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Prebolusing and extended boluses with Apidra

Discussion in 'Parents of Children with Type 1' started by buggle, Jul 4, 2011.

  1. buggle

    buggle Approved members

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    Brendan is finally pumping again. We're going to try Apidra today. For those of you who've switched, what are the main differences? What is the difference in prebolus times and how do you change the patterns and timing on your extended boluses? What time do you set DIA in your child's pump?

    Thanks in advance!
     
  2. Michelle'sMom

    Michelle'sMom Approved members

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    Main differences for us:
    Meal spikes are blunted, corrections usually work faster, numbers are much smoother & best of all it's done in 2 hrs with NO tail.

    When sites fail, there is NO doubt! BGs skyrocket fast!

    In the case of a BG >300 (usually a site failure for us), the highs can be really stubborn. We get around this by using a temp basal along with the correction.

    We prebolus 10-15 mins instead of the 20-30 with Novolog.

    CDE had us start out with the DIA set for 3 hrs. Using the CGMS, we've found that's it's pretty consistently finished at 2 hrs.
     
  3. Darryl

    Darryl Approved members

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    We don't prebolus with Apidra. Try it without prebolusing and you might find that spikes are reduced simply due to the speed.

    I'd start without making any changes, so you have a good baseline. Watch the CGM (you are using one?) and you'll see soon enough what needs to be changed. You can expect shorter DIA, maybe half of what you're used to. We ended up increasing doses around 25% to come out even vs. Humalog, but others have reported different results, so I don't think there's any rule you can go by at first.

    Good luck and let us know how it goes...
     
  4. chbarnes

    chbarnes Approved members

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    The DIAs that have been posted here for Apidra vary quite a bit. Anywhere from 1 to 3.5 hours. Start with your settings for Novolog and make adjustments from there.
     
  5. buggle

    buggle Approved members

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    Thanks for the input. So far, it seems to be going pretty well. But, as you all say, it's going to take time to see how Brendan's body reacts under different situations.
     
  6. Flutterby

    Flutterby Approved members

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    We do prebolus with Apidra, we don't need to prebolus as far in advance as we did with novolog.. If we time everything right (LOL) we do not see a meal spike at all, and not low at the end. Its help a lot with out dinner/bedtime mess.. I did have to make some changes at first, but then everything went back to where it was before about a week later. Overall we're loving using apidra. :)
     
  7. Jacob'sDad

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    I don't think Apidra makes enough of a difference that one can expect to never have to prebolus. Breakfast cereal, for example, can still cause a spike well over 300 without a prebolus. However, if Apidra shaves :15 off the prebolus, then that may be enough to not have to prebolus at all for slower acting carbs.
     
  8. hawkeyegirl

    hawkeyegirl Approved members

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    I'll be interested to see what you learn re: extended boluses. Honestly, that's the one thing keeping me from trying Apidra. I cannot IMAGINE having to figure out extended boluses again for pizza, pasta, etc. It took me over two years the first time around!
     

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