switch from Humalog to Novolog

Rick Ayres wrote in message ...

Quoted message said:

I'm currently using Humalog in a Minimed 512 pump and am considering switching to Novolog.

The reason for the switch would be financial. My insurance company will be using a formulary
(preferred drug list)in 2004. Novolog on the formulary, but Humalog is not. I can continue using
Humalog if I want, but it will

cost

Quoted message said:

me about $200 more per year.

Has anyone made the switch from Humalog to Novolog (or vice versa)? Did you notice any significant
difference between the two? I've heard that some people have found Novolog to be both stronger and
faster (see diabetesnet.cominsulin humalog.phpOpen ↗)

Thanks

Rick

Every testimony I have read claims that Humalog is the faster. I actually read one fellow's
comment to the effect that Novolog seemed to have a delayed response in the multi-hour range for
him. That fellow, (a science PhD candidate), deduced that he was making antibodies specific to
Novolog. Antibodies bind then release insulins and can really slow absorption, e.g. beef Lente is
considered the "best" basal because it is so delayed by antibodies that it can be active for 96
hours in some folks.

The only quantitative data I have ever found on the web implied that Humalog was a bit faster but
Novolog has a longer tail. Many folks like those tails. I for one note that Humalog is faster than
some of my favorite carbs so I sometimes go low after a meal rather than high.

I have discussed this with the Novo salespersons at Diabetic Expos and the like. They have never
claimed that Novolog is faster, or denied that Novolog is slower than Humalog.

When I used them head to head, I thought that the Novolog was a little bit slower but I really
couldn't prove it with bG numbers.

As a practical matter, a pumper can compensate for small differences in absorption speed by
"leading" or "lagging", bolusing early or bolusing late to match the expected glycemic index of the
meal with the speed of the insulin.

I'm on a MDI DAFNE and wouldn't think twice about the matter if my insurance company changed
its formulary from Humalog to Novolog. I would think a a pumper could handle it even better
than I could.

Regards
Old Al

I'm a pumper as well... I use novolog

I've had to use humalog a few times when pharmacy was out of novolog. I also started MDI's on
humalog endo switched me.. I DO find novolog to be faster with less of a long tail.. but a hefty
punch at it's tail end. where humalog was more flat at the end for me.

you should also check out the IP list, theres many there that have switched and found novolog works
10x better pumping.

insulin-pumpers.orginsulin-pumpers.orgOpen ↗

good luck.

--
RK - t1 In tribute to the United States of America and the State of Israel, two bastions of strength
in a world filled with strife and terrorism.

"Rick Ayres" <[email hidden]> wrote in message "]news:[email hidden]...

Quoted message said:

I'm currently using Humalog in a Minimed 512 pump and am considering switching to Novolog.

The reason for the switch would be financial. My insurance company will be using a formulary
(preferred drug list)in 2004. Novolog on the formulary, but Humalog is not. I can continue using
Humalog if I want, but it will

cost

Quoted message said:

me about $200 more per year.

Has anyone made the switch from Humalog to Novolog (or vice versa)? Did

you

Quoted message said:

notice any significant difference between the two? I've heard that some people have found Novolog
to be both stronger and faster (see
diabetesnet.cominsulin humalog.phpOpen ↗)

Thanks

Rick

I switched about 9 months ago, and never noticed a difference
whatsoever. I was cautious when I first made the switch to check my
blood sugar every hour, but now I am back to checking every 3 hrs and
things are just fine 🙂

Rick Ayres said:

I'm currently using Humalog in a Minimed 512 pump and am considering switching to Novolog.

The reason for the switch would be financial. My insurance company will be using a formulary
(preferred drug list)in 2004. Novolog on the formulary, but Humalog is not. I can continue using
Humalog if I want, but it will cost me about $200 more per year.

Has anyone made the switch from Humalog to Novolog (or vice versa)? Did you notice any significant
difference between the two? I've heard that some people have found Novolog to be both stronger and
faster (see diabetesnet.cominsulin humalog.phpOpen ↗)

Thanks

Rick

--

"Rick Ayres" <[email hidden]> wrote in
:"]news:[email hidden]:

Quoted message said:

I'm currently using Humalog in a Minimed 512 pump and am considering switching to Novolog.

The reason for the switch would be financial. My insurance company will be using a formulary
(preferred drug list)in 2004. Novolog on the formulary, but Humalog is not. I can continue using
Humalog if I want, but it will cost me about $200 more per year.

Has anyone made the switch from Humalog to Novolog (or vice versa)? Did you notice any significant
difference between the two? I've heard that some people have found Novolog to be both stronger and
faster (see diabetesnet.cominsulin humalog.phpOpen ↗)

That is actually the first report I have seen that cites Novolog as faster. Most of the anecdotal
reports and the very little published data I've encountered claims the opposite. You would think
that just comparing the activity curves would yield a simple answer, but it doesn't work that way.
The details of an activity curve are affected by the exact techniques that you use to produce the
curve and every study is slightly different. Then there is a fair amount of individual variability
that can cause overlap.

I was in a clinical trial which tested pumping Novolog against a Novolog/Lantus regimen, so I used
Novolog for 12 weeks. I was unable to see any functional difference between Novolog and the Humalog
I've been using for years.

Have your doctor write you a prescription for Novolog and try a bottle or two.

--
-------
Charly Coughran [email hidden]

On Mon, 24 Nov 2003 08:35:46 -0600, "Rick Ayres" <[email hidden]>

Quoted message said:

I'm currently using Humalog in a Minimed 512 pump and am considering switching to Novolog.

The reason for the switch would be financial. My insurance company will be using a formulary
(preferred drug list)in 2004. Novolog on the formulary, but Humalog is not. I can continue using
Humalog if I want, but it will cost me about $200 more per year.

Has anyone made the switch from Humalog to Novolog (or vice versa)? Did you notice any significant
difference between the two? I've heard that some people have found Novolog to be both stronger and
faster (see diabetesnet.cominsulin humalog.phpOpen ↗)

Thanks

Rick

I switched from humalog to novolog. only 2 things I noticed were fewer sudden hypos and the diarrhea
I had at the time cleared up.

Mack Type 1 since 1975 alt-support-diabetes.orgalt-support-diabetes.orgOpen ↗ insulin-pumpers.orginsulin-pumpers.orgOpen ↗

In tribute to the United States of America and the State of Israel, two bastions of strength in a
world filled with strife and terrorism.

If you decide that you'd rather use Humalog have you looked into the possibility that the insurance
would accept a "letter of necessity" from your endo to continue with Humalog WITHOUT incurring
additional charges? Besides which, formularies are always subject to change...

dave

Rick Ayres said:

I'm currently using Humalog in a Minimed 512 pump and am considering switching to Novolog.

The reason for the switch would be financial. My insurance company will be using a formulary
(preferred drug list)in 2004. Novolog on the formulary, but Humalog is not. I can continue using
Humalog if I want, but it will cost me about $200 more per year.

Has anyone made the switch from Humalog to Novolog (or vice versa)? Did you notice any significant
difference between the two? I've heard that some people have found Novolog to be both stronger and
faster (see diabetesnet.cominsulin humalog.phpOpen ↗)

Thanks

Rick

Dr. Biggs was the only I noticed who commented on this, so I'll mention it as well. The switch from
pumping Humalog to pumping Novolog for me enables me to keep the infusion set in twice as long.
I don't often go 6 days, but 5 days is quite comfortable for me, and the Novo doesn't fade for
me. At precisely 72 hours, the Humalog always faded, and a fourth day on it inevitably was
disastrous.

The only other comment I have is that the tail does appear to last longer on the Novo.

Best,

Randy

In misc.health.diabetes Rick Ayres said:

I'm currently using Humalog in a Minimed 512 pump and am considering switching to Novolog.

Quoted message said:

The reason for the switch would be financial. My insurance company will be using a formulary
(preferred drug list)in 2004. Novolog on the formulary, but Humalog is not. I can continue using
Humalog if I want, but it will cost me about $200 more per year.

Quoted message said:

Has anyone made the switch from Humalog to Novolog (or vice versa)? Did you notice any significant
difference between the two? I've heard that some people have found Novolog to be both stronger and
faster (see diabetesnet.cominsulin humalog.phpOpen ↗)

Quoted message said:

Thanks

Quoted message said:

Rick

Mon said:

I'm currently using Humalog in a Minimed 512 pump and am considering switching to Novolog.

The reason for the switch would be financial. My insurance company will be using a formulary
(preferred drug list)in 2004. Novolog on the formulary, but Humalog is not. I can continue using
Humalog if I want, but it will cost me about $200 more per year.

Has anyone made the switch from Humalog to Novolog (or vice versa)? Did you notice any significant
difference between the two? I've heard that some people have found Novolog to be both stronger and
faster (see diabetesnet.cominsulin humalog.phpOpen ↗)

i'm biased against all 4 synthetic insulins ("human"/pisspro/aspart/lantoss)

it's still early days for aspart, but so far it might be a better insulin than the pisspro that you
currently pump with

why not switch to a combo?

use Novo's Velosulin-BR ("human"😉 in the pump coz that is likely the one truly safe synthetic
insulin and you'll have the option of using longer site times with it

and carry 2 30u BD syringes in your shirt pocket (prefilled to maybe 25u with NovoLog, enclosed in
one of the BD plastic bags that 10 syringes are in and sealed with a piece of cellophane tape)

use the NovoLog for your evening meal, which is the main meal where very fast meal insulin has merit

that way you'll 1) cycle thru the insulin in the syringes and 2) have backup insulin (in case of a
user error or rare pump failure)

bill t1 since '57, ex 8-yr pumper

So, Mack, do you think Humalog caused you digestive problems?

dave

Mack said:

Rick Ayres said:

I'm currently using Humalog in a Minimed 512 pump and am considering switching to Novolog.

The reason for the switch would be financial. My insurance company will be using a formulary
(preferred drug list)in 2004. Novolog on the formulary, but Humalog is not. I can continue using
Humalog if I want, but it will cost me about $200 more per year.

Has anyone made the switch from Humalog to Novolog (or vice versa)? Did you notice any significant
difference between the two? I've heard that some people have found Novolog to be both stronger and
faster (see diabetesnet.cominsulin humalog.phpOpen ↗)

Thanks

Rick

I switched from humalog to novolog. only 2 things I noticed were fewer sudden hypos and the
diarrhea I had at the time cleared up.

Mack Type 1 since 1975 alt-support-diabetes.orgalt-support-diabetes.orgOpen ↗ insulin-pumpers.orginsulin-pumpers.orgOpen ↗

In tribute to the United States of America and the State of Israel, two bastions of strength in a
world filled with strife and terrorism.

Charly,

As much as I respect John Walsh's writing in the past, I think he made a significant editorial error
to compare two dissimilar studies in his attempt to determine which was faster.

This has not been the experience of our users at all. Most can't tell a timing difference between
Novolog and Humalog. There seems to be less insulin fading at day 3 with Novolog, thus most users
prefer it for that.

William C Biggs, MD

"Charly Coughran" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"Rick Ayres" <[email hidden]> wrote in :"]news:[email hidden]:

Quoted message said:

I'm currently using Humalog in a Minimed 512 pump and am considering switching to Novolog.

The reason for the switch would be financial. My insurance company will be using a formulary
(preferred drug list)in 2004. Novolog on the formulary, but Humalog is not. I can continue using
Humalog if I want, but it will cost me about $200 more per year.

Has anyone made the switch from Humalog to Novolog (or vice versa)? Did you notice any
significant difference between the two? I've heard that some people have found Novolog to be
both stronger and faster (see
diabetesnet.cominsulin humalog.phpOpen ↗)

That is actually the first report I have seen that cites Novolog as faster. Most of the anecdotal
reports and the very little published data I've encountered claims the opposite. You would think
that just comparing the activity curves would yield a simple answer, but it doesn't work that way.
The details of an activity curve are affected by the exact techniques that you use to produce the
curve and every study is slightly different. Then there is a fair amount of individual variability
that can cause overlap.

I was in a clinical trial which tested pumping Novolog against a Novolog/Lantus regimen, so I used
Novolog for 12 weeks. I was unable to see any functional difference between Novolog and the
Humalog I've been using for years.

Have your doctor write you a prescription for Novolog and try a bottle or two.

--
-------
Charly Coughran [email hidden]

No, I hadn't thought of the letter of necessity. I may give that approach a try if I decide I want
to stay with Humalog. But I think I'll try a vial of Novolog before I make any decisions.

As you say, the formulary could very well change again in another year. Hopefully both insulins will
work about the same for me so I can switch back and forth without making any major adjustments.

Rick

"Bay Area Dave" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

If you decide that you'd rather use Humalog have you looked into the possibility that the
insurance would accept a "letter of necessity" from your endo to continue with Humalog WITHOUT
incurring additional charges? Besides which, formularies are always subject to change...

dave

Rick Ayres said:

I'm currently using Humalog in a Minimed 512 pump and am considering switching to Novolog.

The reason for the switch would be financial. My insurance company will

be

Quoted message said:

Quoted message said:

using a formulary (preferred drug list)in 2004. Novolog on the

formulary,

Quoted message said:

Quoted message said:

but Humalog is not. I can continue using Humalog if I want, but it will

cost

Quoted message said:

Quoted message said:

me about $200 more per year.

Has anyone made the switch from Humalog to Novolog (or vice versa)? Did

you

Quoted message said:

Quoted message said:

notice any significant difference between the two? I've heard that some people have found
Novolog to be both stronger and faster (see
diabetesnet.cominsulin humalog.phpOpen ↗)

Thanks

Rick

Mon said:

I'm a pumper as well... I use novolog

I've had to use humalog a few times when pharmacy was out of novolog.

you'd be better off to not do that

given that they are radically different types of insulin (aspart vs. lispro) and that both require
separate scripts, i wouldn't think that the pharmacy could do a switch like that on it's own

so either you did it...
(i.e. you have scripts for both)

... or the pharmacy called your doc and got the doc to ok the switch (!)

... or the pharmacy really did do it on their own (in which case they are waaaaaay out of line!)

which was it?

bill t1 since '57

does your endo know you are leaving a set in that long (5 days)? No professionals I've spoken with
have advocated a set being in that long. The few times I've tried extended periods, I've ended up
with an infection. Usually the set starts getting irritating after 3 days.

dave

Randy Sigman said:

Dr. Biggs was the only I noticed who commented on this, so I'll mention it as well. The switch
from pumping Humalog to pumping Novolog for me enables me to keep the infusion set in twice as
long. I don't often go 6 days, but 5 days is quite comfortable for me, and the Novo doesn't
fade for me. At precisely 72 hours, the Humalog always faded, and a fourth day on it
inevitably was disastrous.

The only other comment I have is that the tail does appear to last longer on the Novo.

Best,

Randy

good call, Bill! Now that's twice we agree. 🙂

dave

willbill said:

Mon said:

I'm a pumper as well... I use novolog

I've had to use humalog a few times when pharmacy was out of novolog.

you'd be better off to not do that

given that they are radically different types of insulin (aspart vs. lispro) and that both require
separate scripts, i wouldn't think that the pharmacy could do a switch like that on it's own

so either you did it...
(i.e. you have scripts for both)

... or the pharmacy called your doc and got the doc to ok the switch (!)

... or the pharmacy really did do it on their own (in which case they are waaaaaay out of line!)

which was it?

bill t1 since '57

--
RK - t1 In tribute to the United States of America and the State of Israel, two bastions of strength
in a world filled with strife and terrorism.

"willbill" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Mon said:

I'm a pumper as well... I use novolog

I've had to use humalog a few times when pharmacy was out of novolog.

you'd be better off to not do that

I've only ever done it out of sheer need. It's not a every month lets play.. el-switch-o-ru

Quoted message said:

given that they are radically different types of insulin (aspart vs. lispro) and that both require
separate scripts, i wouldn't think that the pharmacy could do a switch like that on it's own

so either you did it...
(i.e. you have scripts for both)

... or the pharmacy called your doc and got the doc to ok the switch (!)

... or the pharmacy really did do it on their own (in which case they are waaaaaay out of line!)

which was it?

um, actually we both did.. neither phoned my doc, as "I" am incharge of my diabetes care, I just get
scripts when I need them.

They were out of the novolog, since they normally don't carry it, I showed them i'm a pumper, and
yes was right after we moved I was on my last set change before I was totally out of insulin. I told
them to give me whatever they had, he gave me 1 free vial of Humalog and ordered another 4 vials of
novolog for me. 2 days he phoned to let me know they were in.. I picked them up, 3rd day, did a pump
change and gave the rest of the humalog to a friend that uses it.

Quoted message said:

bill t1 since '57

Hey Bill,

It depends on your State, but Novolog seems to be treated as a generic substitute for Humalog in
some, if not most-through different schemes.

The VA converted everyone enmass when they went with sole source Novo. This has been a challenge as
they go back to Lilly for lente.

My physician told me with incredulity, that pharmacies are offered a $50 incentive to get
patients to opt for generics and then they're empowered to substitute Novo insulin for Lilly. she
said it was $50.

I confronted Biggs on his kicko, but of course he has no recollection, and as usual cannot comment.

It starts with free samples for indigents and then becomes a defense of:

'I'M NOT INFLUENCED.'

He gets to help with the buzznames tho :'}.

willbill said:

Mon said:

I'm a pumper as well... I use novolog

I've had to use humalog a few times when pharmacy was out of novolog.

you'd be better off to not do that

given that they are radically different types of insulin (aspart vs. lispro) and that both require
separate scripts, i wouldn't think that the pharmacy could do a switch like that on it's own

so either you did it...
(i.e. you have scripts for both)

... or the pharmacy called your doc and got the doc to ok the switch (!)

... or the pharmacy really did do it on their own (in which case they are waaaaaay out of line!)

which was it?

bill t1 since '57

willbill said:

Mon said:

I'm a pumper as well... I use novolog

I've had to use humalog a few times when pharmacy was out of novolog.

you'd be better off to not do that

given that they are radically different types of insulin (aspart vs. lispro) and that both require
separate scripts, i wouldn't think that the pharmacy could do a switch like that on it's own

depends on the pharmacist. I've done it with no problems with only one script for humalog on file no
novolog script.

Quoted message said:

so either you did it...
(i.e. you have scripts for both)

... or the pharmacy called your doc and got the doc to ok the switch (!)

nope, just did it, no phone call to make the switch.

Quoted message said:

... or the pharmacy really did do it on their own (in which case they are waaaaaay out of line!)

it helps when you know your pharmacist.

Quoted message said:

which was it?

bill t1 since '57

Mack Type 1 since 1975 alt-support-diabetes.orgalt-support-diabetes.orgOpen ↗ insulin-pumpers.orginsulin-pumpers.orgOpen ↗

In tribute to the United States of America and the State of Israel, two bastions of strength in a
world filled with strife and terrorism.

Bay Area Dave said:

does your endo know you are leaving a set in that long (5 days)? No professionals I've spoken with
have advocated a set being in that long. The few times I've tried extended periods, I've ended up
with an infection. Usually the set starts getting irritating after 3 days.

dave

I've had no problems using a set for 5 days though I prefer 4 days.

Mack Type 1 since 1975 alt-support-diabetes.orgalt-support-diabetes.orgOpen ↗ insulin-pumpers.orginsulin-pumpers.orgOpen ↗

In tribute to the United States of America and the State of Israel, two bastions of strength in a
world filled with strife and terrorism.

Quoted message said:

Randy Sigman said:

Dr. Biggs was the only I noticed who commented on this, so I'll mention it as well. The switch
from pumping Humalog to pumping Novolog for me enables me to keep the infusion set in twice
as long. I don't often go 6 days, but 5 days is quite comfortable for me, and the Novo
doesn't fade for me. At precisely 72 hours, the Humalog always faded, and a fourth day on it
inevitably was disastrous.

The only other comment I have is that the tail does appear to last longer on the Novo.

Best,

Randy

Bay Area Dave said:

does your endo know you are leaving a set in that long (5 days)? No professionals I've spoken with
have advocated a set being in that long. The few times I've tried extended periods, I've ended up
with an infection. Usually the set starts getting irritating after 3 days.

I told him I wanted to try Novolog in place of Humalog just for that reason. He wrote me the
prescription. He gives me the proper advice and then I simply do what I feel is best for me. I've
not had a site infection in 3-4 years, and it never seemed to me to be a result of keeping a set in
for too long. This is one of the many YMMV things, and I would not suggest to others that they keep
sets in longer than what their respective docs suggest.

It may also have something to do with the fact that I average about 20-25 units usage per day. I
don't know if any kinds of studies have ever been done (I would doubt it) but the volume of insulin
delivered to a given site over so many days may have some effect on whether the site remains clean.

Randy

Quoted message said:

Randy Sigman wrote:

Quoted message said:

Quoted message said:

Dr. Biggs was the only I noticed who commented on this, so I'll mention it as well. The switch
from pumping Humalog to pumping Novolog for me enables me to keep the infusion set in twice
as long. I don't often go 6 days, but 5 days is quite comfortable for me, and the Novo
doesn't fade for me. At precisely 72 hours, the Humalog always faded, and a fourth day on it
inevitably was disastrous.

The only other comment I have is that the tail does appear to last longer on the Novo.

Best,

Randy