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Apidra/Potency/Heat/Sites

teasytux

teasytux

Active Member
Messages
27
Location
Cornwall
Type of diabetes
Type 1
Treatment type
Pump
Hello All,
I have been pumping 7-8 weeks now and still finding it difficult to get a basal rate. Had to stop my fasting tests every time. I'm using Apidra, which during the early hours of starting day 2 its effect starts to go and by that evening its potency is not very good. I always change my complete set/site starting the the 3rd day, earlier if the site isn't working well. I do have absorption/site issues (after 39 years MDI) and not much skin left to use and changed the site after a couple hours before as it's not been working. I found out that Apidra after 48 hours in the plastic pump cartridges shouldn't be used as its potency wears quickly. I keep the vials refrigerated until I need them (stops bubbles when filling when out) and I always take another vial out when I've half used a vial. I did some searching and found that some people cannot go the 48hr distance with Apidra, 72 with plastic cannula. I also note that the pump when I'm wearing it, especially at night using the waist band, gets quite hot and wondered if this is affecting the Apidra? There does seem to kinda be a pattern to every second day about 30-36hrs, higher glucose. But, rare occasions I don't get any issues with it. Has anyone else had/have these problems as I really need some help?
I'm so grateful I have a pump and it's early days. Its affecting my retinopathy quite a bit which is now background retinopathy as I kept my Hba1c at 6-6.5 the past few years to combat the 'opathys' - all of them I have.

Does anyone pump with Novorapid? I used to take Novorapid by pen for years until my DSN changed me to Apidra when I connected to the pump. I had site issues with the pen but nothing as bad as on the pump. I used to take Humalog before Novorapid but for some reason I didn't get on with it.

Anything anyone can tell me would be greatly appreciated.
Thank you
TeasyTuxter
 
Hi

I think you will find if you phone Aventis, that Apidra will critalise in the tube if it is not changed every 2 days so that is probably why you start to see a change in your bg levels. Your consultant should be able to explain more about this.... Novorapid doesn't tend to do this so that is why I changed from Apidra when I was using MDI and used Novo instead in my pump.
 
On the apidra instructions it definitetly tells some details of having to change the cartridge alot more often as well. I haven't got apidra anymore in my fridge to look at the instructions, as I went back to Novorapid because of the necessity to change not just the sets but the cartridges so often.

It is definitely somewhere on the apidra instructions for pump users....
 
donnellysdogs said:
On the apidra instructions it definitetly tells some details of having to change the cartridge alot more often as well. I haven't got apidra anymore in my fridge to look at the instructions, as I went back to Novorapid because of the necessity to change not just the sets but the cartridges so often.

It is definitely somewhere on the apidra instructions for pump users....
Click to expand...

Hello,
Thanks very much for your reply. I have read the Apidra leaflet and yes it does say to change the complete infusion set and site every 48 hours which I am doing. My DSN and the pump rep also said that too. My research from the net seems to indicate that quite a few people have issues with Apidra and I now regret allowing my DSN to switch me to it from Novorapid on the pen. I have lost some weight in the 7/8 weeks pumping, hoorah for that! and the TDD is around the 50+/- unit mark from 78 using MDI pen. I spoke to my DSN about these issues and because of the costs of the supplies she wanted me to change the cartridge and site every two days and saw no point to being on a pump if I had to change site every day. I think because the supplies budget is very tight and limited. My DSN gives Apidra to all the people starting to pump as she said it was better suited in a pump. Only one person is using Novorapid and I think in my email to her later today I'm going to suggest trying a vial or two of Novorapid if she permits it.
I am really grateful to be on the 6 month pump trial and can already see positive changes pumping is making for me. I wouldn't want to go back to MDI but that's up to my consultant and if he sees no benefit then disconnection is immediate.
Thanks again and best wishes,
TeasyTux
 
iHs said:
Hi

I think you will find if you phone Aventis, that Apidra will critalise in the tube if it is not changed every 2 days so that is probably why you start to see a change in your bg levels. Your consultant should be able to explain more about this.... Novorapid doesn't tend to do this so that is why I changed from Apidra when I was using MDI and used Novo instead in my pump.
Click to expand...

Hello,
Thanks for you reply. I shall do some more investigation!
Best wishes
TeasyTux
 
Teasy Tux

I have heard of some hospitals setting everybody up on Apidra and not novrapid. I was on Novorapid, but asked to try Apidra because I saw that Apidra supposedly gave less airbubbles. I switched back to Novorapid because I found the airbubbles weren't any better with the Apidra. I also didn't like having to change the whole cartridges every 2nd day. With Novorapid it can last 6 days, although some use it longer.

However on both change overs, it did affect the basals and bolus's and acting time set up on my pump. I needed less with Apidra. Even now with Novorapid I have about 28 units total a day.

I wear my pump on my arm and the pump does get very warm, but it doesn't affect my levels.

You say your levels are not as good as you want-are they high or low?

The best bit of advice I got told was if I was low or high 2-3 hours after eating then to alter my bolus, otherwise to alter my basals.
There is a lot of setting up with a pump that I certainly wasn't informed about by my HCP's, I found out so much form a lovely lady on this website who gave me fantastic help, and still does.

What have you got your acting time set up to?
Are your probs with high's or lows or are they all just erractic?
Are you running at a 50/50 basal/bolus ratio, or has that gone out of kilter?

You can get huge amounts of advice here. Are you happy enough about changing your set ups on your machine?
 
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