Ad hoc

Skin reactions, too, was a concern in the beginning. We had read, that it could be a good idea to apply some kind of coating to the skin before inserting the needle, in order to protect the skin from the adhesive and to improve the adhesion. In our case, we used the product Skin-Prep – and unfortunately, it did no good. The adhesion of the needle was not as good as without Skin-Prep, and Emilie’s skin did not like the substance. So we stopped using it.

However, Emilie’s skin did not like the white adhesive of the needle itself, either. After some time her skin showed heavy reactions to the adhesive – irritation that almost resembled light burns. Again, we had to feel our way and today we do as follows:

At first, we cleanse the injection site with a 0,05% chlorhexidine solution. Then, we apply a tiny spot of 1% chlorhexidine lotion at the spot, where we will insert the needle. Then we apply a 6×7 cm IV3000 dressing through which we will insert the needle. This approach works very well on Emilie’s skin. But the point, again, is: One have to feel one’s way and be prepared to run into trouble.

So we did when it came to insulin. We started out with Novo Rapid (the rapid analog insulin from Novo Nordisk - I belive in the USA it is sold under the name Novolog) because we were familiar with that type of insulin. After a while, however, we talked to our endocrinologist about using Lily’s Humalog instead. As we use the Disetronic D-Tron pump (now Roche Accu-Chek D-Tron) we would like to change simply for practical reasons: The D-Tron uses standard pen fill cartridges (well, standard Lilly cartridges, that is …) and it is much easier to pull out a standard cartridge from the fridge and load it into the pump than to actually refill twice. Which is what you have to do when you want to use anything else than Humalog in a D-Tron: First, you have to draw the insulin into a plastic syringe, then inject it into the proprietary glass cartridge, which is sold empty via the pump distributor.

However, we had to go back to Novo Rapid and the double refill procedure. And why was that so? Well, some might suspect patriotic reasons for the change, but no … We made the clear experience with Humalog that sometimes, after a few days – perhaps in a combination with warm weather – it could loose much of its potency. Not always, but sometimes. Moreover, we became aware of an ongoing debate about the reliability of Humalog used in insulin pumps – and then we made the change. We do not have any ’smoking gun’ indicating, that Humalog is bad in insulin pumps, but in our case our experiences pointed in that direction.

Moreover, Humalog is no longer available in Denmark as pen fills so either way we have to fill the pump cartridge manually.

This is the thirteenth post in a series - read the first post here.

Read the next post.