“Rapid-acting” insulin taking hours to work…

I use Fiasp. Fiasp mostly takes longer to work than the 5 minutes on the packaging (sometimes up to an hour) depending on injection sites, age of vial, age of insulin, hormones, insulin resistance time of day, if the insulin is over two weeks old, lipodystrophy, exercise etc, etc. It's the usual variability that is part of my day. The secret is to follow the numbers and remember that injected insulin isn't like a normal person's insulin. Walking after eating helps manually kick the insulin into action so you don't need to take so much.

They are currently developing a Smart insulin so hopefully, there will be better insulins in the future:
https://jdrf.org.uk/our-research/about-our-research/treat/smart-insulin/

amym06 said:

Hi all,

I have been type 1 diabetic for 19yrs now after being diagnosed aged 7. After spending most of my diabetic life on Novorapid and finding it would take at least 2hrs before bringing my glucose levels down, I asked my diabetes consultant if there was another insulin I could try. Not only did this irritate me that I had to suggest it when that should be part of their job surely(?!), but to then be told “oh yes there’s this other insulin called Fiasp which starts working within 5mins” I nearly lost my rag with them as this was hardly a new issue for me!

Anyway, I have now been on Fiasp for around 1.5/2yrs and honestly, I am just completely frustrated. I thought this was going to be a game changer but I can honestly say I’ve hardly noticed any difference and it still takes at least an hour for my sugars to start coming down since injecting… I’m now convinced it’s just me!

Is there anyone else out there who finds their body takes at least an hour to react to insulin and start lowering glucose?? I’m just sooo fed up with it because I just seem to go sky high after eating because the insulin doesn’t seem to kick in or take effect for an hour and then it will come crashing back down!

19 long years of this and my patience is wearing thing

I just want to be able to grasp some kind of control over my diabetes. Especially as I want to start family planning on a few years and with my current readings I don’t think it would be safe/possible!!

Click to expand...

Hi Amym06
You are not alone, I have been type 1 for only 3 years (19 is an achievement) and switched to Fiasp about 18 months ago for the same reason Novorapid was just taking hours to kick in. Fiasp takes 30-40 mins to kick in for me. It has been great. However recently it’s been taking over an hour and then after 4 hrs of taking it, I presume it’s wearing off, I go sky high. Including overnight, if I increase my basal I am having hypos. I am covered in bruises and starting to get red lumps where I have been injecting and the more correction doses I have to inject the worse this becomes. I am seeing my nurse in person early September She is suggesting changing to silicone coated needles to alleviate bruising.
Any other ideas you have please post, this is causing me problems too. I couldn’t get my BG below 15 for most of yesterday despite taking double my usual dose of Fiasp. I had to ask my sister to drive my son, as my vision was so bad I didn’t feel it was safe to drive. Very fed up too, I only eat 50g carbs throughout the whole day so it’s not the food. I also walk 5 miles a day.

Lyumjev is another rapid acting insulin that’s supposed to faster than Fiasp, new this year. I will be asking about it.

I have been using Fiasp for a couple of years. Like you, I had to request it but my DSN is great because she knows I understand what I am doing.
I find the shelf life of Fiasp once taken out of the fridge is less than two weeks (less than NovoRapid) which is frustrating because it means I have to waste some. But once it is too “old”, I may as well be injecting water.
The other thing I find is that it works fast when my levels are lower. If my levels are in double figures, it can take over an hour for the Fiasp to work. If my levels are in the 4s, I have to inject after eating to avoid hypos. Now I know this, I resist the bolusing when high and use the combo/extended bolus option on my pump when my levels are low.

Do you use a pump or inject? I find my insulin works faster with a pump and it gives me other areas for sites.

In Response said:

I have been using Fiasp for a couple of years. Like you, I had to request it but my DSN is great because she knows I understand what I am doing.
I find the shelf life of Fiasp once taken out of the fridge is less than two weeks (less than NovoRapid) which is frustrating because it means I have to waste some. But once it is too “old”, I may as well be injecting water.
The other thing I find is that it works fast when my levels are lower. If my levels are in double figures, it can take over an hour for the Fiasp to work. If my levels are in the 4s, I have to inject after eating to avoid hypos. Now I know this, I resist the bolusing when high and use the combo/extended bolus option on my pump when my levels are low.

Do you use a pump or inject? I find my insulin works faster with a pump and it gives me other areas for sites.

Click to expand...

Hi
That’s very helpful thank you I have been using each Fiasp for 4 weeks. I am not on a pump, I think I might be having absorption trouble due to the bruising and red lumps, not sure why this has started to happen.

Hi @Hertfordshiremum. It may be that you're having a reaction to the extra ingredients put in to Novorapid to turn it into Fiasp.

Or it’s just that you’re trying to replicate what an organ in your body would normally do very quickly and without the thinking and planning and problems we have as type 1’s trying to do daily.

I don’t think there’s anything wrong with you. Unfortunately, artificial insulin is never going to be as good or quick as real working beta cells so we just try our best and use our injected insulin as best we can.

You’re doing amazing, don’t stress too much about trying to be a perfect pancreas

Hopeful34 said:

Hi @Hertfordshiremum. It may be that you're having a reaction to the extra ingredients put in to Novorapid to turn it into Fiasp.

Click to expand...

Thank you, I do have allergic reactions to quite a number of other things eg certain make up, shower gel, some foods…I will definitely ask about this at my in person appointment

Emily95 said:

Or it’s just that you’re trying to replicate what an organ in your body would normally do very quickly and without the thinking and planning and problems we have as type 1’s trying to do daily.

I don’t think there’s anything wrong with you. Unfortunately, artificial insulin is never going to be as good or quick as real working beta cells so we just try our best and use our injected insulin as best we can.

You’re doing amazing, don’t stress too much about trying to be a perfect pancreas

Click to expand...

Thank you for your support, I don’t mind having the odd bad day but when it turns into a week and I can’t drive the car or struggle to work it gets really frustrating. I really appreciate your kind words, you are right it will never be perfect, I will try not to stress so much.

I also find that my NovoRapid can sometimes take a couple of hours or so to work and yesterday one big shot never did work at all. It's very frustrating as my Libre 2 works reasonably well in showing what is going but I still find it difficult to control my BS as the NovoRapid is unpredictable.

Daibell said:

I also find that my NovoRapid can sometimes take a couple of hours or so to work and yesterday one big shot never did work at all. It's very frustrating as my Libre 2 works reasonably well in showing what is going but I still find it difficult to control my BS as the NovoRapid is unpredictable.

Click to expand...

Thanks for posting

Old hack of 47 years here....hi
Been on novo rapid about 15 years.
From time to time I suffer from insulin resistance where I take my usual dose in the usual way and it doesn't work!!
Its like its hiding somewhere.
Its very strange but please don't despair we are all different and I've only got to where I am because of the good the bad and the ugly side of type 1 diabetes.
I'm quite philosophical about it but then again I am not you and wanting to start a family!

Suggestion...

There is one thing that helps me during periods of resistance ..

Walking....simple walking.

After a meal and I notice the novorapid is hiding somewhere I go for a walk for about 30 minutes.

So I have a high bg level with food and insulin sloshing about my body......add 30 minutes walk and somehow it coaxes out the insulin.
Sounds bonkers I know but it works and sometimes I have to walk for longer but the beauty of having a libre I can see whats happening to my levels.

Its only a suggestion..

I would like to add I am a bloke who has a 21 year old non diabetic son.
My sister who is an old hack of 53 years a type 1 has a non diabetic son now 25.
I only add this so you know the magic can happen.

I wish you all the luck in the world

Tony

I don't per se have advice, but I will share my experience which is similar.

In February/March, I was moved onto Fiasp. March-May I was getting great results. Fiasp was working about 50% faster* than my Humalog. However, things started to change in June (around when the weather got HOT), from that point on I've noticed the Fiasp get slower and slower. It's still getting slower now in August. At the moment, the Fiasp is now 100% slower than the Humalog**.

Another observation is the Fiasp now seems incredibly tied to activity levels. For instance, if I have lunch at my desk and work for a couple of hours I might as well have taken no Fiasp at all. Whilst inactivity affects all Insulin the difference between Fiasp when coupled with inactivity and other Boluses is much much more profound. If I was to take Insulin, eat Lunch then go for a fifteen-minute walk back to my office, then work for two hours, I'd get normal in-range results. However, if I was to do the same as the last example, but after an hour of sedentary work, I discovered I need to go out and get something, meaning a brief walk and back (totalling 15 mins), not only would I run the risk of going low, but my Blood Sugar would keep going low*** over and over again for hours. Again, whilst needing less Insulin whilst active is normal, the profound effects of a minimal level of activity is highly unusual compared to other Insulin.

*For example, if I needed to pre-bolus by 10 mins, I'd now only need to pre-bolus by 5 mins.

**For example, if I needed to pre-bolus by 15 mins, I'd now need to pre-bolus by 30 mins.

***Treatments of the Lows would work as per Hypo guidelines but then after 30-60 mins of stability, my Blood Sugar would crash down again.

EllieM said:

My understanding (possibly incorrect) is that the preservative used in different insulins is different, so if you become allergic/intolerant to one insulin it is worth changing to one with a different preservative...

As a T1 of 51 years I find that my insulin seems to act much slower if my bg is above 8 (ish), and exercise and injection sites also make a massive difference.

Click to expand...

Thanks that’s really helpful, I changed my Fiasp early to see if it was the vial and was much better this morning, 9 rather than 15 all this week so I thought great going in the right direction. However despite a brisk 2 mile walk this afternoon I am now at 13 pre dinner. Lots of good ideas though to discuss with my nurse. Think I will definitely request a change.

Hi All,
I can't offer much advice but like other members happy to share my experience.
I am 54 years old and have been type 1 for 43 years.
I went on Fiasp about a year ago having previously been on Novarapid.
If I am honest Fiasp only works well for me if I am in range with my bg and active. If I am outside of range and inactive It doesn't appear to work, I may as well squirt it down the sink...!
In relation to having children,I wouldn't hesitate.My wife and I have a 22 year-old son and 19 year old daughter neither have diabetes, or any other health condition for that matter.
Don't beat yourself up, your not alone!
Good luck
Mark

amym06 said:

Hi all,

I have been type 1 diabetic for 19yrs now after being diagnosed aged 7. After spending most of my diabetic life on Novorapid and finding it would take at least 2hrs before bringing my glucose levels down, I asked my diabetes consultant if there was another insulin I could try. Not only did this irritate me that I had to suggest it when that should be part of their job surely(?!), but to then be told “oh yes there’s this other insulin called Fiasp which starts working within 5mins” I nearly lost my rag with them as this was hardly a new issue for me!

Anyway, I have now been on Fiasp for around 1.5/2yrs and honestly, I am just completely frustrated. I thought this was going to be a game changer but I can honestly say I’ve hardly noticed any difference and it still takes at least an hour for my sugars to start coming down since injecting… I’m now convinced it’s just me!

Is there anyone else out there who finds their body takes at least an hour to react to insulin and start lowering glucose?? I’m just sooo fed up with it because I just seem to go sky high after eating because the insulin doesn’t seem to kick in or take effect for an hour and then it will come crashing back down!

19 long years of this and my patience is wearing thing

I just want to be able to grasp some kind of control over my diabetes. Especially as I want to start family planning on a few years and with my current readings I don’t think it would be safe/possible!!

Click to expand...

I am on Fiasp (previously novorapid) and have the exact same problem currently, accompanied by apparent new insulin sensitivity. I have reduced my LA (toujeo, previously lantus) from 21 to 18, and my 1 unit per 10g ratio seems f****d as well I have had to make it 1 to 15g. Not a clue what’s going on right now

amym06 said:

Hi all,

I have been type 1 diabetic for 19yrs now after being diagnosed aged 7. After spending most of my diabetic life on Novorapid and finding it would take at least 2hrs before bringing my glucose levels down, I asked my diabetes consultant if there was another insulin I could try. Not only did this irritate me that I had to suggest it when that should be part of their job surely(?!), but to then be told “oh yes there’s this other insulin called Fiasp which starts working within 5mins” I nearly lost my rag with them as this was hardly a new issue for me!

Anyway, I have now been on Fiasp for around 1.5/2yrs and honestly, I am just completely frustrated. I thought this was going to be a game changer but I can honestly say I’ve hardly noticed any difference and it still takes at least an hour for my sugars to start coming down since injecting… I’m now convinced it’s just me!

Is there anyone else out there who finds their body takes at least an hour to react to insulin and start lowering glucose?? I’m just sooo fed up with it because I just seem to go sky high after eating because the insulin doesn’t seem to kick in or take effect for an hour and then it will come crashing back down!

19 long years of this and my patience is wearing thing

I just want to be able to grasp some kind of control over my diabetes. Especially as I want to start family planning on a few years and with my current readings I don’t think it would be safe/possible!!

Click to expand...

I am at the same point you are Although I havent managed to get my insulin changed yet
I have been a diabetic type 1 for 35 years And been on Novorapid for about 10 years now. But I recently (6 months) started using freestyle Libre 2, and realised that my sugars are waaaaay to high. So I consulted my 'cough' specialist doctor, and asked if I was possible insulin resistance, only to be told NO...... he gave me a stupid insulin/carbs regime to try, which almost drove me mad for the first few days (and made no difference what so ever anyway, so I went back to my original routine and dosage. He had told me i must NOT take my insulin more than 15 minuets prior to my meal, and that the insulin would reach its peek in a few hours and be depleated at about 4-5 hours. so I monitored my bloods every more.. jeeze my sugers were through the roof, and I realised they it didnt start wroking for FOUR hours, and then maybe a little. I am convinced (and will tell my Dr) than I need to change my insulin, to see if that makes a difference. I will give it 6 months, and if still no change, I need to talk to him about the possibility of me being insulin resistant, and what I can do about that,.....


I hope you manage to figure out your insulin issues to.