Lyumjev prescription

[Sideburnt]

Hi,

I've recently tried to switch my rapid insulin from Fiasp, which now has lost it's fast onset to the new Ultra rapid Lyumjev by EC Lilly.

I've managed to dig out the prescription PIP codes but for some reason both my GP and my diabetes team are being really odd about making a switch.

Has anyone else made the switch here in the UK?. what hurdles did you all have to jump to make the change?

 

[MarkMunday]

... I've recently tried to switch my rapid insulin from Fiasp, which now has lost it's fast onset ...

Sounds like you have lost some insulin sensitivity. Changing to a marginally quicker insulin isn't going to fix that. Reducing carbs and exercise help improve insulin sensitivity. Have you tried bolusing a few minutes before meals?

 

[Lyndsey179]

Hi,

I've recently tried to switch my rapid insulin from Fiasp, which now has lost it's fast onset to the new Ultra rapid Lyumjev by EC Lilly.

I've managed to dig out the prescription PIP codes but for some reason both my GP and my diabetes team are being really odd about making a switch.

Has anyone else made the switch here in the UK?. what hurdles did you all have to jump to make the change?

Hi just came across your comment on Google.
Interested to know how you are progressing.
Asked if could go on Lyumjev but got a similar answer from consultant about it not being avaiable for my local health authority to prescribe. I think it would need agreed funding. Is that such a problem..
I was asked if I wanted to try fiasp but having read mostly bad reviews i dont think it is for me. Be good also for your views but obv it's not great or you would nt be changing.

 

[In Response]

Sounds like you have lost some insulin sensitivity. Changing to a marginally quicker insulin isn't going to fix that. Reducing carbs and exercise help improve insulin sensitivity. Have you tried bolusing a few minutes before meals?

I believe you have misunderstood the problem @Sideburnt is reporting.
It is not an insulin resistance problem because no more insulin is required. The problem is the speed at which is starts working.
It is not uncommon that our bodies appear to "get used" to Fiasp and the initial euphoria of the ultra fast acting is lose when it resembles Aspart without its Fast Insulin part which gives Fiasp its name,

Unless I have misunderstood what I have read about low carb diets, reducing carbohydrates does not address the speed at which insulin works.

Please remember that there are more problems encountered by someone with diabetes than insulin resistance.

 

[MarkMunday]

I believe you have misunderstood the problem @Sideburnt is reporting.
It is not an insulin resistance problem because no more insulin is required. The problem is the speed at which is starts working.
It is not uncommon that our bodies appear to "get used" to Fiasp and the initial euphoria of the ultra fast acting is lose when it resembles Aspart without its Fast Insulin part which gives Fiasp its name,

Unless I have misunderstood what I have read about low carb diets, reducing carbohydrates does not address the speed at which insulin works.

Please remember that there are more problems encountered by someone with diabetes than insulin resistance.

When the new analogue insulin stop work, it is not because of a change in the insulin. It is because of a change in how the body responds to it. In other words, reduced insulin sensitivity. Eating low carb addresses this by removing the need for a quick response to insulin. Exercise has a similar effect. Eati g low carb also opens up more insulin receptors, improving the insulin response. Eating more fat flattens the glycemic index of food, making slower acting insulin more suitable.

 

[In Response]

@MarkMunday i am referring to a common issue that has been experienced by multiple people who have recently switched to Fiasp from another insulin.
It is a known problem with Fiasp. Not the person taking it.
Read the reports on Fiasp and you will realise this is NOT an insulin sensitivity/resistance issue.

I think it is great that you have found a lifestyle that suits you but please please please stop providing it as the answer for everyone else.

 

[Antje77]

Thanks for your comments. They're informative and somewhat linked to the opening post.
However, further discussion on this subject is better placed in a thread of it's own, as it derails from @Sideburnt 's question, which is on how to get Lyumjev prescribed in the UK.

Should anyone wish to continue the discussion on Fiasp or insulin resistance, please start a new thread.

 

[Jaylee]

OK, back on topic.

@Sideburnt , i see from your profile status you pump. (Nice A1c by the way.)
I feel the problem is right now, Lyumjev is a new insulin, only approved last summer? (June/July 2020?)
There maybe a little reluctance with HCPs prescribing until they have their heads round it..
I did find this, which may help you? https://www.diabettech.com/lyumjev/insulin-lyumjev-not-as-urli-as-i-expected/

@Lyndsey179 , welcome to the forum.

 

[DCUKMod]

Hi,

I've recently tried to switch my rapid insulin from Fiasp, which now has lost it's fast onset to the new Ultra rapid Lyumjev by EC Lilly.

I've managed to dig out the prescription PIP codes but for some reason both my GP and my diabetes team are being really odd about making a switch.

Has anyone else made the switch here in the UK?. what hurdles did you all have to jump to make the change?

I don't use insulin, but at a recent Endo (not diabetes) review I was discussing a tweak to medication with the Doc. There was some real resistance, on the basis that lots of medical facilities are running in unusual ways at the moment, and if the strategy went wrong, prompt access to the required care could take quite a bit longer than usual.

I wonder if the fact the insulin is new, and therefore the medics are likely less familiar with it, and therefore less experienced supporting individuals using it influenced things at the moment.

I managed to negotiate a way forward, so I hope you do too.

 

[Chickenboy]

I recently asked my Senior diabetes specialist if I could yet be prescribed Lyumjev after reading Tim Street's Diabettech article about its used in APS. I'm based in Scotland and was told that it hadn't yet been approved by the Scottish Medicines Consortium, which after checking, it hasn't. Not sure what the deal is in England but looks like we'll be waiting a while longer for it in Scotland... like most things!

 

[Lyndsey179]

Thanks for your comments. They're informative and somewhat linked to the opening post.
However, further discussion on this subject is better placed in a thread of it's own, as it derails from @Sideburnt 's question, which is on how to get Lyumjev prescribed in the UK.

Should anyone wish to continue the discussion on Fiasp or insulin resistance, please start a new thread.

I've been told Lyumjev is not on the formulary list in London and the whole of South East. How long to wait??

 

[Antje77]

I've been told Lyumjev is not on the formulary list in London and the whole of South East. How long to wait??

I'm not the one to ask, I don't even live in the UK!

 

[Chas C]

Lyumjev is approved and priced by Nice - its the same price as other insulins like Humalog so access should soon become more localised. https://bnf.nice.org.uk/medicinal-forms/insulin-lispro.html

 

[Sideburnt]

Hi all, sorry for the radio silence.

To answer a few questions, @MarkMunday I already low carb around <50g a day is my norm. I also exercise 2,3 times a week to help with insulin resistance. I would say that my only option at this point has been to shift to intermuscular doses with a pen using 8mm needles. Bolus doses through my omnipod simply fail to either work or absorb anywhere near fast enough. I simply can't do the 2-3h wait to correct high blood sugars, or pre-bolus over 1h before I eat.

@Antje77 much like many other areas of the UK Leeds Formulary still has Lyumjev listed as not yet approved. That has been the case for a year now and I've written and emailed them several times which is clearly not making any diffeence. It's frustraiting as it has been both FDA approved and has the NICE nod of approval for use. The cost, as a few people have mentioned is no more than Humalog. My only sympathy is that perhaps during the Pandemic that normal running has slowed down for things like this.