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33 Responses

  1. CALpumper aka Crystal
    CALpumper aka Crystal September 22, 2009 at 6:33 am | | Reply

    Canadian OTC price for 1 vial of 10ml Apidra…..$64. Twice as expensive as Humalog.

    Hence why I have not changed nor brought it up to my Endo.
    Last time him and I discussed insulin prices, he suggested freakin’ Regular because it’s cheaper. Doesn’t mean it would work for me.

  2. Doug
    Doug September 22, 2009 at 6:35 am | | Reply

    Ive tried all the fast acting versions
    Used Lilly insulins for years and eventually made it to Humalog. At some point I switched to Novalog, either at a Dr recommendation or because the copay was lower. Then tried Apidra. I honestly cant see enough difference between them to justify the 3x difference in copay between them. Currently using up left over Apidra, once that bottle or 2 are gone its back to Novalog which has the lowest copay through Medco

  3. Scott S
    Scott S September 22, 2009 at 6:38 am | | Reply

    You write: “… when it comes to comparing insulin in the same family, say Humalog versus Novolog or Lantus versus Levemir, most of us only try something new when something goes very wrong, such as burning at the injection site.” I beg to disagree … the reality is that many patients have switched insulins, due in part, to fomulary changes, or healthcare plan changes imposed by their employers, changing jobs, etc. In fact, most endocrinologists are used to changes, and often help to facilitate these with free samples used to assist patients in making a decision.

  4. Amalas
    Amalas September 22, 2009 at 7:11 am | | Reply

    I tried Apidra once and I hated it. I was an absolute roller coaster on it. Humalog works for me and I’ll be really hesitant to try something else unless there’s a major improvement.

  5. Andrea B.
    Andrea B. September 22, 2009 at 7:37 am | | Reply

    I’ve never tried Apidra but I might mention it to my Endo when I go back in a couple of months.

  6. k2
    k2 September 22, 2009 at 7:56 am | | Reply

    My insurance only covers 40% of my insulin since it doesn’t come in a generic version. 2 bottles costs me a whopping $138 out of pocket and I’m only reimbursed $55.20.
    Forget the fact that I need insulin to actually live my life-it’s not a luxury medication, it’s a necessity. While I do have my favorite long acting insulin, it really comes down to finances. Bottom line- what ever fast acting insulin my Endo has in the office for samples purposes, is the fast acting insulin I use.
    Kelly K

  7. Anne
    Anne September 22, 2009 at 9:13 am | | Reply

    I’ve tried them all (I think) except for Apidra. Occasionally I have gone off the pump when I was having trouble getting to the bottom of BG issues, and have tried both Lantus and Levemir. I was initially really impressed by how much better these insulins are than the old NPH, Lente, Ultralente stuff. Also, I noted how much more freedom I felt to be disconnected from my pump! But in the end, they still have peaks and the flexibility of dosing with the pump always wins me back. I think Lantus and Levemir worked pretty similarly for me, and worked pretty well on 2 daily doses.

    I had a CDE tell me that Novolog has a longer tail and would therefore be a better insulin for me in my pump (vs. Humalog). (???) Does that make any sense?

  8. Betsy
    Betsy September 22, 2009 at 10:22 am | | Reply

    I tried Apidra in my Omnipod and kept getting bad highs on day 3. I called Omnipod about it, and when they found out I was on Apidra, they told me that Apidra spoils at a lower temperature, and since the pod (and so the insulin) is worn against the skin, I might want to try another kind of insulin. I switched back to Novolog, and the problem ended immediately. So for Omnipod users, I think that Apidra isn’t the best choice.

  9. Hans
    Hans September 22, 2009 at 10:53 am | | Reply

    Rapid action can be quite relative. With my breakfast shot at 6 the meter reading starts counting (not falling!) down shortly before 7 o’clock. No difference between Humalog, Novolog and Apidra. I got stuck with Apidra because it was the last brand I tried for it’s rapid promise, and the penfils fit into my fully automatic diapen, and all 3 of them are the same price for me with my insurance.

    For the rest of the day it’s just normal injecting and eating without any necessary delays, although 10-15 minutes waiting for a pizza doesn’t make me go hypo.

  10. Lloyd
    Lloyd September 22, 2009 at 11:01 am | | Reply

    I need 24% less Apidra than Novolog.
    Apidra gets me back to pre-meal levels in 70 minutes, vs 100 minutes for Novolog.
    My insurance negotiated a lower price for Novolog, so if I don’t use their preferred insulin, my insulin costs quadruple. :(
    So I switched to Novolog.

    -Lloyd

  11. xim1970
    xim1970 September 22, 2009 at 11:25 am | | Reply

    I had been on Regular and NPH (and their human counterparts after pork insulin was banned in the USA) since 1981…when Novolog and Lantus first came out, all I heard was about how people were having hypos on a regular basis (pun sort of intended!), and was too afraid to try it…finally wound up in the hospital with ketoacidosis, and was told I really needed to try this…finally did, and, with the right education, learned to use it effectively. Apidra sounds like a good product (if not worn with an OmniPod, and with proper education from your endo), but I’m still injecting and can’t always get to my doc (about 80 miles away, best in the state of Maine) but I am thinking about going with a pump. Almost 29 years with this, I don’t know that I can last much longer without complications, so THANK YOU Amy, and all posters for another great and useful article!

  12. Marco Bianchi
    Marco Bianchi September 22, 2009 at 11:57 am | | Reply

    I was on Humalog then switched to Novo-Rapid (Novolog), at first it was realy terrible but i realised that i needed to modify my settings (sensitivity, carb ratio) then it was much better than Humalog. After that i tried Apidra. it worked very well, maybe even a little better than Novo-rapid. However i noticed it wasn’t as stable when i was at the end of my insulin reservoir. Apidra is known to be more sensitive to heat than the others. Company reps try to make me believe that catheter blocage becomes less of an issue with their newer insulins, but i’ve never noticed any of this.

  13. Stacey Divone
    Stacey Divone September 22, 2009 at 12:11 pm | | Reply

    Thank you so much for posting this (and mentioning what I wrote too! or at least I think that was what I wrote!) … I am going to ask my cde next week to give apidra a try. The choice was never really given to me but I feel I have a right to change that if I want to. Very fortunately for me, cost shouldn’t be an issue since I believe all the short acting have the same copay under my insurance plan. I’m also wondering if we could possibly become “immune” to certain types after a long time?

  14. Laura
    Laura September 22, 2009 at 12:35 pm | | Reply

    Nice timing on this post! I just had my endo appointment last week and asked him about potentially switching to Apidra (I think it’s been in Canada about two years now but I only became aware of it this past year). My endo told me that I’m only the second person to ask him about Apidra and that, from what he’s read in the literature, there is very little difference between it and the other two major brands. I nodded and took his word for it…but now I’m wondering if I shouldn’t have been more firm about giving it a try!

    Regarding how many insulins I’ve tried? Well, I started off on Humulin R and Humulin N (and was, ever so briefly, on Humulin U) but made the switch from R to Humalog when it came on the market. A few years later, I switched from Humulin N to Lantus. And, a few months after that, I ended up switching from Humalog/Lantus to NovoRapid/Levemir. This switch was for purely “practical” reasons as I much preferred using the NovoPen 4 to using a vial of Lantus (this was before Lantus was available in pen form). I, personally, never noticed any physiological differences using Humalog/Lantus versus using NovoRapid/Levemir. But, I did notice that Novo Nordisk’s insulin pens were way more stylish than Lilly’s!

    When I switched to my insulin pump in April, I stuck with NovoRapid as my brand of choice.

  15. Ronald Mutimba
    Ronald Mutimba September 22, 2009 at 1:28 pm | | Reply

    I was on novolin when I started back in 1998 but that only lasted a few months untill I swiched to novorapid for about 6 years…My doctor took me off it 5 years ago and am just on metformin now thank God coz I have a serious phobia for needles so you can imagine how my days went in those years. all I have to worry about now is the pricking…….small graces right

  16. Sarah
    Sarah September 22, 2009 at 1:38 pm | | Reply

    Hey Amy. I was on Apidra for over a year, and when I switched to OmniPod, I had some issues. It wouldn’t last a full 3 day duration w/o having to constantly increase my doses. It also didn’t work as fast either. So, my endo switched me to Novolog and I’ve been happy with it. I’m actually sad to have to switch pods at the end of the three days.

  17. Erin
    Erin September 22, 2009 at 2:55 pm | | Reply

    I’m glad several of you wrote about Apidra’s tendency to wimp out faster than the other insulins. I love using it because it works so much faster in my body than humalog and novalog seem to, and is also gone a lot quicker than the others, but I always have the problem of having to use more towards the end of a bottle. (I’m on MDIs). I open and use a whole bottle of Humalog & Novalog with out having to refridgerate it or change my dosages, but I always seem to need to take more Apidra the longer I have been using the bottle. Glad to hear others are experiencing that too. Maybe someday we’ll have a perfect insulin. *sigh*

  18. Dan Patrick
    Dan Patrick September 22, 2009 at 4:38 pm | | Reply

    Hi Amy,
    I used Novolog with an insulin pump. I moved to Apidra to deal with one fact. When going out to eat, sometimes we are not in control of what will be eaten, when it will be eaten and the impact on my bloood glucose levels. The ability to bolus toward the end of a meal with a closer “guess” as to the number of carbs and the the two hour check on the “guess” on how close I was to the number of carbs has allowed me to come closer to better control.

    As always have a greatr day and hope this helps.

    D2

  19. Scott Doerner
    Scott Doerner September 22, 2009 at 4:57 pm | | Reply

    I just wanted to thank you for at least having some direct info on apidra, I have been a type 1 for 31 years, and have been pumping for 9. doc wants me on apidra to help a1c, but I cannot find info on switching anywhere. at least you gave some info (may be personal) But Thanks
    Scott

  20. Monica
    Monica September 22, 2009 at 7:28 pm | | Reply

    I used Apidra for 1.5 years until a month ago. I switched to Hypurin Regular Porcine insulin recently, and it is so much better than the human insulins. It’s more stable, predictable, and reliable. I also don’t have as serious hypos, either. My memory, energy, and overall well being has improved, too.

    All I have to do is take the insulin 30 minutes prior to eating, and all is good.

  21. T1 in Boston
    T1 in Boston September 22, 2009 at 9:16 pm | | Reply

    Like the article suggests, I have never initiated an inquiry into changing insulins. I was diagnosed in 1981 and was on R & NPH, followed by Humulin as soon as it came on market, did a brief period with ultralente while on MDI’s and then switched to Humalog in minimed pump in 1997. Same every day since then! But from reading these comments, I’m not sure Apidra is a good solution for us pumpers (more concerns with it than affirmations of it, I guess). (But the blog did get me to try a new meter – I just got my new Wavesense – we’ll see if it makes any difference). (Like you, xim1970, no major complications after 29 years and counting….) (A1C’s are in the high 6′s, low 7′s consistently since start of pumping — I know, not THAT tight, but I try!)

  22. Nevada
    Nevada September 23, 2009 at 2:57 am | | Reply

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  23. nr
    nr September 23, 2009 at 6:20 am | | Reply

    Good post. However, I’m not really sure why the insulin manufacturers concentrate so much on being the “speed champions” as you say. Though it is obviously a benefit for the insulin to start working more quickly, it seems like it is not necessarily a benefit to have it completely through your system more quickly.

    At some point, if the insulin acts too quickly surely it will be too fast compared to the speed of digestion and processing of the carbohydrates. I certainly have to be careful when I eat big meals that I extend part of my bolus. Otherwise, I will get a low or good blood sugar within the first couple hours after eating, followed by a high blood sugar as the insulin gets used up faster than I digest.

  24. Edwin
    Edwin September 25, 2009 at 4:20 am | | Reply

    Thanks for your suggestions.

    The carbohydrates cause a high rise in blood sugar that causes the pancreas to release insulin. Insulin drives the protein building blocks in the meal into muscle cells to hasten healing from intense workouts.

  25. Mike
    Mike September 25, 2009 at 10:08 am | | Reply

    With the NPH and Ultralente insulins, I think I remember hearing that both of those patents were expiring and drug companies began to switch people over before both patents expired since they wouldn’t loose the revenue streams.

    I had near perfect A1C with a routine that used both. Had one low after a jumping time zones and got a doc who tossed out the N & U. Seriously miss those insulins since the more expensive insulins haven’t lived up to their promises (or effectiveness).

  26. June S.
    June S. September 27, 2009 at 10:13 am | | Reply

    I switched to Apidra when my endocrinologist swore it did not cause clogging in pump tubing. I had been having occasional problems with insulin delivery by pump while using Humalog. So far, so good, and it has been almost 2 years ago since I first switched to Apidra!

  27. Symposier
    Symposier September 27, 2009 at 10:27 pm | | Reply

    I have always used Lantus Insulin, and really did not know that there were other options like Levemir. I’ve used Lantus for 6 years and never have had a problem, I think that the only way I could change is if My endocrinologist tell me to do that. But in my next visit to him i will ask about this Levemir and why he never mentioned it.
    Great article, Thanks!!!

  28. Sarah
    Sarah September 28, 2009 at 7:40 am | | Reply

    I had bad skin reactions to both Humalog and Novolog, so I am now pumping Apidra. I don’t personally find it any faster, but the difference for me is that I have sites that last more than 24-36 hours before they would fail due to extreme irritation. Prior to going back on the pump I gave Levemir a try for two weeks and it didn’t work for me at all – in fact it seems to have accelerated whatever is causing the irritation I now experience with Novolog, since I had previously used Novolog for almost 8 years with no notable problems, and that changed, fairly suddenly after being on Levemir.

    Are the two really related? I have no idea, but I am glad that Apidra is available for me to use, and I am crossing my fingers that it will continue to work well for me.

  29. MelissaBL
    MelissaBL October 1, 2009 at 8:34 am | | Reply

    @AmyT and Betsy. I use Apidra in my pods with no problems on Day 3. Used Apidra in my Cozmo and my Minimed Paradigm, too. No one at Insulet has ever told ME they don’t recommend it.

  30. Gary D. Snow, Ph.D.
    Gary D. Snow, Ph.D. November 5, 2009 at 8:04 pm | | Reply

    I tried both Levemir and Apidra. After a couple of months my control was less effective than when I used Lantus and Humlog. I’m back to Humalog and Lantus. Works much better for me during a 24-hour cycle. I also get much better control with syringes…simple, basic syringes…than with a pump, and find it far more convenient. The electronics and pens really fall short. Just gimmicks, I believe, that don’t make things better. The industry continues to get wealthy off of fancy gimmicks. :>)

  31. sydlit
    sydlit March 1, 2013 at 7:33 pm | | Reply

    Recently in hospital pre and post op gallbladder removal. House MD ordered Novolog Regular insulin for my blood sugar coverage. The nurse gave me only 7 units of this insulin to cover a 275 blood sugar. I doubted it would work as I used 25 units coverage of Apidra insulin to cover that blood sugar. at home. I was amazed that the 7 units worked! I asked my endocrinologists to change my coverage to Novolog Reg Insulin.

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