FIaSP V NovoRapid - Personal experience

LWA

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Personal Findings after trialling FIaSP for several weeks.

Need as much as 60% more FIaSP for same amount food intake:-

FIaSP daily Split 5/7/8 units - (The longer I was on FIaSP the more I needed)

Personal NovoRapid daily split 3/5/6ish units

FIaSP Very slow to recover from 10+ corrections - plus need more!
Seemed odd how an insulin that works quicker takes so long to correct ‍♂️

With FIaSP sometimes experienced Delayed post meal highs after approx 3hrs - appears to tail off quicker than Novorpid.

FIaSP Very good in morning to counter Liver dumps

Previous Novorapid Libre average recording 80% (High and low split generally 10% each)

Achieved similar with FIaSP (Below) but found harder to maintain.
IMG_0830.jpg


FIaSP more susceptible to warmer temperature & doesn’t last as long out fridge. Used Frio cooler which I don’t do with NovoRapid unless abroad on holiday

FIaSP Disposable Pen mechanism doesn’t feel as ‘certain’ as Novorapid pen - small shots sometimes left me wondering if it actually administered.

FIaSP pen same & similar colour to Tresiba pen so could easily be confused.

Conclusion
Evidently FIaSP advantage is it works quicker so able to decrease injection lead time. Also worked better to counteract liver dumps.

I will be reverting back to Novorapid as more consistent & reliable to ensure better overall balance. I also don’t need to administer as much.
 

Fairygodmother

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It takes time to learn how a different insulin affects previously embedded T1 actions, and it can be disconcerting.
I’ve been using Fiasp for a while now and also switched to it from Novo. Like you, I find that a larger dose is required to reduce a high; I wonder if the first phase of the action is the time required to prevent the high from rising further. Some of the dose could be used dealing with glucose that’s still being released from digestion or liver storage.
Do you pre-bolus? I’ve found that I need to inject at least 10 minutes before I eat if my bs are 6 and progressively longer if they’re above that. I discovered my own reaction to Fiasp by charting it.
I also use a Frio, even in winter. I also use one for Levemir. Frio does seem to be more sensitive to temperature changes than Novo.
Do you use a Libre sensor? Setting alarms that warn when bs is above or below range helps me.
 

Fairygodmother

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PS a half unit pen is very useful, maybe you have one already?
 

StewM

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My experiences have been a little different to yours. The biggest issue I have with Fiasp is it’s long tail. Since I’ve been using it finding it takes longer and longer to finish working. It’s got to the stage now that it can sometimes take up to 9 hours to stop reducing my blood sugar. And I suspect spreading the action over such a long action time reduces its hour by hour potency.

I’ve Basal Tested numerous times to check it’s not the Basal and every time the Basal Test has shown an extremely flat action (like no more than 0.4 +/- the original starting point).
 

bonerp

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Interesting - proves everyone is very different!
I started to see some strange behaviour being on FIASP for 2 years so went back on Apidra for 2 months or so. I forgot how slow this stuff is!!!
So decided to go back to FIASP in the last 2 weeks and even though large meals can take an age to come down (something I find using a pen can help with), generally I don't have slower to get down highs which then drop off a cliff in normal use.
 

LWA

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Hi guys - thanks for your response

I would have been aware if it were first phase action to prevent high from rising further from many years experience with Novorapid, but this was never the case.

As I need more FIASP (than Novorapid) it did explain why I would also need more units to correct, but I just couldn't understand the time delay.

Yes I do pre-bolus (Via injection not pump)- with FIASP usually 5-10 mins before food which is an improvement on Novorapid times - especially beneficial in mornings when Rapid can take longer - no doubt due to the liver dump process.

I have also heard they do pens that give a half unit but I don't believe as a disposable pens which I have become very reliant & accustomed too?

bonep - it certainly does shows how we all respond differently - and like your sign off caption I also got annoyed with FIASP so I'm now happy to be back on my tried and trusted Novorapid.

It was a shame as i was hoping for balance to get easier (like when i changed from Levimir to Tresiba) but unfortunately wasn't to be the case this time round
 

donnellysdogs

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I take fiasp in the mornings for getting up and novorapid for foods. Did not get on with it for foods at all but for my “feet to floor phenomenon in the mornings it’s brilliant.
 

donnellysdogs

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Hi guys - thanks for your response

I would have been aware if it were first phase action to prevent high from rising further from many years experience with Novorapid, but this was never the case.

As I need more FIASP (than Novorapid) it did explain why I would also need more units to correct, but I just couldn't understand the time delay.

Yes I do pre-bolus (Via injection not pump)- with FIASP usually 5-10 mins before food which is an improvement on Novorapid times - especially beneficial in mornings when Rapid can take longer - no doubt due to the liver dump process.

I have also heard they do pens that give a half unit but I don't believe as a disposable pens which I have become very reliant & accustomed too?

bonep - it certainly does shows how we all respond differently - and like your sign off caption I also got annoyed with FIASP so I'm now happy to be back on my tried and trusted Novorapid.

It was a shame as i was hoping for balance to get easier (like when i changed from Levimir to Tresiba) but unfortunately wasn't to be the case this time round

Novopen echo’s are superb. Give 1/2 units and you can check dosage if you have a lousy memory like me, and the time of injection too.

I’ve accidentally been prescribed disposable ones at different times and have tried them but boy, only having full units and as I only take 1 unit or 1/2 unit to get up they really did not seem to work well at all. With the echo pens I never have problems.
 

LWA

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I take fiasp in the mornings for getting up and novorapid for foods. Did not get on with it for foods at all but for my “feet to floor phenomenon in the mornings it’s brilliant.

Do you take FIASP in morning (to counter dawn Phenomena /liver dump) and then Rapid for breakfast ?

I’m not sure my surgery will allow me to keep Novo and FIaSP on my repeat prescription as they are both Bolus insulin designed to have with food
 

donnellysdogs

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Do you take FIASP in morning (to counter dawn Phenomena /liver dump) and then Rapid for breakfast ?

I’m not sure my surgery will allow me to keep Novo and FIaSP on my repeat prescription as they are both Bolus insulin designed to have with food

I’m under a good consultant at hospital, and he basically allows me to state my insulins. So yes, I have fiasp for waking phenomenon/liver dump.! However, I very rarely eat breakfast or lunch. Just one meal a day at tea time. Odd occasions I do have breakfast, then I lump the bolus as fiasp because hubby will have cooked breakfast by the time I get up!! . Lol!! I very rarely eat during day- perhaps once/twice a year at lunch time.. if I do it’s Novorapid.

It may be worth speaking to a Gp but I doubt the dr would give it to you… but worth asking and explaining why and what research you have done.

Are you not under a hospital consultant?
 

In Response

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I have been using Fiasp for a couple of years.
My experience is
- it's shelf life out of the fridge is less than NovoRapid. After a couple of weeks, it can feel like I am injecting water.
- the speed at which it starts working seems to be very dependent on my blood sugar levels. If my levels are around 4/5/6, Fiasp will start to work straight away. If my levels are high (over 8), Fiasp can take at least 30 minutes to start working. This can be an issue when correcting a high (over 12) because it takes a long time to come down, even when I take into consideration insulin resistance at higher level. I have to remind myself not to overcorrect when I don't see movement in my levels because if I do, I tend to hypo after 90 minutes or so.

I use a pump and, because of the second observation, I use the combo/extended bolus most of the time when I bolus for food and adjust the upfront percentage depending on my current blood sugar levels.