I used Novolog for several years. I starting developing a red bump at the infusion sites, especially if I let the site last into the third day. The swelling and redness would take several days to recede.
I switched to Apidra and the site irritation went away.
Re tail - some days, Apidra has a surprisingly long tail for me. Up to 5 hours sometimes.
I do still have some spare Novoslow pens and if I’m eating something that needs a super long tail, I will stick some in at the same time as the Apidra. But I can do that easily enough on MDI.
Hi Scott. You said you might get a sample of Humalog. My experience with it was not good on the pump. Humalog formed a cream-colored blockage in the tubing as it enters the reservoir so I was lucky to get 24 hours with an infusion. I use up to 25 units daily, so maybe the relatively small amount of daily insulin contributed to the problem, but nothing like that happens with Novolog or Apidra.
I really like my Apidra, and am willing to just work around the temperature problem to use it; you just can’t beat it for speedy corrections and taking care of those nasty spikes. I have slow digestion, which can lead to dinner time problems. The pump takes care of that with the dual options, but with MDI, I pair up the Apidra with Regular, half and half (and Levemir). The Apidra takes care of any carbs immediately, the Regular with its long tail helps with the protein and fat. In fact, quite a few people use the option of three insulins with slow digestion or Gastroparesis.
I know someone else that it lasts about 4 1/2 hours for. I am glad that isn’t the case for me - the main reason I like it is because it goes away fast.
“I really like my Apidra, and am willing to just work around the temperature problem to use it”
Me too!
Interesting. I always thought of the irritation as due to the hole that is poked (and left) in the skin, and getting dirty, sweaty, and all that. I never thought of the insulin to have an effect. Which type of infusions sets do you use? Some are so deep under the skin that I wouldn’t expect such a thing.
Trudy and Kelly, I’m glad you both chimed in with that sentence. After reading all of these stories, I was ready to just say “the hell with it” and go back to MDI. Either that, or bring my diabetes back to St. Peters Hospital (where they told me I had it) and ask for a full refund.
But seriously, now that you mention it, I think I recall hearing things about Humalog not being “approved” for pump use. I suppose that is why.
I hope you don’t mind my asking, but if you are only shooting up at “double-up-arrow speed” at breakfast, do you think that this suggests something about breakfast rather than insulin onset, peaking and duration?
I’m just sayin that perhaps you are eating a “different” meal at breakfast than during the rest of the day. In particular, eating cereal with milk may have a very rapid effect on your blood sugar, as opposed to your other meals which have more of a mixture of protein and fat.
So what are you eating in the morning?
ps. One thing nobody mentioned is timing. You can advance the onset of the insulin by bolusing 15 minutes earlier. If you are a little high before breakfast, it is even better to do this.
Absolutely, it could be… I generally have 30g of carbs with breakfast as well as protein (egg, cheese, or something like that). I’m sure that bolusing earlier would help, I particularly do this if I’m high to start, but if my fasting BG is in the 80s, I’m not really comfortable doing that. Also, at times I need to get out of the house really early, and eat when I get to work, so “pre-bolusing” isn’t always a comforting option in case there are delays in my travels.
Then there’s the morning coffee. I’m sure that doesn’t help things.
I’ve used Apidra for 3.5 years & never got an infection. Site infections happen regardless of type of insulin.
I’ve tried apidra, novolog and humalog, and found them to be almost identical. I absolutely must take my bolus 30 min before I eat, though, or I get the same thing. When I eat out, I take 2.5 u of bolus as we are being seated and the rest as a 30 min square wave, this works well to keep me from that post spike, but not to make me crash when dinner takes longer than expected to get to me.
Scott,
I was on Apidra for almost 6 months then ended up
switching to Novolog. The Apidra worked great
and had great numbers, but for some unknown
reason I started developing premature atrial contractions
do to the Apidra. The Endo thinks it might have
been a reaction to the preservatives. Once I stopped
using the Apidra the PAC’s went away. My son
is on Apidra and has wonderful numbers
Best of luck
I never used Novolog, but I have been on Apidra for about 6 or 7 years, It kicks in for me in about 20 to 30 mins. I usually hit it about 10 to 15 mins before I can eat, And then usually dont have a spike in BG an hour or so later. I love Apidra!
I find I am much more sensitive to carbs (or less sensitive to insulin) at breakfast than at any other time of the day.
I use a a different I:C ratio and some foods I just avoid due to the spikes they cause: cereal, etc (even low carb cereals). To make things easier, I eat a low carb breakfast - usually eggs (scrambled or an omelette) optionally with cheese or sausage. I sometimes have a light yogurt (15 grams of carb) and need an I:C ratio of 1:7 to cover.
Doesn’t seem to be the speed of the insulin for me, but rather the amount and what I eat.
Hi Scott,
I have been on Novolog since it’s coming out and have recently, in January, switched to Apidra. I do use it in a pump and have a CGMS so I know of it’s onset/duration. I went from pumping roughly 140-200u a day of Novolog to now using around 45-75u of Apidra a day. The duration of Apidra is around the two hour mark, some days especially if it’s a particularly fresh vial, it goes to around three hours, but not anything longer than that for me that I’ve seen. It is SUPER heat sensitive and you’ll know it as soon as it’s denatured as you’ll start rising rather quickly. That being said, it is a little tricky if you’re prone to pulling sites out in your sleep as I’ve dealt with full blown DKA due to a site coming out in my sleep because of the duration of Apidra.
When I first went on Apidra, I did have to adjust my basals and then eventually my ISF and I:C. Little corrections go a long way. My endo did have me send her numbers for the first week just to make sure essentially ■■■■ wasn’t hitting the fan. I do notice that when you’re stuck high Apidra works best given via syringe. Oh and I do have to bolus for my showers as being disconnected tends to make me go high now. If you have any other questions or anything just ask. My roommate and I are both on Apidra so we’ve got lots of experience between the two of us!
Hope this helps!
Elizabeth
PS- I don’t prebolus with Apidra… I bolus about halfway through the meal when I know how much of it I’m going to consume unless I’m high.
That sounds like a dramatic difference. Do you think that maybe you became resistant to Novolog? Some people develop specific allergic reactions to some insulin’s but not others.
Well, it’s been about 2 1/2 days on Apidra…and I really don’t know what to say yet. After over-correcting for a low on Sunday, those numbers are not valid. Monday I noticed a peak - in the high 100s - after breakfast, but not too as high as it’s been. My CGM has been going haywire for the past couple of days - don’t know if it’s a bad calibration or a bad sensor - so I can’t really compare yet. But I’m hoping for a few more steady days before making a decision.
But my new question is this: Apidra is obviously very temperature sensitive, as discussed here and in the literature which comes in the vial (that I rarely read, but thanks to your feedback, I did). It should be stored in the refrigerator and the reservoir should be changed every 48 hours. I also know that I was also told to keep an extra vial of insulin with me when pumping, in case the pump goes bad. I’ve taken to that advice if I was going on long trips (say, 45 minutes from home), but how can I do that with Apidra? Taking a vial in the car on a non-sweltering-hot day – or putting one in my laptop bag when I go to work – is one thing. Keeping it cool is quite another. Do I just keep bringing Novalog with me as a backup?
Carrying Novolog (as long as you have it) is a good idea. I either carry my Apidra in an insulated bag with a cooler, or carry my Regular (which is super-slow, but is better than nothing) in my purse or cargo pants. Hope the Apidra works out for you.
Normally I would say to get some pens and keep them as a backup, but Sanofi just announced last week there is going to be a shortage of the pens. If you can get a frio pack to keep it cool or take some insulin in a syringe as a backup.
So. . . I am seeing my doc in a little while, and am wondering about Apidra. I’ve also just gone super high after breakfast on Novolog. . .superboluses, and will be going low momentarily. So, yes, or no on Apidra?