Apidra® v. 140 | Sanofi-aventis

Apidra

It had been well over a year that I had been inquiring of Caleb’s endo about Apidra®. I consistently got two responses: (1) it’s the same as the other fast acting insulins and (2) there’s nothing wrong with Caleb’s management, so don’t mess with it.

I wasn’t convinced about point one, but I did accept point two.  Change plus diabetes often equates to hell on earth and I wasn’t too interested in inviting that in.  I wasn’t trying to change Caleb’s numbers, so buying into “if it ain’t broke don’t fix it” seemed reasonable.

But the problem is, it is broken.

His pancreas is broken and achieving acceptable blood sugars with a broken pancreas is a lot of work and I’ll take all the help I can get.

My gut told me Apidra® would help Caleb and after talking to a number of users, I firmly dug my heels in and instead of asking for an opinion, I simply asked for a sample.

Our Apidra® journey started a couple of months ago and so far I am enjoying the ride.

My sole reason for wanting Apidra® was to minimize the tail of insulin duration.  If I could minimize tail-chasing, I would be more than satisfied.

I cannot point to statistical specifics about how things have changed.  I just feel like it’s better. The changes have been subtle. But subtly better.

This is what I can tell you with certainty:

  • Caleb’s school nurse thinks it’s fantastic. She, more than me, sees a marked change in Caleb’s numbers.
  • I don’t talk to Caleb’s school nurse much anymore.  Caleb’s plan dictates that she call me with anything under 70 or over 200. We’ve gone more than two weeks without a call regarding blood sugars. TWO ENTIRE WEEKS! If we previously had gone two days without talking, I considered that a great success.
  • Caleb has fewer lows and I don’t find myself tail-chasing quite so much.

But this is what sealed the deal for me. We recently went to NYC to see Wintuk and went out to eat afterward.  I totally guessed at his carbs. My guess was 140 in total.

One hundred and forty carbs. All at once.

Caleb’s meals are typically fifty to eighty carbs.  One hundred and forty is almost certain to be a very bumpy ride at best. Consistency works with diabetes and doubling a meal bolus usually does not.

This is how it went:

Apidra v. 140 carbs

His blood sugar pre-meal was a nifty 105, it did not exceed 158 and there was no tail to chase afterward – he ended at a flat 109.  There was no big spike from the enormous amount of carbs he took in and no plummeting low afterward from a huge tail of insulin from a huge bolus.

Caleb has indulged similarly on other occasions and it was never this straight-forward.  Perhaps the planets were aligned this night and they will never be again. But my gut tells me that Apidra® is helping with Caleb’s D management.

I will leave you with this little tidbit:

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41 thoughts on “Apidra® v. 140 | Sanofi-aventis

  1. Originally what was his fast acting insulin? Sorry only ask because Cliffy is on Humalog and we are finally out of the honeymoon phase but experiencing an awful lot of both highs and lows.

    Looks great, the numbers seem awesome! And yay for no phone calls from the nurse.

    • Such an important detail that I left out! Thank you Bridget for asking. Caleb has always used Novolog as his fast acting prior to a couple of months ago.

  2. This is excellent news, Lorraine! I think I might try a sample as well. Novolog works good, but it’s stubborn for high blood sugars. Keep going strong! :D

    • i find the same thing to be true for me!!! Novolog works fine for my meals but whenever i corect for a little blip in the glucose, it takes FOREVER to work and i quite frankly find it annoying.

  3. I have to be frank, I am a little jealous and wondering what do I do wrong? Joe’s numbers RARELY look like this AND seriously…on the school nurse? WOW. If I had your parameters I would have been called THREE freakin’ times yesterday. All for highs, and then no ketones were checked – ugh – and I digress, sorry.

    I asked our endo about it too and received the same answer as you did. I think I will push harder in Feb. What about your post-breakfast spike? Has it helped there at all? Joe still spikes up to 400 then crashes down to a mid 100 level within 3 hours.

    Great post, as always!

  4. As I mentioned on Twitter, I pay more just do I can continue to use Apidra rather than the other insulins. I was on Humalog before and was constantly having super tail-inducing lows. Some people find that their insulin usage even goes down. I didn’t find that but I know that it is matching my digestion closer and that it brings highs back into range quicker.

    Glad it is working for Caleb too!

  5. Agreed, i got the runaround too…and in the back of my head I’m a bit like you were…why mess with a good thing? And times 3? Would I lose my mind? Maybe in the summer I’ll have the confidence to take it on. It is one of those things I have to make up my mind to push for. My mind is making itself up now….thanks for the post!

  6. Wow Lorraine! Love the look of that Dex!

    I asked about it and my daughters endo wanted to add Symlin instead. We held off on that. I think I’ll try talking to him about it again.

    Is Caleb using it in the OmniPod?

    • Ooo, Symlin. Interesting. I’ve heard many people having success with that, all adults though.

      Yes, Caleb is using it in the OmniPod

  7. I’m so excited about the piglatin name!!
    Camden’s Dr. suggested we try it in January but she had no samples at the time. The next time we went I asked about it and she acted like I was being ridiculous. I think it was something like, “How much faster/better do you think you can get than what you’re using?” It kind of made me feel like a dork for asking…
    p.s. it’s snowing on your website!!! love it.

  8. Thanks for sharing about Caleb’s experience with Apidra; I had pretty good luck with Apidra for the limited time I was able to use it (which ended a year later when my employer switched to a new plan), but in general, I found it worked pretty well for the reasons you mention! Thanks for sharing!!

    • Oh it breaks my heart that people are restricted that way. I’m hoping your employer makes another plan switch, but only if it’s for the better of the employees of course!

  9. Wow. I am jealous of Caleb vs 140 Carbs! That’s an amazing Dex line. Perhaps I’ll give another nudge about Apidra to my own doc….

  10. Wow! Thanks for the informative bit of information. When I see my endo next – going to ask him about Apidra in my pump (I used NovoRapid – think that’s like your Novolog in the USA?). To be able to have more level BG’s after a large carb amount is amazing! I had to guesstimate at many of the meals at my sis-in-laws recently due to her chucking out boxes (she uses alot of premade foods – unlike myself – where I cook from scratch and know exactly what is in it). I had some pretty ugly BG’s – even with careful combo boluses, I’m just not used to eating such high carb meals – even with taking the same amount I would eat here at home. You and Caleb have given me hope :)
    Curious – does Apidra cost more then what you used before? I know I’ve asked other Americans what they pay for their insulin – most don’t seem to know – as they only pay a “co-pay” – here in Canada we pay outright for the insulin – and then are reimbursed 100% (depending on if you have company coverage or government coverage). For myself, a bottle of NovoRapid is $35 CDN (I think – hubby has hidden the last receipts from the pharmacy in his “organised” system)..

  11. That’s really good to know!
    We just switched from Humalog to Novalog and saw a big change in blood sugars, similar to what you’re describing (despite official Endo guidance that they were identical).
    Now I’m curious about Apidra – thanks for posting!

  12. One question… we refer to a carb as a unit of 15grams. I assume you are referring to each mg. Otherwise, that would be a LOT of carbohydrates!

    Also, for our family, and probably for the vast majority of families, the cost of the newer insulins can be prohibitive. especially now that my son is an adult, and has individual insurance, with a $5K deductible…. many doctors probably forget to ask if you can afford the difference. I am glad you are getting such great results with Apidra.

    • Yes, I’m referring to grams of carbs as opposed to carb choices in groups of 15. That would be an insane amount of food otherwise, indeed!

      Good point about the coverage. Scott and Sara make reference to that in their comments as well.

  13. Wow thats awesome! Im going to ask for a sample I think. Although they never even mentioned it. The tail off seems to be our issue. He will end his 2 hour mark right where I want him and then always ends up with a lil iob to crash him. Yet when we change IC he goes high. Im babbling. Anyway thats awesome! Did i say that alread?!

  14. My 5-year-old was diagnosed in June. She started on Humalog. They quickly switched to Apidra as doc thought is was better for children taking insulin after eating their meals, up to 20 minutes after. I was told Humalog and Novolog are the same, but Apidra worked a bit differently and was more recommended for kids.

  15. I have gone from Humalog to Novolog to Apidra..& I very much prefer the later. I think it wears off more quickly then the other 2.(YMMV,of course) Glad to see you’re experiencing such positive results from it.I don’t know how insurance companies get the idea that all fast-actings are created equal..they’re not.

  16. I switched to Apidra about 3 years ago and love it. When I go high it kicks in faster and brings me down. As stated it doesn’t last as long in the system so I don’t have to worry so much about the tail. I also see almost no clogging of my infusion sets with this insulin vs Humalog that I was on.

    Yes it cost’s more, but I am willing to pay a higher price for better control.

    Jonathan T1 since September 1982

  17. We moved Martin off of Humalog to Apidra and it has been great. Kelsey is still on Humalog but I think I am going to ask to move her over next time as well. His numbers have been so much tighter…

  18. First…. I’m having too much fun making it snow in different directions by moving the mouse!

    We’ve been thinking about it, too. We don’t have the problem of her crashing at the end… but Novolog seems to not start working for her until the 2 hour mark… sometimes 2 1/2 hours. Then she crashes. Or comes in fine. We were originally looking at Apidra because we still can’t totally prebolus a meal. But you know… I think I’d run naked down the street (and it’s 8 degrees out) for her Dex to look like that and for her to be between 70 & 200 for 2 weeks. Hell, I ‘d do it for just one day!

    Thanks for the info! SO GLAD you are liking it!

  19. I too switched to Apidra from Novolog about 3 years ago. My insurance changes in Jan, making the Apidra cost twice as much, but I’m going to stay with it. My Dexcom lines on Novolog looked like seimograph readings from a major earthquake; I was too low before meals to take insulin 30 min before eating; I would spike up to about 275 on anything then crash. The Apidra smooths it out, so much that my high warning is now set at 160 not 220. And I still don’t wait 30 min after bolusing to eat. So I’m sticking with Apidra from now on. I’ll add myself to your linky list.

    • I love hearing all these stories of success! Sometimes I wonder if I’m just willing it to be the Apidra even though deep down in my heart I believe it is. Knwoing that others are seeing the same results further validates it for me (even though I suppose it shouldn’t). :)

  20. This blog and all the comments have made up my mind! I just asked the endo last week if he thought I should try it and he said sure! But he didn’t really have anything grand to say about it…he said he had quite a few people using it. So I decided I’d wait until January 1 when I quit my job and can be home for the transition. My question is…when you changed over did you have to adjust your “mindset”? I picture if it’s a little faster and doesn’t tail it will change some of the way you dose or read the numbers??? Like do you correct for smaller numbers than before? If that makes sense? She is doing fine on the Novo, but I think the faster acting the better! Let me know if you have any tips for the change!

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  22. Hi Lorraine, thank you so much for this post. I’m on Novorapid right now but I’m seriously considering switching to Apidra on my next endo visit in February. I’ve been having problems with novorapid being too slow, particularly correcting high blood sugars (even as “low high” as 160 mg/dl) takes about 6 hours and sometimes my system seems to ignore the insulin I shoot in…
    Wish me luck that my endo approves it and hopefully I’ll soon join the Apidra club :-)
    ps: Happy New Year to you and your family!

  23. Apidra doesn’t have PenFill cartridges, like Novolog, which allow for smaller half-unit dose increments in a pen.

    When on MDI the ability to give 1/2 units doses with a pen is a big deal. This is a non issue for pump users.

    I guess we could try it with a vial and syringe but that doesn’t sound too appealing.

    Just my two cents worth.

    • We actually use syringes with the insulin we have in pens because we like the syringes so much better! When we have used up all the pens we have, we will switch to vials if we aren’t pumping yet. You might try the syringes and see what you think.

  24. Hi, Lorraine,
    Your post was the first I heard of Apidra and I later read of other D-Moms switching their kids to Apidra and liking it. I asked our Endo and they also told me it was just the same as the other insulins, that they all basically do the same thing. Well, we switched last week with 2 sample vials the Endo gave us, and we love it thus far! I did a Dexcom upload last night and the pie charts showing her BGs (target, low & high) showed a marked difference between the time with Humalog and the time with Apidra. Before Apidra, she was in target about 35-50% of the day, but after Apidra, she was within target about 80% of the time, even with some mistakes in carb counting on my end. Thanks for bringing this to other parents attention! I hope our insurance will cover this!
    Happy & Healthy New Year to you & your family. :)

  25. Hi Lorraine,
    I am a T1D (as of the cute age of 35) and 5 years into my journey my 6 year old son got it.:( Needless to say, we are a lot of FUN! Flying aircraft probably requires less planning than the two of us leaving for a road trip. Now to my question. I have been reading about Apidra and my concern is that on another blog, someone was having trouble getting the bubbles out of their reservoir when using it and that was causing their bs numbers to go up. I think this is a non-issue for ya’ll using the Omnipod because (I think) it removes them for you. My son wears an Animas Ping and I use Medtronic Paradigm. Do you keep Apidra refrigerated after the vial is open? If so, I could see that being an issue as cold insulin is a bubble nightmare. I had read that Apidra is less stable than the other insulins thus it should be changed every 2 days. Thoughts? Of course I am just reading different Diabetes blogs so I’m not certain any of this is valid. My son’s endo gave me the same impression as yours did about Apidra, she was not impressed. I want so badly to makes things easier for him and am hoping this could be it!:) Thanks for sharing your knowledge!

    • Hello Heather! I’ll start by saying I’m still trying to figure Apidra out (after using it for almost two years). Bottom line – I still love it.
      1) Shortly after I wrote this post, we started seeing highs after two days. I still haven’t posted about this experience because I’m still uncertain as to why. But I had a strong reason to believe (after about 4 months of analysis) that it might be the Apidra clogging. We started changing Cal’s Pod every two days and we’ve been golden since. Added bonus – virtually no kinks, clogs or other issues and scarring is MUCH less with 2 day changes. We go three days every once in a awhile and have been fine, which is why I wonder…
      2) The Pods prime and I believe that should remove bubbles, but we haven’t used any other pump so I can’t compare. Over time I’ve gotten more lax in getting those bubbles out of the fill syringe and we’ve not had a problem.
      3) I do believe that Apidra is less stable and have found the explanation why – something about the reason it’s faster is it’s broken down and because it’s broken down it’s less stable. Please don’t quote that as that is just the way my brain has processed the explanation. Although I can’t say for certain, it does seem like when we get to the end of a vial, Caleb’s insulin needs have gradually increased, then start a new vial and they decrease. I haven’t documented this to really analyze – that’s more of a gut feel. We now use pen vials which are smaller and thus need to be replaced less frequently which means the vials are open for shorter and thus less susceptible to going bad because:
      4) No I do not keep it in the fridge after I open it. I tried that and it was just a pain is the rear. If it’s warm out, I try to keep it in a Frio pack, but I’m not always good about that.

      Lots of people love Apidra, and they are also those who say it’s no different than other fast actings. We haven’t eliminated that tail issue completely – big bolus’ still can linger, but overall, it’s made enough improvement that we’re still sticking with it!

      • So glad you are making it work for ya’ll! This info is very helpful and I appreciate it so much. Changing subjects here but I can’t help but ask…what were the factors in making the decision to go on a CGM? Did you feel his a1c was unacceptable or were his nights filled with lows? My sons a1c has always been a 7 which is disappointing for me since we work so hard for a ‘not so great’ number but our endo always thinks this is great. I know too much and know it’s not what I want for him. Our endo said she will request a cgm for us but personally she thinks he is doing well and to remember “it’s another site and you have limited real estate.” The thought of taking on more stuff and more technology scares me but I don’t want to settle if he can improve his numbers. Of course, anything that might help me to able to actually sleep through the night would be a huge bonus. Thx!!! :)

      • Caleb started using the CGM when he started first grade. We weren’t having any specific issues that I thought it would address, I was just hoping that a device of this nature would help in general. It does. I’ve learned a great deal from seeing what happens in between the finger sticks. I understand food better. Dealing with new foods or new situations is not so anxiety-filled because I’m not left to wonder. Using it has smoothed things out, though has not changed Caleb’s A1C. It can indeed be a pain. Caleb uses his torso for Pods and limbs for CGM. The biggest pain though is when it doesn’t work – it’s just a big bugger. It can also cause anxiety as a constant reminder of what’s going wrong. :) I think this is a go with your gut kind of decision.

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