Faster Insulin Aspart: Finally in the wild and in my hands!

[JaneC]

Am liking what I'm hearing on Fiasp and plotting how to get hold of it ASAP.

 

[slip]

I think we all need to be aware that Tims setup is quite unique - running a closed loop AP, and boy does it look like it works a treat especially with fiasp!

With a curry like that and using fiasp - it would take me a good few attempts to find the sweet spot of when and how much fiasp to inject, I currently use novorapid and know pretty well now how to tame my usual curry (it's curry night tonight too!) - but still not to the same level Tim (or should I say his bionic pancreas) can!

 

[Sideburnt]

To give the Fiasp more of a challenge, I rolled out the Chicken Katsu Curry challenge.

OpenAPS and Fiasp would need to keep me on the straight and narrow with a 160g bucket load of carbs (if you're going to have them, you might as well enjoy them) combined with fats to make the absorption profile a little painful.

In the interests of safety I Pre-bolused five minutes before eating as I knew it would take the five minutes to deliver the 12u I was giving up front. The rest was over to the system. And it delivered.

Boy did it deliver. Peak at 8. Back to 6.8 3.5 hours after eating. Smooth and low. Very impressive stuff!

Great to see someone else using Xdrip+, fantastic branch from Xdrip. I have mine set up through a Freestyle Libre (LibreAlarm). Android Wear connection for the bridge (Sony smartwatch 3) could be a lot more rock solid although I've managed to implement some safetynet scenarios to re-establish connection with the Tasker App (And the fantastic AutoInput addin).

I would 100% love to dose at the point of eating, especially on Low carb Fiasp would be incredibly beneficial. Having corrective bolus shots actually start to do their job as soon as possible would also be a huge bonus as there's notning worse than bolusing and it only kicking in 1.5h later to bring a 10+ reading down. I find the higher I am the slower the bolus works.

It's hugely interesting to see your setup AP in a closed loop. Have you posted anywhere about your setup?

 

[tim2000s]

Hi @Sideburnt - take a look here: http://www.diabettech.com/artificial-pancreas/

 

[Sideburnt]

Also, do we know anyone on the boards who is NHS employed, they could se what the Fiasp status is on the BNF database. There's even a nifty app if you can create a login account.

https://play.google.com/store/apps/details?id=uk.org.nice.bnf&hl=en

 

[tim2000s]

What do you mean @Sideburnt ? It's there, available and prescribable by anyone. The only limitation to getting Fiasp is the Medicines Management Group in your CCG. They need to sign it off for it to be paid for directly by specific name.

 

[Sideburnt]

What do you mean @Sideburnt ? It's there, available and prescribable by anyone. The only limitation to getting Fiasp is the Medicines Management Group in your CCG. They need to sign it off for it to be paid for directly by specific name.

Ah now that's interesting and different from what I got told by my GP. He said from his findings it was still awaiting NICE approval for distribution. Thanks, I'm going to contact my GP again.

 

[Sideburnt]

@tim2000s Just out of interest you mention that you organised with your pharmacy to search under the term (insulin aspart). With that in mind, there would be two products potentially listed under that term

• NovoRapid (insulin aspart) and all it's individual options and PIP codes.
• Fiasp (insulin aspart) and all it's individual options and PIP codes.

Am I right in thinking your pharmacy only found one PIP code that was aligned to Fiasp.

• Fiasp vial PIP 403-9897

and not the Penfil or FlexTouch options? I'm just trying to build up a clearer message for my pharamcey to do the same, I've also just contacted my district CCG asking for an update.

 

[tim2000s]

I actually asked the pharmacy to search on PIP codes first, and vials was the only one they had. It was listed under insulin Aspart.

 

[Sideburnt]

I've just this morning picked up my prescription and it arrives in the chemist for collection in about a week. It'll take a little longer as it's a new product but otherwise, very excited to finally be able to use this new insulin I've been reading so much about.

I'll post some first impressions in the forum when I've got a feel for what's different..

 

[Eldorado]

So how good is this stuff? Well... After my Krispy Kreme, my glucose level never exceeded 9.3 mmol/l and I was back at 7.3 mmol/l three hours later. With a 10 minute pre-bolus. Wow!
View attachment 22297

Wow. I can see all sorts of uses for this, what with Easter coming and all.

 

[Eldorado]

So to crank things up, I had a second Krispy Kreme waiting (with similar CHO properties). This one was given a n 18 minute lead time and so far my BG has remained flat. I ate it an hour ago!

Can I ask, did you bang in the same number of units as you would have done for your 'old' insulin?' I'm just wondering if the strength varies between makes? I hope that's not a daft question.

 

[tim2000s]

Can I ask, did you bang in the same number of units as you would have done for your 'old' insulin?' I'm just wondering if the strength varies between makes? I hope that's not a daft question.

The underlying insulin is the same as Novorapid @Eldorado, so it made sense to use the same numbers. I did some testing to confirm this though, which turned up okay.

 

[JaneC]

48 hours in am finding quite a lot of tweaking to be done, particularly dawn phenomenon where I'm about to increase the basal a little. Am also having to use extended bolus for most meals to avoid a dip post eating followed by a rise. Successfully ate huge bit of salted choc cake with extended bolus at 5pm yesterday and numbers all good. Ate cheese/ ham roll and large orange today for lunch without extended bolus and BS was 12.3 three hours after. It's early days and as with all new insulins, pumps etc; there will be settling in period.

 

[richyb]

my pumped humalog works very quickly when in normal range. I rarely pre bolus, only it I am a bit high then oly for 10mins. I found pumping humalog works faster than on mdi. I have been on novo rapid long time ago (mdi) and was changed to humalog and found it to be faster

 

[Scott-C]

Just noticed this from Scottish Medicines Consortium, 10 April.

Fiasp as vials, cartridge or pre-filled pen approved for NHS in Scotland.

The PDF says it's available at equivalent cost.

www.scottishmedicines.org.uk/SMC_Advice/Advice/1227_17_insulin_aspart_Fiasp/insulin_aspart_Fiasp

 

[Scott-C]

Yay, popped into my local chemist to see if they can get fiasp, couple of taps on the computer, she says, sure, if you can get a prescription, we can fill it.

 

[tim2000s]

48 hours in am finding quite a lot of tweaking to be done, particularly dawn phenomenon where I'm about to increase the basal a little. Am also having to use extended bolus for most meals to avoid a dip post eating followed by a rise. Successfully ate huge bit of salted choc cake with extended bolus at 5pm yesterday and numbers all good. Ate cheese/ ham roll and large orange today for lunch without extended bolus and BS was 12.3 three hours after. It's early days and as with all new insulins, pumps etc; there will be settling in period.

Sounds about right Jane. I've got a loop handling it for me, but I'd definitely agree that the behaviour I'm seeing works out to dual-wave bolusing on a pump. I get the initial bolus used up in about 2 hrs then not a lot of tail.

 

[tim2000s]

my pumped humalog works very quickly when in normal range. I rarely pre bolus, only it I am a bit high then oly for 10mins. I found pumping humalog works faster than on mdi. I have been on novo rapid long time ago (mdi) and was changed to humalog and found it to be faster

Azure mentioned the same thing. I think Humalog is rather different for different people. I know a few that have said this, but also plenty that have said they need a 30 min Pre-bolus with it.

 

[sassycat]

Hi there, am seriously impressed with what I'm reading here. Has anyone experimented with Fiasp and exercise as yet?