Which insulin are you using on the pump?

My daughter is using NovoRapid (ie. NovoLog) in a t:slim

I’ve used Humalog ever since I started pumping (2002). It works really well for me.

What’s the difference betweeen humalog and novolog. Why did you rate one better than the other?

I used Humalog for years, then insurance forced me to Novalog. Turns out something probably in Novalog preservatives causes my skin to get very red and peel off. Backed on Humalog with no issues Andy

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Humalog for years since I starting pumping in 2002.

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For me, Humalog provides a quicker response to both highs and lows, and it is better in handling large excursions from the target range. For example: if I am at a BG of 250, Humalog will start bringing me down faster than Novolog and Novolog quits decreasing the BG after about an hour, requiring another bolus. And a larger bolus of Novolog up front doesn’t make any difference. It seems to need that “booster”. Novolog takes nearly 2 hours to start the downward change, Humalog only about 20 minutes. I emphasize that this is just me, not everyone. And, 5 years ago, I found that with Novolog, I used nearly 1/3 less than Humalog every day to get the same results. That has changed, as they are now about the same. Neither one of those works as quickly as Fiasp, which will be my insulin of choice if I can’t get Lyumjev covered by Medicare Part B.

Mmnnn, that’s interesting, i read somewhere that humalog was slower than apidra and novolog. Hence why when given the option, I said I’ll take the faster one ie novolog.

But I’m getting the same thing you are describing with novolog seeming to lose effectiveness on bg after the first hour. I may ask to try humalog then.

I’m not sure we have Lyumjev, is that supposed to be even faster? Like on the fiasp spectrum?

I have used novolog and humalog. Both work the same for me.
I was on vacation in Mexico many years ago and I broke my vial of humalog.
I went to a pharmacy and bought a bottle of Regular Humulin and I pumped that.
It was all I could get without seeing a doctor.
It worked surprisingly well. However there was no looping back then.
I just bolused 45 min ahead of meals. It got me through 3 days.

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Weird how this stuff works. I prefer Novolog over Humalog. I feel like I need to take more Humalog to get the same effect as Novolog, so a vial doesn’t last as long.

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I get best results from novolog, compared to humalog, but have not tried fiasp or other newer insulins.

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Lyumjev is Lilly’s product to compete with Fiasp. It is Humalog with a couple additives to make it start working faster. Accordingbto Lilly, it is priced the same as Humalog (in other words, I guess, excessively high).

Rob

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Hell Rob, checking into see how your long term use of Lymjev in your pump went. I ended up developing allergic reactions to both Fiasp and Apidra with my pumps and am planning on trying Lyumjev. Thank you for letting me know your longer term experience.

My bottom line was that I gave up on Lyumjev, for three reasons, two of which are probably the same thing:

  • Medicare tells me that not only do they not cover Lyumjev now, but they do not intend to ever cover it.
  • After two days of a cartridge load, Lyumjev pretty much quits working for me. It takes 3X the bolus to handle carbs or do a correction.
  • Again after two days, my cannula site gets painful (minor, not major pain).

I suspect that the latter two are the same, caused by inflammation at the site.

Unfortunately, Medicare is now hassling me in a major way by refusing to cover Fiasp under Part B for my pump. And I’m going to have major surgery with a 10-day hospital stay in less than two weeks. The hospital says I have to bring my own insulin if I want to use my pump.

Rob

Humalog.

This topic is a little old but I thought I would try to revive it with some updates on insulin usage in pumps.

I have been very successfully using Fiasp in my Tandem X2 pump (using the Basil-IQ software) for over a year and my A1C has been reduced from the mid to upper 6s down to the mid 5s which I think is wonderful. I no longer have post meal highs above 200 unless I just miss the carb count for the meal and I feel better overall.

The problem with Fiasp is that, for me, it drastically lost effectiveness on day 3 of my infusion set usage. Luckily, my doctor and CCS Medical were able to get Medicare Part B to pay for infusion set changes every 2 days (45 every 90 days). Although it isn’t costing me more money to change my infusion set/site every other day, it’s a bit of a hassle and I waste more insulin having the additional cartridge loads.

Recently, my Endo gave me a couple of Lyumjev vials to try and I had great success with it. For me, it had the same advantage as Fiasp and the Tandem X2 pump programs I had for Fiasp only had to be slightly tweaked for Lyumjev. I even experimented with extendong the use of the infusion sets and had no apparent drop-off of effectiveness for 3, 4, 5, or even 6 days at one site. I could never do this with Fiasp.

The problem I ran into with Lyumjev is that the Pharmacy couldn’t get Medicare to cover it under Part B like they do for my Fiasp. This is important to me because having my insulin covered under Part B results in zero cost to me because of the supplemental Part B insurance I pay for.

I have created another post on the forum about the Lyumjev Medicare Part B issue but I also wanted to report the success I had with my Lyumv trial on this thread as well.

One last thing. I don’t know that I would try to use either Fiasp or Lyumjev in the Tandem X2 Control-IQ software. They both act much faster than Humalog or Novolog and I think that would really mess with the algorithms for Control-IQ. That is the main reason I made the decision to stay with the Basil-IQ software and continue using my own well tuned profiles for Basil, Correction, and Carb Ratios.

While perfectly understandable, this actually isn’t true. The insulin action curves for all the fast-acting analog insulins (Novolog, Humalog, Apidra, FIASP, Lyumjev, and the genetics/biosimilars) are nearly identical. It’s only the first 45 minutes or so that they vary, basically the time to peak and immediately thereafter. And that early on, the difference doesn’t really matter. You’re not likely to be doing correction boluses that soon, and you’ll have too much insulin on board still for control-Iq to be doing automatic bonuses. They all come into alignment fairly quickly.

Control-iq’s insulin degradation algorithm is the first to use a delayed logarithmic curve, rather than the traditional curvilinear model, and it’s much more accurate than what you’re accustomed to with Basal-Iq and what you may have seen on other pumps. But none of them are EXACT. It’s just a best guess. The approximation that Control-Iq can guess, even with the fixed 5-hour DIA, will still yeild a more accurate picture of active insulin remaining.

Thanks for that additional information. That’s really helpful if I decide at some point in the future to reconsider Control-IQ. The other issue I had with Control-IQ is that the target BG is 110 and not 100. I realize why they did this but, with my current tight control, my Endo and I both felt that it would be a step backwards for me. Since things are working so good in Basil-IQ and my last 2 years of quarterly A1Cs were 5.6, 5.4, 5.2, 5.3, 5.5, 5.5, 5.7, and 5.9 (most recent in front) I’m really hesitant to change from Basil-IQ which is working so good for me.

I was concerned too, but have maintained a 5.1-5.7 A1C with CIQ. The primary benefit for me was improved overnight control.

While I acknowledge the general insulin stats cited by @Robyn_H, I have found in myself and the reports of others over the years, that some insulin formulations just work better for some individuals than others.

I have used Humalog, Novolog and Apidra insulins in insulin pumps since 1996 when Humalog first appeared on the scene. I used Novolog for a few years until I started reacting at the pump site with raised red welts. That’s when I switched to Apidra in about 2008.

I think the apparent slight advantage that Fiasp and Lyumjev portray by getting to a peak 10 or 15 minutes sooner than the standard rapid acting analogs could be a difference that translates to better meal control. And I think that that advantage may be more prominent in some individuals than others. I speculate on this point and only from my reading the reports of people using those insulins, nothing with any basis in science.

I think we need to start with the science and facts but must allow for the individual variations. Novolog is preferred by many but doesn’t suit me due to allergic site reactions, for example.

Your A1c history is excellent and places you in a distinct minority of our demographic.

Your success is a double-edge sword. On one hand, you don’t want to fix something that isn’t broken. Yet on the other hand, I believe that it’s always good to keep one eye open to new products or techniques that may come along. Success can breed complacency. While we can never arrive at perfect, we can always reach for better.

Actually, I’m the opposite. I’m definitely a “heat seeker” and always have been. I dove deep into Control-IQ research when it was announced and more information was available. I always want to have the latest/greatest/best. I recently tried Lyumjev for several weeks to see if it was an improvement over Fiasp and it definitely was. Unfortunately, I couldn’t get Lyumjev covered by Medicare Part B. I have another thread on this… Lyumjev Insulin & Medicare Part B Coverage for Pumps