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Humalog vs. Novolog.

It wasn't until recently that I started thinking about building up a tolerance to insulin.  Do you build up a chemical familiarity, a resistance of sorts, to a drug after taking it for ... oh, say a few decades? Do PWD eventually become the Dread Pirate Roberts, building up a tolerance to iocane powder

"I realize this is probably ridiculous, and I'm sure there aren't any studies on this," I said to my doctor the other week.  "But it has prompted me to want to try a different kind of fast acting insulin, to see if I have better results.  Is that something I'm able to do, to have a script written for a one-off in order to assess how the insulin might work for me?"

"We can do that."

And I left the appointment, expecting my pharmacy to auto-dial me when my order was complete.

Instead, a three-month supply of Novolog ended up on my doorstep, having been accidentally shuttled through my mail order pharmacy and eating up my insurance order that was intended for my normal course of Humalog. Which is why I'm experimenting with Novolog for the next few months, as a result of a shipping error. 

Does it even matter?  Jury is still out for me.  Also, the smell of the maple candle my mom bought us is making my head hurt.  I'm throwing it out today.  So ends this aside.

I've been taking Humalog for over ten years, after switching from Regular insulin before starting on my insulin pump, so I feel like I'm familiar with how Humalog acts in my pump and on my blood sugars.  Switching to a different, but similar, rapid-acting analog should hopefully be a seamless transition.  Last night was my first pump-load of Novolog, despite the last unopened bottle of Humalog in my stash.  (I didn't want to use up the Humalog entirely, then switch to Novolog, because if I absolutely hated the new insulin, I'd be stuck with it.) 

So far, last night was entirely uneventful, and the biggest change I've noticed (in less than 24 hours of use) is that the bottle of Novolog plays host to way more bubbles, which I hope doesn't translate to a bubblier reservoir.  I'll have a better sense of how this insulin plays once I dial in a few meal boluses and then watch the Dexcom graph play out.

Has anyone switched from Humalog to Novolog?  Or Novolog to Humalog?  The responses to this question, when I posted it on Facebook, varied quite a bit.  Did you notice any changes?  Does it all come out in the wash?  (And if that's the case, why were you washing it?)  Or is it like the Pepsi Challenge, where some people just can't tell the difference and others are left with a bad taste in their mouths?  

Comments

YES--I noticed the bubble too. Or rather, my dd uses novolog in her insulin pump and when she developed a mysterous allergy (not related after all) we switched to humalog and I noticed how much fewer bubbles the humalog produced. Other than that, it was exactly the same.

I had to switch to novolog at the beginning of this year because of changes in my insurance. I'm running a little bit lower now, which isn't necessarily a bad thing. My endo said that novolog is less "sticky" than humalog, so that it should flow through the pump tubing better. I thought that was interesting! Good luck :)

I've gone back and forth a couple of times between the two and have never noticed much of a difference. Well, I haven't ever been looking for a difference, so maybe there's something that just isn't jumping out dramatically. Hope your transition is uneventful!

I am also hoping to try a different rapid, I have taken Novorapid for at least 10-12 years and I wondered if Humalog or Apidra would prove to help lower my BG's. I am known to be insulin resistant despite being Type 1.
I look forward to reading of your results!

Kerri, you have somehow done it again. I think, at times, there is a parallel diabetic universe. The blog concerning your 1 minute infusion set, happened on the same day my PWD ripped his omnipod off his stomach less than 5 minutes after insertion, on a door way, on a cruise ship, on vacation. The omnipod went flying, the blood went dripping, and the volume of the cursing, well, you can probably imagine.
He has also used Humalog forever. He tried Apidra for a month or so, but control was NOT GOOD so he went back to Humalog. His insurance company now has Novolog as a preferred drug. We did get Humalog approved, after a battle, at a higher cost of course. I will be interested to find out how Novolog works for you. Maybe he can reconsider, and try it also.
I really do learn so much from you. Usually all the things my PWD is thinking, but would never say. Thank you for being here (there) for me.

I had to switch to novolog for insurance reasons a few years ago. I had no issues at all, and didn't notice any changes. However, after years of always being on humalog, I felt like I was on the 'lesser' insulin. As soon as my insurance changed, I went back to humalog, which I am still taking now. I think it was all in my head - as my A1C was consistent across both brands. Good luck, Kerri!!

I've noticed the last couple of days that I'm spiking after meals now (as you know, because of insurance reasons, I had to switch 3 weeks ago from Humalog to Novolog) ... the first week of the switch I was high all week. The second week was perfect. Now this week I'm spiking 2 hrs post meals. But like I've said before.. mine is likely pregnancy related so I feel like I'm working with moving targets. *sigh* Keeping me on my toes, though! :) Not literally.. I can't even see my toes these days. lol

I made the switch a couple of months ago. My CDE suggested it, because I had been using Humalog for more than 10 years and apparently there is some kind of resistance to Humalog, or a reaction of the body to the additives in Humalog that makes it less effective. For me, the last months on Humalog were totally unpredictable and chaotic BG-wise. After the switch, I didn't notice any dramatic changes, my basals and dosage stayed the same, I just saw more constant results. Which makes me glad I did the switch.

I changed from Humalog to Novolog several years back without noticing any real difference in the action.

I have actually sent quite a few pens through the wash, but never a vial...

I've tried all three of the fast-acting insulin analogues out there now. I didn't notice a difference between Humalog and Novalog, but I found that Apidra seemed to run its course a little faster, which I liked - the onset time wasn't necessarily faster, but the "tail" of a bolus didn't seem to last quite as long. I like that, so I've stuck with Apidra for a few years now.

so did the dr. say anything about the dread pirate roberts theory?

We're getting ready to, as Kaiser switched us from Novalog to Humalog. Next bottle I open will be Humalog as I'm saving the remaining Novalog in case the Humalog doesn't work and I have to switch back (to give me time to argue with Kaiser). So far most people seem to think it's the same, with a few exceptions. I'll be interested to hear your experience!

I've used Humalog consistently for about... I have no idea. 15 years maybe? A little less? And I've tried both Apidra and Novolog but I've never noticed a stark difference in the two. It wasn't better, it also wasn't worse. Of course, all of this has been through pens or vials, not insulin pumps, so I don't know if that would have made a difference.

This is something I've thought about a lot. I developed an allergy to Lantus after using it for more than ten years. I'm on a pump now, but I do worry about developing an allergy to humalog. I just hope they keep making new insulins so there are plenty of options in the future.

I got the letter from our insurance last week. "Dear Meri, we don't care what you want for your children, you will now be using Humalog and not Novolog. Blah Blah Blah...deal with it." Funny thing, I got the same letter 3 years ago switching me the other way around. Thankfully, back then we didn't notice much of a difference, so I'm hoping for similar results. I'll be anxiously awaiting any updates you have. We have another weeks supply until we make the switch X 3.

I've gone back and forth, due to supply availability. They both work pretty well the same for me.

We switched from Novolog to Humalog in large part because of insurance. We went from $100 3 month mail order to $20 mail order with UHC. There are lots of bubbles with Novolog. We just started this week. We switch my son's site every two days. - Nathan

Our son had to switch to Novalog several years ago from Humalog... insurance again... I see a recurring theme here. Not sure if it's my imagination or not, but it seems like the "tail" is a bit shorter on Novalog. I think we have his pump set to 2.5 hours rather than 3 or 4 for "insulin on board". After about 2 or 2.5 hours... it's not doing anything. But that's just our personal observations. As for your reference at the beginning... "Never go against a Sicilian when death is on the line!"

I did one of the clinical trials for Apidra, and I switched from Humalog to Novolog about eight years ago(surprise, insurance directed!). On MDI, I didn't see a difference between any of them, but I have heard that Novolog takes a little longer than Humalog to start working after a bolus. I have only used Novolog in my pump, and there are bubbles, but they don't seem to impact anything. Good luck!

I've been on both Humalog and Novolog (currently on Novolog). I originally switched for insurance reasons and never noticed one was bubblier than the other; they both give me bubbles which I thoroughly whack away with my infusion inserter. I didn't notice any changes in how I responded to either one; it was a fairly easy transition.

I switched to Apidra a few months ago, and I've noticed that my blood sugar responds very well and quickly to it. I think it's good to switch things up every now and then!

We switched from Novolog to Apidra and also found that it worked a bit faster in the pump and was out of her system quicker.

I switched from Humalog to Novolog several years ago after hearing on the DOC that it was faster than Humalog for some people. I really didn't notice any difference in pump settings or duration.

More recently I switched back after finding that the Tandem t:slim pump and Novolog didn't work well after two days. At that time I also found out that the Novolog info leaflet indicates that it only best for 48 hours in a pump (my wording, don't remember how this was said). I know that the Deltec Cozmo worked fine with Novolog for 3 days.

So now I'm back on Humalog. Once again no changes in settings were needed. FYI I've set a duration of 5:45 on my pump and found that works well for me. YDMV.

"Dear Meri, we don't care what you want for your children, you will now be using Humalog and not Novolog. Blah Blah Blah...deal with it."

That level of honesty would be refreshing.

Very interesting - I never thought about building up a tolerance to insulin and I'll be interested to see how your experiment goes!! Sorry you got stuck with more Novolog than you expected. (If you ever want to experiment with Apidra and your endo thinks it would be okay to try it, I probably know someone who could slide a bottle to you.)

My son's prescription for insulin is written for both Humalog and Novalog (one or the other) since it is a general computer generated RX and the doctor's at CHOP (Children's Hospital of Philadelphia) see a lot of patients and some insurance plans only cover one or the other.

I switched from Humolog to Novolog about 8 years ago. I find that it brings a stubborn high down faster and that the tail is shorter. I like both of those effects. I also tried Apidra and saw no difference between it and Novolog.

I tried Humalog again a few years ago after a mix up with the doctor resulted in a shipment of the wrong brand. I still found Novolog to work faster and to have a shorter tail.

I have paid a premium for Novolg when it is not the insurance company's preferred brand. I think it's worth it.

I switched from Humalog to Novolog after being on the pump for a few years. Humalog was stinging everytime I gave a bolus and my CDE thought Novolog would solve the problem. It did! The only thing I found is that Novolog works a little bit quicker and also is a bit stronger. Good luck!

I was on Humalog for about 7 years pre- and post- pumping, then Apidra for nearly 8 years. I recently have been playing with all three of the fast-acting to try to find what I can use successfully in my t:slim. I find that my body really prefers Apidra. My highs come down faster and I feel more stable in general. I didn't notice a difference for me between the Novolog and Humalog, but I tried only 1 bottle of Novolog. I tried about 90 days worth of Humalog before going back to Apidra. I may give Humalog another go though - still have 2 or 3 bottles.

I had a horrible transition to Apidra last year - I still have 5 unopened, not yet expired bottles if anyone wants them (they're free). I took it for about a week during which I used literally twice my regular daily insulin dose and still was high constantly. I switched back to Humolog asap and everything instantly went back to normal.

I have switched a number of times too. Never noticed a difference between Humalog and Novolog. Thanks again for your blog. I'm pregnant for the second time and your experience with the Dexcom has finally inspired me to try it out. Now just need to get on that on top of all the other doctor appointments :) Thanks again for all the work you do here!

I use Novolog for seven days in my Animas Ping reservoir and did the same with my Medtronic Revel. The Novolog patient insert says that Novolog can be used for 6 days in a pump reservoir. I think that it is Apidra that says 48 hours in a pump.

I've switched several times for insurance. When I switched endos I was told contradictory information compared to my past several endo's. I was always told they are like comparing Kleenex vs Puffs- no difference. My new endo has a different opinion. She changed my "on board" time by one hour. Active for Humalog = 4 hours/ Novolog = 3 hours. I don't know if it was a good or bad change because my A1C definitly took a beating, but I chalk it up to moving, buying a house, and a new stressful job.

I switched from Humalog to Novolog in my pump several years ago when my endo said it might handle heat better (100+ degrees in the summer, pump clipped to bra = hot insulin!), and it does seem to. I have the opposite problem of many though - Humalog is my new prescription plan's preferred insulin (literally $37.50 co-pay for 5 bottles vs. $175 for Novolog), so I'm headed back that way. I never noticed the bubbles. Neither one works fast enough for me, but I've had pretty good control since switching. We'll see what this summer brings!

I can vouch for Novolog being bubbly - and for me it has caused problems. When it gets bubbly, it didn't deliver well from my Ping so I went high. Frustrating, to say the least. So I tried all kinds of things to lessen the bubbles. What worked? I don't inject air into the vial anymore, as is recommended by the Animas folks. I just draw out the Novolog each time, and of course, over several withdrawals, negative pressure develops in the vial (which makes it harder to draw out the insulin, but it's a price I'm willing to pay). Voila! No bubbles anymore!

My daughter switched from Humalog to Apidra just a few weeks ago and we are very happy with the difference. She metabolizes insulin very slowly. The tail end of humalog hits 5 1/2 hours after it is injected. The tail end of the Apidra is more like 4 to 4 1/2 hours. When it takes that long to finish working every minute counts. We have read that with apidra you need a site change every 48 hours, but have talked to plenty of people who go longer without a problem. We are on day 3 of pumping so can't say for sure yet, but since it does work faster we will continue to use it even if that means changing sites every 2 days. We did wonder if changing it up every now and then would help. I wish there was a study on it.

Hi Kerri, Good luck on your switch over.

I have read and learned (from personal experience)that taking INSULIN - for long Chronic persiods of time... me, 35 yrs w/diabetes.... it is harder for people with DIABTES to Metabolize & use INSULIN properly. The variables become more haphazzard. With all things being equal - Insulin is not a constant as you age.

Novorapid- > Humalog (just because I moved to a country when at the time Novorapid wasn't available). No difference in terms of BG whatsoever.

I have been on apidra for a couple years now. Of course, I have to pay double the copay to do so. Just last week I was in to see my endo, and he invited me to be a part of a new two year trial on a new, fast acting insulin specifically for the pump. For one year I will stay on apidra, and the other year I will be on the new one. Wish it wasn't two years long, but I'm hopeful that something else is in the works.

Hi - I have switched between Novolog and Humalog without a problem. The insulin I had problems with was Apidra. I could not use it for more than 2 months without apparent resistance - noticeably higher bgs, etc. When I alternated with humalog and Apidra (2 months on each) the resistance stopped. I just got tired of having to keep track.

I've used both. And I've used Apidra. I don't recall significant differences between any of them, though my NP says that Novolog disappears faster than Humalog. I'm on Novolog now because of insurance.

I switched from Novolog to Humalog for insurance reasons. I really didn't notice many changes. I have less issues with bubbles in my tubing with Humalog than I did with Novalog. Overall I think I prefer Humalog to Novalog. I seem to have more stable blood sugars with it, less lows at night, than I did before.

I switched from hum along to Novolog back in college because my Endo said it "hung around" slightly longer in the body, and I was having some trouble with the Humalog spking and leaving my body too fast. (Possibly a consequence of college cafeteria food-even the salads had hidden fat) and I never went back. Living in a hotter climate in the South, Novolog is nicer in the summer because it is has more resiliency when subjected to heat. I had my fair share of Humalog cartridges go bad after a day in 90 degree weather. Fun fact: Novolog was the only official pump approved insulin for a long time. Humalog technically wasn't approved for pump use, but everyone did it anyways cause regular sucked it up so badly.

I never thought about becoming more insulin resistant on the same insulin... I have been on Humalog for almost 14 years, since being diagnosed. This year I have found it harder to keep my BG's down and now I am wondering about trying Novalog. Thanks for the idea!

I switched from Humalog to Novolog back when I was still on insulin pens. My endo (who tended to zero in on one or two hypos, ignoring the 20 highs in between) thought that my mealtime insulin was working faster than my food, and with its slower onset (but faster, um, offset?) that Novolog would work better for me. Rather than argue, I switched.

I can't say I have enough data to say if it's better or worse, but it's the only stuff I've ever pumped with. I've wondered about trying Humalog again, but having a longer tail kinda discourages me. Also, it took Humalog longer to get approved for pump use to begin with, for some reason which may or may not be legitimate...

I have heard from my endocrinologist that Humalog has a trace amount of latex in the insulin so people with latex sensitivity may have trouble with it. I definitely notice less pump site irritation from Novolog or Apidra than from Humalog. I currently use Apidra- works faster and doesn't have the tail low effect. If I try something other than apidra I always go for novolog over humalog!

I've used all three and I don't do well with Humalog, it is too "sharp" for me blood sugar wise, like Laura posted a few commenters back. Also, I live in Las Vegas and it routinely gets above 105 in the summer and Humalog was just done a day and half into a set change. I've had more bubble trouble with Humalog than Novolog. I didn't notice a difference between Apidra and Novolog and Apidra is covered at a much higher copay so I've stuck with Novolog and I'm pretty happy with it.

I am seeing a pattern of differances here. The differances is not about the product. It is about what our insurance companies will cover.

Let me display this scientificlly:

Humalog $100 co pay
Novalog $15 co pay for 90 day supply.

I made the change 6 months ago. Notice some minor changes the first week. After that no differance.

I have used both Humalog and Novolog. I was on Humalog for the first 5 years of diagnosis, and then Novolog for the next 10. About two years ago I became resistant to both Humalog and Novolog. I was unable to use either insulin for about two years. I would get a patchy, itchy rash under my infusion sites (and often bruises). I had a lot of pain using my insulin pump. I actually had to switch to Apidra for two years before coming back to Novolog. It was pretty scary not being able to use both Humalog nor Novlog. I do not really notice a difference between the two, but I definitely do not like Apidra.

Allergic to Novalog, so had to switch from Apidra to Humolog to go on the t:slim. It feels like I'm watching corn grow waiting for the Humalog to begin having an effect! Maybe you can get a shipping error that allows you to use Apidra next time!

I have been using a pump for 17.5 years, and started using Humalog 11/9/1996. It has remained consistent over that time. Bubbles have not been a problem. My insurance has been Medicare for 15 years, and it wouldn't surprise me if they suddenly decided to switch me, but I don't want to switch. Currently using about 40u per day plus about 30% more to cover prednisone.

I switched to Novolog about 3 months ago because it was a lot cheaper. I have never had a hypoglycemic reaction to the point of unconsciousness in 25 years of being T1D... until Novolog. The insulin seems to stack then completely crash. In the last three months (due to the large supply) I've had to have my husband rescue me four times. I'm switching back to Humalog despite the savings - it's not worth losing my life.

I was just forced into using Humalog after having been on Novolog for over a decade. I was really upset that I couldn't use the insulin of my choice because of insurance switches, but alas it was out of my hands. I've heard that Novolog is better for pump use because its chemical structure allows it to not occlude the catheter tip (especially towards the end of your 2-3 day cycle). Having been on Humalog for a few cycles now it is THE SAME as Novolog. No worries.

I just recently changed this past month from humalog to novalog for insurance reasons. I wasnt thrilled about it but didnt want to fight insurance company anymore than i had to. I was in very good control right before I switched which made me nervous that would change. I dont know if it is just me but I am low more often. Especially for exercising I have to turn off my pump an hour before and leave it off throughout in order to stay around 100 throughout my workout. Might just be for me though. Other than being low a little more often I still feel lile I am in good control.

After 9 years as an MDI on 70/30, then Lantus + Humalog for another 3 years, I finally got a pump about 8 years ago and went 100% Humalog. After about 6-7 months on the pump, I started having an allergic reaction after every bolus. I switched to Novolog and had no more problems. It was interesting to see the earlier post about trace amounts of latex in the Humalog - my endocrinologist never mentioned that specifically, but he did say my reaction was likely an allergy to one of the stabilizing ingredients and not to the Humalog itself.

I, too, worry - both about building up resistance and developing an allergy to Novolog. I'd sign up for a study on either...

I changed from Humalog to NovoLog (NovoRapid in RSA) a few years ago. I used to get pump occlusions on the Humalog, which quickly resolved when I switched...

I was forced to switch from Humalog to Novolog several years ago because of -- do I HAVE to tell you? :-)

I have found no appreciable difference, except that Novolog gives up faster for me. So I had to change my pump setting to 3 hours instead of 4 for the duration of insulin action. Which means I have to pay more attention to when that 3 hours is up -- my food is usually NOT out of my stomach by then, and I almost always have to take a correction bolus. Pain in the somewhere!

When my son was using Humalog he would get a burning sensation at the infusion site when the insulin was initially delivered. His doctor said it was a side effect of the Humalog. He was switched to NovoRapid and never experienced the burning sensation again.

I switched from Novorapid to Apidra because my numbers were too high on Novorapid. So my doc switched it... saying the dose would be the same. Nope.... I was chasing lows all the time and ended up cutting my dose in half (or more). I'm old school MDI.... no pump for me, yet!

Not sure if anyone mentioned this, but I was told to let the Novolog warm to room temperature - that as it loses the chill, bubbles come out, so using it room temp lessens the bubbles. Hope it helps? I didn't see any other difference when I made the switch from Humalog.

I own latex allergy and have spina bifida. Never tolerated Humalog well, many rashes and poor site life. Doctor switched me to Novolog (I was his first diabetic on it), no troubles on NovoLog or NovoRapid (NovoRapid is the name for this insulin in European lands)

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