You're supposed to change out your insulin pump sites every 3 days.
Got it?
It's just that one of the biggest concerns I had about Apidra had been the number of times I ran across the complaint that it didn't seem to last well beyond the 48 hour mark in an insulin pump. I'm just not interested in troubleshooting high blood sugars every other day, if I can avoid it.
Right now I'm just observing, that's all.
Here's the play by play of our initial experience with Apidra. I checked in around the 24 hour mark, somewhere between 9 - 10 pm each evening...
(Keep in mind that LOW stretch at the beginning of Day 1 never really dropped below 78 by fingerprick. New Dex sensors take us about 6 hours before we begin to see consistently accurate readings.)
(Forgive the photo. I was frazzled.)
I hadn't made any adjustments to her pump settings. She spent the majority of her time above 200, and I was feeling pretty down about it. I wanted so badly to see this experiment work, but also wanted to see if Apidra was even going to last in her pump. I didn't want to invest the brainpower into tweaking her pump settings if this insulin wasn't going to work out. I was afraid that we'd have the same 48 Hour FAIL experience that I had read about.
It took everything I had not to yank her site, and throw this idea out the window. Keep in mind that, by now, seeing blood sugars over 250 had become commonplace for over 2 weeks. I was feeling really bummed, and feared we'd never get out of this rut, but decided to see if things settled down after she fell asleep, and we could eliminate food from the picture.
When I saw that her numbers did, indeed, come back into range overnight, I went ahead and made some adjustments to her morning basal settings in anticipation of the infamous breakfast spike.
Apparently it worked. The proof is in the pudding, my friends. In this case, the last of a pumpkin cobbler and a bowl of strawberries. I realize that's not the most nutritious breakfast, but I was all about pushing Apidra's limits while she was under my watchful eye, before returning to school after the long weekend.
Even without making afternoon adjustments, she still only made it to 250 once, and the lowest BG we saw was 78. In fact, 78 by fingerprick has consistently been the lowest BG we've seen since this experiment started. Day 3 was full of carbs...from pumpkin cobbler to pretzels to a hot fudge sundae, fruit, yogurt covered raisins, and hot chocolate with marshmallows.
I wanted to see this stuff work under pressure.
I just sent Sugar to school on her 4th day of Apidra in the same site we started with........ummmm.......more than three days ago.
Every. Three. Days. People.
Don't go telling your endo that you read some sleep deprived mother's blog who let her kid's site go indefinitely.
I'm not creating a science experiment, trying to see if I can fester an infected site in her bum.
Promise.
I'm simply gathering data. Changing the site changes a very relevant variable, and I want to see how things are going with as many stable variables as possible.
Well, except for food. As far as food goes, I was practically throwing it at her to see how well Apidra could handle it.
I sent her back to school with a graph that looks like this...
I'm giving this experiment 1 more day.
Then I'm pretty sure I'll be requesting a prescription change.
(And now's a great time, because we qualify for FREE Apidra until April 2012. I like FREE.)
More on our APIDRA experience...
The day we started.
The experience.
The trial end.
The 6 week review.
The verdict.
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We've had good like with Apidra in the OmniPod. Numbers are much flatter at night than with Novolog and BG comes down a lot faster when in need of a correction. I wonder if it could be the different pumps?
ReplyDeleteWe usually go about 4 days per site...only cuz I am so busy and tired that I forget to change it until it alarms "low cartridge" I have never seen higher numbers after 48 hours, maybe only on those last few hours on day 4 ;-) I think that may be an OmniPod thing. Anyhow, glad it is working out for you! LOVE that it is currently FREE...so worth the switch right there! :-)
ReplyDeleteSo glad it's working for you!!! I love those graphs! Glad you are putting it to work and seeing how it does. I loved how it attacked highs, much quicker than Novolog ever did. And just so you know, it's actually in the package insert and drug guidelines that it's only recommended for 48 hours in a pump, any pump. There are so many more people who get many, many more days out of it. We got some good 3 day stretches out of it too and we would SO still be on it, save those 3 experiences with bottoming out at the 48 hour mark. I plan to try again about 6-8 months from now, who knows, something may be different the 2nd go-around. I do think it's an improved insulin for our kiddos. Glad you are documenting your experiences with it, I like reading how it's going for others. Love to you.
ReplyDeleteI change Cam's site every 3 days... except sometimes it's 4 on accident so I always put extra insulin in to last and then end up being lazy since there's enough. So... ya, every 3-4 days. I have seen NO problems on the third day using Apidra. However, I do notice that often on that 4th day I realize we should've changed it on the third day because he's stuck high and there's nothing I can do to correct it. I don't really even need a reminder on my phone anymore because the Apidra makes its case pretty clear on day 4.
ReplyDeleteI too am glad you are seeing some changes with Apidra! We tried Apidra for a week with our NPH but switched back to our old faithful Humalog. I have loved reading about your experiment...thanks for sharing it with us! xoxo
ReplyDeleteThanks for sharing your experiences with Apidra! Can't wait to finish C's last vial of Novolog and start doing our own "experiment"...which will probably be right in time for the Christmas holidays :)
ReplyDeleteI tried Apidra for 3 weeks earlier this year. I was having unexpected highs every day. I was using 32-35 units per day (bolus + basal). that is not a lot of insulin and I found that the Apidra might be clogging the tubing in my pump. I saw several other people say they had clogging with Apidra on one of the diabetes websites. Apparently someone who uses larger amounts of insulin does not have this problem since the enough insulin is flowing through the tubing to keep it clear. There are times that my basal is only 0.1 units per hour. Over a tw hour period like that the highs were occurring. I do not have that problem with Humalog even though I have the same basal rates and rates of flow. I hope you continue to be happy with Apidra, I know many insulin dependant diabetics who love it!!
ReplyDeletethat''s awesome Wendy let's hope it keeps going like this :)
ReplyDeleteThat's great! Very interesting to read about. We difn't have great luck, but good question as to whether pump, basal needs, etc make it act differently.
ReplyDelete