# Problems with apidra (used in insulin pump)?



## Turtle11 (Nov 14, 2012)

Hi all, I wondered if anyone using apidra in an insulin pump could tell me how they are finding it? I've been having problems with my control since I started it; becoming hypersensitive to exercise, major fluctuations in the amount of insulin required (resolved with a temp basel), severe hypo symptoms at 3mmol etc - has anyone else experienced any of this when changing to apidra? I'm concerned that it might be the root cause. Any advice appreciated, thanks


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## Pumper_Sue (Nov 14, 2012)

Turtle11 said:


> Hi all, I wondered if anyone using apidra in an insulin pump could tell me how they are finding it? I've been having problems with my control since I started it; becoming hypersensitive to exercise, major fluctuations in the amount of insulin required (resolved with a temp basel), severe hypo symptoms at 3mmol etc - has anyone else experienced any of this when changing to apidra? I'm concerned that it might be the root cause. Any advice appreciated, thanks



Hi turtle,
           I don't use apidra so just a few general pointers for you.
Have you since changing to apidra done any basal testing?
Did you remember to change your duration of insulin?
Once you have your basal sorted perhaps look at your carb ratio and correction sensitivity.
Are you also changing everything out after 48 hours? I noticed before that the manufactures state 48 hours max for usage in a pump.

From what you have written I would suspect it's your basal and duration that is wrong. 
Hope you are soon sorted.


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## trophywench (Nov 14, 2012)

Did you even know it acts quicker than Humalog or Novorapid?

And - why did you change to Apidra, what was it to address that your previous fast acting wasn't?


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## Turtle11 (Nov 15, 2012)

Thanks for your advice. I had checked basel rates, altered my insulin sensitivity, carb ratio and I did change the duration of insulin setting on the pump. I couldn't say for certain if it is the apidra but I'm suspicious enough to be trying novorapid again. I put it in my pump this morning and despite dropping to 3mmol at the end of a walk earlier, the symptoms have been completely different and much less 'severe'. Clearly I need to see how things work out over a few weeks but i'm encouraged! 

I did wonder about the 48hrs rule too but the peaks usually last a few days in which the insulin is renewed (i.e. I need the temp increase regardless of how long the insulin has been in the pump). 

I changed to the apidra because it has a far quicker onset than humalog and novorapid. I was having highs due to stress and it was taking a while for it to correct - apidra is a lot faster for that purpose.


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## trophywench (Nov 16, 2012)

Use your Temp Basal for stress Turtle!

Or program an extra  'Stress' basal rate?


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## MaryPlain (Nov 17, 2012)

I've always used Apidra in my pump.  I change the cartridge every six days. When I first started, I thought that the insulin was losing potency after two days and I used to change everything every two days, but that doesn't seem to be the case any more for some reason. It's probably a good job, as a while back Roche were rationing the infusion sets and I could only get half and half sets and cannulas - the assumption being that the set, and hence the insulin, would last twice as long as the cannula.

I was already using Apidra in a pen before changing to the pump so it was a bit different for me.  I found that Humalog and Novorapid had very long "tails" of action which gave me unexpected results including hypos five or six hours after a dose. Apidra is more predictable for me, but I find that I react very quickly to carbs so I need an insulin with a rapid and short action. 

I haven't noticed any change in my hypo symptoms, the biggest change was in changing to pumping which made my hypos much less severe and gave me back my warning symptoms.


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## trophywench (Nov 17, 2012)

Mary, I was told 6 days for tubing - ie in my case with a 2-day turnaround on my cannulas due to bad absorption areas - every third cannula or if you change em every 3 days every other one.

They did have a supply issue last year which took longer to sort out than they wanted, but they never ever let me down.  I have a lot of tubing I saved in my supply drawer though, as the tubeless were more of a prob than the tubed for some reason and so sometimes I used one of them as just a cannula, and now I'm gradually doing the opposite .....


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## liam (Nov 29, 2012)

Hi

Have you got to the bottom of the problem yet?
I use Apidra and it has been the best insulin I have used.  It doesn't hang about so this might be the problem with exercise - some people have higher BS when exercising but then have lows a few hours after.  It could be possible that if you are going high from exercise that your hypos are connected with exercise.  If I do streneous exercise I increase basal for a short time, then redcue it, then test 2 hours after and adjust as needed.  Ordinary exercise such as long walks I reduce basal as this has a different affect than more streneous exercise.  If you have very little insulin in your body as is the case with pumping then streneous exercise can send your BS up and Apidra is the shortest acting insulin around from my experince.  This has mostly good points though as it doesn't peak when you donlt expect it!! Hope you are getting on better with it.


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