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DIA for Apidra

Discussion in 'Parents of Children with Type 1' started by Charlotte'sMom, Aug 14, 2012.

  1. Charlotte'sMom

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    What is yours set at? I'm just looking for other people's experiences to get an idea. I've never done enough testing to tell with my 5 year old, so I just put 3 hours into the pump settings and haven't seen anything glaringly obvious to suggest it's off.

    Still trying to fine tune basals and I can't decide if the gradual decline at the 3-4 hour mark is a basal issue or just the tail of the apidra.



    When I search "dia apidra" it tells me "dia" is too common on not included in the search results, so I'm not finding relevant search results.
     
  2. Flutterby

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    We have ours at 3hrs.. I suspect it may be a bit shorter, but I don't have the option to change it to 2.5 in her pump, so we keep it at 3, I'd rather it a bit longer than to short.
     
  3. emm142

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    It was 3 hours for me.
     
  4. mrcool

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    Ours is set at 2.5 hrs. Initially I set it at 3 hrs (coming from Novolog's 4 hrs), but it seemed not to last quite that long. But I haven't really done any testing to see how right it is, it just seems to work. ;)
     
  5. Charlotte'sMom

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    Wow! I didn't realize for some it was even less than 3 hours.

    So, a related question then... I'm hoping to adjust Charlotte's basals in such a way to avoid lows from recess and PE which are both between 10-11am. Right now I have a basal decrease set to start at 9am. Should I change that to 830? Or should just lower the 9am basal amount a smidge more?
     
  6. sarahspins

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    Mine is currently set to 3 hours... but usually I disregard the IOB when it's under about a unit, which is where it would be for an average meal bolus towards the end of the 3 hours... I think most of it is usually used up within 2.5 hours, but I was having some trouble with what looked like stacking when using that DIA, but sticking with 3 hours, even when I ignore the IOB seems to be working fine for me... go figure, since the net effect should be the same.

    I had to adjust ALL of my daytime basals with Apidra when I went on it.. with less of a "tail" all of those basals had to be bumped up a bit to compensate - which overall evened out my basal rate profile significantly (previously I needed much more basal at night, which makes sense if I was relying on an awful lot of "tail" to keep me in range during the day). I also had to slightly tweak my IC ratio a little as well, and I rely on combo boluses more often than I had on Novolog.

    I have also found that personally, 3u is the limit to what I can bolus at once and expect all of it to work.. I don't know why or what happens, but larger boluses all at once just aren't as effective If I extend them they work much better (that goes for large boluses for food as well as larger boluses for corrections).
     
  7. sarahspins

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    When does she normally have breakfast? That would really make a difference in the timing as well... if some of the breakfast insulin is still active she will probably still go low no matter what you do with her basals (though lowering that and/or starting it sooner will help, but it may not prevent that low if it's meal related). It might be better to back off on the breakfast I:C a little if she's going to bring that down pretty quickly with the activity.
     
  8. Charlotte'sMom

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    I'm hoping to have her bolused by 7am. That way by 10am I can reasonably hope it's out of her system. Today her bolus was at 7, but her blood sugar was still coming down a little bit between 10-12, more than I'd like anyway. I'm hoping to do some basal testing on Friday morning when she's at school to see if it's working the way I think it's going to work.

    Also, most of her boluses are less an 1 U. If we ever have pancakes or something really high carb it can up to 2-2.5 units. But I've been keeping her breakfasts low carb at least this first little bit as school is starting out.
     
  9. Michelle'sMom

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    This is almost exactly what we see with Apidra....much higher basal needs. Our DIA is set to 2 hrs. Based on what we see on the Dexcom, it's actually about 2 hrs 10 mins.

    Larger corrections don't work here either. We bolus part of it, & run a good sized temp basal along with it.
     
  10. mmgirls

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    Breakfast it is 3hrs because it is a much larger bolus compared to the rest of the day. otherswise it is around 2.5hrs. I leave it at 3hrs and lower the ISF at school since there is only one duration setting.
     
  11. Darryl

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    We started using Apidra when Leah was 9. The DIA is around 90 minutes except for large boluses, it can be 2 hours. It can be a lot faster than other insulins, so worth some testing to find out.
     
  12. Charlotte'sMom

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    That's really interesting that you find different DIA depending on the size of the bolus. I'll admit that with a 5 year old who resists basal testing, I just don't pay that close attention to whether it's basal or bolus affecting her bg and get myself into "just fix it and move on" mentality rather than really fine-tuning pump settings. With school I've been forced to pay more attention as I want her as steady as possible.


    Here's how today went

    630am - 161 bg
    654am - 1.85 bolus (added a banana to breakfast, and this is fairly large bolus for her as most are closer to just 1 unit
    1000am - 151
    1100am - 153 (and here I start to get all cocky thinking I've perfected her basal patterns!)
    1130am - 92 AND she informs she had a juice box on the bus within the last 15 minutes. Dex is currently holding steady at 120-ish

    Ugh.

    Here are her most recent basal patterns.

    330am - .125
    630am - .300
    830am - .225
    900am - .200
    1100am - .275

    Could the .275 basal at 1100am be what's pulling her down that fast? Surely it can't be that quick?
     
  13. wilf

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    Next time she's high, try a correction and measure every 30 minutes without giving carbs or additional insulin until she levels out. That will tell you how fast she's responding to the Apidra.
     
  14. Mish

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    nope. That's doubtful, especially if she had a juice box just before that. That basal wouldn't be doing anything yet. I'd probably look at the 9am basal BUT, it could just be a fluke.
     
  15. hawkeyegirl

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    I would also look at the 9am basal.
     
  16. Charlotte'sMom

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    I'm thinking that may be it. Is 9am early enough? I'm thinking I'll start a .200 basal at 8am. Or maybe .175? I'd like to send her to school tomorrow doing some basal testing, but already it's making me nervous.

    If Apidra is this fast, I'm surprised that she still spikes into the 250s with some whole grain toast, eggs and cantaloupe. I try to prebolus by 15 minutes. Today she had homemade yogurt (aka: slightly tart) with breakfast and she spiked into the 300s, but came back down to 182. Maybe her I:C still isn't low enough? It's just hard for me to grasp having I:Cs that low when the days of 1:45 ratios seem so recent. :eek:
     
  17. Mish

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    We've recently started apidra. I can't say that I really much difference in how fast it works for us.

    I've also found that in my child, even a 30 min prebolus isn't too early. I can watch on the CGM and on novolog I'd not see any budge for 45 min or more sometimes. It was crazy. Insulin just seems to take a long time to work with him.
     

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