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.




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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

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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!!!!   :)

We changed Nate's insulin to Apidra from Novolog and I am LOVING it!




When we were doing our trial on DexCom we discovered that Nate's bg would drop too low during his meals because I was bolusing him too early.  The reason that I would bolus early was to try and avoid such a large spike in Nate's bg after a meal. 

In comes the Apidra!  Wow!  We have been using Apidra for about 2 weeks and we love it.  It works fast, Nate has been having great numbers and we no longer have to bolus 15-20 minutes before a meal.  We bolus Nate right before he eats and we still have great numbers.

At our endo office --- 90% of patients on the OmniPod use Apidra.  That is a pretty big percentage.  I had asked to switch from Humalog to Apidra when we started pumping but was turned down. I forced the issue and insisted that we at least be able to switch to Novolog because I had read a study that indicated the higher levels of zinc in the Humalog caused occlusions in the OmniPod (I can't remember if it was just OmniPod or all pumps). Anyway - - - I am so glad we are finally pumping with Apidra.  It really seems to be working well for Nate and really isn't that what it's all about?? 

What do you do with 50 old pods lying around the house?


After the children are done playing with them . . . you recycle them!!!

It's easy peasy --- so easy that a 4 and 6 year old can do it!!  Ok - I drove them to the FedEx store but they did the rest!




Easy Peasy Lemon Squeezy!!



The Houston Family - - - Saving the Earth one pod at a time!!!

Introducing our new fund raising blog . . . TEAM SUPER NATE!!!
Please head on over and take a look!!

I know everyone is tired of me posting pictures of my son's bum on my blog - - - - ok, maybe only my son is tired of me posting pictures of his bum on my blog!  I have these pictures that I took of his little bitty bum after the DexCom sensor was removed - - -it doesn't look good.  :(




The good news is -- he really doesn't seem to mind and after wearing it for a few days when the alarm would go off in his pocket he would come find me, point to his pocket and say 'beep-beep-beep!".  It was his way of telling me he was low.  AWESOME!  He cannot yet verbalize his lows so this is an awesome tool to help us prevent severe hypoglycemia.  

I really miss Dexie!!  I miss the arrows, I miss the beep, beep, beeping to alarm of an upcoming high or low, I miss the knowing!!  I feel so selfish. Am I really going to subject my son to another site insertion because DexCom makes me feel better?  He's too young to have an opinion so I am making yet another huge life altering decision for him but I have to continue to tell myself that is what I am here for - - - this is why God gave me this special little boy.  I'm just not sure if I am doing it for him or if I am doing it for me?
If I do it now it will just be another piece of hardware that he will become accustomed to wearing. Just like his diabetes - he will never know any different. 

I emailed the paperwork late last night. Waiting to see what insurance says?!?!?!

That little sample of DexCom was just enough to get me hooked.

If Cigna says YES -- it is a go.

Wish us luck!

Sophie had her follow-up appointment with her GI on Thursday.  After reviewing the biopsy results unfortunately we are not really any closer to knowing whether she has Crohn's or Ulcerative Colitis (UC).  Right now he said it looks more like UC but there are a few factors that are pointing towards Crohn's too.  The trouble with these 2 diseases is that Crohn's often presents as UC and then the Crohn's diagnosis is made at a later date.

The good news is that Sophie is responding to the treatment that we have chosen and is feeling SO much better. 

The results from the blood draw are not all back yet --- we are still waiting for the Celiac results.  Thank you to those that sent messages advising us to check for Celiac.

I may or may not be in love with the DexCom Seven Plus CGM.   It is too soon to tell!

Quick Definition for my non-T1 peeps -

A continuous blood glucose monitor (CGM) determines blood glucose levels on a continuous basis (every few minutes). A typical system consists of:

• a disposable glucose sensor placed just under the skin, which is worn for a few days until replacement
• a transmitter which communicates to a radio receiver
• an electronic receiver that displays blood glucose levels with nearly continuous updates, as well as monitors rising and falling trends.

Continuous blood glucose monitors measure the glucose level of interstitial fluid.
 It does NOT replace the finger pricks that Nate receives but it does help reduce them.  You cannot dose insulin from the CGM reading but you can get an idea of what his bg looks like at any given moment.  I believe the DexCom checks every 2 minutes (don't quote me on that).

On with the show . . .



Nate's endo provided us with the DexCom Seven CGM to try out for a week.  We started our trial last Thursday and by Friday morning at 5:00 AM we had a sensor failure.  Boo!!  I had just started falling in love and was excited to show off our new toy when it went kaput!  Friday was Sophie's procedure so I had to try and block the big sensor failure out of my brain while I focused on getting Sophie Doodle to the hospital.

Luckily, my good friend, Kimberly a T1 and DexCom user came to our rescue Friday afternoon.  She brought over one of her sensors and did a site change on Nate for me.  Why did she do it?  Well, have you seen the needle on that thing?  Ummm - I nearly passed out just looking at it.

So, by Friday evening we were rolling again with the CGM and I am seriously thinking about running away to Mexico with the thing.  It's THAT AWESOME!

What I love about the DexCom:

* We discovered that Nate was actually going LOW (and I mean really LOW) before breakfast.  We have started bolusing Nate about 15-30 minutes before he eats to try and avoid the post-breakfast spike but what we didn't know was that Nate's insulin starts working fast!  Two mornings in a row he actually dropped down into the 50's with double arrows pointing down WHILE he was EATING!  He didn't show any signs so I NEVER would have known.  We now wait no longer than 15 minutes which gives the insulin a little time to kick in  without plummeting his bg.

* Sleep - oh beautiful sleep! I've been able to sleep more in the last 4 nights than I have in the last 4 months. I set the receiver just outside of his bed and beside his baby monitor and an alarm will go off if he drops below 100. We set it for 100 at night and 80 during the day.  It also has an alarm that goes off if he goes too high but (knock on wood) we have not heard that one yet.

* I cannot tell you how many times I have looked at his glucometer and wondered which direction his bg was going?!?!  You know that perfect number you get at bedtime but that little nagging voice in the back of your head that is wondering if it is going to stay steady, drop lower or go higher . . . well, hello little arrows on DexCom receiver - - - this little feature STOPS the NAGGING!


Why I am not sure if it is meant to be:


* Do I really need to say anything more?  I just don't know if he has enough real estate to carry this off for a long period of time.

Even when we move things around:


there just isn't that much space available!  His arm could work but I was WAY to chicken to do a site on his arm.  His pod is almost always oh his bum, back or leg so his arm could work --- I will have to think this all through.

* The other concern that I have is that I am just not sure I can do the site insertion.  OmniPod has really spoiled me with its auto-insertion.  I've gone back to my old needle phobia ways (and yes, there is a name for that - - - Trypanophobia).  I have not done one single injection since Nate started podding on 3.1.10. Not one single injection!

* Nate is a podder which means he doesn't have a pump to carry around.  He wears the pod and currently I carry the PDM.  We have struggled a little with him wanting to carry around the DexCom receiver.  I tried clipping it to his pants but he kept taking it off and throwing it at me.  I tried it in his back pocket and that was a no go.  I finally remembered  a tank top (Kangaroo Pouch) that another D mom had sent me before we had decided on a pump. I dug that out of his drawer and it has worked like a charm - - - the receiver fits in a little pocket on the back of the tank so he can't reach it.  The same momma also suggested putting it in the pocket of cargo shorts and that has worked well too.  The trouble is that the receiver is NOT waterproof and he has almost walked into the pool with it twice!!  That would have been a disaster since it's not even ours!!  YIKES!



 Thankfully, I have 3 more days and 3 more nights to ponder the DexCom situation.  In the meantime I am going to get some good sleep, enjoy no nagging bg questions and keep watching those bg trends.


PS - I already know that my son is going to want to kill me one day for constantly posting pics of his bum on my blog!!  It's ok - I'll cross that bridge when I get to it!  :)