Lyumjev

[PattiEvans]

I tried Fiasp for a while (about 3 months) but it didn’t work well for me and the initial speedy action (where I needed to split doses of ‘normal’ meals to avoid a dip soon after eating) more or less stopped happening at the end of the first vial. It then became a bit erratic and stingy as @Kol describes.

I switched back to NotveryRapid after 3 vials, which is annoyingly sluggish, but at least predictably so!

Hope you get on well with it if you give it a go @Charl

Fiasp and Ljumjev work brilliantly for several members here.

Mike, have you ever thought of giving Apidra a try? It's pretty stable and predictable and quite a bit faster than Novorapid. Plus it doesn't last too long as Novorapid can.

 

[rebrascora]

Hi all,

I was changed to Lyumjev from NovoRapid some time ago and it sounded a great idea to start with but in practice finding it unpredictable to be honest, often it can be all or nothing, doesn’t last as long Novorapid so evening meal will always require additional injection, often several! certainly wary of too much at once as level can drop like a stone.

I think it suits during the daytime while working, active and when only few units here and there might be required, but not so in the evening.

So thinking of going back to NovoRapid, unless they let me have that as well, I’m going to ask but I doubt it!

Sounds like a similar experience to mine moving from NR to Fiasp. I went back to NR after 3 months the first time I tried it and then gave it a second go about a year later when I promised myself I would stick at it for a year before I went back to NR again. About 4 months in I made a bit of a break through and have been using it ever since. I find small meals when BG is in range to start with us fine but if I have a larger meal it will take the original bolus plus sometimes 2 or more stacked corrections over the next few hours to maintain reasonably good levels.... or at least prevent them heading into orbit. Once my levels get into double figures, Fiasp simply doesn't want to work unless I stack corrections, or I can exercise with a correction on board, which isn't really practical through the night.

 

[Kol]

Haven't started it yet , hopefully pick it up this afternoon, regarding dropping like a stone would I be ok eating then injecting after or is it a case of trial and error. Thanks

Yes trial and error,
Yes i would not inject before eating, until you know how it affects you, i would inject while eating and continue to watch Libre but remember it's limitations and confirm with finger pricks before eating, during eating and several hours after eating since we are all different, alot also depends what your level is at as to how quickly it seems to work and what the meal is etc, etc, then you can relax!
I tend to split my evening meal dose until i know where it's going.
The unfortunate thing for me is it ticks along quite nicely for small corrections during the day combined Lantus but larger amount and a lazy evening is not my friend!

Hope i'm not making it sound bad! because it might work fine for you

 

[Kol]

Sounds like a similar experience to mine moving from NR to Fiasp. I went back to NR after 3 months the first time I tried it and then gave it a second go about a year later when I promised myself I would stick at it for a year before I went back to NR again. About 4 months in I made a bit of a break through and have been using it ever since. I find small meals when BG is in range to start with us fine but if I have a larger meal it will take the original bolus plus sometimes 2 or more stacked corrections over the next few hours to maintain reasonably good levels.... or at least prevent them heading into orbit. Once my levels get into double figures, Fiasp simply doesn't want to work unless I stack corrections, or I can exercise with a correction on board, which isn't really practical through the night.

What @rebrascora says.

 

[rebrascora]

I personally rarely find that Fiasp causes my levels to plummet and there are times when I rather wish it would! 🙄 For me the only time it does is if I exercise or do more rigorous activity with active Fiasp on board.

 

[Finn]

Haven't started it yet , hopefully pick it up this afternoon, regarding dropping like a stone would I be ok eating then injecting after or is it a case of trial and error. Thanks

This is what I did when I started using Lyumjev. Once I understood how it worked for me, I shifted my bolusing timing little by little.

I've had times when I needed a post-bolus at dinner with Lyumjev (about 20 minutes after eating), rather than a pre-bolus, or else I'd drop too fast. But this timing fluctuated with my monthly hormones and insulin sensitivity and wasn't an issue all the time.

 

[everydayupsanddowns]

Mike, have you ever thought of giving Apidra a try? It's pretty stable and predictable and quite a bit faster than Novorapid. Plus it doesn't last too long as Novorapid can.

I used to think about Apidra - and I know you’ve got on great with it.

I’m due to change pump in the summer, and depending on which I go for it would be worth considering as part of that process.

Control IQ fixes insulin duration as 5 hours (and you can’t change it) so I wonder whether Apidra might confuse it a little? But if I switch to a different system it might allow that value to be tweaked?

 

[Charl]

Eventually got to try lyimjev today but depending on finger pricking as awaiting replacement libres ( two failures one after another ) injected as my DN instructed, inject then eat, used my usual carb count , before eating reading 10 inject then eat, 2 hrs 30 mins later checked and I've dropped down to 5, usually I would be running higher than that, looking like it's going to drop further , any suggestions, like I said no difference regarding carb count, should I have took it later, split dose, less insulin, nothings easy...
Thanks.

 

[Kol]

I would try a bit less insulin first, and meter check every 30mins see where its heading.

 

[Finn]

Eventually got to try lyimjev today but depending on finger pricking as awaiting replacement libres ( two failures one after another ) injected as my DN instructed, inject then eat, used my usual carb count , before eating reading 10 inject then eat, 2 hrs 30 mins later checked and I've dropped down to 5, usually I would be running higher than that, looking like it's going to drop further , any suggestions, like I said no difference regarding carb count, should I have took it later, split dose, less insulin, nothings easy...
Thanks.

I found my I:C ratio didn't change when I used Lyumjev versus Humalog, but injection timing did change.

I think I started injecting Lyumjev 10-15 minutes after eating, then adjusted in 5 minute increments over the next few days.

I think I landed on a 20 minute pre-bolus for breakfast (instead of the usual 40 minute with Humalog), bolus when eating for lunch (rather than 15 minutes with Humalog) and bolusing 15-20 minutes after eating for dinner (versus a 10 minute pre-bolus with Humalog).

Obviously everyone will be different and it will depend on what you eat, but this is what I found worked for me.

 

[Lucyr]

Mike, have you ever thought of giving Apidra a try? It's pretty stable and predictable and quite a bit faster than Novorapid. Plus it doesn't last too long as Novorapid can.

I’ve never tried any of the fiasp, novorapid, lyumjev… I’ve always been apidra (other than a brief terrible humalog stint when the apidra factory had issues). I’m always surprised at how rare apidra seems to be. Other than you Patti I’m not sure I even know of anyone who has tried it, and certainly rarely see it reccomended on the forum.

I love the apidra, especially compared to humalog, but since I’ve never tried anything newer I don’t feel qualified to recommend it. Feels like it’s the perfect option though, okay maybe not quite as fast as the newer ones like fiasp but I never heard of anyone on apidra complaining that it doesn’t work when they’re high

 

[Lucyr]

Control IQ fixes insulin duration as 5 hours (and you can’t change it) so I wonder whether Apidra might confuse it a little? But if I switch to a different system it might allow that value to be tweaked?

Possibly, I find apidra is more like 3.5hrs duration for smaller doses, 4 for larger doses. Doesn’t do anything useful for me at 5hrs whereas humalog had a random sting in the tail at 5hrs.

 

[Charl]

Tried a different approach, took a dose 15mins into my evening meal,carb ratio the same as always, went to bed at 10pm finger prick reading 14.4 (not usually that high) got up this morning 06.30 reading 15.1 took 9 units, 7 for food 2 correction , shower, before breakfast 30 mins later.. reading 14.9
Off to work 8 am ...16.9
9am...14.5
10am...9
Thought it was supposed to be quick acting..is it weaker than novorapid....seems a pointless change to me.

 

[helli]

@Charl I wonder if you are seeing similar behaviour to what I experience with Fiasp - the speed at which it works is dependent upon my starting BG.
If, for example, your BG was lowish (but not hypo low) before you injected for your meal, it may have dropped quickly. Hence your concern about dropping further after 2 hrs 30 mins.
However, when you took your bolus in the morning, your BG was high so it takes longer to work.
With Fiasp, I find my bolus timing is very dependent upon my starting BG - it works faster than digestion when my BG is in the 4s so I have to bolus after eating. Whereas, it can be very slow when my BG is in double figures so I have to bolus an hour ahead of eating if I don’t correct soon enough.

 

[Charl]

Does it matter if I mix my insulin, went to bed on 9.5 got up this morning and it was 15, an hour later and its 16.3, going out for a couple of mile walk very soon so a bit concerned my readings are gonna drop like a stone, would it matter too much if I take my novo rapid now before breakfast , bearing in mind I'm out in about an hour....nothing simple...cheers

 

[Inka]

You can take Novorapid as long as you’re aware of possible stacking, just like you would with any insulin. I know a number of people who use two bolus insulins ( obviously not together!) and I do myself.

 

[Charl]

Hi all,

I was changed to Lyumjev from NovoRapid some time ago and it sounded a great idea to start with but in practice finding it unpredictable to be honest, often it can be all or nothing, doesn’t last as long Novorapid so evening meal will always require additional injection, often several! certainly wary of too much at once as level can drop like a stone.

I think it suits during the daytime while working, active and when only few units here and there might be required, but not so in the evening.

So thinking of going back to NovoRapid, unless they let me have that as well, I’m going to ask but I doubt it!

Spoke to my DN regarding using both as it's usually the breakfast time that takes a
Long time to drop, she didn't advise to so going to up my insulin dosage breakfast only see if that makes a difference..

 

[Kol]

Hi @Charl did your Libre sensors turn up yet?
What Basal insulin are you using?

 

[Charl]

Hi @Charl did your Libre sensors turn up yet?
What Basal insulin are you using?

Basal is tresiba...yes thanks sensors turned up, working fine....touch wood.

 

[Charl]

Well today I doubled my dosage for breakfast, 4hrs in and dextro at the ready, breakfast was around 60g so upped dosage to 12 units, breakfast first then insulin after.