I’ve been on an insulin pump for nearly 15 years. I’m thinking of going back on injections, primarily due to the costs of the pump supplies. I’ve been on both minimed and Omnipod and both have worked well for me. My question is since it’s been so long since I’ve been on injections, I’m not even sure what new choices I have. 15 years ago, I was talking 70/30 in the morning and a type of rapid insulin with meals. I was using regular syringes. I’ve never used the pre-filled pens or any of the newer types of insulin. If you have Some advice about making a switch away from a pump or what questions I need to ask my doctor, feel free to respond. I’m nervous about making the switch.
hi, i have started a discussion here, talking about my recent switch back to MDI. back then it looked like i would get back to the pump eventually, but it looks like i might wanna stay. if you search the forum for the word “pump vacation”, you will find many more discussions about people going back to MDI after pumping. there is also a discussion here, where we talk about the basal insulin i have been using. it really is awesome and if you can get your hand on it i would highly recommend it. @Terry4 has asked me to do an in detail description of what exactly i did when switching back, i have been pumping more or less for 10 years consistently before i took the break in mid december. i will try to get that discussion about switching back to MDI up eventually, but i would like to wait another few weeks until i feel confident sharing the full experience. but feel free to ask away anyway
if you have been off shots for so long i would consider talking to your endo before you make the switch, but definitely dont go back to 70/30, that stuff is aweful, especially if you have had the experience of pumping for so long!!
I’ve never been on a pump, nor have I personally had to use any of the older insulins, as I was just diagnosed diabetic in 2011 and put on insulin pens in 2013. But between 1999 and 2003 I was caregiver for my late husband after his stroke and he was on the older insulins. The newer analogs are so much more predictable that there is just no comparison.
If your insurance will cover any of the fast-actings, my preference is for Apidra. It starts acting faster. When my BG was elevated before a meal, my most frequent pre-meal dose of 8u would drop my BG by 30 points within 30 minutes. When I tried that on Humalog and Novolog, though, my BG didn’t drop a single point in 30 minutes, and in some cases not even in 40 minutes.
Apidra is also done with the insulin action faster, or at least it has been for me. I usually can get a good enough idea within three hours from dinner bolus to feel free to go to bed after a test based upon a BG reading at that point. Rarely would my BG drop more than an additional 10-15 points after that. With Humalog I had to wait four hours from bolus to test, and with Novolog a full 5 hours. Unfortunately, my insurance won’t be covering Apidra this year and it would have cost me an additional $1300 a year to go to a company that would, so I’m going to have to go back to Humalog after my current supply runs out.
You might want to do a search on a comparison of Novolog versus Humalog, as I’ve noticed that there are others who have a preference for Novolog.
I’ve only used Lantus as a basal and have no personal experience with Levemir. In an online course I took on diabetes through U of California, however, an instructor said that with Levimer, some type 2s can get away with taking only one dose a day, but almost no type 1s can because the duration of action is somewhat dose dependent and most type 1s use a small dose. I know a lot of people also seem to find that a split dose of Lantus works better than a single dose. But a single dose taken about 6 pm works just fine for me and I’m all for saving one jab a day. I take an unusually low dose of 8u, but I understand basal needs for “the elderly” tend to drop considerably and most younger people would be taking more.
Thanks @Uff_Da For that great information on apidra. I have been using humalog for the last 15 years and I agree it takes hours to get out of your system and work. I doubt my insurance will cover apidra but I’m certainly going to look into it.
Thanks for your comments on Apidra!! I think it was Humalog I had tried before but did not see any real advantage over Humulin R. I’ll need to ask my Endo if she has a sample or write a script to try it. BTW - check with Sanofi for a Savings Card for Apidra, Lantus and Toujeo.
As a note - I have not noticed much if any difference with Lantus as a single vs split dose and do mine in the morning.
Thank G_d my daughter now uses only one Sanofi product: Apidra. If it didn’t work so darned well, I’d switch her to Humalog or Novolog just to avoid giving Sanofi any more of my hard-earned cash after what they did (actually what they didn’t do) with Afrezza…
I hear ya… I also use Apidra. Though it does not start working faster for me, as it does for many, it does tail off a lot quicker than Novolog or Humalog. I can’t use Humalog, due to a sensitivity (allergy?). Novolog’s longer tail is the only problem I have with it, and in fact, I find it irritates my skin the least, by far. Also, with Apidra, I have to watch the tubing a little closer than Novolog, as it tends to crystallize more easily than the other two analogs and is more sensitive to heat.
My experience of Apidra is pretty similar. A shorter tail than Humalog or Novorapid. I used it for about 2 years on MDI and then my first 6 years on a pump. I did have a lot of problems with my sites degrading after as little as a day and a half. I now use Humalog which will reliably give me 2 days out of a site. There is some data to show that the problem is due to denaturation in the cannula (rather than the tubing). Apidra is much more easily destabilized by local changes in pH caused by carbon dioxide at the site.
Never been on a pump but am on MDI and have used both needles and pens and still use a needle every so often, but after using a pen for even a short time I find it annoying to have to use a syringe. The pen is just so convenient to carry and to use that I know that other than occasional use I will never go back to syringes for everyday use. I can carry all my daily supplies in my shirt pocket including my bg tester and strips. No way could I do that while using syringes. I was DX in 2006 so all I have ever used have been the newer insulins, although I have experience with the older insulin I’ve never personally used them on my self. I use Lantis and Humolog and figuring the peak on Humolog even if I stack it is pretty easy.
Eric, I don’t mean to nitpick, but technically Apidra didn’t actually make your blood sugar go high. It may have not been effective in lowering your blood sugar, but it didn’t actually increase your blood glucose level.
Regardless, I’m very happy to hear that Novolog is working out well for you!
i don’t know, what was wrong, with it, it just did not, want to come, down, i find out with, Novolog it will stay, where i want it to,. & nitpick, never,.
@erice what you’re describing with the highs is not that unusual when making the switch to Apidra. My daughter’s endo warned us that we might battle highs for several days while her body adjusted to it. We switched on a Friday & by Sunday I couldn’t stand it anymore. We waited a few weeks & tried again & still fought highs for the first week. Once she adjusted, Apidra was a much better fit for her. Later, I found other users who had the same issues.
all, i know is, i’m better off, on my Novolog, & after 3 days & nights, i gave up on Apidra, with Novolog i can sleep, my highs, are much better now on Novolog,.
