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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Why do Novolog and Apidra work differently in controlling blood sugar?

I am trying to deal with a pharmacy...silverscript..part D Medicare. Approx 10 months ago I was taken off Novolog......high weight gain, Nausea, ineffective action to reduce bloodsugar levels below 200. Mailaise, increased depression.From July 2016 until January 2017. As of January endocrinologist...put me on Apidra instead....having much better lowering bloodsugars below 200..even some below 100. Pharmacy did an exception to their formulary to get Apidra--but is charging me $200 copay wants me to go back to Novolog at a copay of $46.00 financially this is good for me because I am on limited income and disabled. However I do not wish to go back on an insulin which made me gain from 191--to 224 pounds in approximately 10 months, was not adequate to lower bloodsugar. I was taking Bolus at fingersticks and if eating right after, a restricted carb diet 3 gm carb=2 more units. I was taking upwards of 50 unites for carbs depending on meal mostly because of hidden carbs in some foods. However, it did not matter how low or high carb count was I was still over 200pts by next meal. My new Dr. has me titrating every three days up apidra 2 units and Lantus at bedtime by 2 units every three days if fasting is greater than 200. Now I am telling you that this regimen is working greatly better. I would like your opinion of how/why these two act so differently in controlling bloodsugar. I am having such nice results from apidra than novolog..side effects are less on apidra. However the cost is prohibitive and punitive from silverscript. this one medication now costs more than my total budget for ALL of my other medications. and if I go into donut hole of medicare, I will be unable to afford and have to stop some meds as I did last year.
Thu, 12 Oct 2017
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General & Family Physician 's  Response
Although Novolog and Apidra both are short (rapid) acting Insulins but Apidra is said to be fastest as compared to Novolog in controlling blood Sugar levels. Mostly “very short acting Insulin” is expensive than the “ short acting”. Apidra has apparently less side effects just because it is very short acting. it starts working in 10-20 minutes and has a shorter duration of action. But all rapid acting insulins have a drastic side effect, that is Hypoglycemia. Huppglycemia is rare or less in long acting insulins if given in appropriate dosage. But truly speaking there is no scientific proof which confirms which rapid acting insulin is fast or faster or fastest. The price tag is a separate issue and it depends upon the manufacturer’s will and the government authorities who allow to set a price of/for certain medicines as per law in your country.
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