So my certified diabetes educator gave me a sample pen of apidra. I have been using novolog, and she says they are the same. Fast acting, to be taken with meals. I am nervous to take a different insulin without understanding the difference. I take lantus as my long acting insulin.
My CDE seems to think that carrying my novolog around, unrefridgerated is not a good idea, but the website says it is fine for 28 days. Why would the pen be any different than a vial, as far as "shelf life". Any input would be greatly appreciated.
Apidra and Novolog (and Humalog) are all rapid acting insulins. Apidra (according to the pamphlet, if I remember it all correctly) has a slightly faster onset than Novolog (so it’s supposed to kick in a few minutes faster). That’s really the only difference between them.
As far as the pen’s shelf life, it is the same. I think the idea your CDE is getting at is that you’ll go through the pens faster than a vial, so they aren’t out as long. If you like pens, stick with pens. If you like your vial, stick with the vial. Don’t let the CDE boss you around.
I didnt realize the pen was only 3mL and the vial is 10mL. My CDE thinks that the vial cannot be left out, but the pen can? I have never refrigerated any of my insulin vials, I carry them with me for 28 days, both novolog and lantus. I live in the Bay Area, Ca. No extreme temperatures here.
My issue is my insurance wont cover pens. My CDE says my doc can write a prescription, saying the pen is medically necessary, but my doc says she will only do that if I have a vision problem or manual dexterity issues.
I find it strange that the CDE gave me a different type of insulin, yes both meal time, but not identical in action. And I don't have a prescription for the pen needles. I guess the rep gave her samples and she is handing them out? Why is a pen any better? easier, less waste?
You can leave pens and vials out, both for 28 days in moderate temperatures like you're doing. It's in the pamphlets and on the websites. So you are correct and fine.
CDEs and docs tend to get lots of samples and hand them out for people to try. The office might have something going on with the makers of Apidra so they get samples from them.
You can use Apidra like you would Novolog. I actually just switched a few months ago and haven't noticed any difference between them (other than the itching; Novolog made me itch).
Pens are just a different tool. It is easier for dexterity and vision, but that's about it. A pen is no better (or worse) than using a vial and syringe. It's just a preference that some people have.
I've used both Novolog and Apidra and for me their respective onset, peak, and duration did not vary enough for me to even notice.
If I was on MDI, pens would be more convenient than drawing every dose out of the vial. It's easier and more convenient to dial up the pen dose and simply inject. You're right, you can keep both the pens and vials unrefrigerated for 28 days. If you use less than 35 units per day then you will waste some insulin in the vial. The pen and the vial both have the same shelf life.
A Frio cooling pouch will keep your immediate insulin source, pen or vial, at a lower than room temperature.
I had an allergic reaction to Novolog when using a pump. That caused me to switch to Apidra.
I like pens, they are more convenient, especially when I travel. If I have to carry around supplies for 5 days, I need a big bag of syringes. Also, both vials and pens of Novolog (like most insulins) expire in 28 days once opened. Unless you use a lot of insulin, that means that a vial will be thrown out long before being used up. As a T2, I use about 15-25 units/day for meals and corrections, a vial (which holds 1000 units) will last me 1.5 to 2 months but has to be thrown out at 28 days. If you only use 5 units/day, a vial will last for 200 days and will need to be thrown out mostly full. A pen on the other hand contains 300 units, lasts 2-3 weeks in my case and I never waste insulin. And cost can be a factor. Under my insurance, a vial of Novolog is $150, a pen is $50. It actually costs less to use a pen because I end up throwing out less. And this argument may be the key selling point in getting insurance coverage for a pen.
In the case of syringes and pen needles, these are not prescription controlled items. However to get insurance coverage you need to have your doctor prescribe them. In some cases you may be able to get them cheaper by just buying them at Walmart. Relion pen needles are $9/50 at Walmart, syringes are $12.58/100.
Everyone's physiology responds in an individual way, so it just depends on the individual. For me, Novolog and Apidra are about equally effective, but Apidra starts sooner, peaks faster, and has a shorter tail. But that's just me. Others get different results. The only way to know how it will work for you is to try it and test thoroughly.