Apidra in a pump

[vicktrick]

Does Apidra work faster in the pump? is it worth me changing from Humalog?

[everydayupsanddowns]

There are some members here who pump Apidra I think. When I switched to a pump I was moved from Humalog (back) to NovoRapid as my DSN had had problems with Humalog crystallising in tubing. That said, I know several peeps who use Humalog in pumps without problems.

What problems are you having with Humalog? What are you hoping to achieve?

[Si Greenwood]

Used Apidra in my pump for about 12 months and never had a problem with it at all. I also find that Apidra is the fastest working Insulin I've tried, gets into the system and peaks quickly and then is all gone after 3.5 hours or so.

[sedge]

Think Winni may have pumped with it too?

[Dollyrocker]

I'm hoping to change to Apridra next time I have a review, I love the idea of only having a 3.5 hour 'active' period

[Winni]

Yes-it definitely is gone much quicker. I've got my active time set to 4 hours (the dr was very sceptical about it being less than that-I think Si is closer!).
I found it was much quicker when I used it on MDI. Not overly convinced about it in pump compared to novo. But I still think it fits my needs better than anything else available.

[everydayupsanddowns]

I've got mine set for 4hrs for Novo - which is too short really, but 5h was meaning I constantly had to ignore IOB and/or correction suggestions after eating. Tch! Never straight forward!

[Dollyrocker]

Gosh, I was told to set my novo active time at 6 hours! I nudged it down to 5 after a few months and it works much better

[sedge]

My hospital automatically set Novo and Huna at 4 hours.  Dunno bout Apidra cos nobody that day was on it.

[everydayupsanddowns]

Gosh, I was told to set my novo active time at 6 hours! I nudged it down to 5 after a few months and it works much better

I was told 'it's individual' and that higher was safer. Started at 5, which is probably strictly speaking more accurate, but I nudged it down to 4 which works better more of the time I think. A few extra low-ish levels have snuck in, so I prob need to tweak target range or some other settings. I think my problem is that the predefined 's' shaped medtronic curve is not how Novo acts for me, so the duration might be OK but the calc of effective units doesn't play out right. Setting a shorter-than-actual duration is just a compromise in the other direction. Swings and roundabouts really!

[sedge]

Or alternatively your own requirements have changed, which has really been (and still is) quite a learning curve for me pumping - ie how often this happens!

I really appreciate what an awfully blunt instrument MDI is, in comparison.

Wouldn't it be INTERESTING to be able to have a closed loop 'artificial pancreas' device for a couple of weeks or so, to see what we really need/use?  And whether the guesses we make with the pump doseages bear any resemblance to the facts?  LOL

[TerryG]

I use Apidra. Switched from Novorapid and found it was a bit shorter in duration. I was on 6 hours for Novo; now on 5 for Apidra and it seems to work for me.

[vicktrick]

Thank you. I just wanted to give it a try. I will speak to my Doctor about trying it.

My pump is set so it's gone after 3.5hrs on Humalog. My Pump trainer told me to set it at this. I have to say it seems right. I never have massive doses at anyone time so not much in me to be hanging around after that time anyway.

[cjo20]

My pump is set so it's gone after 3.5hrs on Humalog. My Pump trainer told me to set it at this. I have to say it seems right. I never have massive doses at anyone time so not much in me to be hanging around after that time anyway.

I've been looking at IOB calculations today (mine is currently set at 6 hours for novorapid, which I'm not convinced is entirely correct - I'm debating lowering it to 5 hours) and the suggestion seems to be that if your insulin duration is set outside of 4-6 hours for novorapid/humalog then the basal rate or I:C ratios might be incorrect. What proportion of your TDD is basal at the moment?

From a presentation by John Walsh (author of Pumping Insulin): "A DIA time less than 3.5 to 4 hours almost always indicates that basal rates or carb boluses are too low and is usually indicated by an elevated A1c level."
http://www.childrenwithdiabetesuk.org/wp-content/uploads/2009/09/bolus-on-board1.pdf

It seems like it is possible to get away with a too-short DIA as long as you aren't stacking doses. If you have a bolus for dinner, followed 30 minutes later by a bolus for dessert, then a correction 2 hours after that then the hidden tails of the insulin action may start to 'gang up' on you, causing a low.

I'm not saying that your setting is necessarily wrong - I'm not a trained professional, and if your current settings work for you then that is great - just trying to present what I've seen when researching it. You shouldn't change your DIA settings without talking to a professional.

[claireabell]

I've logged on here today to discuss this.  I have been to clinic today and mentioned that Apidra works much more quickly than novorapid in me.  I was told the two insulins should act the same but it very definately is not the case for me.  So as I seem to be more sensitive to the apidra we have agreed to put me on it.  I go back on monday to change insulins.  I'm looking forward to it after a very long time using novorapid.