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Re: [IPk] NovoRapid/Detimir

 Thanks for the information Melissa, i'll certainly have a chat with my doctor
before going on the pump with insulin,i still currently have saline solution in
my pump.

Melissa Ford <email @ redacted> wrote:
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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 
going hypo.

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 
called detemir: 
http://www.novonordisk.com/investors/rd_pipeline/rd_pipeline.asp?showid=1 .

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.

All best,
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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