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Apidra as a bolus insulin

Discussion in 'Parents of Children with Type 1' started by Toni, Feb 19, 2010.

  1. Toni

    Toni Banned

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    Does Apidra need more of a combo bolus for higher fat foods than Novolog? Already using more Apidra for food; basals went up very slightly and sensitivity seems the same so far. Apidra had a DIA of a solid four hours (no tail) since we started using. It kicks in quicker, though. No cgms on so can't see exact action. Apidra was 130 at the 1.5 hour mark and 200 at the four-hour mark after breakfast today. I am 1000% positive about the basals until 3pm (have gotten a fasting basal this week). 45 gram breakfast: saltines, pistachio, mozerella slices, clementine. Had good numbers last night after dinner because I upped the basal by 40 percent temporarily.
     
  2. Mom264

    Mom264 Approved members

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    I can't answer that for sure because I don't think I had the right combo bolus with Novolog -- we didn't have the CGMS for long with it, but I can give you my experience.

    For high-fat food -- Here is what I now do for Chinese buffet-- the food dd chooses is always the high fat, fried stuff. I do a dual wave 70% up front and 30% over 3 hours.

    I learned this after much trial and error and we no longer have a huge drop 2-1/2 hours after the meal or the tremendous unstoppable spike 5 hours after.

    For us 3 hours and 30% seems to be the right mix to keep the CGMS line fairly steady for Chinese food.
    Pizza is a little different.

    The other thing I have noticed about Apidra is it seems tougher to bring down a big spike. And adding Spike and additional food really complicated things. So, if the BG is very high prior to a meal, I correct and bolus and do not begin the meal until the BG has come down substantially.

    And if the BG is over 150 at meal time, I bolus and wait 15 minutes. But if the BG is normal I bolus and let her eat right away.

    Also, it took a few weeks to settle into Apidra. I would recommend connecting your CGMS as you figure how Apidra works for you. I found it very helpful.
     
  3. sarahspins

    sarahspins Approved members

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    In my experience yes, but I've also offset that with *longer* combo boluses due to the lack of tail - that seems to be helping.
     
  4. Toni

    Toni Banned

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    I had noticed this first go-around, but I just noticed something else. I think it is tougher to bring down a big spike with Apidra but only when using as a bolus insulin. In other words, it's the food, I think. Not 100% sure yet. But our first night using, had to do a site change because BS was 359. With Novolog would do increase temp basal of 30 to 50 percent with such a high BS. This was a new insulin so I did not. She came down close to 100 points first hour and a half; another 87 points next hour; 50 next hour and was back to target hour 4. Then stayed completely flat. I have used for corrections when she is sleeping, took down a 140 to 90 again. But with food, all bets are off. Sis had better persuade her to put Dex on because I need to see what is going on. P.S. Apidra seems very flat as a basal; she is holding very steady overnight on it. So far.... crossing fingers.......
     

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