Curious what others’ experiences have been with this. I have taken Humalog exclusively since I was diagnosed about 20 years ago (well, there was a short period of about a year right after diagnosis where I was on MDI so took long acting as well, but after that was switched to the pump and only humalog) and it seems like it takes an increasing amount to get the same results. It also doesn’t work nearly as fast as it is supposed to (sometimes more than an hour to start working even on a fresh site in a rarely used location). My endo and most people say that all rapid acting insulins are pretty much the same, and that one shouldn’t build up a tolerance/resistance to it, but I sure seem to have.
Now this said, I have only tried one other recently which was Apidra which seemed to be a bit better the first day maybe, but ended up with the common crystallization problem so the second day wasn’t so great and not a great example for comparison. Has anyone had this issue and tried Novolog, or the newer FIASP and had better results?
My bolus ratio is about 1u:2g or 1u:3g in the morning till about lunch, and 1u:3-4g the rest of the day. My correction ratio is about 1:20 in the morning and 1:25 after lunch, though I feel like it has actually decreased (increased?) and is probably more like 1:10-15 in the morning and 1:15-20 in the afternoon and night. My basals aren’t horribly high, most are around 1u/hr. I don’t know if those requirements are higher than usual or not, though they seem much higher than most people I have heard from elsewhere. I have heard of some people using u200 concentrations, but I don’t know how beneficial that would be in my case. I also question if higher concentrations would lead to more weight gain, though there seems to be some disagreement on whether insulin actually causes weight gain. I do have issues with site longevity, and many people say large boluses can contribute to that, so I’m not sure if the higher concentration would help or hurt with that. My endo seems to feel that I would have to be doing much larger boluses for that to be a problem.