Considering a different insulin

Status
Not open for further replies.
Flower

Flower

Well-Known Member
Relationship to Diabetes
Type 1
I've used Humalog insulin for decades, I've never considered asking to try something else.
I don't need a faster insulin for meals, I only need to prebolus by a few minutes for food and that's worked for me for years however my
new problem is insulin pump cannula failure. I used Medtronic for 16 years and although the adhesive caused me to react in the past few years the actual cannulas worked well for me and I didn't get many failures.

I love my TSlim pump but I'm having such problems with insulin absorption even after changing to Steel cannulas. They are better than the teflon cannulas but yesterday I had to do 3 cannula changes until insulin started to be absorbed. I'm spending hours floating along in the high teens/20's correcting and not knowing what insulin has been absorbed. I'm getting at least one failure per week. When I last discussed this at my pump clinic I was asked 'why did I think it was the cannulas?' Hmm whatever the reason I haven't got many reliable places I can use for cannulas and having raised glucose terrifies me with significant sight loss and Charcot foot plus a few other complications I need to try and manage as well as possible.

I've read about Lyumjev and it appears very similar to Humalog but faster acting. I don't know if any one is using or has used it in a pump but would be interested to hear if it's possible and if it helped you. Thanks
 
Try bolusing by pen @Flower It’s helped my absorption problems (I’ve been on a pump for 20+ years). I wouldn’t touch Lyumjev or Fiasp personally and if you don’t need their speed, then I can’t see the point. Fiasp can cause crappy sites, I’ve read, quite apart from the ‘like water’ faffing around with it. If the Humalog suits you, use a pen and branch out into areas you don’t/can’t put cannulas in.
 
Thanks @Inka I have thought of injecting but I’m really scared of stacking without hypo awareness. It is a good solution as I know how Humalog works for me if I can get it through my skin. I’m probably at higher risk of stacking when correcting with numerous new cannulas.

Like you I’ve used a pump for 26 yrs & have got so many areas that just don’t absorb. I can’t use my legs as I wrecked them injecting through my clothes in the 80’s -my rebel years- do not do this!

I’ve got some old school syringes as a pump failure back up plan. Time to try be brave & try them out.
 
I’ve never injected through my clothes because I have a fear of germs :D Every body is different but you could try new areas that you wouldn’t use for a cannula. If I’m nervous, what I do is split my bolus, eg inject half in my arm and half in my leg. I’ve used my arm but there’s only a smallish area to inject there, I’ve also used the top of my bum (quite slow) and just to the inner side of the middle of my thigh. I’ve also used the side of my waist.

I don’t see how you could stack. If I eat lunch say, and then want a mid-afternoon snack of 20g, I bolus for 15g just to knock a bit off the bolus. To me, the real danger with stacking is from corrections. To start with, you could stick to three regular meals maybe. They don’t make a reuseable half unit pen for Humalog now, but you can get a Junior Kwikpen (think it’s called that).

Using my pen for boluses really helps my sites. I hope it helps you too.
 
I was worrying about stacking if I started using a pen for corrections & not knowing how much insulin I’ve got onboard after a cannula failure.

I would only use a pen for corrections as I’m looping and don’t want to stop using that as it works really well for me with a functioning cannula.

I need some new skin!
 
I totally get you! I often dream of an extra couple of legs or a thigh extension or similar! :D
When I have a failed site, I correct cautiously to start with in order to avoid hypos. I don’t really get failed sites now, just occasionally a site that isn’t as good, meaning I’ve gone too high. I always correct by pen unless I’m doing a tiny amount, eg 0.25 units.
 
Ack! Sorry to hear the tSlim sites have been giving you the runaround :(

One thing I have noticed with tSlim cannulas (I use the Mio-esque Autosoft 30s) is that the little initial sticky strip doesn’t sit quite right from the ‘serter. So I have to hold the site and get it seated flush to the site, so that there isn’t a little slack that allows the cannula to fractionally pull out backwards when withdrawing the serter assembly.

I think it was this little movement that allowed ‘tunnelling‘ where insulin could leak back to the surface.

Hopefully that isn’t a problem with the steels, bit I had a bit of a learning curve for insertion in my first year - especially when I can‘t see the site!
 
Sorry to hear you’re having problems @Flower. I hope Mike’s suggestion sorts out the problem. (((Hugs)))
 
Your thread title asks about other insulins. Have you tried NovoRapid to see if it works better for you in the t:slim pump?

When I was on MDI, I used Humalog (the Junior Kwikpens) and Lyumjev (also the Junior Kwikpens). Those worked well for me on MDI.

When I switched to the t:slim, I was advised to switch to NovoRapid. The only reason is that NovoRapid is approved for three days in a pump, while Humalog is approved for two days (at least here in Germany). I switched and had no issues with the change. I haven't tried Humalog in my pump to see if there's a difference.

I currently use NovoRapid in my pump and Lyumjev Junior when I need something quicker (for a quickly-rising high), fast (when I just want to eat that doughnut now) or when I want a shorter-lasting insulin (before bed or when I'll be going for a walk later and don't want insulin on board). I'll often do a combo Lyumjev/NovoRapid bolus to get the both of best worlds (fast acting Lyumjev manually and extended bolus NovoRapid on my pump).
 
I keep my Humalog in my pump for 6 days with no issue @Finn To me, it sounds like the cannulas and/or sites. I think I saw somewhere on here that the recommendation is 4 days but didn’t see it differentiate between insulins.
 
Inka said:
I keep my Humalog in my pump for 6 days with no issue @Finn To me, it sounds like the cannulas and/or sites. I think I saw somewhere on here that the recommendation is 4 days but didn’t see it differentiate between insulins.
Click to expand...
Things vary from country to country.

I was taught at my Tandem t:slim training to change sites every 3 days minimum for Autosoft 90s, or every 2 days minimum for TruSteel. I'm pretty sure I also read this in the pump manual or in the booklet that comes with the infusion sets.

The Tandem trainer also mentioned Humalog was approved for 2 days, but NovoRapid for 3 days. I believe I saw the same thing in the pump manual. The trainer was pleased to hear I'd be switching to NovoRapid. The trainer and my endo separately confirmed that Lyumjev wasn't approved in pumps in Germany.

I don't know their criteria for determining how long sites and insulins can be used, but this is what I was told in Germany.

Obviously things don't stop working entirely after they pass their approved usage period, but I can stick to my team's guidance, so I do.

For me, this means filling my pump with 100u which lasts me 3 days. I use both Autosoft 90s and TruSteel. Autosoft 90 sets line up nicely with infusion set changes. When I use TruSteel, my infusion set changes (2 days) and reservoir changes (3 days) are offset.

I also am prescribed as many (and whatever) supplies as I request, within reason, and everything is covered by insurance, so regular reservoir & infusion set changes adhering to the guidance given in Germany are encouraged. I assume this leads to good site health with good absorption, but it does mean more supplies used.
 
Finn said:
Your thread title asks about other insulins. Have you tried NovoRapid to see if it works better for you in the t:slim pump?

When I was on MDI, I used Humalog (the Junior Kwikpens) and Lyumjev (also the Junior Kwikpens). Those worked well for me on MDI.

When I switched to the t:slim, I was advised to switch to NovoRapid. The only reason is that NovoRapid is approved for three days in a pump, while Humalog is approved for two days (at least here in Germany). I switched and had no issues with the change. I haven't tried Humalog in my pump to see if there's a difference.

I currently use NovoRapid in my pump and Lyumjev Junior when I need something quicker (for a quickly-rising high), fast (when I just want to eat that doughnut now) or when I want a shorter-lasting insulin (before bed or when I'll be going for a walk later and don't want insulin on board). I'll often do a combo Lyumjev/NovoRapid bolus to get the both of best worlds (fast acting Lyumjev manually and extended bolus NovoRapid on my pump).
Click to expand...

I haven't ever used NovoRapid @Finn but since changing to TruSteel cannulas they need to be chnged every 2 days which ever insulin I use. I was concerned about getting my glucose down more quickly after cannulas failing to absorb and thought maybe a faster acting insulin might be a solution even though I don't need a faster acting insulin for food.

I think I'll stick with what I've got for now and correct with syringe/pen when I get a cannula failure.

Thanks everyone
 
Lyumjev is humalog with an additive to speed it up. From what i understand from the lyumjev world when i was on it is that it can block pumps. I dont use a pump but i quite often had to discard an unfinished vial due to bits floating in it.
 
gillrogers said:
Lyumjev is humalog with an additive to speed it up. From what i understand from the lyumjev world when i was on it is that it can block pumps. I dont use a pump but i quite often had to discard an unfinished vial due to bits floating in it.
Click to expand...
I'd heard this with people using Fiasp in pumps, but I'd hadn't heard it about Lyumjev. I think some people work around the issue by mixing NovoRapid and Fiasp in their cartridge to speed it up without getting blockages. I don't know what ratio they use and I haven't tried it.

I fill my pump with pure NovoRapid and inject Lyumjev manually as needed. My endo didn't suggest it, but I started doing it with leftover Lyumjev pens after I switched to the pump and I found it works well for me, so my endo is happy to have me carry on with it. I'm in Germany and my endo has no problem prescribing both insulins (NovoRapid cartridges for pump and Lyumjev Junior Kwikpens for manual injections, plus Abasaglar for major pump failures), and my insurance has no issue with paying for it. 🙂 I don't know if it's possible to be prescribed multiple fast-acting insulins in the UK, but it can give a lot of flexibility.
 
Status
Not open for further replies.
Back
Top