I could use some advice folks. Saw my endo today, and he had no problem switching me to a trial of Apidra. I'm currently pumping novolog. I have horrendous pp spikes, even if I pre-bolus, so I'm hoping the switch will moderate the spikes some. I'll start tomorrow, next set change. I understand I'll have to change sets every other day instead of every 3?
My novolog is set to 3.5 hrs duration... how much should I lower it? Start with 3 hrs? 2.5?
He said my basals should stay the same... yes?
Do I still pre-bolus? How much?
Anything else I didn't ask? LOL
Thanks for any advice...
I think everyone is different, and you'll have to do some trial and error to see what's best for you. I don't find I need to pre bolus, but if I do, I don't do much past 15 minutes. The biggest difference for me was that I stopped having post-prandial lows. With novalog, if I adjusted my carb ratio to get me in range 2 hrs after I ate, I would ALWAYS go low at about 2.5-3 hrs post meal. In my body, Novolog always has this weird second peak between 2.5-3 hrs. Apidra works faster and doesn't seem to have that second peak for me.
Jrtpup, I have been on Apidra for over 5 years. I notice that for me,it starts to work about 20-25 minutea after injecting, if ou are in normal range. It corrects a high in about the same time as N=Humalog, which is th last insulin I use efore changing to Apidra.. I changed becaus my endo says it would be less cahnce for apodra to clog in the pump. I neve had that problem that I can recall, but I just went along with his recommendations. I used the sam amount of basal and still prebolus by 15-20 minutes Apidra lasts for me about 2.5-3 hours, depending on the time of day. I really do not see THAT much of a difference from the Humalog.My high pps are usually because I overeat and underbolus due to miscalculated carb counts, or am having a site issue. And I am finding I ablsolutely must change by no lster than the beginning of the third asnd I used to be able to go well into that third day before I changed out the set, with good absorption,but lately I am finding that the set sites are getting sore and lumpy, even a little inflamed with poor absorption after 2 1/2 says. Has the new Apidra changed its make-up? I never had these skin inflammation/iritation problems unti recently, when Apidra started coming in a blue, rather than a white box. Is there a new formulation?
Maybe I will need to go back to humalog.
The samples the endo gave me are in a white box. These expire 1-13. Are they older than the ones you're using?
Yes. I have Apidra in Navy blue boxes. This newer order expires in 4-14. That is is why I am asking. The ones that did NOT that do not appear to inflame my skin were due to expire, like yours in the white box, in 1-13.
I felt some very slight irritation with the Quickset duration ( 3 full days) this time, but still a lttle redness around the site.. I will see how the Mio does with the Apidra in newer packaging. Maybe that is all that has changed.
Haven't really figured the Apidra out yet, for me. I seem to go up just a tad 1 hr pp, then spike some at 2 hours. Haven't made sense of it yet! My basals seem to be doing about what they were with novolog.
I was a bit lightheaded the first day, but seems to have gone.
To me fast is not always good. Some components of our food will take longer to digest. Thus if Apidra builds up quickly and fades out too fast you will see an uncovered spike later. This is why I prefer NovoLog. It is quick and at the same time it has a small tail to cover the remainig carbs after the 2 hour mark.
I switched to Apidra to try and smooth out the spikes I get an 1 hr. Novolog just isn't fast enough for me. So, I'm thinking maybe I need to do combo boluses with the Apidra.
Humalog worked fine if I ate <10 carbs - not what I'd call a huge spike - but more than that and I'd spike (unacceptably high, for me), then crash to where I'd intended to be. (I generally eat ~30 carbs a day).
This is going to be a longer learning/tweaking curve than I'd expected LOL Suggestions welcomed ;)
I like your new picture. I was just looking at it on your page, and at the pictures of your pups, and I had an aha moment what your name stands for. Jack Russell terrier pup?
OK, on to the subject at hand: Apidra insulin. I have my duration of action set at 4.5 hours. Gary Scheiner in Think Like a Pancreas says rapid-acting insulin-Humalog, Novalog and Apidra-starts 5-15 minutes, peaks 3/4-1.5 hours, and lasts 3-5 hours. John Walsh says in Pumping Insulin that it takes a minimum of 4 to 6 hours for all of the insulin action from a recent bolus to stop lowering the blood sugar. I try to pre-bolus 15 minutes before I eat.
it takes a minimum of 4 to 6 hours for all of the insulin action from a recent bolus to stop lowering the blood sugar
4 to 6 hours can not be true. If it starts to work after 15 minutes it will NOT take hours to lower the blood glucose.
I think there's some "hedging" in the use of 3-4-4.5 hour times for duration. Most of the insulin has run it's course but I think that there may be some floating around too. I think that this is most prevalent at times when your metabolism slows down, particulrly at night, stringing tendrils of "action" beyond when the "duration" says it's done. I refer to this as the "tail" but, sometimes, the tail can wag the dog?
After thinking about it I came to the conclusion that Sue's more general description of 4-6 hours taken from Walsh will fit more people than mine. For me it is up to 4 hours but others might respond very differently. The greeting box of every newly diagnosed diabetic needing insulin should contain all the different brands to try. This together with a hand out what to look for when testing them: who is wagging who and where is the tail of this madness?
Novolog had a 3 - 3.5 hour action for me. Not a thing left after that. YDMV, as usual