a piece, now the Humilin R 500 is around $250 for one bottle which lasts me a month an a half.

[am1977]

I am currently on a MM Paradigm 511 and have been for around 4 years (Warranty up in 7 months, and eagerly awaiting upgrade). Until the last 6 months or so I was using Humalog insulin. I was having to refill my insulin resorvoir every 20 hours because of the high amount of insulin I was taking (resistance, body mass,...etc). After complaining to my new Diabetes Educator here at my new job at a local hospital, she recommended I change to a new type of insulin called Humilin R 500. This is a very concentrated regular insulin that is 5x more powerful than normal Regular insulin. It has been great so far and I am noticing that I am needing less and less insulin. With the Humalog, I used to have my nightime basal rates set to give me twice the rate of insulin much as my regular daytime basal rate just to be at a decent number in the AM. Now I have had to reduce my nightime basal rate to less than half of my daytime rate. I also now give smaller boluses and basal rates because of the higher concentration of the insulin (Go through less batteries, refill resorvoir every 3-4 days, boluses dont take 10 minutes to enfuse=less wear on the pumps mechanics). I still have the anxiety and difficulty with trying to give my blous 30 minutes before eating without knowing exactly when I will eat, or what if I dont get to eat on time, or wht will I eat. This also has saved my insurance company alot of money as I would normally get 6 bottles of humalog at a time with one refill at $65-70 a piece, now the Humilin R 500 is around $250 for one bottle which lasts me a month an a half.


Is this an option for most people? :questionm I think you are the first I've heard mention it and it seems to be working for you quite well... Hmmm, maybe this is an option more should look into :idea:.

[Funnygrl]

If my doctor doesn't prescribe me novolog or humalog soon, I may very well be pumping with R.

[spike]

If my doctor doesn't prescribe me novolog or humalog soon, I may very well be pumping with R.

How long have you been waiting for an Rx? If my doc takes more than 2 days for an Rx, I'm on the phone and they take care of it that day.

[Funnygrl]

They want me to use R on shots, novolog on pump. I have gastroparesis, so R matches up stomach emptying, while on pump, I will take care of that with the extended boluses.

[seacomp]

she recommended I change to a new type of insulin called Humilin R 500. This is a very concentrated regular insulin that is 5x more powerful than normal Regular insulin.
Hi and welcome to the Forum. And don't be mad ;), for you're a man for 'a that.
I heard about U500 some time ago so it's not really new. It's meant for cases like yours and also it is used in medical experiments. Generally it is not prescribed before the stuff is dangerous!
If it work for you Great!
We're glad to have you on the forum and ask, comment, or rant:puke: , if you wish at any time.