Why can’t use just adjust the duration of insulin action time (or whatever your pumps calls it) to 6-8 hours and then you can use Humulin?
Have you read the Insulin Access Affordability Working Group convened by the American Diabetes Association
I don’t know id this will change anyone’s opinion, but the ADA released their recommendations now - and they did not say ‘Prescribe Regular’
I started pump therapy in 1987. I used Regular insulin, both pork and the bio-engineered Humulin, for nine years. Pumps have had this capacity since the beginning. You need to adjust the duration of insulin action to a longer time and calibrate your pre-bolus times for longer as well.
Were you able to get comparable results to your results with Humalog or Novalog? I’m thinking of a comparison between 1995 and 1997.
I remember feeling better in a general sense with changing from Regular to Humalog in my pump in 1996. My treatment style back then, however, created so much turbulence in my control that I think the net effect between Regular and the new rapid acting analogs was obscured by my habits.
Back then, I exercised regularly on my bicycle and often aggressively beat down any hyperglycemia with insulin corrections. I didn’t use a CGM back then but I’m sure my BG variability was much higher than it is now.
My overall perception and memory was that my control benefitted from the new insulins but I don’t have much hard data to back that up.
Here are my A1c’s during that time. They’re up and down with no clear cause and effect when I started on Humalog mid-1996.
Cn anyone decipher this bullet point from the ADA link that @Thas supplied:
"Requiring utilization management protocols to
be evidence-based and consumer-friendly. "
Tomorrow, I’m gonna contact the ADA.
I puzzled over that one quite a bit, too. They are studiously vague about what evidence they mean and about what regimen. But “consumer-friendly” appears to refer to their discussion of human insulins, which can be bought OTC for much cheaper than analogs, and “evidence-based” I can only assume–because they don’t actually refer to any studies about outcomes of particular treatments–that it means studies that show outcomes don’t differ all that much with human-based insulins vs analogs. “Outcomes” meaning complications, premature mortality and the like, as opposed to quality of life, where the gap widens considerably.
As @Thas points out, the final recommendation document doesn’t mention more reliance on using R/N to rein in costs, so that’s good, but it does seem to be lurking in the background here, and the very vagueness of just what they are suggesting makes me question their good faith. Maybe I’m prejudiced by the critique in the OP, or maybe they’re being vague because they know how much it would ■■■■ people off.