I’ve been on Apidra for three days now and have seen a lot of lows. This is a little scary, but it’s really relieving too because I’ve been running so high for the past couple of months on Humalog.
I’ve noticed that Apidra brings my 200 BG down in about 45 mins, where Humalog would’ve taken around 3 or 3.5 hours to bring it down. I’ve also noticed that I wake up a bit lower (46 yesterday) in the mornings, which makes me think that maybe I should go to bed around 90 or higher, instead of at my target of 75-80.
Maybe using Apidra will lower my need for Levemir too? I’ve been using much smaller doses of Apidra and my numbers have been pretty great- though I’ve been nursing quite a few lows over the past two days.
I have big hopes for this! I’m working really hard to keep myself on target-
July 15, 2009
T1Ds, please respond to this discussion if you’ve used both Humalog and Apidra- for comparison.
I’ve just filled a new prescription for Apidra, hoping to test its abilities with my immune system for a month. I’ve been using Humalog for about three years and it’s slowly losing its potency. My ratio went from 1:15 to 1:7 and it’s nearing 1:5 now. I’m hoping that the quick peaks with Apidra will help me lower my A1c.
Do the dosages pretty much match Humalog’s? I’m afraid to use the same amounts of insulin that I’ve used with Humalog at first because I don’t want to hit another insulin shock coma- not fun.
When you switched, was the conversion simple and similar?
I know, I participated in the discussion that was started in 2008 this morning too- but I’m not worried about how it works, really- just the CONVERSION… any thoughts? I worried I’m gonna crash.
I switched from Humalog to Apidra for my pump earlier this year. The amount was the same for both types, but the timing may be a little different, as in when you take it in regards to meals. Also, it tends to get out of my system in about 3 hours, where as humalog would tend to tail off for an extra hour or two. Just be a little conservative until you get used to it. Letting your sugars run a little higher than normal for a few days while you get it all dialed in might help with the worry. Lord knows, I’ve run high for a few days before without changing insulin types! lol
Thanks Scott. I really appreciate the input.
So, basically stick to what I’m doing, but expect my BG to drop sooner than it did with Humalog- so maybe inject after dinner instead of before?
I hope this works. I’m beginning to get worried about my fluxuations.
I am interested in this topic as well…mainly just to have another weapon in the arsenal. I hear it’s the only insulin that is OK to take after a meal rather than before. I also want something to take as a blous when I’m up and and I want it down fast…likely yo improve the A1c.
As far as your Humalog losing it’s potency, I go through those phases now and again. I’m not exactly sure if an insulin switch will change your ratios, but it’s worth a shot (no pun intended).
A small (<10%) increase in my Lantus dose seems to revitalize my humalog sensitivity back to normal. Of course, I do get concerned regarding high doses of insulin and weight gain.
I loooove Apidra way more than humalog! I was on humalog/lantus cocktail for a few years and like you, i slowly started noticing a resistance to the Humalog, by the 3rd year or so i had gone from using around 10 units at meals to 30!! When i switched over to apidra i cut back a whole lot on my insulin usage, and when i started on the pump with apridra i cut back even more! it takes a while for insulin to kick in, in my body so as a fast acting insulin this has been the best one yet for me- although it still takes some time personally for it to show an effect on my BG. But be careful and monitor yourself when you first start using it- Ive heard some people need to eat 5-10 minutes after dosing or they bottom out, and others, like me, wait up till 30 minutes. So its just trial and error. but good luck!!
Hi Marps!
I was on humalog…for a very long time before my pump and for the first 3 years on the pump. Earlier this year I switched to Apidra. My endo and I started with the same ratios and sensitivity levels but I quickly learned that they were not the same. I tried apidra for nearly 3 months and after a low that drew the paramedics in my tiny apartment I swtiched back to humalog. I think Apidra could help me in the end but those first 3 months were so hard I couldn’t take it at the time.
Apidra definately starts working faster than humalog, and I found it also doesn’t last in my system quite as long. So for me my basal rates didn’t change but the insulin to carb ratio did as did the insulin sensitivity. I didn’t always need as much apidra to cover a high blood sugar, and I definately needed less to bolus for food.
Keep tracking your blood sugar very closely the first few weeks/months to see how it works for you.
That was the other thing strange about my switch to apidra. The first 4 weeks on it things were almost exactly the same but maybe I didn’t need as much insulin as I did on humalog. The next 4 weeks on it I had extreme highs that I coudln’t get to go away and the last 3 weeks on it I had severe lows.
But everyone is different! If you’re resistant to humalog definately trying apidra is a good idea. Good luck!
Yeah, the high doses of insulin and weight gain is annoying. My endo doesn’t seem to see the correlation. He’s kind of “accused” me of gaining 5 lbs in the last 10 months and inadvertantly made me feel like junk. I haven’t changed my eating habits at all- so wtf? Right? But, yeah, I’ve def been increasing my insulin dosages for corrections and coverage. Either way, I’m losing, it seems (but not the weight! haha)
Oh, Revvy, you’ve got my hopes up!
Humalog used to work well for me, but yeah, after 3 years with it, I’ve started to take almost 30 units per meal too! I hate it!
I can’t wait to try Apidra. I’m waiting for the approval from my endo office on the scrip.
Great! I hope it goes well. Again, I think the only reason I am NOT on it now is the highs & lows were just too much for me to handle at the time. Maybe in a while I’ll try it again though. Keep us posted!
Apidra works fast, leaves fast. Changing from injecting from before dinner to after dinner is a big change to make. It doesn’t work that quickly. If you do this, be sure to check BG 1 hour after dinner & then in two hours to see what’s happening. You don’t want to see a rise & then a sharp drop from this timing. It all depends on how quickly you digest. Most take Apidra 10-15 minutes before meals.
Any insulin (Dino’s statement) can be taken after meals. It just depends on individual digestion & stomach empyting to time food to dose right. Been there, done that because I have gastroparesis & this makes bolus timing a crap shoot.
I’ve been on Apidra for three days now and have seen a lot of lows. This is a little scary, but it’s really relieving too because I’ve been running so high for the past couple of months on Humalog.
I’ve noticed that Apidra brings my 200 BG down in about 45 mins, where Humalog would’ve taken around 3 or 3.5 hours to bring it down. I’ve also noticed that I wake up a bit lower (46 yesterday) in the mornings, which makes me think that maybe I should go to bed around 90 or higher, instead of at my target of 75-80.
Maybe using Apidra will lower my need for Levemir too? I’ve been using much smaller doses of Apidra and my numbers have been pretty great- though I’ve been nursing quite a few lows over the past two days.
I have big hopes for this! I’m working really hard to keep myself on target-
I have used both Apidra and Humalog in the pump Three years ago, My doctor suggested Apidra because he said that it was less likely to cause interrupted flow of insulin and clogging in the tubing. Supposedly Humalog is more viscous and prone to clogs. ( Did I spell that one right?) I got good results with both.I will note that Apidra works faster, but does not linger as long as Humalog, as the other posters have noted. I like Apidra better, because it makes corrections quicker. However, you have to really be careful so that you do not overbolus for corrections. You can plummet very quickly with Apidra, unless you are quite High ( over 300). My carb insulin ratio stayed the same, insulin sensitivity had to be slightly increased, and I had to slightly lower my basal rates. I will stay on the Apidra as long as I have good insurance. It is VERY expensive :my pharmacy charges $103 a vial. I could not afford Apidra without insurance and my $30 co-pay for a two-bottle refill script. When I retire, I may go back to Humalog if the group insurance I get at that time does not pay as much.
Yes, I’ve noticed a slight change to insulin sensitivity- which I LOVE. I’ve also noticed that I drop very quickly with Apidra- and this is very favorable to me
My co-pay for the vial wasn’t different from my co-pay with Humalog kwikpens. I’m not sure how long the vial with last me, but the box of kwikpens for Humalog lasted me for about 5 weeks. Hopefully Apidra lasts the same.
I searched for this discussion because I was wondering about Apidra. But according to this chart I found on insulin pumpers, http://www.insulin-pumpers.org/images/composite_graph.jpg, Apidra has the same “fastness” as Humalog, and Novolog is the fastest. Too bad the chart doesn’t include a curve for insulin produced by a non-D person after a meal.
There are many type 1 diabetics who have posted that their control was better with Apidra. There are also some who stopped Apidra because it acted so quickly and they had too many hypos.I have a friend who was type 2, then his pancreas was producing so little insulin that he became insulin dependent and used a pump. He used Apidra for many months and had excellent control. His insurance company then required him to use Novolog (very much like Humalog). The insurance would no longer cover Apidra. He had much trouble adjusting to Novolog because it acted so slowly. He had to use larger amounts of Novolog and his total daily dosage was about 40% higher than with Apidra. That made it much more difficult for him to control his weight. I have been type 1 for 64 years and have found that the more insulin I use (Humalog), the more weight I am likely to gain. I had to limit myself to 130g of carbs per day and increase my exercise to lower my insulin dosage. That resulted in my losing 34 pounds.
When I first tried Apidra, I was concerned because I had read that it was really fast. I have gastroparesis so wasn’t sure about doing that but I wanted to try something different. For me, it takes about 20 minutes to actually kick in. I do find that it is a lot more consistent than Humalog was for me. I still have some of those WTF days but not as many as I did when I was on Humalog. I especially like that it gets out of my body faster so when I do make corrections, I don’t have tail ends of insulin hanging around.
Anecdotally, I haven’t tried Apidra; though I’ve used Humalog for years. I did try two bottles of Novolog and couldn’t tell any differences with Humalog so went back to Humalog.
Contrary to the anecdotal reports that Apidra is faster than Humalog, this study LINK HERE suggests that Apidra and Humalog are very similar, with Humalog being slightly faster (50 min vs 56 min): “The rate of absorption of insulin glulisine [Apidra] is equivalent to the rapid-acting insulin analogue, insulin lispro [Humalog], and almost twice as fast as RHI (Tmax 56, 50 and 99 minutes, respectively)”
Apidra is great because it works faster than the other insulins. Not sure if this is true for everyone. She does not use the Dexcom all the time, but have observed it definitely does start working within a half hour, i.e., her blood sugar is very slow to climb (as if the Apidra is keeping up with the food), but at the one hour and ten minute mark, her blood sugar will reach to its highest level, the down arrow on the cgms will start by one hour and a half, by two hours she may be anywhere from 120 to 150 and by two and a half hours, we will usually have to cover insulin on board with a few grams of carbs. We set the pump for a 3 hour duration, but she will actually still drop hour 3.5 to possibly 4. No tail. And insulin is more “front loaded,” meaning, less of a drop toward the end of the DIA. The down arrows on cgms usually occur 1 hour and 20 to 30 minutes until 2 to 2 hours and fifteen minutes. I have read Apidra is usually much faster for most. Novolog had a 4.5 to 5 hour duration. She still can spike up to 200 or so but that is very brief in duration usually. Initially, she needed more Apidra than Novolog as basal in her pump, but now she uses a little less as basal. Different for everyone so keep an eye on things for a month or so. Takes about a month or so for things to settle in. P.S. Depending on what she eats, Apidra has dropped her too low (working faster than food in some instances for a brief period of time) so we never prebolus.
