Do you think...

[Type1Lad]

Hey guys just a quick question, Do you think they will get rid of Novarapid and swap everyone over to Fiasp in due course.
The reasons I am asking this is.
1. Made by the same company
2. Works Faster
3. Same price as Novarapid.

 

[tim2000s]

Hey guys just a quick question, Do you think they will get rid of Novarapid and swap everyone over to Fiasp in due course.
The reasons I am asking this is.
1. Made by the same company
2. Works Faster
3. Same price as Novarapid.

I spoke to Novo about that. It will depend on a few factors.

1. how many people react to it in a way that makes them not want to use it.
2. Whether a Generic Bio-similar to NovoRapid comes out (there is one in the wings for Humalog).

The answer is not for the time being, but we'll have to wait and see.

 

[ickihun]

I wonder if type2s will get fiasp too?

I guess depends if novarapid is totally replaced or if fiasp is mainly for type1s.

I feel type2s should be offered it too if they are at risk of diabetic complications. I'm all for keeping us complication free. All of us.

If the same price as novarapid it would make sense to replace if those 2 above criteria specifications in @tim2000s post is satisfied.

 

[Deleted Account]

I understood there were limitation to Fiasp in terms of high volume injections (more than 10u).

 

[tim2000s]

I understood there were limitation to Fiasp in terms of high volume injections (more than 10u).

I've not seen that anywhere. Do you have any sources for that?

My experience is more that there is a maximum number of units a cannula can take and once you are beyond that it needs changing. I need to properly capture that in Nightscout though and do some checking, rather than a limit on the effectiveness of a large bolus (i.e. I've taken 16u and not seen any issues with absorption, except where a site is getting old).

 

[ickihun]

If I wasn't tied up on bariatric surgery I'd put myself forward to test huge amounts.
Mind u I'm not sure how much I'll be on after surgery. Its anyones guess. I will ask what specialist is expecting for me. Or his aim.
Currently needing 66 units of toujeo300 and 25, 20 and 15-20 novarapid. (60-65units per day).

 

[TheBigNewt]

Usually when a drug company comes out with a "better" version of their patented drug (Novorapid, made by Novo Nordisc) it means that patent is due to run out. That's what happened to Lantus, made by Sanofi, so they came out with Toujeo right before Lantus went generic (Basaglar). The other thing they do is combine the drug due to expire with a new drug and they patent the combination. Or they change the delivery system and patent that. Drug companies are pretty crafty about making sure they can charge us up the **** for their stuff. Right?

 

[alhubb]

Usually when a drug company comes out with a "better" version of their patented drug (Novorapid, made by Novo Nordisc) it means that patent is due to run out. That's what happened to Lantus, made by Sanofi, so they came out with Toujeo right before Lantus went generic (Basaglar). The other thing they do is combine the drug due to expire with a new drug and they patent the combination. Or they change the delivery system and patent that. Drug companies are pretty crafty about making sure they can charge us up the **** for their stuff. Right?

While what you're saying to probably right, in this case Fiasp is actually a better version

 

[TheBigNewt]

While what you're saying to probably right, in this case Fiasp is actually a better version

Supposedly so is Toujeo, longer acting/peakless, just like Fiasp is supposedly shorter/faster acting. Whether that leads to lower A1C's is the question. Does it? Did they compare it to Novorapid in a randomized study? I'd be interested in seeing that if it was done. At least in the US when a popular drug does generic the price doesn't come down much the first year because our FDA only lets one company come out with a competitor drug. So for me Basaglar doesn't cost any less than Lantus did (and Lantus came in 10cc vials, Basaglar only comes in 3cc disposable pens). But I figure eventually the price will come down. Where I work at a Veterans Administration healthcare facility we prescribe a LOT of Lantus to Type 2 diabetics, so the savings could be huge for the government eventually. When Lipitor went generic the price we pay per pill went from about $1 to about 5 cents.

 

[ickihun]

Supposedly so is Toujeo, longer acting/peakless, just like Fiasp is supposedly shorter/faster acting. Whether that leads to lower A1C's is the question. Does it? Did they compare it to Novorapid in a randomized study? I'd be interested in seeing that if it was done. At least in the US when a popular drug does generic the price doesn't come down much the first year because our FDA only lets one company come out with a competitor drug. So for me Basaglar doesn't cost any less than Lantus did (and Lantus came in 10cc vials, Basaglar only comes in 3cc disposable pens). But I figure eventually the price will come down. Where I work at a Veterans Administration healthcare facility we prescribe a LOT of Lantus to Type 2 diabetics, so the savings could be huge for the government eventually. When Lipitor went generic the price we pay per pill went from about $1 to about 5 cents.

I'll let you know if my hba1c is better on Toujeo300, compared to humulin m3. I read on-line it had good results, if anything a tiny bit better than lantus.
I've had to change which way I eat to keep morning insulin resistance from spiking me. Basal is fantastic. I have no concerns with it, at all.
It has taken a few weeks to get used to novarapid again thou. Toujeo300 was a breeze (thanks to my brilliant dn).

 

[tim2000s]

Supposedly so is Toujeo, longer acting/peakless, just like Fiasp is supposedly shorter/faster acting. Whether that leads to lower A1C's is the question. Does it? Did they compare it to Novorapid in a randomized study? I'd be interested in seeing that if it was done.

You won't have to wait too long. ONSET 3 and 4 are comparing Fiasp and Novorapid in a double blind randomised study. The results are due out later this year. I know a few of the involved HCPs (and one of the clinics involved is mine). According to the senior consultant, a number of people have identified they are on Fiasp, but the key point about the study is that it has taken normal T1s with Hba1C between 7.5% and 10% and used them. Most aren't as heavily engaged as most of us are. It will be very interesting to see the outcome.

Personally, Fiasp lowering Hba1C isn't the reason I was interested. It was the reduced time from bolus to eating (30-45 mins to 0 mins) and the avoidance of post prandial highs. As it happens, after 6 weeks on Fiasp, with a prior six weeks on Novorapid, both using the closed loop I use, the same algorithm, and if anything, a higher carb diet than when on Novorapid, I saw an Hba1C drop from 5.8% to 5.1% which shocked me and I didn't expect. Now I'm n=1 but the other studies that Novo have done also suggest reductions, and generally people are seeing good results with it.

My only question would be one of population. If someone discovers that they can much more "eat what they want" with an insulin with a faster response, do they then go and do this and stuff it all up again?

 

[ickihun]

I think overeating type2s can reverse their diabetes with low carb and exercise with additional other lowering bg techniques and skills. However no overeating type2s should be helped with insulin therapy as a first step or knee jerk reaction.
That's just my opinion.

So eventually all quickly court type2s can have a resolution before getting to the uncontrollable insulin resistance gets way out of control and needs huge amounts of insulin injected. This obviously doesn't apply to burnt out pancreas type2s nor medication brought on diabetes either.

I should have been court at 5-6yrs old not 32yr old and struggled with controlled and uncontrolled diabetes in ignorance. In fact I can honestly say I've never understood my diabetes until very recently (courtesy of this forum). At 46yrs old and using Insulin therapy with an intelligent diabetes team. Ignorance in health is never good!
What more do I not understand about type2 diabetes? Much much more, I'd guess!