I’ve been reviewing my insulin history over the last 26 years and it appears that while I’m able to sustain a reasonably long relationship with an insulin brand, I have been a bit of an insulin tart over the years swapping to the latest thing when it’s caught my eye.
When I was diagnosed, back in the dark ages, Eli Lilly were the big thing in insulin. They’d just brought out this new stuff called human insulin. In the dark ages most people used animal insulin, produced by boiling up dead cows and pigs, running the resultant broth through an insulin extraction machine then bottling it. (Here, I must admit that the finer details of this description may be a little inaccurate and I acknowledge the process was probably a little more refined than this, likely using microscopes and stuff.)
Anyway, human insulin was the next big thing and my consultant was very excited that Lilly’s Soluble and Isophane human insulins were on his prescription pad. At the time they seemed fine, they kept me alive which was better than my own body could manage so they were a good thing. Looking back, they were pretty crude. The long acting liked to peak and fall like a rollercoaster and the short acting needed to be injected six weeks in advance of you thinking about eating.
It was the best we could find though, so we stuck with it. My promiscuity started early when aged 9 I jumped ship and moved to NovoNordisk. They’d brought out a marvellous new invention – the NovoPen. Instead of using a syringe twice a day, you could now use a super sexy metal pen to inject with four times a day – it came with Actrapid, a faster, shorter acting insulin you injected just 2 weeks before your anticipated meal. This was intergalactic type progress!
Actrapid’s long acting partner was Ultratard, still with plenty of ups and downs but it also had the additional quirk of only lasting about 18 hours when you actually needed it for 24. Nice.
About 10 years ago the world really changed. A new thing called insulin glargine arrived. And being the insulin tart that I am, I went for it. Sanofi-Aventis became my new best friends with their 24 hour lasting, flat as a pancake Lantus. Marvellous stuff, so much better than that nasty Ultratard although personally the no peaks/no dips thing didn’t really work for me, I found it liked to rocket about 6 hours after I’d injected it, but perhaps that was just me.
The best thing was still to come though. A properly fast acting insulin. Despite my long term relationships with other drug companies, it seems I still held a torch for my first love, Lilly. That smouldering torch was ignited again when they brought out Humalog. You could inject and then eat pretty much straight away (well 20-30 mins but who’s counting?). And it didn’t last for hours on end causing hypos 5 hours after meals like some of it’s predecessors.
I’ve used Humalog for at least 6 years now and we get on just fine. But am I being complacent in this relationship, have I just got all comfy with Humalog and taken myself off the insulin dating scene because we’re lazily snuggled up on the sofa together? There’s plenty more fish in the sea, should I be setting up a date with the slightly newer Apidra or NovoRapid/Novolog? They claim to work a little bit faster and possibly for a shorter duration, but is it enough to be worth the hassle of getting to know a new insulin?
At the moment I think I’m settled in front of the fire in my slippers with my Humalog, not because it’s earth-shatteringly fabulous, but because it’s doing what I need it to do.
Are there any Apridra/NovoRapid/Novolog lovers out there who can convince me it’s worth getting back on the dating scene?
I tried Apidra recently (I should really write up a proper review) to try and level out my post-breakfast insanity, but noticed no major difference between it and humalog. It was the view of two DSNs I spoke to that most of the modern quick acting insulins were much of a muchness.
I’m actually pretty happy with humalog (though not being diagnosed back in the dawn of time like you I’ve never used anything else) but being a typical diabetic I do want to moan about how it could be *even* quicker acting!
Ultratard? Did someone SERIOUSLY think that was a good name for a product?
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Ah good ol Actrapid.. I was introduced to that plus Insulatard upon diagnosis whey back when in 1998.. Then moved on to Humalog for a couple of years.
Today me is on a lovely blend of NovoRapid and Lantus…
@Dave
and I thought it was my doctor calling me names instead he was telling me to try injecting more insulatard! grrrrrrr 🙂
Mike, have you noticed any difference between the Humalog and the NovoRapid?
I should imagine that a few Doctors and pharma reps got some strange looks when trying to sell those products 😉
Still – if anyone’s got an “Ultratard” t-shirt, I’ll buy it! I always wanted to be a superhero…
Lucky you, as per the pole on the front page “My local healthcare provider is… So bloody awful I may as well use a witch doctor” back when I was diagnosed I was on Humulin M1 & M2 and was only taken off it when it got discontinued. I’ve now been on S & I for the last 15ish years!
I’ve given up the Humalog and downscaled to Insuman Infusat. Its as slow as Actrapid (can you imagine?!) but when you’ve got a DiaPort it doesn’t need to be any quicker. I can still bolus after a meal and not have any spikes! Mwaahahahahaha….
@Alison
Very little to be honest.. Both seem to be the quickest acting and most of the time seem to be quicker than me.. 🙂
Would be interesting to see how the Apidra works though as everyone is different I guess and results do and will vary..
Hmmm. I’m a tart too. Nice. 😉 It’s a good club to be in Alison, good company us tarts are.
I’ve thought about pridra/NovoRapid/Novolog but like you, I am complacent with my Humalog. Been with H for a Long, Long time. It works for me.
@Alex Other than my first set of insulin, the rest of the changes were driven by my parents and then me once I was old enough. I don’t think my Dr has ever suggested changing insulin, I’ve always been banging on the door wanting to discuss how I think the new stuff will make a difference! If yours is working for you, I guess there’s no reason to change, if it’s not, you might want to give your doc some gentle encouragement 🙂
@Lesley Now I’m intrigued! Is a DiaPort where the insulin goes directly into the blood stream rather than into the subcutaneous tissue? If it’s not, I’m wondering if it’s a device that allows you to travel through space and time to meet other people with diabetes?
Now, that would be cool!
@Dave I think the British Lion forwards might spare you an “Ultratard” (it is a robust leotard guaranteed to keep brawn and bollocks on board when scrumming).
@ Alison: I prefer not to consider myself an insulinic lecher; as penpusher one is allowed polygamy – currently I am married* to Mr. Actrapid, Apidra and Lantus (and happily divorced from abusive Mr. Protaphane.)
*shotgun-enforced, and now I have to put up . . .until DiaPortage to sweet oblivion.
@Ckoei So, sort of like a kevlar unitard then? That is an image which I really didn’t need whilst sitting in a conference!
I started out with Actrapid and Protophane,then I moved and ended up changing doctors, with the change of doctors came a change of insulin,introducing Novorapid.Goodbye Protophane, Hello Lantus. I was doing well with Lantus for about 2 years when, for some insane reason, my doctor decided to put me on Levimir, since then my BSL has been all over the place!!
@starr96 Can you not ask (nay, demand!) to go back onto Lantus?
@Tim You took the words right out of my mouth, although I’d take the approach of just telling them I intend to go back on Lantus, please, thank you, job done.
I have been told Levimir is supposed to be good. Ha!. I just had my Levimir increased, so hopefully my Sugars will level out. I am not very good at persuasion so I don’t see Lantus in my near future, I am also under 18
@starr96 I think all insulins are good for some people, the trick is finding the one that’s best for you. Being under 18 doesn’t mean you should have to do whatever you’re told – would you feel comfortable sitting down with your Dr and telling them that you think Lantus worked better for you and that you’d like to try it again?
Erm… can you run that past me again in English Lesley… pretty please?
I would agree Alison, the patient is as much part of the team as the SDN and the doctor, just because the doctor thinks something is a better idea, doesn’t mean you have to accept it, especially if you feel something works better. I’m lucky in that I have a good rapport with my team, any changes are made after a reasoned discussion and there’s always a route back.
Then the nurse takes me out the back, knocks seven colours out of me and I do as I’m told! ;o)
PS: Where’s the smileys? I’m dumb without smileys! (Dumb stupid that is!)
@Terry Ozbourne You can do smileys – but you have to use a ‘-‘ for the nose, not an ‘o’ 😀
Terry Ozbourne :
I think the patient should consider themselves the team leader – more than mere partner – you take advice from the professionals but then make the ultimate decisions about your own care.
have you noticed any difference between the Humalog and the NovoRapid
No, but the pens are different colours, so there must be a difference !