Ok - peeps! I am not doctor and I have no ambitions of being one . . .I'm just a mom, a pancreas and a night time (wanna-be) nurse but I will try to give you some more information on Apidra and how it is working for Nate. Ok, just trying to cover my you know what here!!
Apidra (insulin glulisine [rDNA origin] injection from the makers of Lantus
'ALL ABOUT APIDRA' from Diabetes Reference Guide from Sanofi Aventis:
Apidra is a rapid-acting insulin that works like your body's natural insulin to help manage your blood sugar. It comes in a standard vial or the optiClik pen, and it also works well in your insulin pump. In fact, Apidra is shown to have low rates of pump clogs and infusion site reactions.
Apidra also gives dosing flexibility because you can dose within 15 minutes before or 20 minutes after you start a meal.
More Apida information from their handout about pediatric indication - - -
Apidra is a rapid-acting human insulin analog indicated to improve glycemic control in adults with type 2 diabetes mellitus or adults and children (4 years and older) with type 1 diabetes mellitus.
Apidra has a more rapid onset of action and shorter duration of action than regular human insulin. Apidra should normally be used in regiments that include a longer-acting insulin or basal insulin analog.
** As with all insulin preparations, the time course of Apidra action may vary in different individuals or at different times in the same individual and is dependent on site of injection, blood supply, temperature, and physical activity.
Ok - I think I hit the highlights from Apidra literature.
Now here are some answers to the questions from my last post:
* We currently have Nate's DIA (Duration of Insulin Action) on his OmniPod set to 3.5 hours. Once I get a better feel for the new insulin in his pump I may kick it down to 3 hours.
* We previously had it set at 5 hours with Novolog (very conservative) when we 1st started pumping and then changed it to 4 hours before we made the change to Apidra.
* Our Co-Pay is about the same. We use CVS/Caremark and fill our Rx 3 months at a time and there is a minimum difference in co-payment
* We didn't make any other pump setting changes due to the Apidra. We were/are still working on his breakfast ratio and correction factor but the changes had nothing to do with the insulin change. We were experimenting with our AM bolus before we officially made the change.
* The dosing is the same unit for unit for Nate.
I hope this helps at least a little - - -
For more information check out www.apidra.com
For the record - - -
the day that I wrote the Apidra post Nate's numbers looked like this:
225a - 108
323a - 74 (treated with 7g)
700a - 209 (huh?) breakfast bolus and correction
842a - 168
938a - 100 (woot-woot) bolus for snack
1037a - 120
1133a - 170 lunch bolus
338p - 108 snack bolus
506p - 122 dinner bolus
721p - 152 bedtime snack bolus
825p - 191
1032p - 192
and then I posted this little statement on my blog:
"We bolus Nate right before he eats and we still have great numbers."
Why would I write that? Why would I even think about putting that out there? Why didn't I knock on the big hunk of wood that is my desk??? Why??
Because the next bg check looked like this:
224a - 335 WTH? Corrected very conservatively because well because it's 224a!!
331a - 301 Nate woke up crying, thirsty, we rocked and fell asleep in his rocking chair
720a - 400 OMG! Freaking out - haven't seen a number with a 4 in front in a LONG time (knock- knock-knocking on wood right now)
900a - 439 Because I'm a nerd I didn't use his PDM because I didn't want to see another bad number in the history. I know - I'm a nerd that way.
1025a - 286 Yippee!
1111a - 121 Wow - that was fast! We were at playtime with our local D friends so treated with 10g
1146a - 143 lunchtime bolus, lunch, then off to play in the Chic-fil-A play area!!
156p - 99 Nice number since we were at his endo appointment!!!! :)