Lyumjev

[RoseH]

I’m being moved onto this insulin from nova rapid , mainly because I have two young children so by the time I remember to put my insulin in between running round cooking and sorting the kids it’s usually time to eat , so my team decided this would be better as you put it in just before. Just looking for people’s experiences. Thanks

 

[Inka]

I think @gillrogers uses it but I can’t think of anyone else. I just bolus when I can. Children rarely work with schedules 😱 It does get easier. X

 

[RoseH]

I think @gillrogers uses it but I can’t think of anyone else. I just bolus when I can. Children rarely work with schedules 😱 It does get easier. X

I think @gillrogers uses it but I can’t think of anyone else. I just bolus when I can. Children rarely work with schedules 😱 It does get easier. X

thank you yeah children definitely don’t work with my diabetes haha , especially the two year old I’m still fairly new to everything so trying to just find what works xx

 

[Inka]

I think @gillrogers uses it but I can’t think of anyone else. I just bolus when I can. Children rarely work with schedules 😱 It does get easier. X

thank you yeah children definitely don’t work with my diabetes haha , especially the two year old I’m still fairly new to everything so trying to just find what works xx

If you bolus close to the meal - ie when you have a chance or remember! - I find that by the time everyone has sat down and been settled, I can delay my eating a little by feeding/helping children, and that adds a few minutes to my pre-bolus time. I just use Humalog and find that works fine. It also avoids hypos when children ask for help or a drink or a toilet visit mid-meal and slow my eating down. I have 3 children, and the biggest effect on the diabetes is my poor scrambled brain

Remember too that if you’re still in your honeymoon period, you will have more erratic sugars because you’ll still be making some of your own insulin. I found that time more ‘spiky’.

 

[RoseH]

If you bolus close to the meal - ie when you have a chance or remember! - I find that by the time everyone has sat down and been settled, I can delay my eating a little by feeding/helping children, and that adds a few minutes to my pre-bolus time. I just use Humalog and find that works fine. It also avoids hypos when children ask for help or a drink or a toilet visit mid-meal and slow my eating down. I have 3 children, and the biggest effect on the diabetes is my poor scrambled brain

Remember too that if you’re still in your honeymoon period, you will have more erratic sugars because you’ll still be making some of your own insulin. I found that time more ‘spiky’.

Yep still in the honey moon period , can’t wait for it to be over to be honest so I don’t have to deal with random unexplained spikes and drops and hopefully can manage it a bit better , thanks for the advice xx

 

[rebrascora]

I would be interested in how you find Lyumjev if you don't mind letting us know how you get on.
I changed from Novo(notso)Rapid to Fiasp which is a bit better but I still need to bolus 30-45 mins in advance of breakfast and 20-30 mins in advance of other meals most of the time.... I'm very quick at digesting food but slow at absorbing insulin 🙄 Thankfully I don't have to figure children into my schedule, just horses, cats and chickens. You guys have my greatest respect!

 

[RoseH]

I would be interested in how you find Lyumjev if you don't mind letting us know how you get on.
I changed from Novo(notso)Rapid to Fiasp which is a bit better but I still need to bolus 30-45 mins in advance of breakfast and 20-30 mins in advance of other meals most of the time.... I'm very quick at digesting food but slow at absorbing insulin 🙄 Thankfully I don't have to figure children into my schedule, just horses, cats and chickens. You guys have my greatest respect!

Yeah of course I’ll let you know I’m just waiting on the prescription , and you have my respect , my one animal is just about as difficult as both kids hahaa x

 

[SB2015]

Good morning @RoseH

I will also be very interested to hear how you get on with Lyumjev.

Well done on getting to grips with things so well, as you juggle all that you are already doing. The honeymoon period can very frustrating, with the unexpected activity now and then from the remaining beta cells dribbling out some extra insulin without any warning.

Let us know how you get on.

 

[RoseH]

Good morning @RoseH

I will also be very interested to hear how you get on with Lyumjev.

Well done on getting to grips with things so well, as you juggle all that you are already doing. The honeymoon period can very frustrating, with the unexpected activity now and then from the remaining beta cells dribbling out some extra insulin without any warning.

Let us know how you get on.

Thank you , been the hardest few months of my life trying to gain strength from a very close call with a bad DKA ( how I was diagnosed ) whilst trying to understand all that comes with being type 1 , it’s been a journey to say the least haha , but places like this to speak to others is so helpful ! I’ll update you all on the new insulin , fingers crossed it’s a good change x

 

[Proud to be erratic]

Good morning @RoseH

I will also be very interested to hear how you get on with Lyumjev.

Well done on getting to grips with things so well, as you juggle all that you are already doing. The honeymoon period can very frustrating, with the unexpected activity now and then from the remaining beta cells dribbling out some extra insulin without any warning.

Let us know how you get on.

I'm also very interested to hear how you get on with Lyumjev. My Endo is talking about changing me to that, but I think my Bucks cost centre doesn't have this on their "list" of meds they routinely fund. Also, there are no longer half unit pens (except for children) and I've come to appreciate that small differential since I got the Nova Echo pen.

Good luck with everything; it's challenging at times but manageable!

 

[helli]

I'm also very interested to hear how you get on with Lyumjev. My Endo is talking about changing me to that, but I think my Bucks cost centre doesn't have this on their "list" of meds they routinely fund. Also, there are no longer half unit pens (except for children) and I've come to appreciate that small differential since I got the Nova Echo pen.

Good luck with everything; it's challenging at times but manageable!

Have you looked at (or been able to try) Fiasp?
This is the NovoNordisk equivalent of Lyumjev so supported by the NovoEcho half unit pens.
I have been using Fiasp for a few years now. It took a while getting used to as it has a few quirks but, now I know it doesn't last well beyond 2 weeks out of the fridge and it takes longer to work on higher numbers, I would be reluctant to return to NovoSluggish and don't feel the need to try anything new ... at least not this month 🙂

 

[Proud to be erratic]

Have you looked at (or been able to try) Fiasp?
This is the NovoNordisk equivalent of Lyumjev so supported by the NovoEcho half unit pens.
I have been using Fiasp for a few years now. It took a while getting used to as it has a few quirks but, now I know it doesn't last well beyond 2 weeks out of the fridge and it takes longer to work on higher numbers, I would be reluctant to return to NovoSluggish and don't feel the need to try anything new ... at least not this month 🙂

Thank you; yes he suggested both Fiasp and Lyumjev and I had identified that Fiasp could be used with the NovoEcho pen. I understand that Fiasp can sting and has other side effects so am also interested in Lyumjev; right now I'm comfortable with Tresiba, albeit it's not very rapid. But in practice I've got used to the 45 min delay at breakfast time and built that into my routines. I'm retired so no work pressures etc and like everyone else Covid and lockdowns have greatly curtailed our socialising; so no great need to stay in step with others at the moment.

I have delayed changing for a bit. He increased my basal dose and I now seem to regularly fall overnight, so I'm not convinced that helps. He also changed my bolus ratios, which seem fair enough (and simpler for me @1:10 for both lunch and dinner) and softened my correction ratio. So I want to appraise the benefits of all those changes, before changing the actual bolus.

I also can't remember clearly, from a generous and lengthy consult, what his logic was for trying a more rapid bolus and his detailed report didn't include the rationale. So I have a draft letter, shortly to go, updating the changes made and outcomes as well as asking new questions - eg why change bolus. This should help before the next review, due soon, and keep the first part of that next consult focussed.

 

[helli]

Thank you; yes he suggested both Fiasp and Lyumjev and I had identified that Fiasp could be used with the NovoEcho pen. I understand that Fiasp can sting and has other side effects so am also interested in Lyumjev; right now I'm comfortable with Tresiba, albeit it's not very rapid. But in practice I've got used to the 45 min delay at breakfast time and built that into my routines. I'm retired so no work pressures etc and like everyone else Covid and lockdowns have greatly curtailed our socialising; so no great need to stay in step with others at the moment.

I have delayed changing for a bit. He increased my basal dose and I now seem to regularly fall overnight, so I'm not convinced that helps. He also changed my bolus ratios, which seem fair enough (and simpler for me @1:10 for both lunch and dinner) and softened my correction ratio. So I want to appraise the benefits of all those changes, before changing the actual bolus.

I also can't remember clearly, from a generous and lengthy consult, what his logic was for trying a more rapid bolus and his detailed report didn't include the rationale. So I have a draft letter, shortly to go, updating the changes made and outcomes as well as asking new questions - eg why change bolus. This should help before the next review, due soon, and keep the first part of that next consult focussed.

I assume you mean that you use Tresiba as a basal so your comment about it not being very rapid refers to NovoRapid.

As I mentioned, I have been using FIasp and not experienced any problem with stinging but have done with Humalog which is manufactured by the same team as Lyumjev so suspect it is another one of those "people with diabetes are all different" things and I wouldn't be put off Fiasp just because some people find it stings.

As to why a faster bolus is better, it is generally down to the long pre-bolus. You may have been able to incorporate the 45 minute pre-bolus into your morning regime but regimes can be interrupted and breakfasts delayed. What would happen if between your bolus and your breakfast, you/your partner/a neighbour fell and you didn't have your breakfast?

If you are experiencing lows during the night, as you say it is likely to be your basal. There are a few options
- do you have a half unit pen for your Tresiba? You may need to just increase it by half a unit rather than a full unit. As Tresiba is another NovoNordisk insulin, you can use the Novo Echo Pen (but it is a good idea to get one in a different colour to your bolus pen).
- a different, not so long lasting basal such as Levemir may be more suited to you. Many consultants seem to think that a longer flatter basal profile is better. But if your activities vary from one day to the next vary, so may your basal requirements. And many of us find that our night time basal needs are different to our day time ones. Levemir is a twice a day basal which gives us that additional flexibility.
- are you definitely going low at night? This may sound a strange question but if you are using Libre to track your night time levels you may be experiencing compression lows - false low readings when you apply pressure to the sensor such as when you lie on it.

 

[Proud to be erratic]

Again, many thanks for your comments.

Yes, Tresiba is my basal and you're correct that should have read Novarapid.

I'm not put off by the possibility of Fiasp stinging, it was just one of the remarks I picked up about Fiasp; it has undue prominence in my narrative above.

If the pre-bolus time gap is the main reason, then that is a thing to consider. But I thought the overall profile time was also shorter and that, for me, means 2 slightly different aspects to take into account: can I pre-bolus and then get breakfast ready for both of us, before the bolus kicks in (or I will need to adjust my routine(s)) and will the shortened duration of active bolus have other consequences. These aren't impossible obstacles or even difficult ones, just things to think about and encompass in different routines.

The main thing was assessing the outcomes of the various other changes before obscuring those results with a complete bolus change. Interestingly the Consultant's report specifically referred to making step-like changes, then put the full package together and asked my GP to change from Novorapid to Fiasp or Lyumjeev. So right now I'm happy to proceed in discrete steps, while I take the time to understand better the consequences of a more rapid bolus.

I love your thought about responding to a crisis between prebolus and eating; I'd probably dial 999 and snack while I'm waiting!!

Actually, I am SO pleased with the Diabox app piggy-backing on my Libre 2 to provide me with CGM; it's varied alarms keep me fully entertained and certainly wouldn't let me forget that I haven't eaten my breakfast. Since I've had it it's been invaluable. I did something wrong yesterday eve (don't know what, but have investigated most aspects) and after a slightly bigger than normal dinner, with a conscientiously calculated bolus at 7.10pm I went to bed around 11 and from what seemed an ideal steady sleepstart level of 9, I unexpectedly got my first alarm from Diabox telling me I was crashing. From 11.45pm to 01.30 I was in or very close to a low glucose state - big red line on my LibreLink - with alarms every 5 mins. I didn't feel hypo and didn't finger prick, because Diabox allows me to calibrate to actual BG and I can usually trust that. I spent all that time gently snacking then more aggressively snacking, with 5-10 min interval to see what response I was getting; thanks to the CGM I could see, almost minute by minute, what was happening - except I was tired and dozing but rewoken by the next alarm. Proper recovery started at 01.30 then an inevitable rebound, by 5am I'd reached 17.2, then a steady fall to 11.1 by 8am. How - no other insulin taken since 7.10pm the previous night. After my (late) dawn rally to 13 again, when I woke and took my basal, I lay quietly in bed and steadily dropped to 8.1 before bolusing from 9.30am and making breakfast. A really erratic 10hrs. But overseen by Diabox, with little nudges from the alarms, thank goodness.

I'll follow up on another NovoEcho pen for my Tresiba, thank you. I like the soft feel of the Tresiba pens, but would be happy to take the reduced fridge storage space for the replacement cartridges! I was originally on Levermir, but asked to change the 2x daily injections for a 24 hr basal. I will change if necessary, but I like the possibility of a slightly smaller dose; I had considered alternating between 10 and 11 units Tresiba daily - then apathy took over.

While not absolutely ruling out compression lows I've been wearing Libre on my chest for a few months now. This works for me and I'm happy to fingerprick when I need to drive; when I spent a week away with the car I put my sensor back on my arm for a fortnight. But Covid and cautious isolating means we aren't out and about as we might otherwise have been. It's a rare night when I don't wake up needing the bathroom. I invariably scan for Librelink as well as look at Diabox and watch a false dawn phenomenon at c.4am - my BG goes up by c. 2 points then falls back to where it was within 20 mins at which time I'm usually lying on my back. From this I deduce the sensor is not experiencing compression, just responding properly. It begs the different question, for me, where does that BG surge go in those 20 mins? Was it real or just a trick of my metabolism? But I have absolutely no pancreas, so none of the regulating hormones that others might have.

 

[everydayupsanddowns]

I think @gillrogers uses it but I can’t think of anyone else. I just bolus when I can. Children rarely work with schedules 😱 It does get easier. X

I think @martindt1606 uses Ljumjev in an insulin pump too?

Hope you get on well with it @RoseH - always a bit of upheaval and relearning when you switch insulins I find.

 

[Coline]

I’m being moved onto this insulin from nova rapid , mainly because I have two young children so by the time I remember to put my insulin in between running round cooking and sorting the kids it’s usually time to eat , so my team decided this would be better as you put it in just before. Just looking for people’s experiences. Thanks

I’m being moved onto this insulin from nova rapid , mainly because I have two young children so by the time I remember to put my insulin in between running round cooking and sorting the kids it’s usually time to eat , so my team decided this would be better as you put it in just before. Just looking for people’s experiences. Thanks

I use an alarm clock and set it up for the same time each day, this works OK. but I am retired and usually at home.

 

[gillrogers]

Hi everyone, @RoseH, sorry I'm here! Yes @RoseH I use it. Been on it 5 weeks now. Sometimes it stings sometimes it doesn't. But it made a huge differance on wether i prebolus or not. I do with breakfast but for about 3 mins but them I'm eating porridge! I don't with anything else. I've upped my basal as interestingly my basal started showing signs of going up over the last few nights. Some here will know I was going to press for a two dose basal. I'm trying this new basal unit of 9 instead of eight and so far I've had to reduce my bolus by half a unit at mealtimes so far and my numbers are much better.

 

[RoseH]

Hi everyone sorry about no updates , there was a massive mess up with the prescription and I’ve just put my first dose in now , I’m super anxious ( I suffer with health anxiety anyway so medication scares me , ironic I know ) , but first breakfast dose is in , fingers crossed it works well x

 

[RoseH]

Hi everyone, @RoseH, sorry I'm here! Yes @RoseH I use it. Been on it 5 weeks now. Sometimes it stings sometimes it doesn't. But it made a huge differance on wether i prebolus or not. I do with breakfast but for about 3 mins but them I'm eating porridge! I don't with anything else. I've upped my basal as interestingly my basal started showing signs of going up over the last few nights. Some here will know I was going to press for a two dose basal. I'm trying this new basal unit of 9 instead of eight and so far I've had to reduce my bolus by half a unit at mealtimes so far and my numbers are much better.

Honestly as I’m a nervous wreck sat here after my first dose this has made me feel better , so difficult to find any body else on this insulin so had nothing to kind of put me at ease , so glad it’s working well for you xx

 

[gillrogers]

Honestly as I’m a nervous wreck sat here after my first dose this has made me feel better , so difficult to find any body else on this insulin so had nothing to kind of put me at ease , so glad it’s working well for you xx

I was nervous too with mine. Thankfully the libre sensor mean I could keep an eye. I was fine with it after that first dose. Hopefully it will be a benefit to you. X