Porcine / Animal Insulin in Pumps

-Artemis-

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Hello....

As I think a few of you know, I'm on porcine insulin, I switched to it because I *really* didn't get on with the analogue insulins.... and once I'd switched I got on much better.

I'm now about to start on an insulin pump, and so as not to complicate things, I agreed to using Novorapid -- I know people do use animal insulin in pumps but I really didn't want to give them the teeniest reason to turn down an insulin pump.

Now as I'm approaching my start date (this tuesday am - so less than two days to go!) I'm getting a bit apprehensive about the novo... I know if I wanted to use animal insulin I could (I can get it on prescription because I've used it already) but it would mean entirely figuring things out myself -- which is exactly what I did when I switched my injections to porcine too - but the pump makes me a little mor nervous about doing that.

I have been using entirely novo as my fast acting for meals the last few days, to help with the switch over, and I've already had hypos I've not felt and only picked up on through testing. I also feel super bloated and achy -- but this could be "girls stuff" -- but it's worrying....

So; I have some questions/concerns and wondered if anyone who's used animal and either stayed with it for their cross over to a pump, or switched to newer insulins, could share their experiences please...

- I *suspect* that it was the long acting that caused me the biggest problems before -- and the pump obviously only uses short acting -- does anyone else feel they do OK on just the short acting where they didn't on long acting analogues?

- I'm worried that the porcine neutral (the one I would use solely in a pump) has a definite 'tail' (kick) at 5 hrs for me.... on MDI it's not a problem at breakfast cos I always wake high, but presumably would be once I'm on a pump as I hopefully won't have the problem of being high... at lunch I often skipped injecting as I walk 4 miles straight after, and at dinner I used to watch it/test, in case I needed a snack at about 4.5hrs into it's duration.... but my brain can't figure out how you would overcome this if you were having tiny doses of insulin all day?

- I'm also worried that my whole life felt "controlled" by insulin injections and timings; the long duration nature of the porcine was brilliant for helping reduce anxiety around hypos, but it did feel very very rigid -- no snacks, no unplanned exercise etc etc... part of the huge appeal of the pump is getting those aspects of my life back, but if I were to use porcine I still wouldn't be able to have snacks or do unplanned exercise would I....? I don't often need / want to do these things when it's just me, day in day out, but those aspects crippled my relationships with friends, family, my boyfriend....

- but the flip side of that is that the weight gain and moodiness and aches -- not to mention lack of hypo awareness....


Those are my early thoughts -- you can see I'm a bit unsure of things and would muchly appreciate any advice / thoughts from peeps; particularly who have either switched from animal to new insulins to go on the pump and been fine (or indeed not!), or those who use animal insulins on the pump; and how/if they manage things like the 5hr "tail", snacking, unplanned exercise etc....

Thank you! :)
 

CarbsRok

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@-Artemis- yes I use animal insulin in my pump and all I do is set the basals 2 hours before needed to come into operation. IE, low at 4 AM then adjust pump at 2 AM. Yes there is a bit of a kick in it at 5 hours so just make sure you factor that in. If you can't sort the basal out for a particular patch and dropping low then perhaps consider adjusting a bit sooner or have a few carbs.
Snacking I don't do as feel no need to do so. But if you want to snack then make sure it's carb free or you bolus and wait the 30 mins before you eat.
As you are used to dealing with animal insulin you shouldn't have a problem.
 
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-Artemis-

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@-Artemis- yes I use animal insulin... Yes there is a bit of a kick in it at 5 hours so just make sure you factor that in. If you can't sort the basal out for a particular patch and dropping low then perhaps consider adjusting a bit sooner or have a few carbs.

Thanks CarbsRok... Again, apologies if being slow, but if the pump is continuously dripping in tiny amounts then how do you 'catch' the 5hr kick and factor it in...? That's the biggest bit I can't get my head around... :-/

-- also, as a possible irrelevant aside / just being nosy -- am I right in thinking you use bovine? Any reason you use that over porcine...?

Thanks again :)
 

CarbsRok

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So the 5 hour kick doesn't affect you set your basal pattern to take this into account. You can set your pump up to deliver insulin at any rate and by the hour.

I use bovine because I'm allergic to pork insulin :)
 

azure

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Hi @-Artemis- ,

I use porcine in my pump and I felt a lot better as soon as I changed over. I used to use Humalog in my pump andit made me feel like cr*p as time went on. I then swapped to porcine and felt better in approx a week. So, for me, the fast acting Humalog caused the problem. I've never taken a long acting analogue.

Yes, I have snacks. I bolus for them or have the snack before exercise or shopping or something so I don't need a bolus. I have no problem with insulin stacking. I test regularly so am always watching my BS. I don't always bolus the full half hour before my snack. It depend on my BS and what I'm doing.

I also take unplanned exercise. I wish I was more organised and could plan my day, but I'm really busy so can't always. If it's planned, I reduce my basal 1 to 2 hours before, if not I reduce it as soon as I can. I sometimes also have a snack or some glucose to cover me.

I don't find the porcine any less flexible in my pump. The only bad thing about it us having to bolus in advance of meals.

I have better hypo signals on porcine and my hypos aren't as fierce. I much prefer this.

The 5 hr kick is only something that bothers me in the evening. Eg if I need to do a corrective dose, I'm wary of the porcine kicking in during the night so I don't increase the basal rate, I bolus with porcine, or if I'm really nervous, I will use a one-off Humalog correction.

I can't imagine using an analogue in a pump again. I do feel a lot more myself and a lot more energetic and healthy on the porcine.
 
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noblehead

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How far ahead do you bolus @azure when using porcine insulin, seem to remember when I last used this it was 30-45 mins before eating.
 

azure

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@noblehead Usually 30 mins before eating, but for breakfast when I often spike afterwards, I do it at least 45 mins in advance.

If I have to, I can vary this though, eg if I'm eating out, I err on the side of caution and do it closer to eating time. I find it's basically like when I first got diabetes and was using MDI and Actrapid for boluses - try to bolus 30 mins ahead, but if an unusual situation, you can do it closer to the meal.

I had never used animal insulins until I changed to porcine in my pump.
 
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-Artemis-

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Thank you so much @azure for taking the time to write this and address all my concerns :)

-- it's good to know you still snack... That's one of the things I found really hard with MDI on porcine -- with friends etc if someone impromptu-sly (is that a word?!) pulls out something and everyone's tucking in, it's hard to say 'hang on everyone, I just need to test my blood sugars, go inject, wait half an hour -- and then I can join you' -- by then whatever impromptu snacking is long gone...! ;-)

... I guess in that situation the pump allows me to not need to excuse myself to inject, and I guess I'd just have to deal with being higher than I'd like for the half hr or so it takes the porcine to kick in? It's not like the scenario I'm describing happens that often...

@noblehead I'm exactly as azure described on MDI; I need to bolus thirty mins before lunch and dinner and 45 before breakfast... But I never want to eat as soon as I wake so I just bolus as the first thing I do, then do other stuff... Then eat... And for lunch and dinner I'm almost always making my food -- so I just figure out what I'm eating and bolus for that, then make it... The timing usually works out that way :)

-- one other question @azure - I've been using just novo this week and whilst there's a lot I don't like about it, I do like that I can decide what I'm having for dinner, bolus for it... Then if a couple of hrs later I decide I fancy some chocolate, I can do another bolus for the choccie... I don't worry about the effects of stacking doing that because the duration is short in novo, and had no tail... But with porcine would you do this...? I'm talking more about evening meals and when you get a craving for something a while after your dinner... ;-)
 
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-Artemis-

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... Hmm... Not sure what to do now!

Whether to start for a month with novo and see how it feels, or whether that's just creating double the effort for me cos I'll just start to get settled with novo, then have to readjust everything as all my doses are different with porcine...

Plus if I give Novo a month, I fear it will take longer to get back out my system if it does make me feel cr*p...

But, I will be learning a new pump entirely on my own if I use porcine, and possibly not fully utilizing all its features I may be able to with Novo....

What to do?! :-/
 

novorapidboi26

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decisions decisions...........

i suppose giving novo a shot may be worth it just to avoid hassle.........

and then move on to porcine when you have familiarized yourself with the pump operation etc......

good luck.......
 

noblehead

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... Hmm... Not sure what to do now!

Whether to start for a month with novo and see how it feels, or whether that's just creating double the effort for me cos I'll just start to get settled with novo, then have to readjust everything as all my doses are different with porcine...

Plus if I give Novo a month, I fear it will take longer to get back out my system if it does make me feel cr*p...

But, I will be learning a new pump entirely on my own if I use porcine, and possibly not fully utilizing all its features I may be able to with Novo....

What to do?! :-/


Its your call @-Artemis-, why not ask if you can stay on the porcine insulin when you go back to the clinic, just explain that you felt lousy before on Novo and don't wish to go through it all again.
 
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-Artemis-

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I think that's what I'm going to do, thanks @noblehead... I'm more nervous about the switch to just novo than I am about my pump start up! Which is tomorrow!! Squeeee...!!
 

CarbsRok

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But, I will be learning a new pump entirely on my own if I use porcine, and possibly not fully utilizing all its features I may be able to with Novo....
You can use all the features on the pump whilst using animal insulin. :)
 
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azure

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....

-- one other question @azure - I've been using just novo this week and whilst there's a lot I don't like about it, I do like that I can decide what I'm having for dinner, bolus for it... Then if a couple of hrs later I decide I fancy some chocolate, I can do another bolus for the choccie... I don't worry about the effects of stacking doing that because the duration is short in novo, and had no tail... But with porcine would you do this...? I'm talking more about evening meals and when you get a craving for something a while after your dinner... ;-)

I'm always more wary in the evening whatever insulin I've been on, especially late evening. Analogues can stil cause crashing hypos if you snack. So i try not to snack after say, 9pm ( I usually go to bed around 11pm). Ideally it'd be closer to 8pm. I then test after and just before bed. I also make sure I've bolused correctly and, if unsure,I have slightly less than I think I need. If I've had a major and/or late snack ( eg if someone got takeaway or chips or similar), I'd set an alarm to get up and test in the night. I used to do this for the Humalog too. I'd rather be safe and certain, and I don't like nocturnal hypos.

Often, if I'm only having a small amount of chocolate, I find I can eat it without a bolus and without going too high, or I'll run up and down stairs or something a bit.

Obviously, everyone's different and we all have to watch our BS, but I don't find the snacking any different with porcine in the pump than with Humalog. And I do love my snacks so I have lots!

Hope that helps!
 
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tigger

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Hi

I've just started a pump with porcine neutral today. I don't know if I can answer most of your questions as the pump is all rather new to me. Only thing you may want to consider is that pumps are not "licensed" to take porcine insulin which means that you will need a consultant to sign off they're happy for you to use it in a pump. Mine was happy to do so because I was adamant I wasn't switching insulins and they were keen to get me a pump. I also got a good article from IDDT on using animal insulin in pumps. It might cause you a delay though so bear it in mind. I've had a number of snacks today which has been quite fun and my sugars seemed to do well until the tail caught me and I couldn't work out how to adjust the basal rate. Oh well, it's a learning experience....

Good luck with whatever you decide.
 
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-Artemis-

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Good luck to you too!! Yes, I have a feeling that getting basals right on porcine may have an extra challenge cos of its duration and its tail... Hopefully we can all figure it out between us :)

.. When you're feeling a little better I'd love it if you were able to send me the article you mentioned... Don't worry if you can't though... And more luck to you!
 

CarbsRok

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Hi

I've just started a pump with porcine neutral today. I don't know if I can answer most of your questions as the pump is all rather new to me. Only thing you may want to consider is that pumps are not "licensed" to take porcine insulin which means that you will need a consultant to sign off they're happy for you to use it in a pump. Mine was happy to do so because I was adamant I wasn't switching insulins and they were keen to get me a pump. I also got a good article from IDDT on using animal insulin in pumps. It might cause you a delay though so bear it in mind. I've had a number of snacks today which has been quite fun and my sugars seemed to do well until the tail caught me and I couldn't work out how to adjust the basal rate. Oh well, it's a learning experience....

Good luck with whatever you decide.
I find that odd that animal insulin isn't licensed for pump use. Pumps were in use long before synthetic insulin's were manufactured.
The only insulin that is not supposed to be used in pumps is actrapide sp* and it says so on the tin.
 
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