Lyumjev

[SB2015]

Has anyone used this new insulin. It seems to be Lilly’ equivalent to FIASP. I spoke to someone at the weekend who is using it in a DIY closed loop system and finding that it acts a lot more quickly than FIASP which he was on previously. Has anyone else any experience of it?

 

[rebrascora]

No, but I am interested, since Fiasp isn't that quick for me. Any idea how to pronounce it, so that I don't look a total idiot when I ask my consultant about it??

 

[Bruce Stephens]

Any idea how to pronounce it

https://www.lyumjev.com says LOOM-jehv (and has a audio clip).

 

[SB2015]

Thanks Bruce
I have found out that it is approved for my pump, and now know how to pronounce it!!
I might do a bit more research before I decide whether to try it.

 

[mikeyB]

It’s just Humalog with a couple of vasodilators added, so you get the characteristics of Humalog with quicker onset. I’m not convinced that would be effective with a pump, because of the continued constant administration of local vasodilator.

 

[SB2015]

Thanks for the info @mikeyB and the link @Benny G

I reacted badly to FIASP so do wonder whether the continuous administration of the vasodilator will work for me. The graph does not show a massive improvement in the reaction time of the insulin, so I may well just stick with what I know. We all react differently to insulins and I know that the person I spoke to was fine with FIASP, which I was not, he is also quite new to T1 relatively speaking

 

[MrDaibetes]

I do use lyumjev and had issues with Fiasp. Unfortunately, it's hard to get on prescription in some areas but I was lucky and my consultant agreed to let me use it. If you have any questions, I am an open book, so will answer them.

 

[rebrascora]

As a low carber I have often found my humalog works a bit too fast, and finishes too early. A slower insulin would suit my fat and protein based meals better. I asked my consultant if I could try 'regular' insulin as recommended by Dr Bernstein: consultant said no.
I like to keep my options open, that means staying informed. But I agree that it's fine to stick with what we know, especially when 'what we know' is working fine.

Interesting as I also low carb but would prefer a faster acting insulin as my digestive system seems to be very fast but insulin acts slowly with me, so I have to wait ages for it to kick in before I can eat. I tend to do corrections after meals for protein release but again, a faster acting insulin would be helpful to bring levels back down a little quicker and sometimes the Fiasp corrections just seem to sit there and do nothing until I get sick of waiting and stack a second correction on to it. I now regularly stack corrections after meals to get back down into range but regularly skipping meals shows that my basal is right, so it does just seem to be that the Fiasp is less effective and slower than I would like.

I do use lyumjev and had issues with Fiasp. Unfortunately, it's hard to get on prescription in some areas but I was lucky and my consultant agreed to let me use it. If you have any questions, I am an open book, so will answer them.

What issues did you have with Fiasp and do you find Lyumjev faster?

 

[Bloden]

Where DO they get these names from?!

 

[Inka]

As a low carber I have often found my humalog works a bit too fast, and finishes too early. A slower insulin would suit my fat and protein based meals better. I asked my consultant if I could try 'regular' insulin as recommended by Dr Bernstein: consultant said no.
I like to keep my options open, that means staying informed. But I agree that it's fine to stick with what we know, especially when 'what we know' is working fine.

Consultant shouldn’t have said No @Benny G I believe we’re all entitled to the insulins that suit us best. There’s nothing wrong with regular insulin and it’s an ideal choice for some people. I have some - be a persistent so-and-so! Worked for me

 

[mikeyB]

In the Lilly data there are no comparative tests with Fiasp, so I wonder whether there is any measurable difference. Novo use a different technology to speed up Fiasp action, which is essentially a Vit B3 molecule tagged on to Novorapid.

All these developments have a single reason - and that is the imminence of patent expiry on the base insulin used. Just fiddle with your base insulin and see what happens, and post development push at as far better than the original. This also happened with Insulin Glargine (Lantus) which became ultra long acting Tresiba just as the patent expired on Lantus.

The last mentioned, Tresiba, is actually a marketing failure, still lagging far behind Lantus, simply because Lantus is now cheaper and and already successful.

So that is the reason “new” insulins are appearing. Not for the benefit of patients, even if they do that in use It’s for the benefit of shareholders, even as many folk are finding Fiasp doesn’t seem to maintain its speed of work, and it just plays like good old simple Novorapid.

 

[MrDaibetes]

Interesting as I also low carb but would prefer a faster acting insulin as my digestive system seems to be very fast but insulin acts slowly with me, so I have to wait ages for it to kick in before I can eat. I tend to do corrections after meals for protein release but again, a faster acting insulin would be helpful to bring levels back down a little quicker and sometimes the Fiasp corrections just seem to sit there and do nothing until I get sick of waiting and stack a second correction on to it. I now regularly stack corrections after meals to get back down into range but regularly skipping meals shows that my basal is right, so it does just seem to be that the Fiasp is less effective and slower than I would like.


What issues did you have with Fiasp and do you find Lyumjev faster?

There were several issues for me, It would work faster than novarapid for me, then a few months later it would be similar to novarapid for me. So I would still have to pre-bolus. I switched back to novarapid after these issues but was lucky to get lyumjev to try.

Lyumjev works fantastic for me yes it has its downfalls too, such as stinging, but I much prefer some sort of stinging so I actually know the insulin is going in. Lyumjev is faster for me, I don't pre-bolus now and I just feel much more confident with it. Yes I still spike sometimes, and it is not the answer to everything but for me, it's much better than novarapid.

 

[admc26]

Hi @SB2015 hope you're doing well.

I switched to Lyumjev from novorapid earlier this year I believe (like @MrDaibetes) as I was having to wait quite a while after delivering insulin to eat with novo rapid for some reason - it had never happened before, I think my body must have become resistant or something.

It works brilliant for me and it stopped the need for such a long delay between bolus and eating. I haven't really had any issues with the stinging sensation. My consultant told me that it's a bit of a pot luck as to whole experiences the stinging and who doesn't. I believe its to do with that it's more acidic so it can be absorbed faster or something? (that's what they told me - I am no scientist!)

But it's been wonderful for me and have not gone back to novorapid since 🙂

 

[martindt1606]

Have been using Lyumjev for around 5 months in my TSlim Pump.
1. It has largely resolved one issue I was having with Novorapid. Before the change I was having overnight Hypos - even with the Dexcom G6 and Control IQ running on the pump. Now (over 90% of the time) I am having breakfast with BS between 5.5 and 6.5 and a straightline from 3am or earlier. Interesting that this could be reflective of the latter tail in the Graphs posted by @Benny G.
2. The second issue I had developed with Novorapid is that bolusing with a meal was leading to a spike and then a quick fall in BS. With Lyumjev the spike has been reduced improving Time in Range. Possibly a combination of Lyumjev and Control IQ as the lower spike means no reason for Control IQ to jump in with a correction that may not be required.
3. I don't think that a vial of Lyumjev lasts as long as a vial of Novorapid. I get 6 reservoir changes from a vial and on a regular basis (but not every vial) I will have a day (11 days from starting a new vial) where I fail to hit my Time in Range target due to running high. Note I tend to run 85% plus in range so its extremely annoying to suddenly have a day in the 40 - 50% range.
4. It can sting going in (could be site dependent) but i don't mind - its good to know the insulin is going in.

 

[everydayupsanddowns]

Really intersting that Lyumjev is related to Humalog.

My clinic weren‘t at all keen on Humalog in pumps, because it had a bit of a reputation for crystallising in pump tubing (though I know others who used it with no problems).

Maybe tubing has changed (cos I’m pretty sure Humalog hasn’t)

 

[Inka]

I’d never heard that about Humalog @everydayupsanddowns When I started on my first pump many years ago it was the ‘go-to’ insulin for pumps. I remember just being told that that was the one we needed to use. That was so long ago that my bolus insulin prior to the change to Humalog was Actrapid!

 

[everydayupsanddowns]

I’d never heard that about Humalog @everydayupsanddowns When I started on my first pump many years ago it was the ‘go-to’ insulin for pumps. I remember just being told that that was the one we needed to use. That was so long ago that my bolus insulin prior to the change to Humalog was Actrapid!

Well I had been a long-term Novorapid user, but I had switched to Humalog for a Memoir pen (before the Novopen Echo existed).

Was on Humalog for a year or so, but they wanted me to switch back to NR before starting on the pump!

 

[Inka]

Perhaps each team has its ‘pet’ insulin? Like a kind of Blur v. Oasis thing?

 

[SB2015]

Thanks for all the info from those that are using Lyumjev and those that are not.

I spoke to my pump manufacturer who Said that any quick acting insulin is okay, then their DSN who said that this is not tried and tested in their pumps and said it would be an off licence choice. Not sure what implications that gives.

Interesting to read about the limited time for the insulin and the issues around crystallisation. @admc26 are you using Lyumjev in a pump? @MrDaibetes have you had any issues around the crystallisation?

The person that I spoke found that he didn’t even need to bolus for meals <50g, as his closed loop acted so quickly, the corrections dealt with any rise, and certainly didn’t need to pre bolus.

I shall continue my research, and any further feedback will be great from users. I am happy with what I am achieving at present (usually now >80% TIR) if it removed the need to prebolus it might be worth considering. My consultant is happy to prescribe it if I want to give it a go. Food for thought.

 

[MrDaibetes]

Thanks for all the info from those that are using Lyumjev and those that are not.

I spoke to my pump manufacturer who Said that any quick acting insulin is okay, then their DSN who said that this is not tried and tested in their pumps and said it would be an off licence choice. Not sure what implications that gives.

Interesting to read about the limited time for the insulin and the issues around crystallisation. @admc26 are you using Lyumjev in a pump? @MrDaibetes have you had any issues around the crystallisation?

The person that I spoke found that he didn’t even need to bolus for meals <50g, as his closed loop acted so quickly, the corrections dealt with any rise, and certainly didn’t need to pre bolus.

I shall continue my research, and any further feedback will be great from users. I am happy with what I am achieving at present (usually now >80% TIR) if it removed the need to prebolus it might be worth considering. My consultant is happy to prescribe it if I want to give it a go. Food for thought.

I don't have any issues with crystallization. I was worried too but everything seems okay.