Hi all (especially Samantha and Adrian--I think),
Re Novorapid in a pump: Caroline Batistoni (MiniMed 508 c.18 months, also on
this listserv) and I had a real-life chat about the differences between
Humalog and NovoRapid in a pump a while ago. I posted our conclusion to the
listserv then, but here it is again: unless you have trouble using Humalog
(some people find they're resistant to it, for example), you may find
NovoRapid is better for injection than for infusion in a pump, and that
Humalog is better in a pump.
Humalog has a quick peak--for some people, the same as Humalog, for others a
bit slower or faster than, but still beating Actrapid--but 'wears off'
faster than NovoRapid. The longer 'tail of action' that NovoRapid (which,
again, may start to work at the same rate Humalog does) means it'll keep
working longer--great if you're on Lantus or (dare I say it--bad
stuff!--isophane). But if you're on a pump, and your basals are right, and
your carb counting is pretty accurate, you will probably not need that extra
'tail of action'. You will need your mealtime insulin to 'step aside' (as it
were) when its job is done so that your basal can keep you steady without
After a few years(!) of using Humalog in my pump, I tried NovoRapid for a
month and found that my 1.5-hour post-meal blood sugars were fantastic, but
sometimes too low, even when I reduced the number of units (or tenths
thereof) of insulin compared with how much Humalog I would have budgeted for
the same meal. Then, about 2.5 to 3 hours after a NovoRapid bolus, I'd get a
mild hypo. I started to fear going to the gym in case I got a hypo,
something I hadn't been afraid of in ages and ages. That's when I decided to
go back to Humalog. I'm not saying you shouldn't try NovoRapid in your pump;
I am saying that if you get hypos you don't want, Humalog works differently
and may be better for you.
Adrian, I bet your doctor was talking about Novo Nordisk's new insulin
Detemir has just received an 'approvable letter' from the US Food & Drug
Administration, which means, 'Nice work, fix these things and come back'. On
Thursday and Friday of this week I will be at a Novo Nordisk-sponsored event
in London (see http://www.dawnstudy.com). I will ask when detemir is
supposed to be available in the UK.
still catching up with my correspondence!
P.S. Are there any Oxford area prospective or actual pumpers lurking on this
listserv? If so, would you e-mail me: email @ redacted ? Thanks
IDDM 10 years; MiniMed pumper 7+ years
Co-ordinator, Oxford University Student Union Diabetes Network
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