• Please Remember: Members are only permitted to share their own experiences. Members are not qualified to give medical advice. Additionally, everyone manages their health differently. Please be respectful of other people's opinions about their own diabetes management.
  • We seem to be having technical difficulties with new user accounts. If you are trying to register please check your Spam or Junk folder for your confirmation email. If you still haven't received a confirmation email, please reach out to our support inbox: support.forum@diabetes.org.uk

Apidra or changing insulin for a pump

Status
This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Lucyr

Lucyr

Well-Known Member
Relationship to Diabetes
Type 1
Short version of question: Can you use apidra in any insulin pumps? Or has anyone had to change insulin in order to go onto a pump and how did that go?

We covered insulin pumps on the t1 course this week, final week, so I now know that my clinics favourite pumps are, in order of preference

My life Ypso
Tandem t slim
Medtronic (they don’t use many of these though)
Omnipod (rarely funded except for children)

The ypso one holds 160u in a cartridge to last 3 days, I’d use more than that so I said I was interested in a pump but we provisionally said it would be the tandem one I’d be interested in finding out more about. I think the next stage would be a demonstration session where I’d see that actual pump, then presumably at some point I’d need to get a consultant to agree I met the criteria and go on an actual waiting list.

But, I’ve only ever used apidra, for 15 years, other than a few weeks on humalog which I hated. Ypso you could fill your own cartridges with apidra, but I’d have to change the cartridge regularly. It was the only one with a remote bolus app but only for android and I don’t have android so didn’t sound a good fit. But, from research online tandem and Medtronic didn’t look like you could use apidra in them? Has anyone had to change insulin to go on a pump? Or knows why you can’t use apidra in these pumps?
 
I use Apidra with a Medtronic pump so it definitely can be done! Like you I didn't get on with Humalog at all. Good luck!
 
Radders said:
I use Apidra with a Medtronic pump so it definitely can be done! Like you I didn't get on with Humalog at all. Good luck!
Click to expand...
Oh that’s interesting as the comparison chart shown didn’t list apidra under the Medtronic column
 
Pump companies do love to push their favourite insulin(s) @Lucyr If there’s a reservoir for you to fill, ignore them and their little deals suggested insulin. I know someone who uses Apidra in a pump and has done for years. I don’t know what pump they have now, but most pumps can use Apidra and, indeed, even regular insulin (you just adjust the parameters).
 
@Lucyr - if I'm not mistaken - @PattiEvans uses Apidra in her Omnipod, cos she'd already swapped to Apidra (from her original Humalog) in the pump she had before the Omnipod.

(I've got that wrong several times in the past though so apologies to all if I have again)
 
Inka said:
Pump companies do love to push their favourite insulin(s) @Lucyr If there’s a reservoir for you to fill, ignore them and their little deals suggested insulin. I know someone who uses Apidra in a pump and has done for years. I don’t know what pump they have now, but most pumps can use Apidra and, indeed, even regular insulin (you just adjust the parameters).
Click to expand...
The information I read was that apidra causes occlusions and blocks the pump rather than it just not being their favourite, so it was that angle I was concerned about really, as well as wondering what the clinic would say about it (I know that’s a long way in the future though still)
 
Did they actually say it caused occlusions @Lucyr or was it more “there’s no evidence that it doesn’t”? Like Jenny, I think @PattiEvans uses it in her pump and mentioned others that do too.
 
“Continuous subcutaneous insulin infusion
Apidra may be used for Continuous Subcutaneous Insulin Infusion (CSII) in pump systems suitable for insulin infusion with the appropriate catheters and reservoirs. Patients using CSII should be comprehensively instructed on the use of the pump system.
The infusion set and reservoir used with Apidra must be changed at least every 48 hours using aseptic technique. These instructions may differ from general pump manual instructions. It is important that patients follow the Apidra specific instructions when using Apidra. Failure to follow Apidra specific instructions may lead to serious adverse events.
When used with a subcutaneous insulin infusion pump, Apidra must not be mixed with diluents or any other insulin”.


.
 
Pfftt! I used Apidra in 2 x Accuchek Roche combo pumps. Occlusions were so rare they were a bit like hen's teeth. I recall having one when I was at work and had to go home to change but that was the only one I can recall in 8 years. I am now using Apidra in Omnipod and have been for 3 years with no problems whatsoever, even though the Omnipod rep seemed to think they do not recommend it, she didn't know why. I change the Omnipod every 3 days. I also changed the cannulas on the Combo every 3 days.

I'd not like to change back to Novorapid. I did have 1 vial of it one time and noticed how slow it was in comparison.
 
PattiEvans said:
I'd not like to change back to Novorapid. I did have 1 vial of it one time and noticed how slow it was in comparison.
Click to expand...
Thanks and yes that’s my other question - the comparison sheet said duration of insulin action on tandem is fixed at 5hrs and can’t be changed. Medtronic said duration can be changed. Apidra no way lasts 5hrs.

Would that mean if I was using apidra in a pump I’d need to choose one where I can set the insulin action shorter to match it, or would it not make much difference?
 
I don't think it's irrevocably fixed Lucy. See this link where it says:

Insulin Duration (how long a bolus lowers your blood glu- cose) has a default setting of five hours and can be adjusted from two to eight hours when Control-IQ technology is off.

I imagine, if it's like the Omnipod, you have to turn off any automatic control when adjusting settings.
 
Inka said:
Did they actually say it caused occlusions @Lucyr or was it more “there’s no evidence that it doesn’t”? Like Jenny, I think @PattiEvans uses it in her pump and mentioned others that do too.
Click to expand...
Fiasp is not a preferred insulin for the Omnipod, and I have heard from DSN's this is due to how it can very rarely crystallise, but we all know this will be some deal. I use it and it works.
 
Yes, I use a non-approved insulin in my pump (and my two previous pumps) and have never had an occlusion @PhoebeC over a period of more than 10 years.
 
I was told “No” and “Apidra is being phased out” at my annual review in November. But my consultant was in a “No” mood - she wouldn’t agree to anything I asked for!

Good luck!
 
Bloden said:
I was told “No” and “Apidra is being phased out” at my annual review in November.
Click to expand...
Did she say why apidra is being phased out? Never heard that one
 
No explanation or extra info - just that it's being phased out. I'm in Wales, remember, where the NHS is well and truly on its knees. Maybe we just can't afford it here so they're spinning some yarn. It's a fantastic insulin, much much much better than Novorapid.

I hope you get what you're hoping for @Lucyr.
 
Bloden said:
No explanation or extra info - just that it's being phased out. I'm in Wales, remember, where the NHS is well and truly on its knees. Maybe we just can't afford it here so they're spinning some yarn. It's a fantastic insulin, much much much better than Novorapid.

I hope you get what you're hoping for @Lucyr.
Click to expand...
Checked the BNF
Apidra 5 cartridges £28.30
Novorapid 5 cartridges £28.31

So it’s the cheaper option!
 
Lucyr said:
Checked the BNF
Apidra 5 cartridges £28.30
Novorapid 5 cartridges £28.31

So it’s the cheaper option!
Click to expand...
What's the saying? Look after the pennies...:rofl:o_O
 
Lucyr said:
Thanks and yes that’s my other question - the comparison sheet said duration of insulin action on tandem is fixed at 5hrs and can’t be changed. Medtronic said duration can be changed. Apidra no way lasts 5hrs.
Click to expand...

Yes as Patti says on Tandem, the DIA (duration of insulin action) is fixed at 5 hours only when you are looping (with Control IQ).

Medtronic allows you to set much shorter DIA, and in fact its algorithm tends to like it artificially short. I started at 3.5hrs, when actually 4+ hours is more likely with NotVeryRapid

As for the occlusions I was switched (back) to NovoRapid from Humalog because my clinic said Humalog had a reputation for causing occlusions. Someone else on the forum was switched TO Humalog, because NR can cause occlusions!! It seems to just be the sentence they say when they have an insulin they have found works for most of their people!

If you are looping, having an insulin that the Algorithm is designed around might help - but tbh each algorithm is different, and will work differently depending on your diabetes. I seem to have a diabetes that fits Medtronic’s algorithm better than Tandem’s, for example.
 
I do like Fiasp, better than NovoRapid for me, I found that slow when compared. I have only ever had those 2 Bolus. Anytime I changed by Basal I have been very ill.
 
Status
This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Back
Top