Use of lispro insulin diluted with normal saline to 10 U/ml in an insulin pump: case report.

Corresponding Author: Beata Mianowska, M.D., Ph.D., Department of Pediatrics, Oncology, Hematology, and Diabetology, Medical University of Lodz, Sporna 36/50, 91-738 Lodz, Poland; email address [email protected] In very young children with type 1 diabetes mellitus (T1DM), insulin dose is often below 5–10 U/day, which necessitates infusion of volumes lower than 0.05–0.1 ml/day of 100 U/ml insulin. Some children require as little as 0.2–0.3 U of bolus insulin (0.002–0.003 ml of 100 U/ml) to cover 10 g of meal carbohydrates. These factors pose a challenge for precise and stable continuous subcutaneous insulin delivery as well as for occlusion alarm triggering in insulin pumps. As T1DM diagnosis is made at an increasingly younger age, the problem of low dose delivery may concern more and more patients.1 Lispro insulin diluted with a dedicated diluent has been used in neonates or young children on pump therapy.2–4 We present our first experience with 10 U/ml lispro diluted in normal saline used in an insulin pump.