My wife as been type II diabetic for some 15 years. About a year or so ago the pills just did not cut it at controlling her sugars, and she was put on a combination of Lantus and Apidra. It took a while, but we finally got things down pat and well under control.
Now it appears that there has been some sort of manufacturing problem with Apidra! We have not been able to get the pre-loaded pens for a while, so switched to a pen with cartridges. Now we are being told that it could be APRIL 2012 before we will be able to get any more.
We have enough Apidra to last a few weeks at best, and my wife is in a tail-spin. She bristles at the thought of having to switch away from Apidra. The questions are:
1) What are the alternatives? and
2) What is the BEST alternative in your collective experience???
Please note that my wife will not use a vial and a standard syringe. We need an alternative with wither a preloaded pen, or a cartridge.
Apidra is a fast acting analog and there are two alternatives . . . here in the states they are Humalog (kiwkpen) and Novolog (flexpen), both available in preloaded disposable pens. I've found no noticable difference between these two alternatives, however compared to Apidra they are a bit slower and hang around longer as compared to Apidra. There would be another alternative which is the old "R" insulins however they can appreciably slower, last longer and not as predictable as the newer analogs, however last I read they're no longer available in pens.
I don't know which is the best but I use Novalog. It might be called something different in Canada, Novarapid maybe. I've heard that Apida is a little bit quicker acting and peaks sooner. Whatever the difference she should be able to adapt easily. I have read that some people really don't notice the difference. Good luck with whatever she tries.
I, too, am having problems with the shortage of Apidra (had to get a vial rather than the pen cartridges), and I got some Humalog as backup because I also need something in a pen form in case I have pump problems. I was told February 2012 was when they were expecting to be able to get the Apidra pens.
There is a traditional insulin as noted by Kiva called Regular (R) where the insulin is bioidentical to human insulin, but the action is not very rapid. I had started with R when I started on insulin a year ago, but changed quickly to Humalog and it has worked fine.
These modern analog rapid insulins have similar action, but many people consider that Apridra has the quickest onset, tightest peak and shortest duration of action. For many this matches meals well, not so much for me, I follow a low carb diet and my meals tend to be better matched with a longer duration of action. One comparison finds that both Novorapid and Humalog have an overall longer duration of action. John Walsh (author of "Using Insulin") compares Novorapid and Humalog and he beleives that while Novorapid has a faster onset. Walsh also notes that Humalog is a bit more sensitive to heat.
And of course, both Novorapid and Humalog come in pre-filled pens. So the choice is yours, they are both basically perfectly adequate. And while your wife might be apprehensive over the change, I suspect that after she makes the switch and adjusts she will find that both Novorapid and Humalog are just as effective.
I use Apidra pens as well. I tried to re order yesterday and had no luck. Went to the Apidra website and found out that the plant in Germany that makes the pens is down. No more pens until?? sometime next spring probably. It is available in vials. No issues with the insulin, just the device. I have not used the syringe, but guess I'll be learning. I am having good results with Lantus and Apidra and I really don't want to change insulin just for the pen.
