Lyumjev insulin and pumps

[Herbie1972]

Hi,
I've been on the Tandem T-Slim X2 pump, with Novorapid, for 18 months now (switched from Accu-Chek Insight) and my consultant mentioned that Lyumjev, a faster acting insulin, might be better for me as I have post-meal spikes on the Novorapid, even if delivering a bolus 30 mins before eating.

Is anyone on here using a pump with Lyumjev? The Lilly website says Lyumjev works with pumps but I've not found any clear indication of which make. Tandem say it's not suitable.

Thanks for any help you can give!

 

[RD02]

I’m on Omnipod 5, my diabetic nurse has issued a vial of Lyumjev for me to try. First pod will be filled tonight so will keep you informed

 

[Antje77]

I have a Dutch friend who's on the Medtronic 780-G and has been using Lyumjev in her pump for about 2 years.
She absolutely loves it and her TIR is much higher than on the Novorapid she used before.

 

[eventhorizon]

I use Fiasp in my Tslim.

 

[Herbie1972]

I’m on Omnipod 5, my diabetic nurse has issued a vial of Lyumjev for me to try. First pod will be filled tonight so will keep you informed

Good luck!

 

[Herbie1972]

I use Fiasp in my Tslim.

Wow, I was told that Fiasp wasn't suitable for the T-Slim. How's it been on it?

 

[Herbie1972]

I have a Dutch friend who's on the Medtronic 780-G and has been using Lyumjev in her pump for about 2 years.
She absolutely loves it and her TIR is much higher than on the Novorapid she used before.

Thanks for that info. Will give it a look. Great to hear your friend rates it

 

[Finnlee]

I'm also on the Tandem t:slim and since Lyumjev isn't approved for my pump, I fill it with NovoRapid and keep Lyumjev pens on hand for manual injections. I find this is a good balance for me.

For me, Lyumjev works well for some situations (when I want to eat something carby without waiting, when I need to bring down a high quickly, or when I don't want to have NovoRapid in my system before bed or an activity), but most of the time I find NovoRapid works fine.

 

[Herbie1972]

I'm also on the Tandem t:slim and since Lyumjev isn't approved for my pump, I fill it with NovoRapid and keep Lyumjev pens on hand for manual injections. I find this is a good balance for me.

For me, Lyumjev works well for some situations (when I want to eat something carby without waiting, when I need to bring down a high quickly, or when I don't want to have NovoRapid in my system before bed or an activity), but most of the time I find NovoRapid works fine.

Interesting. Does bolusing on Lyumjev with a pen mess up the pump algorithm?

 

[eventhorizon]

Wow, I was told that Fiasp wasn't suitable for the T-Slim. How's it been on it?

That's what they told me as well, but it was working fine in my previous pump, Medtronic 640g, so the Tandem rep and DN were cautiously happy for me to try and carry on with it. Touch wood, nearly 3 months in and it's working great.

I have a theory it's people with very small insulin requirements which have problems with repeated occlusions. I use 40 to 60 units a day which keeps the pipe work flowing freely.

 

[Finnlee]

Interesting. Does bolusing on Lyumjev with a pen mess up the pump algorithm?

I don't find an issue with that, but when I do a manual correction (especially before I go to bed or take a nap), I try and remember to set my low alarm for the highest possible to catch any drops.

I don't usually have wild swings in my blood sugar (10 mmol/ml would be pretty high for me) so by the time I do a manual injection, the t:slim usually hasn't usually an automatic bolus to try and bring me down, so I'm not doubling up on corrections. I have a Lyumjev Junior pen so I can do half units and I tend to round down my bolus estimate, which probably helps the algorithm.

I have read some people shut off Control IQ when they have a manual injection in their system, or do x units manually and then x units from their pump while unattached (into a bin or the sink, not into themselves) to keep the algorithm working correctly.

 

[Herbie1972]

That's what they told me as well, but it was working fine in my previous pump, Medtronic 640g, so the Tandem rep and DN were cautiously happy for me to try and carry on with it. Touch wood, nearly 3 months in and it's working great.

I have a theory it's people with very small insulin requirements which have problems with repeated occlusions. I use 40 to 60 units a day which keeps the pipe work flowing freely.

Really interesting, thanks. I use a lot of insulin too, so I'll ask about Fiasp too. Thank you.

 

[Herbie1972]

I don't find an issue with that, but when I do a manual correction (especially before I go to bed or take a nap), I try and remember to set my low alarm for the highest possible to catch any drops.

I don't usually have wild swings in my blood sugar (10 mmol/ml would be pretty high for me) so by the time I do a manual injection, the t:slim usually hasn't usually an automatic bolus to try and bring me down, so I'm not doubling up on corrections. I have a Lyumjev Junior pen so I can do half units and I tend to round down my bolus estimate, which probably helps the algorithm.

I have read some people shut off Control IQ when they have a manual injection in their system, or do x units manually and then x units from their pump while unattached (into a bin or the sink, not into themselves) to keep the algorithm working correctly.

Clever tips to fool the system, thanks. Hope it continues to work well for you

 

[RD02]

Good luck!

Well I’ve done a few bolus with Lyumjev in the Omnipod 5. It’s very early days so far, but I have noticed already a significant response time.

Before I was actually using Fiasp and found a need to pre-bolus before a meal, but no more than 15 mins. This morning eating my exact breakfast porridge oats, normally this would spike to max 9 mmol within 45 mins of consumption with a pre-bolus of 15 mins.

Same breakfast/ same insulin amount no pre-bolus and maxed out at 7mmol 45 mins later, and even better still back to its start level of 5.7mmol within less than 2 hrs.

So far I’m impressed, time will tell. I have 1 vial on trial, if it continues like this will be swapping to Lyumjev.

 

[etmsreec]

My experience was that Lyumjev made my sites sore. They were not infected, just sore. Apply a new pod and the soreness moved. Having discussed it with my diabetes team, we think it was the vasodilator that caused it.
I used FiAsp when first using Omnipod Eros as I was using that when on MDI. Like some other users, I found it quite unpredictable. Sometimes it would work just right, yet sometimes it just wouldn’t bring down highs or work as bolus and it was like injecting or infusing water. I moved to Novorapid which was much more predictable and, on a fresh site, is often not that much slower.
The last I heard, neither Lyumjev nor FiAsp were approved and licensed for use with Omnipod 5, although some diabetes teams are supportive of their patients using them.
On the note about blockages, a very small trial conducted a few years ago showed that more users on FiAsp reported blockages than with conventional insulin.

 

[Herbie1972]

My experience was that Lyumjev made my sites sore. They were not infected, just sore. Apply a new pod and the soreness moved. Having discussed it with my diabetes team, we think it was the vasodilator that caused it.
I used FiAsp when first using Omnipod Eros as I was using that when on MDI. Like some other users, I found it quite unpredictable. Sometimes it would work just right, yet sometimes it just wouldn’t bring down highs or work as bolus and it was like injecting or infusing water. I moved to Novorapid which was much more predictable and, on a fresh site, is often not that much slower.
The last I heard, neither Lyumjev nor FiAsp were approved and licensed for use with Omnipod 5, although some diabetes teams are supportive of their patients using them.
On the note about blockages, a very small trial conducted a few years ago showed that more users on FiAsp reported blockages than with conventional insulin.

Interesting, thank you. I'd heard that Fiasp was more 'syrupy', hence the reported blockages.
Will chat about it all at my next appointment.

 

[RD02]

I’ve now been on Lyumjev for a good month now with Omnipod. My prescription has now actually been transferred to Lyumjev. On some occasions I get a mild stinging compared to Fiasp, but somehow find this reassuring that it’s working. For me I’ve actually increased my carb ratios slightly. If I overlay Dexcom graphs with Fiasp/ Lyumjev it’s clear to see eating exactly the same food type, Lyumjev is quicker. I do find that it trails off quicker. If it’s not back to start point within 2 hrs, very small corrections start to turn the level. I’m not sure I would want to use Lyumjev with MDI as min 0.5 dose would be too much. I actually work away a lot so am challenged frequently with restaurant food. I literally bolus once the food is presented to me and give it max 5 mins before eating. I’m sticking with Lyumjev