Here are 8 studies.
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Novalog is pretty much the same as humalog. Of course it is different but we all have different endogenous insulins so the mileage with respect to the analogs varies. If you are ok with humalog then the change to novalog is just two bases. Going to humalin in the first place is the big jump; the analogs are only one base different after that.
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These are important things to understand in discussions like this:
Quoting from that:
A few years later, after researchers had successfully located and sequenced the actual proper human gene for insulin
The problem with that is that it isnât âthe actual proper human geneâ it is âan actual proper humanâs geneâ, just one of us. As Iâve demonstrated before the chance of us all having the same gene is zero.
We are all, pretty much, using the insulin of a single unmentioned, unrecognized and certainly uncompensated human being.
It doesnât work the same way for each of us.
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Eric, I understand the push back on my comments because they may sound a bit arrogant and offensive to some, however, my concern for the last 53 T1D years I have experienced has had way to much misinterpretation of studies and science data, which has ofter results in limiting the best technology, insulins and management protocols that we can benefit from to live a better life with T1D. For example, the misunderstanding that the sites need to changed every 2-3 days, and so do the cartridges, this is not true. Im fact Tandem removed this warning from the documentation, and only note that the site should be changed every 2-3 days. No limit noted for the insulin in the cartridge.
As I noted, there are no studies with the current insulins that are pump approved that demonstrate the issue noted. In fact the most recent paper you linked to, the last you posted, is the best review of all the studies, concluded:
âBased on a limited amount of available data, the safety, stability, and performance of the three available rapid-acting insulin analogs available for use with CSII were similar. However, there is limited evidence suggesting that the risk of occlusion may vary with the insulin preparation under certain circumstances.â
11 year old studies are not showing the issue of occlusion due to fiibrilation unless the insulin is exposed to temp outside or the recommended parameters. Today this is currently part of the criteria used by the FDA to approve insulins for use in pumps. The conclusion also note in the papers that the occlusion concern is focused on the infusion site not the fibrillation of the insulins performance data reviewed. Many of the papers noted that the stability of the insulin is of minimal concern when it is kept in a safe range.
Iâm done with my comments and most likely with comments in general due to the bad info that is posted as fact on the TUDiabetes pages. I knew Manny when he started TUDiabetes and the intent was to provide information that can help us live a better life with diabetes not of push people around.
I do prefer Humalog over Novolog. Novolog works a little slower on me. When insurance companies bargain with the different companies, they have to be willing to say we wonât carry you unless you supply it at this cost. I know years ago I was regularly switched back and forth between Humalog and Novolog depending I guess who struck the best bargain. It finally stopped as I guess they both agreed to the insurance price and didnât want to be left out of the formulary of such a huge carrier.
But my doctor would appeal the decision. I just had to try Novolog for a month and then she would submit the appeal to my insurance and they would agree to cover me, but it was at a different tier because it wasnât on the formulary. Whatever amount I needed I paid $180 for a 3 month supply instead of $100. I was happy with that as I really did prefer Humalog. Iâve since tried Novolog again and same result, it works slower on me. And forget Fiasp, it was like I was injecting water. Novolog and Fiasp have a different chemical makeup and that might make it work differently on some of us.
You can appeal the decision and might be able to get it covered, maybe at a different price. Also check into Costco and their free pharmacy membership plan, I believe you have to be a Costco member though. They give deep discounts to people (and pets) without insurance or if your insurance wonât cover a drug or you have a high deductible.
I worry about Medicare and their new âbargainingâ about prices. It might mean if the companies donât agree we will see some of our preferred medications dropped. From what I understand more drugs are getting dropped by insurance companies nowadays and limiting choices to curb costs. A couple of states have laws in place that a company can only change their coverage once at mid year, one banned it.
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@needlesandmath Your thread is valid. Iâm fortunate enough to have plenty of time on my hands to obsessively check for new PBM formularies. Iâve also spoken to CVS corporate, as well as Caremark, setting up rules, including calls and alerts when there are changes. It doesnât always work, and it takes effort on my part, but it helps with surprises. I hope that helpsâŚ
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@ClaudnDaye Iâm going to be trying out Novolog in the coming weeks, to see if it works any differently for me than Humalog. If it doesnât work great, would that trade actually be something youâd do? I have a decent stock of Humalog regular pens, but I do love the Jr half units!
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Yes. I threw the offer out and, again, I have no plans for my son to use them. I havenât counted them but Iâm pretty sure I have hundreds.
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FUD has the best, most reliable information for anyone looking for great, âreal worldâ, D-management and weâve collectively worked years to get this site there. What you will NOT see here is an obsession with rules and protocol. If thatâs what you are seeking, FUD definitely isnât the place for you.
We have collectively, thousands of years of real world D-experience, one of the most valuable being @Eric who, himself, has been T1D for many decades (he can inform how long if he cares tooâŚnot that it matters.) But heâs helped countless people with whatever struggle theyâre encountering and THAT is what weâre here for. REAL WORLD help for people who are struggling to help them âlive unlimited livesâ in spite of the D-diagnosis.
The opinions youâve expressed are just that. We all have them. At FUD, we intentionally buck the system and the ârulesâ in favor of real world, sustainable information, for people living with diabetes. If you donât gain anything from the information on FUD, itâs probably best that you do move on.
Also, this isnât TUDiabetes, itâs FUD. The co-founders of FUD left TUD and started this forum because of exactly this reason (among others.)
If you are only looking for info that an endo would tell you, FUD ainât that site. Nowhere on this site will you read that anything we state is âfactualâ, âgospilâ or should be taken as âofficial medical advice or recommendationsâ, and we always recommend people to speak with their medical professionals before making any decision. What you WILL find here is what WORKS in the real world (undertaking rigorous testing in many areas to prove or disprove âprotocolâ and âfactsâ passed off by the very companies that profit most to our adherence of their recommendations for things like when we should dispose of our products, etc.); regardless of what the rules, policies and protocols state as âfact.â
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Thanks for the suggestions @Marie . Iâll give the Novolog a try next time I need to refill but it looks like there is a discount card available for people whose insurance doesnât cover Humalog, which is how I got my current supply of 5 pens for $105. States regulating how often formulary changes can happen is a good first step; mandatory notification would be another.
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What might you know about breakdown of insulin in pumps?? T: slim in particular??? Which insulins break down & how does one deal with that?? Does this happen in other pumps too?
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Check out all of the links I posted above. 
The type of pump may make some difference, but all pumps basically do the same thing.
There are perhaps some differences in the type of material they use for a reservoir. The other difference is that Tandem has various infusion types you can use, while the Omnipod does not.
A lot of what you may discover will be from personal experience. Like if your pump works really well on the first day, but by the third day it does not work as well.
Or if some site locations on your body work better than others. And if some locations seem to work better for all 3 days.
If you have access to different types of insulin to try, then try them and see if they seem to make a difference.
But the links above are a good place to start.
By the way, when you read the studies that I posted, the names may be confusing. So keep in mind that the studies use the insulin names rather than the brand names.
So Aspart means âNovoLogâ, Lispro means âHumalogâ, and Glulisine means âApidraâ.*
And then to make it even more confusing - because the medical community would never want to make it simple - they start abbreviating the names.
For example, they refer to Aspart - which is NovoLog - they call that IAsp (insulin aspart).
Anyway, if you can get your head around the names, the articles are very interesting and helpful to understand what can happen with insulin in a pump.
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