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Novalog or Apidra

Discussion in 'Parents of Children with Type 1' started by TimO, Mar 24, 2010.

  1. TimO

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    What's better in the pump, Novalog or Apidra? We're seeing the endo tomorrow and I'm wondering who's pumping Apidra. I've heard it's faster-acting on highs than Novalog. Any input is appreciated!
     
  2. Darryl

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    We've found that Apidra is noticeably faster than Humalog (similar to Novalog), and the added speed has helped us achieve the best possible control since we can make corrections at shorter intervals. Have been using it in the pump (omnipod) for almost 2 years. It works great.
     
  3. Jacob'sDad

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    I think Apidra works faster for some than it does for others. For us it is faster too; maybe by 25 to 30%.
     
  4. sarahspins

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    This is very much a YMMV thing, but personally I notice it has a much "smoother" and faster action curve, and almost no tail at all. That's a good thing and a bad thing. In the past 6 months I've had more episodes of ketones due to bad sites than I ever had before... but since I can't really use Novolog or Humalog due to allergies it's something I've learned to try to manage better.
     
  5. Heather(CA)

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    Apidra is faster, but it's also more heat sensitive, it will go bad faster than the Nov. It will be interesting this summer when it's hot. I hope I don't want to throw the pods out the window....
     
  6. swellman

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    How much more so? Do you have a link?
     
  7. Amy C.

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    To add my experience, we live in hot, hot Texas and have noticed the Apidra going bad with the heat in the 4 years we have been using it.
     
  8. Darryl

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    We've never had Aprida go bad under any circumstances including long days at the beach in the summer (95 degree heat), and time in a hot tub. We are careful to keep the pod under her swimsuit or a shirt to avoid direct sun exposure, but prolonged heat outside has not caused a problem.

    There are times when BG goes high on day 3 and much more insulin is needed (just like on days 1 and 2), but if we happen to be changing the pod on day 3 anyway, we've never seen that the new pod / new insulin changes anything. If basal was high before the pod change, it's high after the pod change. It's easy to assume that high's are due to insulin going bad, but no reason I can see to assume that Apidra is different from Humalog, after using each with the same pump and CGM for more than a year with each type of insulin.
     
  9. alismom

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    We have been using Apidra in the Omnipod with no problem. It does work faster for my daughter and has never gone bad yet.
     
  10. Toni

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    Still working out the kinks with Apidra, but definitely staying with Apidra. Once again verified last night that DIA for Apidra for my niece is 4 hours.:eek: This is evident only with overnight corrections. But from hour 2 to hour 3 there is usually about a 30 point drop and a 10 point drop from hour 3 to 4. So it is a lot better. When there is food in the system Apidra seems to work a lot differently and she does not usually drop past hour 3. Novolog had a 4.5 to 5 hour DIA and a strong tail. So I would choose Apidra if I had to do it again. P.S. We have had a more than a few instances where the Apidra had to be changed 2.5 days instead of 3. We are on a new bottle and now back to 3 day site changes. She puts pump in jeans pocket and I think it may get overheated. Tell her to wear pump out on the waistband when she is home. Yes, agree with that warning regarding going high much faster if there is a problem. Literally in 1.5 hours she can be sky high if she needs a site change or in one case four hours if HIs on the meter before we figured out what the problem was (heating pad).
     
  11. Jacob'sDad

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    I'm going to agree with Toni that the slight tail with Apidra could possibly extend to four hours. I think it does that for us too. Even if that is true, I can't change the DIA in the pump to four hours because the algorithm for the IOB is based on the way Humalog or Novolog absorb, and would not be correct for Apidra. I would rather have the pump not show the slight tail of IOB from hours three to four than to see the pump showing too much IOB in the first couple of hours.
     
  12. Charlotte'sMom

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    I think Apidra works a lot faster. For the couple months we pumped with Novolog I was still overbolusing because DD can sometimes be a grazer so she'd be in the 300s all day. And even without grazing she was only back in a range a short time before the next meal. With Apidra she's back in range a lot faster. Her A1C is about the same, but life is easier without having to overbolus (and sometimes overfeed) DD.

    I've never noticed that it goes bad faster. But it's just starting to get really hot here so we'll see how that goes.
     
  13. Mom264

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    I like Apidra very much. I know it works faster than Novolog because I can see it on the CGMS. It also makes it simpler for me to see if something is a basal issue or a I:C ratio issue.

    Downside: when I miscalculate and the BG rises, it seems to take quite a bit more insulin (than just making up the insulin for the missing carbs) to bring down the high BG.
     
  14. hold48398

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    This is us in a nutshell!
     
  15. Toni

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    Yes, I set the DIA on the pump to 3 hours because Apidra is stronger first two hours. If cgms is on, down arrows still at 1 hour ten minutes to 1 hour 20 minutes (it has started working, just not peaking I guess) to 2 hours. Hours 2 to 3 much less of a drop. Hours 3 to 4 very little drop. I only notice this with corrections at night, not during the day.
     
  16. Jacob'sDad

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    I see this too, but it is difficult for me to absolutely pin it on Apidra. I think you could be right, but sometimes basal need just suddenly changes requiring a major temp basal increase along with a correction to bring BG back down. Without the temp basal, multiple corrections can be needed. Of course Apidra doesn't cause this, but the question remains: Does it take more overall insulin to correct situations like this using Apidra? I think it might, but I'm far from 100% certain.
     
  17. Toni

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    I think once high, it is harder to bring her down with Apidra. But not always. It is not consistent. With Novolog, I am very familiar. So if blood sugar is X amount (very high) I use X temp basal. If it is above target but slightly high, I use less than normal. I have not figured Apidra out yet, not by a long shot.
     
  18. Ali

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    I am no expert and working this all out myself.(I use Apidra) But because there is so little of a tail on Apidra the correction factor is going to be much different then on the other short insulins. Apidra might be a great insulin to use with Lantus as a background insulin (like 30% of your basal needs so you could adjust basal easily for ex or illness) stop gap safety measure. I at least do go high very quickly with a bit of a missed bolus calc or when basal needs change which is regularly or with a bubble, or a site with uneven absorption...you get the point. I love it but it is a different animal and mind set from all the other insulins I have ever used. I am working hard at making it work but it may take several years to work out all the kinks.:eek: Ali
     

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