Okay so here's to day 1 with Humalog in the pump! Those of you using Humalog what do you set the duration time or the Insulin on Board at? We were using Apidra but insurance no longer will cover and I had the duration for it at 2 hours. I've read Humalog can last 4-5 hours. My daughter is 6 who is using it. Please let me know what you Humalog users think. Thanks so much!!!
Hello! Sorry you have to change insulin. After doing the test suggested in Think like a pancreas, I have my pump set for 3 hours. I guess this is real personal though. Maybe start at 4 and see how things go.
yes I decided on 3, was afraid to go 4 as I am afraid she won't get enough for corrections if she needs it
It would be best to do the test. I've found that Apidra lasts 4.5 hours in me. Good luck with your insulin switch to Humalog.
I also don't like Humalog it works slower and I even heard humalog could increase the chances of getting lumps as compare to others. I have set mine to 4 hours by pump trainers but in my case it seems to work lil more than 3 hours. If I had to set mine I would set it to 3.5 hours. Yes, I'm on humalog.
Chadha, Can you not switch if you don't like it?
Actually, my doc liked to all his patients to be on Lilly's products as long as it is possible. he is the body of Lilly I guess. Secondly there is problem here. We only get Pen cartridges of insulin not the bottles. So since I already have a Lilly pen that holds all the Lill insulin it is safe to be on Humalog in case pump becomes unfunctional or any other uncertanity.
My case - In November. After 2 weeks of installing the pump my pump an occlusion thas wasnt solved even after priming and that time I didn't have spare reservoir and Infusion tube, nor even the used splunger at night and the only reasnon I was able to take insulin without spending a single penny is I had the Pen that fits not only humalog but all the catrdiges.
But yes I will mention here Humalog is unpredictable at times.
I like humalog and have mine set at 3 hours. I think it does have slighter slower action than other insulin and that is something I dislike.
I use Humalog, and I have mine set at 3 hours also
Duration of Insulin Action (DIA)is defined as the time it takes for 95% of an insulin bolus to clear out of your system. All the manufacturers have estimated DIA for their analog insulin based on actually measuring insulin levels over time following a bolus, so the numbers are published.
Humalog - 5-6 h
Novolog/Novorapid - 6 h
Apidra - 4-5 h
So why do so many pumpers set their durations at 2 or 3 hours? The OP gives us the answer in her later post - if she sets it at 4 h she is worried her daughter won't get enough for a correction. This is a problem with all pumps. The pump can calculate approx how much Insulin is still active from a bolus (IOB) but no pump can calculate how many of the carbs are still digesting - it assumes that the moment you ate the food, the carbs disappeared from your system.
In reality, suppose you ate (for example) several pieces of pizza (and bolused). Two or three hours later you do a fingerstick or check your CGM and your BG is at 14mmol/L (250 mg/dl). Obviously you needed a bigger bolus. If you have set your DIA on the pump at say 5 h (which is probably about correct for Humalog or Novorapid) and you ask it to suggest a correction, as you may still have 4-5 units active it will suggest a correction of zero. Most of us have been there and know THIS ISN'T GOING TO WORK! The problem is that a third of the carbs in the pizza haven't yet been digested (which the pump doesn't know) and when they hit your system, you are going to need those 4 or 5 units to deal with them.
So what's the answer? You could set your DIA at 3 hours, in which case the pump will think the insulin has all gone and suggest a correction. But IMO this is just trying to fix one error with another one. There IS Insulin on Board, and it's probably a good idea to know how much.
Perhaps a better solution is to OVER-RIDE the suggested correction manually and use your experience to guesstimate how much you might need. Personally, I try to be conservative as I don't want to have a hypo three hours later, so based on my correction factor (ISF) I will over-ride the pump suggestion so as to correct with enough to eventually knock my BG down to say 9 or 10 (160-180). I then check an hour later to see if my BG is actually coming down. I check the IOB to see how much insulin I have active. I might want to make a small extra correction bolus (or even eat some carbs if it's dropping too fast).
I think it's safer and more reliable to do it this way. After all, the suggested correction is just a suggestion. We don't have to accept it.
Joel
Who completely believes companies claims? I haven't checked yet myself how long insulin stays in my body but I'm sure most people here who are speaking the DIA of their pump are telling either from their experience or after checking from the methods mentioned in many books. Why I have set mine to 3 hours or lil above ? My basal hasn't been yet set so jumping to DIA is out question for me.but to be on safe side I have set mine to 4 hours as it is neither too early nor too late.
jjm - I'm curious about where you got the DIA numbers for the various rapid acting insulin analogs. For the Apidra I use, I set the DIA at 4.5 hours, a number supported by DIA numbers you cite.
I found this DIA by trial and error and have noticed that most Apidra pumpers use a lower DIA. I used to use 3, 3.5, and 4 hours but I got slapped too many times with the "hidden tail." 4.5 hours works well for me.
I'd like to know your source cause I'm curious if it also cites onset and peak data for Apidra. The common knowledge is that Apidra works faster, but I suspect that that may not be the case. Thanks.
Terry:
If you look through the brochures produced by the three manufacturers, or better still hunt up their online information, they publish "action curves" with graphs of circulating insulin levels vs time. Each company shows its own analog compared to regular human insulin. These will be the data submitted to the regulators (FDA etc.) and are probably fairly accurate. Here's the one for Apidra:
http://products.sanofi.us/apidra/apidra.html
If you want to work out how much insulin remains after time = x (i.e. DIA), you really need to do this by measuring the area under the curve. To do this accurately is obviously a bit difficult but you can make a rough estimate by eyeballing it!
It's obvious from the curves that with all 3 analogs, there's lots of insulin active after 3 hours.
I set my Apidra DIA at 4 hours, but with the accuracy of the Dexcom G4 sensors I can see there's still activity up to around 5 hours, so your setting of 4.5 seems pretty good.
As to "who believes companies' claims?" (see Chadha below). The figures are published. They may exaggerate the efficacy of some of their drugs and the trial figures can be massaged, but circulating insulin measurements are probably very reliable.
FWIW, if you are interested in Duration of ACTION (as opposed to time of circulation), it is certainly longer than the published figures because insulin remains bound to the receptors for some time after it has left the circulation.
Joel
I use Humalog and set duration for 4 hours.