Lyumjev insulin just recently approved by FDA for use in insulin pumps

I posted earlier this year that I had started using the ultra rapid acting insulinLyumjev and it continues to work much better for me than NovoLog. It had not previously been approved for use in insulin pumps so I had to run it through my Medicare part D insurance which resulted in very large copayments. I was able to get a tier exemption from my drug plan to lower the cost A bit. However now that it is approved for use in insulin pumps the regulations state that it can be run through Medicare part B insurance and with my supplement I should be able to return to a zero copayment as I was getting with my NovoLog. I just saw my endocrinologist on Tuesday and he said it was approved just within the last two weeks. Unfortunately I had just purchased a three month supply of insulin so won’t need to get until the end of the year.

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Sounds exciting! I was speaking with my doctor a while back about using a faster acting insulin - just scratching the surface for info and professional recommendations. Fiasp may have been the “new kid on the block” (I use Humalog) at the time and it may not have been approved for Tandem at the time. Anyway, even you make the switch you might want to start with a one month supply - in some forum convos people found Fiasp worked well - for a while - then stopped. Fiasp Feedback

In all fairness that’s just one side of the coin - positive experiences just aren’t broadcast as much as problems are; so I’m just suggesting you do a “test run” before making a 3 month commitment. It may work just fine for you. I’ve also read that while people expected faster “response time” they were not prepared for just how much of a drop they got (if I can find that I’ll post here, and I encourage you to do your own online research) Again, our bodies are different and that may not be the case for you - just be prepared just in case.

That said, wishing you all the best. It’ll be a while but keep us posted once you’re on board!

It is so very true that each of our bodies can respond totally differently to different insulins. Last year I did try Fiasp and it was no faster than my NovoLog and in fact even after increasing my basal rates by 25% was not giving me any greater benefit than the nova log. The Fiasp I have read from some people’s posts and my doctor confirmed that it sometimes will clog pump tubing and I suppose that is also a potential for Lyumjev as well so we need to stay on the alert at all times.
Patricia My doctor is great about giving me sample vials of things so I can try them for a short period of time and even for free.

Patricia @Pmaddix I’m awaiting your report on your experience with Lyumjev. Like you, I tried Fiasp at my doctor’s request for a report before she prescribed it for her patients - she gave me the vials. I didn’t notice any improvement IN MY BODY over the Humalog I was using or the Novolog I had previously used. I did notice that my BG became slightly more erratic - possibly my imagination because this Fiasp use was prior to my CGM.

The shorter duration for active Lyumjev is a concern for me in that I use the Control IQ [CIQ] algorithm in my pump and “Duration” is locked at 5 hours by CIQ. Other than duration, I think I could manage. Just recalling, I began using Humalog the month it was FDA Approved [April 1996 and the pharmacist thought the doctor spelled Humulin incorrectly] and the strict instruction from the diabetologist was NEVER inject Humalog before you are actually eating.

Hello all,
I have posted information on this new insulin on several different lists and just realized that I was not totally clear at explaining on this list that I have been onLyumjev continuously for the last six or seven months. I started with the free sample vial that my doctor gave me and then started ordering from my pharmacy incurring the large copayments I was explaining before. This insulin is supposed to start working in 12 to 17 minutes and in me that seems to be the case. I have to be very careful that if I take it well I am preparing a meal that I get that meal on the table immediately and start eating or my sugar will start to drop. The insulin is also supposed to peak in around 57 minutes which coincides very well with when my meals also seem to peek as I do not generally use much fat in my food. In general this insulin has really helped minimize or illuminate mealtime spikes and then after the meal the blood sugars tend to stay very steady I have found that I need to snack a bit more often than I used to before being on this insulin as my blood sugars are running close to normal so much of the time that they tend to also drop too low a little more easily. I have been losing weight so the snacking is not a problem. I still use an old Minimed pump in manual mode so have no experience with The active duration feature of an automated pump. The literature indicates that the duration of this insulin can be up to seven hours but it really tapers off quickly after it peaks. I would hope that as new or insulins are being developed that pump updates will have options for being programmed for different types of insulin duration. I would be interested in hearing if anyone tries it in a hybrid closed loop system or anyone who is doing the DIY pumping.

On the occasions when I’ve switched insulins I’ve checked the literature and asked my doctor to see if I might need to make any adjustments to my basal rates. Was there any guidance on that when you made the switch? I find frequent need to snack (with otherwise unexplained weight gain) usually means my basal is too high although it could be my carb ratio as well.
Thanks for sharing!

Dorie,
My endocrinologist said there was no need to adjust basal rates when starting the new insulin but of course to watch sugars closely and adjust as necessary.
Patricia

That makes sense. With basal usually operating 24 hours ago, at varying rates, properly set basal rates would not be affected by “onset” time.

@Pmaddix , @wadawabbit , @Dennis

Just because FDA has approved for pump use DOES NOT mean TANDEM has approved it in their pump line. Other companies may vary.

On a similar note, my endo wrote for generic Novolog and my secondary insurance kicked it back thru Medicare to my pharmacy and indicated it was not approved. I later found out the clerk at my secondary was a pumper themself and knew it was not approved.

Heads up. This is a wild ride

I have always used nova log previously in my pumps so it sounds like from what you are saying that Medtronic must Have approved it for their pumps as well as FTA. My other pump friends in town use Humalog and one of them has a tandem pump and the other one has a Medtronic pump. my nova log and then subsequently generic nova log was going through Medicare part B just fine since about 2015 until I stopped using that insulin in March. I guess I will try to find out from the Medtronic rep if Lyumjev is approved in their pumps.
Patricia

@Pmaddix ,

Based on your comment, there are several facts:
[1] The FDA approved Lyumjev for use in pumps.
[2] Tandem has only approved Humalog and Novolog in their line of pumps.
[3] Medtronic’s approval is its own approval & separate from FDA.
[4] An insurance claims approval staff member rejected a claim for generic Novolog on a claim thru Medicare on my SECONDARY insurance. Medicare & 2ndary did approve Novolog for my Tandem pump and have done so twice since the initial rejection.
[5] My pharmacy processes Medicare Part B thru Omnisys (a fiscal intermediary) & my secondary.

Bottom line: You question was not clear about Medtronic until the end. You will need to reach out to Medtronic. Recently, there have been many posts about endo’s not prescribing correctly. One post was by a person’s Tandem pump warranty voided because they used Apidra in their pump.

Hope this helps.

I just spoke with the Eli Lily company andLyumjev has been tested and the Medtronic pumps starting with the 530 through the 670 models and with the Accu Chek pump that I am not familiar with.
Patricia

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I’m very interested in fast acting insulin for my Medtronic 670. I have been wanting to try the inhaled fast acting for a while, but putting it off. With inhaling….how can you be sure how much you really get? Liquid would be more manageable, imo.

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the inhaled insulin comes in pre-measured “packs” you inhale the whole pack. The packs come in small medium and large sizes see below:
afrezza-01

insulin has to be absorbed, there are many failed attempts at “transdermal” or insulin-through-the-skin delivery systems. The lungs are a huge thin membrane and the Afrezza mechanism allows direct absorption into the blood stream.

I don’t know how anyone would inhale a liquid. maybe a pre-metered aerosol like nasal allergy medicine or a asthma inhaler but both iterations of inhaled insulin have been dry powders.

hope this is helpful

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Of course it is contraindicated for individuals with asthma and various lung problems.

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