A rant on ... The Switch (Humalog to Novo)

Mental and Emotional Wellness
21

I switched from Novolog to Humalog a few years ago because of insurance and noticed zero difference. I find most of the stuff is mental, if you’re expecting a bad result your body will make sure that it conforms to what you’re expecting. rhat may not be the case for you but when there is stress your body becomes insulin resistant. [quote=“YogaO, post:1, topic:52333, full:true”]
I know it’s been awhile, but I have been focused on my upcoming cross-country pedaling adventure - see Two Traveling Trikes for more on that.

One of the monkey wrenches that has been thrown into my planning is my wonderful and awesome (NOT!) PBM, Caremark, decided to throw Humalog off their formulary, and mandated that I go to Novolog. Now I have nothing against Novo, I’ve just never used it and I have a really good feel for how Humalog works. In spite of having a pretty good backup supply of MY preferred normoglycemic elixir, I decided that I should try Novo out and figure out its quirks.

So can you believe this? My very first vial was bad! No matter what I did, pumping the new Novo resulted in a brief drop in the first hour (like from 180 to 130) and then the CGM breadcrumbs started climbing again. I reasoned my way into first trying a new infusion set @ 3 a.m. after several correction boluses. When I woke up @ 6:30, the CGM showed the same dip to 130 @ 4, then the inexorable rise to 220. Note that my correction bolus @ 3 was a full 50% higher and I set a TBR that was also 50% higher. Wow! At this point I was starting to wonder just how much Novo I was going to need compared to Huma. Then, I asked what I would do if I had the same results back on Huma … I would …

Change to a new vial!

**_

Boom!

_**

Back to something approaching normality.

I love diabetes!
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22

Thanks for your perspective.

I may have neglected to specifically note that I am now using Humalog/Novolog interchangeably. The first vial was bad, which I verified by using a new vial that produced “in-range” results for a full week. I then used a syringe with the bad insulin and bolused to cover a meal that I have had many times. My BG was in range before the meal. At 2 and 3 hours post-prandial, I was in the mid-200s, with the CGM still trending up. I gave a correction bolus from the pump and returned into range.

23

On that note, allow me to step in and report that I’ve been back and forth between the two numerous times and can’t detect any difference whatsoever.

24

I can generally switch between various rapid acting insulins without too much issue. A little bit of adjustment on timing or a slight adjustment on carb ratio. Nothing major like I’ve seen some people report.

Humalog, however, at least in the older pens, used to leave me with horrible bruises. I never figured out if it was the humalog itself, or something about their pens.

25

Just an update, Tresiba is working great and I am back to normal using Humalog. My I/C Ratio is now 19-26 Carbs per 1Unit of Humalog! I’m anxious to see my results on my next A1C

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26

I don’t know why but Novolog does not work for me.

27

Each person’s body chemistry is different. In my case, it’s Humalog that doesn’t work. So, don’t feel singled out.

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