What are the differences between Humalog/Novolog/Apidra? How about Lantus and Levemir? Thanks in advance for the feedback!
Good question as I just got a letter from BC/BS that I need to start using Novolog and I have used Humalog for a very long time.
DiabetesInControl just published a comprehensive comparison of insulins. It has lots of details but isn't the easiest thing to read.
Ordinary insulin molecules have the strong tendency to attract each other. In this process they form complex hexameric structures in the vial. The problem is that these bindings stay intact for some time after the molecules have been injected. So we are not only facing the problem that the insulin has to be absorbed from the skin to the blood stream but that this absorbtion is slowed down due to the binding of the molecules.
Researches had the idea to modify the sequence of the insulin in such a way that a) the molecules would only create smaller structures in the vial - and b) the insulin receptor would still accept the molecules.
In that process they have found and patented several modifications to achieve this. Now the real work was to proof that these insulins are still safe for humans. The companies focused on different modifications that are used by the different insulins Humalog, Novolog and Apidra.
Experience of larger groups have shown that Apidra is faster than Novolog and Novolog is faster than Humalog. But this is very individual and the speed is only one side of the equation. Our food contains ingrediences that are digested much slower. Thus speed alone migh not be sufficient for good control. Speed might be good to catch and prevent a spike but without a tail in the insulin activity we would have no insulin left for the slower digested food that will spike later. Thus an ideal insulin should be fast and have an extended activity or tail. Here Novolog in my opinion is the best compromise I have found so far.
Some companies like VIAject have managed to make the ordinary insulin faster just by dissolving less molecules per IU. Instead of U100 they are using U20 if I remember correctly. But without patents this approach seems to be less attractive from the companies point of view. Are you aware that many patents for the analog insulins are running out in the coming years?
Short and easy answer: Not a lot! Or the differences are too minute to matter and too impacted by individual body chemistry and personal habits. Some of us swear by one or the other, some of us have had problems with one and switching helped.Judging by input on here there seems to be more variation between Lantus and Levemir than the three fast acting insulins. If I had to estimate I'd say there is a small preference for Levemir, but there are people who prefer Lantus. I would go with what your insurance covers and only switch if you see a reason to.
I've used all three rapid acting insulins and didn't see much difference in their performance. The data sheets for each show similar onset, peak and duration. The key factor here is how well any one of these perform for you.
I found that I developed pump infusion site allergies to Novolog, inflamed and red "pump bumps." I now use Apidra in my pump. I have no experience with Lantus or Levemir.
Apidra, Humalog, and Novolog are all rapid acting insulins you take at meal time, and they should all work the same way. For some people though they work a bit differently. I get headaches from humalog , and it was very slow compared to novolog for me and had a harder time controlling my blood sugar with it, but a lot of people love humalog and dislike novolog. I have no experience with apidra but it's pretty fast too from what I understand and also very temperature sensitive. Lantus and Levemir are long acting (Basal, background, to mimic what your body makes for normal bodily functions not necessarily food digestion) shots that you take once or twice a day. Lantus is meant to be taken once a day, but sometimes twice, and levemir is taken twice a day 12 hours apart.