Metabolic decompensation in pump users due to lispro insulin precipitation

Small, short term studies show that lispro insulin (Humalog; Eli Lilly & Co, Indianapolis, IN), commonly used in pump therapy, is stable in insulin pumps.1 However, in agreement with reports by others,2 we have noted several patients who have developed erratic and unpredictable glucose fluctuations with lispro insulin that have resolved when the treatment was changed to buffered regular insulin (Velosulin; Novo Nordisk, Princeton, NJ) and aspart insulin (Novolog; Novo Nordisk, Princeton, NJ). We have …