Switching from Novolog to Apidra Options

[gigem99]

I was given about 6 vials of Apidra. I've always used Novolog in my pump. Has anyone switched from Novolog to Apidra? Have you noticed any problems? I've read that some folks have switched and used less Apidra than Novolog (or Humalog). Has anyone experienced this? I'm nervous as heck about this. I sure am glad I have my CGM for this transition.

I also was given some Humalog pens. I'll probably try to extract the Humalog from the pen and fill a reservoir with it.

Damn, I hate being without insurance.

Tom

[Liz]

I was given about 6 vials of Apidra. I've always used Novolog in my pump. Has anyone switched from Novolog to Apidra? Have you noticed any problems? I've read that some folks have switched and used less Apidra than Novolog (or Humalog). Has anyone experienced this? I'm nervous as heck about this. I sure am glad I have my CGM for this transition.

I also was given some Humalog pens. I'll probably try to extract the Humalog from the pen and fill a reservoir with it.

Damn, I hate being without insurance.

Tom

I have no experience with Apidra, but it is very easy to fill a reservoir from a pen if you have some pen needles. When I first got my pump I used up the rest of my Humalog pens to fill reservoirs. I attached the needle to the pen, dialed up the maximum does, and stuck the pen needle into the tiny rubber stopper of the reservoir. Push the button to inject the insulin into the reservoir, and repeat as needed until the reservoir is full. I was using 300 unit Humalog pens so I kept dialing the maximum dose until it was all transferred into the reservoir. If you don't have any pen needles, you can just use a syringe to suck it out of the pen and inject it into a reservoir.

[JohnG]

I was given about 6 vials of Apidra. I've always used Novolog in my pump. Has anyone switched from Novolog to Apidra? Have you noticed any problems? I've read that some folks have switched and used less Apidra than Novolog (or Humalog). Has anyone experienced this? I'm nervous as heck about this. I sure am glad I have my CGM for this transition.

I also was given some Humalog pens. I'll probably try to extract the Humalog from the pen and fill a reservoir with it.

Damn, I hate being without insurance.

Tom

I used two sample bottles of Apidra (40 days) and found no difference in my TDD. I gave myself a couple of meal boluses using a syringe before
loading my pump just to get some idea how I was going to react to it. My Endo said John your not going to see a Big difference and he
was right. It’s U100 insulin so there is little or no difference in how may units it takes to lower BG...they just say it has a faster onset.
Every time I bolus my BG response is different so I could not really say it always had a faster onset. YMMV

[meeaow]

I have no experience with Apidra, but it is very easy to fill a reservoir from a pen if you have some pen needles. When I first got my pump I used up the rest of my Humalog pens to fill reservoirs. I attached the needle to the pen, dialed up the maximum does, and stuck the pen needle into the tiny rubber stopper of the reservoir. Push the button to inject the insulin into the reservoir, and repeat as needed until the reservoir is full. I was using 300 unit Humalog pens so I kept dialing the maximum dose until it was all transferred into the reservoir. If you don't have any pen needles, you can just use a syringe to suck it out of the pen and inject it into a reservoir.

Maybe there is a difference between the Minimed and the Animas reservoirs, but I use the 300u vials all the time to fill my pump because it is really easy. I just attach the reservoir needle to the end of my reservoir, stick it into the cartridge and then use the needle cap to push the rubber plunger of the cartridge which fills the reservoir. Could you do that with the Minimed?? My apologies if you can't (IMG:style_emoticons/default/blush.gif)

[gigem99]

I started the Apidra today. So far - after about 6-8 hours & 2 meals, everything looks the same as with the Novolog. My gosh, this is a relief. I was nervous about this, but it looks like it was no cause for concern.

Tom

[JohnG]

I started the Apidra today. So far - after about 6-8 hours & 2 meals, everything looks the same as with the Novolog. My gosh, this is a relief. I was nervous about this, but it looks like it was no cause for concern.

Tom

I was nervous and had trouble sleeping the first night and tested several times but I could not tell any difference in my basal
compared to Novolog®. I usaly bolus 15-30 min before meals and during the 40 days on Apidra® I never experienced
any lows on the front end of my meal bolus but I've never had a big problem going low on the front end of a bolus unless
I get busy and don't eat for a hour or longer...

[Ralph]

I was nervous and had trouble sleeping the first night and tested several times but I could not tell any difference in my basal
compared to Novolog®. I usaly bolus 15-30 min before meals and during the 40 days on Apidra® I never experienced
any lows on the front end of my meal bolus but I've never had a big problem going low on the front end of a bolus unless
I get busy and don't eat for a hour or longer...

I was told sometime ago that NOVALOG is the only approved insulin for the 722 because that is what MM used to get FDA approval.

[Bollar]

I was told sometime ago that NOVALOG is the only approved insulin for the 722 because that is what MM used to get FDA approval.

For Medtronic, it's "labeled for use with Humalog, Novolog.": http://www.medtronicdiabetes.net/treatment...herapy-overview
For Animas, it's Humalog, Novolog & Apidra according to the Owner's Booklet that came with my Ping.

[Mike G]

For Medtronic, it's "labeled for use with Humalog, Novolog.": http://www.medtronicdiabetes.net/treatment...herapy-overview
For Animas, it's Humalog, Novolog & Apidra according to the Owner's Booklet that came with my Ping.

All I can tell you is that I have only ever used Apidra with the 523 and Revel and have had wonderful results. Apidra is fine and you have nothing to worry about.

[Marty]

All I can tell you is that I have only ever used Apidra with the 523 and Revel and have had wonderful results. Apidra is fine and you have nothing to worry about.

My endo told me that Apidra can be a problem for people with low basal rates, ~0.4u/h, like me. As I've commented before, my brief experiment with Apidra did not go well-Highs attributable to interruptions of Apidra flow in the tubing followed by rapid crashes due to delivery of "backed up" insulin. I'm sure Apidra works very well for most people, but people with low basal rates should be alert to similar problems when switching to Apidra.

[gigem99]

My endo told me that Apidra can be a problem for people with low basal rates, ~0.4u/h, like me....

I'm beginning to wonder if this is the cause for all the 'No Delivery' alarms I've been plagued with for the past couple of months. I take a little more than .4 u/hr, but not a lot.

I think when this vial of Apidra is gone, I'm switching to some Humalog that I've had stashed for a while. It expired in 11/2010, but I'm really not too concerned - I don't think. I'm definitely gonna keep an eye on it.

Tom

[Mike G]

My endo told me that Apidra can be a problem for people with low basal rates, ~0.4u/h, like me. As I've commented before, my brief experiment with Apidra did not go well-Highs attributable to interruptions of Apidra flow in the tubing followed by rapid crashes due to delivery of "backed up" insulin. I'm sure Apidra works very well for most people, but people with low basal rates should be alert to similar problems when switching to Apidra.

Could be - can't see how that would matter - but I have a basal of .8

[jbkjr]

Tom,
I have been on apidra for 7 years and on a few occasions I have had the insulin crystallize in the set. If I go extended periods of time with no bolus in the heat(I'm in SC and it's hot, don't know if this contributes or not) it has clogged also. When I remove the set it's like sugar crystals and you can "crunch" the insulin with your fingers. I have only had this occur 5-6 times. I would get an occlusion alarm most times. My doc warned me this could occur. It was always near the end of the 3 day cycle. I had my basal set to .25 for 4 or more hours when this would occur. Not sure if I recall this being mentioned on here or not.

J. B.

[gigem99]

....I think when this vial of Apidra is gone, I'm switching to some Humalog that I've had stashed for a while. ...

I switched over to the Humalog a couple of days ago. As I used the Apidra, I noticed my TDD gradually creeping up - I had gotten up to 30-35 u/day. It looks like with the Humalog, my TDD is dropping back down to around 25 u/day, which is essentially where I've been for the past 4.5 years I've been pumping.

The Humalog appears to be fine even tho it expired about 18 months ago.

Weird.

Tom

[Liz]

I switched over to the Humalog a couple of days ago. As I used the Apidra, I noticed my TDD gradually creeping up - I had gotten up to 30-35 u/day. It looks like with the Humalog, my TDD is dropping back down to around 25 u/day, which is essentially where I've been for the past 4.5 years I've been pumping.

The Humalog appears to be fine even tho it expired about 18 months ago.

A couple of years ago when cleaning out the bottom shelf of my fridge, I found a bag with 9 vials of Humalog in it that I had forgotten about. The insulin had just expired when I found it. I decided to use it anyway even though I had newer stock. A few times I had problems with high BGs and thought maybe it was the insulin so I switched to a non-expired vial but had the same results. That batch of expired insulin lasted about a year and was fine right up until the last vial. If I had found the insulin a year after it had expired I might have thought twice about using it.

[gigem99]

My endo told me that Apidra can be a problem for people with low basal rates....

I was at a Diabetes Expo today sponsored by the ADA, and I spent quite a bit of time talking to the Novolog rep. He told me that the Apidra folks had sponsored a study to show that Apidra didn't occlude like Novolog and Humalog.

Their study backfired on them - he said that in the study, Apidra occluded 41% of the time, Humalog 16.2% and Novolog 9.2% of the time. I suspect that's what your endo was talking about - the insulin occluding. I do know I had a bunch of 'no delivery' errors with the Apidra. I don't think I'm going to use it again unless I have to.

He was a pretty interesting guy - I spent about 1/2 hour just chatting with him.

Tom

[jbkjr]

I was warned about apidra crystallizing in the set. I have had this happen 3 times in 6 years. All times I had not eaten for hours and it was hot as the dickens. My basal rate is from .4 to .75 an hour. Having not dosed a bolus lead to this problem with the heat. I did not get an occlusion but when I pulled the set you could crunch the insulin in the set and see the crystals. I average 220 carbs a day and the apidra for me works faster with less of a tail at the end. I have not tried lilly brand but did try the novalog. Novalog would last too long for me as I would be high in the middle and low at the end of 4 hours after meal. If this happens again I will have to try and get a pic as I could squeeze the crystals out of the set on the tip of my finger.

[calvic]

Interesting topic. I've recently switched from Humalog to Novalog due to insurance changes. I have been low B/S issues now. I've really had to cut back on my basals.