Fiasp - faster acting insulin aspart

[Svenske vikingen]

I am fed up with trying to get hold of Fiasp. Apparently it is available in the UK but when I google BNF evidence , Novorapid is the only insulin aspart listed under 'short acting' insulins!!!
I've been on Novorapid for years but for me it has too much tail action with hypos 2-3 hours after dosing several times a week.

 

[GrantGam]

I am fed up with trying to get hold of Fiasp. Apparently it is available in the UK but when I google BNF evidence , Novorapid is the only insulin aspart listed under 'short acting' insulins!!!
I've been on Novorapid for years but for me it has too much tail action with hypos 2-3 hours after dosing several times a week.

Have you enquired with your diabetes clinic @Svenske vikingen? As you found with Tresiba; it may not be an insulin which they are issuing yet; or even intend to.

I spoke with my Diabetolgist there a week ago and they have no experience or dealings with FIASP as of yet. Your team may be in a similar situation.

Regarding your Novorapid, you shouldn't be having hypos 2-3 hours after injecting - providing that both your I:C ratios and basal dose (basal rate if you're pumping) are set correctly. The DIA of Novorapid and FIASP are "allegedly" the same (3-5 hours), so in theory, you'd be unlikely to see a reduction in tail action of FIASP vs Novorapid.

@tim2000s has been using FIASP for a fair while now so will more than definitely be able to provide a good insight into the new bolus insulin; specifically the DIA - which I think is a concern of yours.

 

[Scott-C]

I'm keen on trying it too. Popped into my local Boots, showed them a pic of the box of flextouch pens, they tapped around on their computer, said, sure, if you can get a prescription we can fill it.

So, phoned my DSN. Surprisingly, (or maybe not, considering the inate conservatism of the medical profession), she said the consultants haven't really discussed it and they hadn't prescribed it for anyone yet.

Although fair to say that it had only been approved for nhs use by the Scottish Medicines Consortium (it plays some cards on cost and clinical effectiveness) a week before.

She told me to wait till my next check up on 30 May and raise it then. Couldn't get an earlier appointment. Will be going along with a full sales pitch, and if they don't prescribe, there'll be a few hissy fits! I remember the consultant on my DAFNE course telling us all that he's a "book" diabetic and we know way more than he does about the realities of it, so that'll be getting flung back in his face if he gets too cautious!

@GrantGam , your post says your team have no experience of it yet. I'm further south than you, in Lothian and Borders, I recall you're biding your time further north east. Can I ask, did you get the impression that they're just not going to prescribe at all until they start getting feedback from other parts of the country or have some of their T1 staff try it?

Like I say above, docs can be cautious, so they might be tempted to delay till they see whether others mess up with it.

 

[GrantGam]

@GrantGam , your post says your team have no experience of it yet. I'm further south than you, in Lothian and Borders, I recall you're biding your time further north east. Can I ask, did you get the impression that they're just not going to prescribe at all until they start getting feedback from other parts of the country or have some of their T1 staff try it?

It was a brief conversation regarding FIASP, I wasn't really pushing it to be perfectly honest as I was also seeing about pushing forward my pump referral...

The doctor did throw out some phrases like "as with everything new" and "being long in the tooth", etc. So from that I took it that she would be wanting to see some sort of feedback from other regions or further study of sorts, but I'm only guessing.

I am aware of T1 staff at my Clinic, but don't know the feasibility of HCP's trying out new medication, etc.

Feel free to PM me; I am at work and have a terrible phone reception though. I seem to have partly derailed a thread already today through 'healthy structural debate', so don't want to derail anymore - regardless of the reason

 

[donnellysdogs]

I discussed with a diabetes educator and she knew of it but said its peak working time was 11 mins faster than novorapid... and for me would mean another injection as it was supposedly out of body quicker.
They say they cant prescribe yet.
For me I will rely on mass real human trials in the public domain first. Inalready have to start DP and waking injections way early and really cant see a benefit to having to do more before my waking phenomenon stops about 12noon...
As for food, I already have two basal pens for different background each day (tresiba at 6pm and Insulatard at 6am and 8am with a correction bolus as well). Having 4 different pens would absolutely confuse the heck out of me..

 

[Scott-C]

It was a brief conversation regarding FIASP, I wasn't really pushing it to be perfectly honest as I was also seeing about pushing forward my pump referral...

The doctor did throw out some phrases like "as with everything new" and "being long in the tooth", etc. So from that I took it that she would be wanting to see some sort of feedback from other regions or further study of sorts, but I'm only guessing.

I am aware of T1 staff at my Clinic, but don't know the feasibility of HCP's trying out new medication, etc.

Feel free to PM me; I am at work and have a terrible phone reception though. I seem to have partly derailed a thread already today through 'healthy structural debate', so don't want to derail anymore - regardless of the reason

Cheers, Grant. I get the sense that there's going to be a bit of reluctance to prescribe till there's some learned article published saying it's fine, I can understand doctors wanting to ca' canny and all that, but I'll have a stab at it anyway on the 30th.

 

[tim2000s]

My only comment on Fiasp is that I used to prebolus 30 mins beforehand with Novorapid and I do it 0 beforehand with Fiasp. The data that all the clinicians are quoting is rapidly being turned over in real world testing.

It does still hang around in the body as long as Novorapid, but because you get considerably more absorption, earlier, you don't have as much insulin in the tail, even though it's as long.

 

[GrantGam]

My only comment on Fiasp is that I used to prebolus 30 mins beforehand with Novorapid and I do it 0 beforehand with Fiasp. The data that all the clinicians are quoting is rapidly being turned over in real world testing.

It does still hang around in the body as long as Novorapid, but because you get considerably more absorption, earlier, you don't have as much insulin in the tail, even though it's as long.

Tim, I read your initial review of FIASP and was surprised at your findings regarding your correction factor and I:C ratio increase. Is this still the case?

 

[tim2000s]

Yup. I am now working to fewer grams of carbs per u of insulin and being less sensitive. It was a pain in the. It whilst it happened but it's been working nicely since then.

 

[Heathy]

I am fed up with trying to get hold of Fiasp. Apparently it is available in the UK but when I google BNF evidence , Novorapid is the only insulin aspart listed under 'short acting' insulins!!!
I've been on Novorapid for years but for me it has too much tail action with hypos 2-3 hours after dosing several times a week.

Where do you live, i am in belgium and am interested in trying Fiasp insulin I have a pump and my blood sugars seem high after having eaten 3 hrs ago, this is happening a lot I could raise my bolus but am wondering whether a different insulin would help I am on humalog, did you ever get Fiasp?

 

[Diane85]

I am in Glasgow, just been for review and was offered fiasp by consultant. Will see how it goes.