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Apidra...I wanted to love you...future of 'fast insulin'?

Discussion in 'Parents of Children with Type 1' started by Dave, Aug 29, 2013.

  1. Dave

    Dave Approved members

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    I just finished up a two day trial of apidra - boy did I try. I tried with my heart and soul. I just had too much trouble.

    First the good - its dependable. It clears in 3:15 on the nose. This means wherever my DS landed, then I could correct and be done.

    Now the bad...for some reason it took awhile to really kick in. And thats sort of ok...we tested blood sugar every ten minutes after bolusing and still no movement after 30 minutes...we would eat at that point.

    Blood sugar would then go up pretty fast after eating and hang until about 2 hour mark...we were low carbing to really try to learn and be careful. At a spike of about 200, suddenly there is a whoosh in hour three. The drop made my son feel low.

    As someone who stacks boluses (1 unit every hour and feed twelve carbs every hour in a workable attempt to keep postprandials about 140), I couldnt use that trick with apidra - it was too difficult to time the comedown...you could get in a situation where you are dropping 200 points in an hour if you screw up or get hung in the 300's.

    Our A1C is 5.9, so Im back to the humalog since we are having success with that. Really wanted the apidra to work though.

    So when you look ahead to inhalable insulin as a 'fast acting' insulin...it makes me wonder if fast acting is such a good thing. Really what we need is instantaneous insulin, but also tiny amounts of glucagon to control.
     
  2. mamattorney

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    My daughter's never tried anything but Humalog, so I'm not an expert about Apidra, but I'm a little hung up on this. Your child eats food on a regular basis at a rate of 12 carbs an hour?
     
  3. Michelle'sMom

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    Interesting. The first time out we lasted 2 days...with constant highs that wouldn't budge. It was a weekend & i wasnt willing to send her to school with jacked up numbers. We tried again over a spring break holiday & it still took a couple more weeks to get the pump settings right. IME, stacking with Apidra is not a good idea. Once it kicks in the drops are fast & hard. It took a while for me to get the hang of things with the shorter DIA.

    Our insurance refuses to cover Apidra now so we're back to Novolog. I miss Apidra. :(
     
  4. Jaredsmom

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    That was one of our issues with apidra it dropped Jared so fast it made him feel like he was going low when in reality he may have only had either a mild low or no low at all. Jared would then over treat those lows ended up on a never ending roller coster. We also figured out for us it wasn't stable in the pods. We ended up ditching the pods before we figured out it was probably the apidra all along. Although we did have a lot of kinking with the pods which was resolved by switching to the ping with a steel set. Since switching back to novalog everything is much more stable.
     
  5. Joretta

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    We love Apidra. My child's A1c is better on it than Novalog or humalog. We tend to bolus as she starts to eat and her numbers run great. I guess we are just lucky.
     
  6. Ali

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    My experience. When you switch to Apidra, basals will change also. It took me three months to start working well with Apidra, at least on a 24 hour basis with a pump. FWIW Apidra for me is more temperamental in a pump re clogging so you may need to change sets a bit sooner-the same was true for me with Humolog. Novolog was the easiest in terms of clogs and stability. A lot depends on the foods you eat and how you correct etc. I simply love Apidra because I can bolus and eat almost right away and I know when it is done and my corrections work super fast. But I am an adult with years of experience and a more consistent specific type diet. Ali
    PS I mention the basal cause that may be clouding your view of the action time. It may work slow for you but for me Novolog and Humolog 15 to 20 minutes to start, Apidra working strong after 10 minutes. I usually bolus and try to eat within 5 to 10 min max. It peaks with my food and zero tail. I can bolus enough to cover my carbs without having a huge tail that I am scrambling to feed at the two hour point after eating. For most of my life on other insulins Reg, Humolog,Novolog I was feeding lows at 2 to 2.5 hours post meal if I truly controlled the food spike.
     
    Last edited: Aug 30, 2013
  7. Michelle'sMom

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    Our experience was similar, & we also found Apidra was much less forgiving when it came to basals. If basals were off it sent her into a very distinct rollercoastering. Pre bolusing 30 mins with Novolog will help us catch the spike, but since we can't always do that, we're back to the spikes followed by that extremely long tail.
     

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