I know there have been a million posts about the differences between Humalog and NovoRapid/Novolog before. I recently am trying Humalog after using NovoRapid since diagnosis (except for brief Fiasp trial). I was inspired by Terry’s posts about Novo giving him pump bumps. I realized for a while this has been happening to me and had one that was so painful I had to rip my Silhouette off early last weekend. At first Humalog seemed exactly the same and maybe even more potent, but after a few days I notice I need more and more of it to get the same results as I did with Novo. I am constantly tweaking my pump settings, but it does seem to be working and the onset time is about the same. Has anyone else experienced this, or is it just one of those things that is different for everyone?
Good luck with the change. That’s the thing about diabetes that might frustrate me the most - things are constantly changing and we’re continuously adjusting settings for these changes. Caleb changed insulins earlier this year - Apidra to Novolog. It was a fairly easy transition, but still a period of heightened analysis and decision making.
I don’t have experience w Humalog. The only thing I can offer is that when Caleb first started pumping, his insulin use was so low we ordered diluted insulin and the only insulin that could be diluted was Humalog. His doctors at Yale were very reluctant to go this route - their experience is that Humalog is more susceptible to pump occlusions. We got the prescription filled but never ended up using it. Removing Nph from Caleb’s regime resulted in a significant enough increase in Novolog use, dilution was not necessary.
Since then I’ve been aware of conversations about pump occlusions with Humalog and I can’t say I’ve ever heard this as a problem for users.
That’s probably not very helpful, but the only reference to Humalog I have.
I’m not a pumper, but have used both insulins. For me Novolog went a little further, I:C ratio of 1:8 compared to 1:7 for Humalog in the afternoon and evening, and about half those numbers for breakfast. And Novolog had a longer tail, so it often had insulin activity for up to six hours after bolus.
However, I’ve been on Humalog for about 2.5 years now, and it seems it is developing a longer and longer tail, too, so I’m not sure if there would be any difference at this point. So maybe it is just this old body that is taking so long to handle the insulin more than a characteristic of the insulin itself.
Thanks Lorraine! I think Humalog is probably as stable as the other insulins in pumps, my brother and dad are both type 1 and have been using Humalog since they started pumping. For whatever reason the hospital I was diagnosed at gave me NovoRapid, so I just stuck with it. Other than the site issues I was having it’s a great insulin, so glad it’s working well for Caleb.
Thanks! I hope the tail increases, that was my favourite thing about NovoRapid. I know some people don’t like it because it can lead to lows later on, but I found it helped with delayed spikes from slow-digesting food and protein, and prevented post-exercise blood sugar spikes.
I used Humalog from 1997 to April 2017, when I did the switch to Fiasp, except for last December when I got a few samples of NovoRapid from my GP just to check things out.
With NovoRapid, I found that I used less NovoRapid (I:C ratio dropped with NovoRapid) and I found the prebolus time to be a bit more predictable (Humalog prebolus times varied a bit) and had a longer tail. I also found that NovoRapid prebolus times were shorter, which does not agree with the package inserts which show Humalog to be a bit faster up front… but the differences were pretty minor. Since I had a full fridge of Humalog I just went back to Humalog.
Interesting observation. I used Humalog for about 20 years before recently switching to Fiasp. From time to time people here would say what their doses were, and I’d think, “Wow, do I ever take a lot of insulin!” On Fiasp I haven’t had to change my basals or IC ratios, but my correction factor has shrunk from 1.8 to 2.8, to account for Fiasp’s up-front aggressiveness compared with Humalog.
Humalog for me had a really long duration–a particular nuisance overnight. But whether that (or the tail) grew over 20 years, I honestly can’t say.
I don’t recall ever having occlusions with Humalog, either on Omnipod or years ago on a MiniMed. And any site irritations were caused by dumbness and leaving the site in way too long. (Can’t say the same for Fiasp. Five days after removing the first Fiasp pod, the site is still a bit red.)
Just to make you feel less alone in taking a lot of insulin 
On Fiasp I run…
I:C - 1:5g in the morning, 1:7g rest of day
Correction Factor - 1u=1.5 mmol/l in morning, 1u=2.0 mmol/l for the rest of the day.
On Humalog (pre-Fiasp) I was running
I:C - 1:3g in the morning, 1:5g rest of day
On Novorapid I was running last December
I:C - 1:4g in the morning, 1:7g rest of day
I weigh about 170 lbs.
I couldn’t take it anymore and refilled my pump with NovoRapid today. It seemed like every morning on Humalog I had to increase my basal rates/sensitivity and decrease my carb ratio more and more and it still wasn’t working as well or as consistently for me as my trusty Novo. Does anyone have a strategy to help with the redness/pump bumps? I’m almost willing to put up with a bit of irritation since it works so well for me. It’s the best insulin I’ve used overall.
Maybe swapping sites every 48 hours, instead of 72 hours, would help mitigate the irritation. Do you have access to Apidra? My insurance formulary favors Novolog but my doctor has been able to appeal for an exception based on my apparent allergy to Novolog. I don’t know how things work in Canada but you shouldn’t have to compromise your health due to arbitrary health policy.
You also might apply some Neosporin with a band-aid over the pump site when you remove an infusion set.
Thanks Terry! I’ve just been buying insulin over the counter as I’m self-employed and determined it’s cheaper this way than buying an insurance policy. We’re lucky in that all insulins are around the same price up here ($30-$40/vial) and so insurance companies don’t mandate which one you use. Unlike prescription drugs, pump supplies are covered by a provincial program. Once you’re approved for it, you buy the supplies yourself and the province pays $2,400 per year in quarterly instalments. This means they don’t really pay enough to change sites more than once every 3 days given the cost of a box of Silhouettes. I would try Apidra but I’ve heard it has the shortest tail of the 3 analogs, and I stopped using Fiasp because I was unhappy with how short the tail was and I’m terrible at getting extended boluses right. Looks like it’s a band-aid and Neosporin for me for now!
When Caleb was little and using much less insulin, the difference in the tail was notably different bt Novolog and Apidra. Before switching to Apidra, I spoke to a lot of users and as many said there was no difference for them as those that said there was.
Because Caleb was having erratic bgs (which is another consideration entirely) he recently changed back to Novolog. I was reluctant because I did not want to deal with long lasting tails of insulin - I’m scarred from the early days.
The results since changing have been: 1) much more stable numbers, and 2) no noticeable difference in the tail.
This likely varies from user to user. Apidra may still be an option worth considering.
You should at least try it to see how it performs for you. Like @Lorraine, I haven’t observed in me much difference in the insulin tail among the three rapid acting analogs. It wouldn’t hurt to request a trial supply from your doctor. That’s what big pharma samples are for!
I pumped with Apidra for about 6 years before switching to Humalog because of site issues, even with a 2-day rotation. I found it had a shorter DIA and tail than Humalog.
Thanks everyone! I will take your advice Terry and ask for free samples next time I see my endo. For now NovoRapid is working great and not much irritation, so I will try to rotate as much as possible and see if I can try things from the pharmacy like Neo/Polysporin on irritated sites. I’m tired of making changes, adjusting pump settings endlessly and seeing higher numbers than I like, so going to take some time to try something new again unless the site irritation gets out of hand.
Has anyone tried Benadryl spray? I bought some on a whim and sprayed it right over the area where the tube punctures my skin. The redness and itching/slight stinging disappeared almost completely. I’m wondering if this is the solution to continuing to use NovoRapid without irritation, and if it will work long-term or if there are any side effects from doing this.
I dropped Humalog and went to Apidra due to site irritation issues with Humalog. Been using Apidra now for 6+ years. Been pumping for 25+ years.
My endo is very strong about changing sites every 2+ days. She prefers two days, but I push to three. Helps prevent the the scar tissue build-up from years of pumping. I have a couple areas that just won’t recover after the years of extended use when I did not change sites with more regularity.