The Day Apidra Died

It was the wee hours of Day 5.

Our Novolog sites easily made it 3-5 days, and I wanted to see if Apidra held up as long.

Apparently not.

Note to self:  Change Apidra sites on Day 3-4.

Period.

So there you have it.

The day we started.
The experience.
The end.


More on our APIDRA experience...
The day we started.
The experience.
The trial end.
The 6 week review.
The verdict.

Update: The Apidra Experience.

Let's be up front here.

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.)

If I had access to Xanax, I'm pretty sure I would have taken at least one on Day 2.

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.

The Switch-A-Roo: Novolog Day 2,297 / Apidra Day 1

Have I mentioned recently how utterly impossible blood sugars have been over here?

Seriously.

If this is a growth spurt, it is the MUTHA of all growth spurts.  The past 2 weeks have been a blur of high blood sugars.

Correct - Spike - Correct - Spike.

Lather.  Rinse.  Repeat.

I think something happens to my brain when we're in a rut like this.  It's hard to concentrate, and I find myself lost in a sea of numbers, trying to differentiate between times and basals and ratios and carbs and on and on and on.

Don't get me wrong.  I HATE LOWS.  But I can fix a low lickety split.  Highs like this?  I feel like I'm being pelted with snowballs from every angle, and all I can do is run for cover behind a tree, trying my best to shield both of us - and every organ in her body - from a fate of doom.

For awhile now, I've been following some DOC Peeps who have been using Apidra.  I scored a bottle to trial, but was waiting until the winter break from school so I could hover.

Until Thanksgiving night.

Something happened.  She was 350 around 9 pm, and I fell off my rocker.  That was it.  I couldn't stand it any longer.  Sure, it was Thanksgiving, but she hadn't really eaten out of the ordinary ... if anything, she had eaten LESS than usual.  Her numbers shouldn't have been so stinkin' wonky.  Period.

We yanked her old site, filled the pump with Apidra, perused Facebook for a little feedback about Duration of Insulin Action times, inserted a new Dexcom sensor, and hit the ground running.

Ready or not...here we come.

Disclaimer:  Switching up your/your child's lifeline right before going to sleep by using an insulin she's never been exposed to when you know that Dead In Bed Syndrome is a very real threat, and recent stats suggest that 1 in 20 people with Type 1 Diabetes die from hypoglycemia is not something I would ever recommend doing.  It's a dumb idea, so don't do it.  You should ALWAYS consult your/your child's diabetes healthcare provider before making any changes to your/your child's insulin regiment.  Period.

That being said, while the rest of the world was making plans for Black Friday, I was monitoring blood sugars closely through the night.

I'm cautiously optimistic, but it does appear that she spent more time between 80-150 when comparing these 2 consecutive 24 hour periods.

A few observations:

• That LOW stretch at the beginning of the Apidra screen really never dropped below 78 by fingerprick.  (As I mentioned, this was a new Dex sensor, and our experience has been that it takes Dex about 6 hours to settle in, before being consistently accurate.)

• Apparently she had quite the breakfast spike on on Apidra, Day 1!!!!  This has actually been a normal occurrence over the past couple of weeks.  On the Novolog screen, the breakfast spike wasn't nearly as bad, but that has been the exception lately.  I'm giving Apidra a few more days, and then will start re-instituting the Superbolus next weekend, if I can't get a handle on it soon.

• I've heard rumors about Apidra losing it's effectiveness around the 48 hour mark when used in an insulin pump.  We haven't reached that time yet, but I'm holding my breath and praying for the best.

• My kid is amazing.  She's been a real trooper, and I'm incredibly proud of how cooperative she's been with the extra finger pokes, site changes, and Dex insertions since this madness started.  She was upset when the decision was made to insert a new sensor the other night, but Mr. Rose sat her down and explained why we felt it was necessary.  None of this is easy for her, but she smiles anyway.

FYI -- This morning's breakfast spike only made it to 300.  

Maybe we're getting somewhere?

More on our APIDRA experience...
The day we started.
The experience.
The trial end.
The 6 week review!
The verdict.