Change to Turapi

Q

Quizzical

Well-Known Member
Relationship to Diabetes
Type 2
I’ve just been told that I’m to change from NOVORAPID to Turapi. I find Novorapid very hard to time correctly- is Turapi as slow?
 
Trurapi is a bio-similar of Novorapid - ie basically the same thing but not branded. Humalog is faster for most people, as are other insulins like Apidra, Fiasp, etc. My guess is the change to Trurapi is simply to save money. If you’re not happy about it, speak up.
 
Inka said:
Trurapi is a bio-similar of Novorapid - ie basically the same thing but not branded. Humalog is faster for most people, as are other insulins like Apidra, Fiasp, etc. My guess is the change to Trurapi is simply to save money. If you’re not happy about it, speak up.
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Interestingly I found Humalog pretty similar to NovoNotVeryRapid, but it had a bit more of a kick in the 'tail' of its action.

Fiasp was much faster for a short while, but I'm one of the bodies that decides to hate it, and that speed (and indeed any semblance of reliable timings) wore off after about a month. I think the additive in Ljumjev (sp?) is similar so haven't tried it.

I am a little envious of those who get good reliably speedy results with Fiasp, but was hugely relieved to go back from thoroughbred to the plodding, reliable, carthorse of NR :D
 
@everydayupsanddowns I wonder if perhaps you didn't stick at it long enough to get the hang of it. It took me 2x3 months of very frustrating trials before I found ways to make it work for me and I actually really like it now.
If I hadn't had CGM I don't think I could have made it work, but being able to track my levels more closely and dose more aggressively than I ever would have done with NR if levels are heading into double figures (when it seems to turn to water 🙄 ) and then keep a close eye on levels potentially dropping too fast if I have stacked corrections to get a high BG down, means it works really well for me now and I wouldn't want to change and the longer I am on it the better I get with it, but I admit it was a relief to go back to sluggish NR after the first 3 month trial..... until I get chewed off again with it being so slow and had another go with Fiasp and even then, if I hadn't promised myself I would stick it for a year, I would have failed again, but the 4th month of the second trial, I seemed to pull on my big girls pants and go heavy handed with it and that helped me turn the corner. I don't think I use much more of it than I would have done with NR now, but I do feel I have to be much more proactive with keeping my levels in single figures to make it work well and I love the fact that it is pretty well gone in 3 hours for me, sometimes nearer 2.

@Quizzical Do you use disposable pens or a reusable pen with Penfill cartridges? I think that would be one of the reasons I would make for sticking with NovoRapid because the NovoNordisk reusable pens are second to none for quality and useful features like half units and last dose reminder and that would definitely influence my choice of insulin.
 
rebrascora said:
@everydayupsanddowns I wonder if perhaps you didn't stick at it long enough to get the hang of it. It took me 2x3 months of very frustrating trials before I found ways to make it work for me and I actually really like it now.
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I had 3 vials (approx 3-month's worth).

Initially it worked fast, such that I needed to split doses for foods I'd usually take 'all up front', to avoid dipping into a hypo.

I'd seen some reports from people who said their ratios began to drift upwards after 2-3 weeks, so I didn't worry when mine followed the same pattern.

I can't remember whether the site reactions started before or after I noticed that the initially observed speed of action had disappeared, and I was now back to NR-level prebolusing times.

I'd pretty much decided by the end of vial 2 (maybe this was too soon), but things became increasingly erratic during the 3rd vial. Sometimes doses would simply disappear and have no apparent effect. And the sites got angriet, even of changing at 2 days (which was a faff).

In the end it was acting at NR timing, but significantly less reliably.

My TIR was negatively impacted, and I was having to work really hard to keep on top of things, for literally no benefit at all.

About 2 days after restarting NR my TIR bounced back up +20% into my usual 'running range'.

www.everydayupsanddowns.co.uk

Fiasp review, fun with 50:50, and the mystery of the missing insulin

My experiences with Fiasp, the new ultra-rapid acting insulin from NovoNordisk.
www.everydayupsanddowns.co.uk www.everydayupsanddowns.co.uk

I'm really pleased when it works well for people. But I was glad to see the back of it. 🙂
 
That was a really insightful blog on your Fiasp Experiment and I am applying for my "perseverance medal" in wading through the 50:50 and 500TDD additional experiments.

Actually I think almost all the points you raised were issues that I had apart from the stinging/soreness although perhaps being on MDI where only a small dose is going into each injection site means this is less likely to occur.

Excerpt which really resonated with me were:-

"What it made me realise, I suppose, was that after something like 15 years of using NovoRapid I had memorised a lot of 'exceptions to the rules'. Little tricks and strategies that I use, almost without thinking, to work around NR's particular activity profile and my individual BG response to different foods. When switching to Fiasp, I was needing to re-invent a lot of these, and discover a whole lot of new ones. If the switch was to become permanent, it would take time to build up this knowledge."

This is why it took me 2 x 3 month trials to make it work. I found it very difficult (particularly being relatively early in my Type 1 diagnosis) to abandon those strategies and form new ones.

Even more perplexingly, rather than acting more rapidly, sometimes my corrections of high BG values seemed to have no effect at all. I would be watching a sensor trace waiting for a high or rising BG to be corrected and nothing would happen. I began to throw in 2u and 3u speculative 'turnaround' corrections to try to halt a rising BG only to see it continue to rise, and where I was expecting to have to mop-up the excess insulin with carbs later, the dose seemed largely to disappear entirely.

This was when I realised that stacking corrections with Fiasp was necessary and safer than rage bolusing a whopper correction. I did also assume that part/most of this was down to protein release from my low carb diet, although I admit I hadn't noticeably happened with NR but I was coming to the end of my honeymoon period and needing significantly more Levemir at the same time.

Finally this....

I am sure I could have made it work given enough time, but I was losing trust with it and finding it not altogether reliable or predictable. This was relatively manageable when I was wearing a CGM sensor to keep track of where doses were not behaving as expected, but I generally only use sensors occasionally and I really need an insulin that I can trust while I'm not able to watch it like a hawk.

I freely admit I couldn't manage with Fiasp nearly effectively enough long term without CGM. I need to be able to see those levels rising and hit them with a correction before they hit double figures and if I get into double figures and have to stack corrections to bring it down, I need to be able to see if they are being effective of if I need another one OR if they are being too effective and I need to head off an impending hypo.

So it seems my experience may well have been very similar to yours indeed, but with use and constant CGM I have found ways to make it work better for me than NR. It might perhaps be interesting to go back to NR now that my honeymoon period is over and see how much more Fiasp I use than I would NR now, but it would involve unlearning all those little strategies and work arounds that become so automatic after months and years and probably make things a little unsafe for a while, particularly stacking NR corrections 😱 whereas I don't think twice about it with Fiasp.

Overall for me I feel the benefits of Fiasp far outweigh those issues now as I have found routines and strategies to offset those drawbacks. Interestingly Fiasp seems to have speeded up a little bit for me in the last year but it may be that it is because I am managing my BG levels better and keeping them more in the 4s and 5s, particularly on a morning and Fiasp works at it's fastest at these lower levels.


Apologies to @Quizzical for derailing your thread.
 
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