I first started using Apidra in the spring of 2008. I saw people talking about it on a message board and wanted to try it. I had some concerns that it would be too fast for me with gastroparesis and my PCP had those same concerns. He didn’t have any patients using it, but one of the nurses in his practice was diabetic and used it. He said that she really liked it. Fortunately for me, even though he had concerns, he was willing to let me try it. He gave me one of the “OptiStick” pens but did not give me a script to get refills. When I asked to try Levemir, he had given me the pen plus a script to get more. I am guessing he didn’t think the Apidra would work!
I love Apidra – I believe that it is currently the best insulin on the market to manage gastroparesis with.
As far as Apidra being super fast, that is not my experience with it. This chart on WebMD comparing insulin has the onset for Apidra at 20-30 minutes. It has the onset for Humalog at 15-30 minutes and Novolog at 10-20 minutes. According to that chart, Apidra is actually the slowest of the three fast acting insulins. For me, it takes about 20 minutes to kick in. In talking to other people, 20 minutes seems to be a common kick-in time.
What I love most about Apidra is that it is totally out of my body in about 2 hours. That chart on WebMD has the duration for Apidra at 1 – 2 ½ hours. The duration for both Humalog and Novolog is 3 – 5 hours. When I used Humalog, it was still hanging around 4 hours after I took it. Obviously, YMMV.
When I found the DOC, I learned that I did not have to take all my insulin at once with my meal. People with normal stomachs were splitting up their mealtime insulin with hard to manage meals so it only makes sense that someone with gastroparesis would also do that. Unfortunately, that had never been suggested to me. When I started splitting up my insulin, I was using Humalog and had a lot of problems because it hung around so long. After I switched over to Apidra, it was a lot easier to break up my meal time insulin because the Apidra was out of my system a lot faster. That made a huge difference for me.
There are other people with gastroparesis using Apidra – I am not the only one. I talked to someone in the Animas group on TuDiabetes that couldn’t believe how much better she was doing on Apidra. Her CDE wanted to put her on Regular insulin and she refused. The CDE thought it would be a better match for her food and she knew it would be dangerous if her food decided not to digest at all.
Doctors seem to push Regular insulin because it is slow. It is slow, but it also stays in your body 5-8 hours after you take it. If your food is not digesting, that is a long time to have insulin floating around in your body. A big problem with gastroparesis is that what you had for lunch today might still be sitting in your stomach at lunchtime tomorrow. If you have food going nowhere, having insulin floating in your stomach for that long is just dangerous.
Back in the fall of 2010, I went to a new endork. I had two years worth of labs with me so she saw two years worth of A1cs. She complemented me on the A1cs then turned around and criticized me for using Apidra with gastroparesis. She obviously did not get that the Apidra was the reason I was able to have half decent A1cs!
I wish that Sanofi would market Apidra as being good for gastroparesis, but they probably have to jump thru hoops to be able to do that.
If you have gastroparesis, I would suggest trying Apidra. There is no guarantee it will work for you, but you don’t know until you try. I believe it will make a huge difference for you.
Sanofi did not ask me to make these statements – it is how I feel about Apidra working with gastroparesis. If you are a regular reader, then you know that I have bad-mouthed Sanofi as far as the SoloStar shortage. I am sure I am on their fecal roster! As much as I dislike what happened with that, I love Apidra and it has made a huge difference as far as managing gastroparesis for me.
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Trials & Tribulations of Being a Type 1 Diabetic 
Now I understand why my endo thought Apidra was slower than the others! I guess its all about how you look at it.
I think your doc was worried about the discipline it takes to tier Apidra. They underestimate us!
It is how you look at it Scott! Like everything, you have look at the good and the bad and decide whether there is more good than bad for your needs. They do underestimate us!
Kelly-
This seems like ages ago, but wasn’t it Doris that taught you about tiering your insulin?!? As much as we argued with her, I think that most of us still learned a lot.
I enjoy your blog a lot and feel that you represent a population that’s not heard from very much in most blogs: Longtime Type 1 who’s not in her 20’s or 30’s and has some of the complications that Type 1 can cause.
Keep up the good work.
Laddie (Lathump)
Thanks Lathump! It was a bunch of people on ADA that helped with the tiering – Doris was one, Ron and TJ were 2 others that I can think of off the top of my head. You are right, as much as we argued with her, most of us problem did learn a lot.
Most of the bloggers are younger – although Richard Vaughn recently joined the blogging scene. He doesn’t have complications though.