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Frustrated with Apidra (I think)

Discussion in 'Parents of Children with Type 1' started by Yellow Tulip, Nov 30, 2011.

  1. Yellow Tulip

    Yellow Tulip Approved members

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    I am looking for some input/advice/ideas regarding a switch from Novolog to Apidra. I switched my son to Apidra 2 months ago, after being on Novolog since diagnosis 2 years ago. At first I didn't see much of a difference regarding pump settings. I did notice that the highs are coming down faster and it is easier to keep spikes at bay. So I do like those things about Apidra.

    I am frustrated though with what seems like my complete inability to keep my son in range for a decent period of time ever since the switch. He's always either on his way up or down. When he was on Novolog, we had ups and downs, highs and lows, but I was always able to react to them and control them to an extent. We had days when his basal were clearly set well, and he was nice and flat when he wasn't eating. I felt I was able to spot trends and fix them.

    Not so much now. If I see he's trending high, I'll change basal by one increment, he goes low. Change it back, he goes high. Changed start times of various profiles to affect duration of certain basal settings - I'm not seeing the desired results. I am just so frustrated with this. I would rather not switch back to Novolog, as I do see how Apidra's response time is faster, but ultimately, I'm starting to wonder if I'm not doing my DS any favor by keeping him on it.

    I feel like I'm starting to ramble, so let me wrap it up. For those who switched to Apidra, what was your experience? How did the basals change? Did you have to do a complete basal overhaul? Are there any ideas you can pass on to maybe help me figure this out?

    Thanks a bunch!

    Arleta
     
  2. JackyH

    JackyH Approved members

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    Hi Arleta,

    I love how fast Apidra works - but I will admit that we see exactly what you are describing. I have found that on Apidra our highs are higher and our lows are lower. When I went back through our CGM stats I could see that on Humalog all our graphs were smoother - with Apidra we have peaks and troughs. Although we have our lowest A1C in two years with Apidra, three days in a row of hitting the 1s (<30) the lows were really getting to me. So we switched back to Humalog for a week and we went back to smoother BGs - we still had lows but 60s which I can take.

    Unfortunately, we then hit his crazy basals period (happens every couple of months) and Humalog just cannot touch those BGs so we switched back to Apidra and that deals with those high basals and corrections admirably with no lows because he needs so much insulin. So what I have settled on is a mixture - Humalog when things are going well with maybe the odd high correction with a shot of Apidra and Apidra in the pump for the hard times. We'll see how that works for us.

    We never got a handle on the swings and ultimately, I just grew tired of it. I'm not much help, sorry.
     
  3. Michelle'sMom

    Michelle'sMom Approved members

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    We saw the same kind of craziness for the first 2 or 3 months with Apidra. We finally settled on a basal that was a bit higher than she needed, & we just made sure she had a small snack or a tab to keep her from dropping too much. I'm not sure if it took a while for her body to adapt, or if it was just some strange phase she was in, but things have settled down the last couple of months. We've seen much steadier numbers around the clock.

    I do think Apidra is much less forgiving than Novolog. If her basal is off by even a little, she drops or spikes in a hurry.
     
  4. Yellow Tulip

    Yellow Tulip Approved members

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    Thanks guys. I'm glad to hear it's not just us. What I did end up doing yesterday is setting up hourly basal profiles. That gives me more flexibility to adjust things in smaller blocks of time. Some of them are the same for a few hours at the time, but I feel that if I need to change something I have the ability to do it gradually. It might just be a coincidence, but last night was one of the best nights we've had in a while.

    Michelle's Mom, you put it exactly right when you said Apidra is less forgiving. I couldn't find the right words to describe it, but that's exactly what I was feeling.

    Jacky, switching between Apidra and Novolog is certainly an idea! I didn't think of that. It's good to keep that in mind. Thank you!
     

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