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Moving From Humalog To Novorapid - Fifth Change In 8.5 Months

Discussion in 'Insulin' started by Metalmama, Sep 10, 2018.

  1. Metalmama

    Metalmama Type 1 · Active Member

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    Hi All,

    I've had quite a nightmare changing from beef to analogue, started the changeover in December last year, and have been on 4 different insulins.

    Humalog is taking hours to work, usually 4 hours and not the 15-20 minutes. Last week it took 6.5 hours. Have stopped eating carbs as a result and am on a minimal amount. Also, so much of my hair has fallen out from using it. Seen online, it happens:
    https://www.ehealthme.com/ds/humalog/hair-loss/


    My DSN has put me onto Novorapid, as it has a longer duration time this is my fifth change. I'm a single parent, scared and have no support as the previous changes have really taken it out of me.

    I am also on Tresiba 18.5 units which suits me just fine.

    Been told to start on 1.5 units per meal and go up a unit after a week. Got no support here, DSN said to wait until she was back from her holiday and then rang and said to just start it and had no idea what dose I should take but go by that.

    I have been told that it is taking so long as I have had Type 1 for 45 years. I rang Diabetes UK and they said that was not true. Does anyone know?

    Does anyone have any advice on a smooth transition as every one has really affected me quite badly.

    Thank you.
     
    • Hug Hug x 2
    #1 Metalmama, Sep 10, 2018 at 8:14 PM
    Last edited: Sep 10, 2018
  2. alphabeta

    alphabeta Type 1 · Well-Known Member

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    I don't understand this changeover? Many members here describe NovoRapid as NovoSluggish and personally I found this to be true. I use Humalog now which is pretty fast and acts as the same pace as my food. I eat carbs, not low carb at all, but a changeover to Fiasp would be better bet. Tagging @kitedoc for this one.
     
    • Like Like x 1
  3. EllieM

    EllieM Type 1 · Well-Known Member

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    Just checking that you haven't got any issues with injection sites, as if you overuse a site it can interfere with the uptake of insulin?

    T1 for 48 years here, have been on my current insulins for about 10 years, but I don't remember any issues when I last changed over. I wonder if your DSN is too used to protocols for introducing insulin to new diabetics rather than changing insulin for established diabetics?
     
  4. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @Metalmama, You sound like you are in caught in a never-ending storm!. The following is just from my experience as a diabetic on insulin for 51 years and the father of a child with thyroid and coeliac disease (CD).
    Personally I was changed from beef and porcine insulin in the 1980's without a problem and my insulin doses have not changed substantially since I was transferred from multiple daily injections (MDI) to an insulin pump some 7 years ago. Changes have been in line with moving from working to retirement 4 years ago.
    Firstly hair falling out - ? looking at nutrition , either lack of minerals. vitamins in diet or poor absorption of them because of things like coeliac disease - it was the latter in my daughter. Also under-active thyroid was a contributory cause to hair loss in her case. She underwent blood tests for CD (test was called TTG) and for thyroid (TSH, T4).
    So your doctor is the best person to see and discuss these and any other possibilities for your symptoms of hair loss and lack of insulin effect.
    Reading up on CD, I could not find a particular cause for insulin not working well but maybe there is something about under-active thyroid as a possible cause. But that is my guess and your doctor can advise.
    Stress can also cause hair loss and add to insulin resistance. Whether that is enough to explain your response to short-acting insulins I am not sure. Various medications including steroids can also cause insulin resistance and so affect insulin effectiveness.
    The drug information pamphlet in the package with your insulin or insulin pens talks about keeping stored insulin between 2 and 8 degrees C (i.e. in the fridge). Freezing of insulin deactivates as does exposure to over 30 degrees C. The pamphlet also talks about insulin being effective if kept out of the fridge, for up to 28 days at below 30 degrees C. If I am in doubt that my insulin has been kept too long out of the fridge, might have frozen or exposed to > 30 degrees C, I try either a new insulin from the fridge or even a new batch altogether.
    The trouble you have experienced with so many short-acting insulins does seem to make storage problems less likely as a cause of you problems. though.
    As others have said injecting into the same site over and over can cause problems with insulin absorption.
    Hair loss as a possible side-effect to an insulin has been reported (rarely with Fiasp and only when combined with a chemotherapy agent), With Novorapid rarely as in combination with another insulin or other medication, and less rarely with Humalog, usually in combo with another insulin and other medications.(above sourced from drugs.com)
    A report about '30 years of human insulin ..' by iddt.org talked more about lack of choice for diabetics and how some diabetics were more stable of animal insulins and were returned to them. It was also pointed out that one insulin manufacturer plans to cease making animal insulins, despite the fact that issues about long-term use of human insulin are still not resolved.
    An article 'Resistance and allergy to recombinant insulin' by Ganz et al jacionline.org/article/S0091-6749(05)80122-8/pdf (1990) describes a newly diagnosed diabetic initially stabilised on animal insulin who on transferred to human insulin, then developed itch skin/swellings and extreme insulin resistance. His BSLs stabilised well on return to animal insulin. It was the measurement of high insulin antibodies that helped clarify what was happening in his case. Also it was pointed out that manufactured human insulin has additives like preservatives etc so that allergies are still possible in highly purified 'human' insulins despite what others might say.
    I hope the above might be helpful in sorting out what is happening. Please keep faith in the fact that things will get sorted. The trick is finding the right health professional to see ? GP ? endocrinologist.
    My Best Wishes to you, keep posting and asking questions and please please let us know how you fare.:):):)
     
    • Like Like x 2
    #4 kitedoc, Sep 11, 2018 at 5:28 AM
    Last edited: Sep 11, 2018
  5. Metalmama

    Metalmama Type 1 · Active Member

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    Thank you so much for your reply.

    I started the new insulin two weeks ago. Still early days yet. It is still working to its own time duration. I have found it helps to eat very little to keep my levels good. I've lost 4lbs and am not overweight (8 stone 8lbs now).

    The problem is there is NO support here at all. My DSN told me to start the new regime when she was back from holiday and then rang and told me to just start it on 0.5 units per meal by myself. She said what my diabetes Dr said - it was slow as I had had it so long (45 years) He told me to stop ringing and asking questions. Our Dr/patient relationhip was good until things started going wrong and I didn't fit the checkbox criteria.

    I've got an underactive thyroid but my haiross has become so much worse since I took Humalog, that people have made comments. I hope that it will grow back now I have changed.

    I spoke to Jenny from IDDT lat week and she told me the Dr should be investigating why there was such a delay in it working. But with limited NHS funding here, that won't happen.

    I think I have to resign myself to the fact that it is what it is
     
  6. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @Metalmama, Sorry to hear of your troubles and the lack of support.
    Is your under-active thyroid being treated with medication (thyroxine) and your blood tests show that your thyroid function is now normal?
    Have you been tested for coeliac disease? Eating bread and other gluten-containing food for at least 6 weeks and etc and then a blood test as a screening test done?
    I have read about some diabetics who have such altered absorption of insulin that they require concentrated insulin.
    Can you be referred a.s.a.p. to a consultant endocrinologist to sort some of these things out?
    Or is it a case that animal-derived insulin is best ?
    Is there another DN who might be more open?? And if your request to see a consultant endocrinologist is declined, or a request for a second consultant opinion (if the first one was useless) is declined you may need to see your local member of Parliament. Please keep posting as you go, many on site have had to battle through the health system and bureaucracy and have learnt various methods in order to succeed. Never give up. There is a solution somewhere!!!
     
  7. lead87

    lead87 · Newbie

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    hi @Metalmama
    i too suffered sudden hair loss in a few months following change to humalog and lantus after using animal insulin for the first ten years of my diabetes so you aren't the only one! I have had good control using it over the years (25)since but only now am i beginning to wonder about side effects... however after hearing about novorapid it appears that unless animal is available to you - humalog is probably the best option
     
  8. edan

    edan Type 2 · Well-Known Member

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    0.5u per meal is a very small dose, that would only cover 5g carbs on the usual ratio of 1u to 10g carbs. Do you carb count? Maybe the reason you aren’t seeing good results is you aren’t taking enough? It’s normal for short acting insulin’s like apidra, novorapid, humalog to have a duration of 4-5 hours
     
  9. Metalmama

    Metalmama Type 1 · Active Member

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    Ahhhh I'm so sorry this is so late. I had to ask how to reply to old posts and only found out this week as left it late to ask!
    Not been checked for coeliac, thyroid is treated with Thyroxine.
    I am on U100 and wonder of I can if I can get concentrated Novo, will have to look.
    I've tried two endo's and neither were supportive. Have had better advice from forums!
    This new insulin just makes me feel tired all the time. DN said I was too stressed but just not been the same since the changeover.
     
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