Type 1 Lantus to Tresiba, Novorapid to Fiasp

[Diane85]

I am changing from Lantus to Tresiba and Novorapid to Fiasp as the newer versions are supposedly more effective and i've been on the same 2 since my diagnosis 5 years ago. I'm just wondering if anyone has changed from the ones mentioned and looking for advice on ratios? Consultant says 1:1. Thanks.

 

[noblehead]

Tag two members who should help, @robert72 who used Tresiba and @tim2000s who uses Fiasp.

 

[himtoo]

Hi @Diane85
welcome to the forum

I only know 1 person on fiasp @tim2000s
he is a pumper so does not take a separate basal insulin but...
he is a whizz on D management.

as a general rule for switching insulins I would err on the cautious side and do lots of testing over a number of days / couple of weeks before I went 1:1

 

[Jaylee]

Hi,

I'll tag in @mahola too regarding Treshiba. Both her & her daughter have recently moved onto it?

 

[eventhorizon]

Hi.
I went from novorapid to fiasp about 6 weeks ago. I'm on MDI and my basal is levimer.
When switching I went 1:1 compared with NR which seemed fine for the first few weeks, now I need slightly more fiasp. Fiasp does get to work a little quicker than NR, it's certainty reduced post meal spikes and it's great for corrections.

Sent from my X9 using Diabetes.co.uk Forum mobile app

 

[tim2000s]

@Diane85 - for Novorapid to Fiasp a 1:1 ratio is perfectly reasonable, as the underlying active component of insulin is the same thing (Aspart). All of the people that I know that have made the switch have found a 1:1 translation to work well.

Where things have differed is with what happens after a few weeks use. Most of those who are on pumps have found their insulin requirement increasing noticeably - by about 20%-25% while amongst those on MDI there has been less of a need to increase the amount of insulin needed.

The best thing to do is to keep an eye on what is going on and be aware that changes may be required to ratios.

One other thing to bear in mind is that you really don't want to change both basal and bolus insulin at the same time - it will make tracking down the cause of any issues very difficult. Change one first and give it a month to settle in, then change the other, so you can attribute any changes clearly.

 

[Diane85]

@Diane85 - for Novorapid to Fiasp a 1:1 ratio is perfectly reasonable, as the underlying active component of insulin is the same thing (Aspart). All of the people that I know that have made the switch have found a 1:1 translation to work well.

Where things have differed is with what happens after a few weeks use. Most of those who are on pumps have found their insulin requirement increasing noticeably - by about 20%-25% while amongst those on MDI there has been less of a need to increase the amount of insulin needed.

The best thing to do is to keep an eye on what is going on and be aware that changes may be required to ratios.

One other thing to bear in mind is that you really don't want to change both basal and bolus insulin at the same time - it will make tracking down the cause of any issues very difficult. Change one first and give it a month to settle in, then change the other, so you can attribute any changes clearly.

Thank you. I plan to change long acting insulin first, see how it goes!

 

[db89]

Where things have differed is with what happens after a few weeks use. Most of those who are on pumps have found their insulin requirement increasing noticeably - by about 20%-25% while amongst those on MDI there has been less of a need to increase the amount of insulin needed.

I can concur with this as someone who has switched from Novorapid to Fiasp on MDI within the last month. Whilst I've not had to make changes to my ratios yet compared to Novorapid, I have found that Fiasp seems to get it's job done more efficiently so there is less likely to be left on board at the next dose if I want a snack or my meals don't happen to be 4-5 hours apart. So I am becoming less concerned about stacking as Novorapid used to still seem to be finishing it's work later for me.

Don't be surprised if you find Fiasp doesn't work quite as fast as the literature suggests. I found generally it halved the time I take a pre-bolus across the board after some trial and error.

 

[slip]

An interesting question and some even more interesting answers! I'm glad someone pointed out not to change both at the same time as that was my initial concern and what drew me in to looking at this thread. @Diane85 keep us posted on your trials and tribulations of your change please!

 

[tim2000s]

Don't be surprised if you find Fiasp doesn't work quite as fast as the literature suggests. I found generally it halved the time I take a pre-bolus across the board after some trial and error.

Whilst this isn't bad feedback, don't make the mistake of pre-bolusing when you first use Fiasp.

On your first use of it, bolus with the meal and then work out if you need to pre-bolus, as the results if you pre-bolus as you would with Novorapid, and discover that you don't need to can be disastrous.

To give you some idea, I normally try and have the bolus finish with the start of a meal. Today the meal was delayed, and I am suitably in hypo territory as a result of a ten minute pre-bolus.

 

[Shannon27]

I am changing from Lantus to Tresiba and Novorapid to Fiasp as the newer versions are supposedly more effective and i've been on the same 2 since my diagnosis 5 years ago. I'm just wondering if anyone has changed from the ones mentioned and looking for advice on ratios? Consultant says 1:1. Thanks.

Hi Diane!
I've just joined, I've been a Type 1 diabetic since I was 4 years old. I've recently gone onto Tresiba myself from Lantus, I was on 32u lantus, started on 28 on Tresiba and noticed that my sugars we consistently quite high, so I started putting it up. I now seem to have found a happy medium on 33units, and noticed it's a lot more flexible too! For example if I go out for a meal I don't need to worry about injecting the Lantus at the exact same time, with the Tresiba it gives 3-4 hours flexibility for me. Hope it goes well for you

 

[db89]

Whilst this isn't bad feedback, don't make the mistake of pre-bolusing when you first use Fiasp.

On your first use of it, bolus with the meal and then work out if you need to pre-bolus, as the results if you pre-bolus as you would with Novorapid, and discover that you don't need to can be disastrous.

To give you some idea, I normally try and have the bolus finish with the start of a meal. Today the meal was delayed, and I am suitably in hypo territory as a result of a ten minute pre-bolus.

Apologies, I should have made this more clear than writing it as a bit of an afterthought. When I say halved any pre-bolus I would take with Novorapid at points in the day we are talking 10 minutes or less. In my experience it's early to mid-morning that took me from around 30 minutes in advance down to 15~20 minutes. With meals higher in fat also I have been able to take it just after eating with reasonable results.

 

[Shannon27]

Hi.
I went from novorapid to fiasp about 6 weeks ago. I'm on MDI and my basal is levimer.
When switching I went 1:1 compared with NR which seemed fine for the first few weeks, now I need slightly more fiasp. Fiasp does get to work a little quicker than NR, it's certainty reduced post meal spikes and it's great for corrections.

Sent from my X9 using Diabetes.co.uk Forum mobile app

Sometimes post meal I end up over-correcting as my blood sugars do tend to spike badly, although I generally inject Novo just before/after I eat. Would you recommend Fiasp to help with this? I've just gone onto Tresiba about 6 weeks ago and have found my best dose to go with Novo, so hopefully this won't change too much?

 

[Shannon27]

Also, as it works into the bloodstream twice as quickly, will a standard dose last the same duration or shorter than that of Novorapid?

 

[noblehead]

Also, as it works into the bloodstream twice as quickly, will a standard dose last the same duration or shorter than that of Novorapid?

I believe it has the same duration @Shannon27

 

[tim2000s]

This compares normal fast acting with Fiasp. WHat you effectively get is more active insulin earlier, and less in the tail, but the tail lasts as long as fast acting:

 

[Shannon27]

Thanks! So from looking at the graph you'd do slightly less fiasp as compared to Novorapid for the same result, just slightly quicker, preventing that spike. And as it does essentially run out quicker it doesn't matter as much as the spike has been avoided. Might give this a try too!

 

[Sarah69]

Just a quick question, are you changing insulins etc because you've read online about them or because your dr is telling you to change?

 

[Diane85]

Just a quick question, are you changing insulins etc because you've read online about them or because your dr is telling you to change?

My consultant has advised I change only if I want to. I find my lantus isn't as effective anymore, my hb1ac has been around 7% but with a change of work routine the last year its creeping up to just under 8% . Fiasp is quicker acting than novorapid and can be taken just as going to eat, its relatively new so i'll swap to that once established on Tresiba.

 

[Sarah69]

My consultant has advised I change only if I want to. I find my lantus isn't as effective anymore, my hb1ac has been around 7% but with a change of work routine the last year its creeping up to just under 8% . Fiasp is quicker acting than novorapid and can be taken just as going to eat, its relatively new so i'll swap to that once established on Tresiba.

Thanks for replying.