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Fiasp experiences

Discussion in 'Type 1 Diabetes' started by pinewood, Jun 7, 2017.

  1. pinewood

    pinewood Type 1 · Well-Known Member

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    Hi everyone,

    I have my annual review appointment tomorrow and will be mentioning Fiasp to my consultant.

    I would be interested to hear from anyone who has been using it.

    I currently use NovoRapid and do not really have any issues with it as long as I inject far enough in advance of eating. My only frustration is how long it takes to kick-in for corrections. I suppose, given that I am used to NovoRapid and familiar with my body's response to it, I am a little nervous about moving to a new quick acting (and would question if it's really necessary given that my HbA1c has been stable in the low-mid 5s) but then I guess I'll never know if I find it better unless I try it.

    Most of the experiences I have read have been people using it in pumps; does anyone use it in pens?

    Thanks!
     
  2. Eldorado

    Eldorado Type 1 · Well-Known Member

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    I'd be interested too.
    I was keen to try it but when I asked my diabetes consultant last week if I could try it I just got a straight 'No'. She wasn't the doctor I usually see.
    Apparently I am too well controlled to change anything! My last HbA1c results have been in the mid 40's. Bit disappointed tbh.
     
  3. pinewood

    pinewood Type 1 · Well-Known Member

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    That's disgraceful; it's not like it costs the NHS any more money so it should be your decision to make. I would not be happy if I was told outright "no" just because I am well-controlled; why should we be restricted from using the newest insulins just because we are keeping our levels in control? We should be allowed to try it if it could potentially reduce the burden of type 1 diabetes; I think health care professionals often don't realise that the only reason we have good control is because of the insane amount of effort that goes into managing our diabetes...
     
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  4. Eldorado

    Eldorado Type 1 · Well-Known Member

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    Yeah. I was a bit ticked off. I'm going to take it up with my GP. I'm betting the consultant that I usually see wouldn't have said this.
     
  5. EllsKBells

    EllsKBells Type 1 · Well-Known Member

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    @Eldorado what quick acting are you on at the moment? I ask because when I spoke to my DSN about Fiasp, she said that they were only going to move people on NovoRapid across, because they don't think there is much difference between Humalog and Fiasp. I can't say I agree with them, but possibly their train of thought?
     
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  6. Kateyo

    Kateyo Type 1 · Well-Known Member

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    I was told the same thing - no your a1c is low enough as it is, we don't want it going any lower!! I argued my case though and got it! At the minute I'm sorting overnight basal out before I change over but looking forward to giving it a go. I've found that I need to bolus 1hr ahead sometimes so hopefully fiasp will help with that!! Hope you are able to discuss this with your consultant before they outright 'no' it. If anything a motivated patient is the best to try these new advancements on!
     
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  7. Eldorado

    Eldorado Type 1 · Well-Known Member

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    Aha! I'm on Humalog. That might explain it then. But she didn't explain it to me! I wish I'd insisted on seeing my usual,consultant.
     
  8. pinewood

    pinewood Type 1 · Well-Known Member

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    What utter rubbish! Annoys me when health care professionals are so ill informed.
     
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  9. tim2000s

    tim2000s Type 1 · Expert
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    @pinewood This is the set of experiences I've captured from others:

    http://www.diabettech.com/user-resources/user-experiences-of-fiasp/

    And mine moving from novorapid:

    http://www.diabettech.com/faster-insulin/

    I know a number of people that have moved from Humalog to Fiasp, and have continued with the Fiasp as they've found its time to onset significantly better than Humalog. If you go back and review all the "Faster Insulin" trials where Humalog was compared to a faster version that Lilly was working on, and Novorapid to FIasp, you can see that Humalog and Novorapid in most cases had equivalent action times, so the spurious statement "We think Humalog has the same type of action as Fiasp" is utter rubbish unless they have some proof of this.

    I'd suggest that, where you are faced with the statement "Humalog and Fiasp are equivalent", you offer to help them prove this at the possible detriment to your health by undertaking some tests and feeding back if there are any differences. I know that @azure sees Humalog acting very quickly, but I equally know people on Humalog that pre-bolus as much as I used to have to with Novorapid, so I think it's very much a horses for courses question.

    I'd also add that as it's your diabetes, the conversation you should have with your team is one of "I am the one who is managing my diabetes on a day to day basis. I would like to try this new insulin because the evidence suggests it may make a difference to my management. Whilst I respect your opinion, that's my decision to make, and it doesn't come at any increased cost to the NHS."
     
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    #9 tim2000s, Jun 8, 2017 at 7:56 AM
    Last edited: Jun 8, 2017
  10. pinewood

    pinewood Type 1 · Well-Known Member

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    Thanks Tim, that's super helpful!

    A little concerning that some people have found hypo frequency and severity to have increased but perhaps that's just part of the learning process and getting used to it.

    To be honest, I'd kind of like to keep NovoRapid but also have a Fiasp pen to use only for corrections. Not sure the consultant will be too keen on that, though.
     
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  11. paulliljeros

    paulliljeros Other · Well-Known Member

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    This is interesting. I asked a consultant at Kingston Hospital (a different one to my normal consultant) and both he, and my DSN stated that FIASP is still undergoing trials, and is not available on their formulary. I have now had the discussion with my DSN 3 or 4 times, but with no success. It is frustrating, as they have been hugely pro-pump and great in all other ways
     
  12. tim2000s

    tim2000s Type 1 · Expert
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    It's an interesting one. Fiasp is generally released and the public have access to it with a helpful set of HCPs, however, there is also an ongoing clinical trial that is looking at its use across the UK. Note that the trial is taking place with people that are not considered to be "Well Controlled" by Hba1C amounts (to participate you had to have an Hba1C between 7.5% and 10%) so one of the key indicators coming out of it will be any form of Hba1C reduction (which is what the manufacturer clinical trials claimed).

    Many HCPs will not prescribe it until they see the outcome of this trial because they don't want to get in to trouble for prescribing something they don't have details of. My frustration with this approach is that when you are engaged, it means you are blocked from trying something that may be better, and probably isn't worse, due to their concerns. One thing that Fiasp has made very clear is that the internet is not UK HCPs friend as it has allowed far more people to access information on treatments like this than in the past, and they want to try them, which very much goes against the grain of many HCPs, despite the "Take control of your condition" rhetoric.

    Personally, it took me a good month to get used to it. I now think I am, and the best bit of using it is being able to bolus when you see food. It makes life much easier. In addition it works extremely well in an Artificial Pancreas, which is what you'd expect. I've also had to change the regularity of pump set changes, and now get two rather than three days, which is slightly more annoying.
     
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  13. ElkBond

    ElkBond Type 1 · Well-Known Member

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    I am picking up my FIASP for my pump tomorrow, I have been following your blog @tim2000s and its interesting, I will keep an eye on my sensitivity swell, and report back.
     
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  14. ElkBond

    ElkBond Type 1 · Well-Known Member

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    I have it, but for the sake of not wasting a pod I will wait until tomorrow when it needs changing. I thought I might be eager and change early but its just a bit wasteful.

    Anyone who is on FIASP pump or jabs, what sort of timing changes did you make? I have read Tims blog and it looks as if I can eat almost as soon as I jab (normally wait a min of 20mins). Is this others experiences too?

    Pump users, how quick for basal updates? Would it be suggested to make a pump program half and hour later on every change?

    In @tim2000s blog - The random 'water' (FIASP not doing anything) was slightly concerning, so if I come across this I will update on this thread (trying to keep all experiences on FIASP in one thread seems good). I will carry my novopen with novarapid on me just in case. The Sensitivity change was also interesting that Tim outlined, but in my case I could do with a little less sensitivity at the moment as I still am very sensitive, so this may be plus point for me. It would be interesting to see what happens if you go back to nova after a period of FIASP and see if you recover the sensitivity. Your blog TIM has been invaluable.
     
  15. tim2000s

    tim2000s Type 1 · Expert
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    @ElkBond I've worked out what the water effect is now. It's when I need a site change. I've noticed (and I've yet to test this theory) that typically if I change sites every two days I don't get a water effect. If, however, I leave it into the third it can go off randomly at any point. The most likely occurrence is third day with a high carb count food, so i suspect that there is a max number of units I can administer in a site before it is spent and I need to rotate. Interestingly, I'm on my second clock face of sites with Fiasp and there don't appear to have been long term effects.
     
  16. Kateyo

    Kateyo Type 1 · Well-Known Member

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    @ElkBond do let us know how you are finding it when you make the switch. I have mine but haven't started it yet as I wanted to wait for the weekend just in case! I read @tim2000s blog on what other users thought of it and some of it made me excited to get started and other things people experienced made me a little nervous of it but it's such a helpful info source and a great idea so thanks so much for sharing @tim2000s! Good luck with fiasp, I'll let you know how I found it too when I pluck up the courage :nailbiting:
     
  17. ElkBond

    ElkBond Type 1 · Well-Known Member

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    @Kateyo FIASP is in, i repeat FIASP is in! Update you on the news
     
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  18. CJOtter

    CJOtter Type 1 · Active Member

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    I agree. The bioavailability graphs are almost identical between Novorapid and humalog. Fiasp is quicker.
     
  19. CJOtter

    CJOtter Type 1 · Active Member

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    I have Fiasp and am just finishing my first vial so that's about a month.

    It does kick in quicker. I have CGM and I get a flat response of my blood glucose with Fiasp. Much better.

    It leaves the system quicker. I have had to reduce my IOB time to 2 hours and it seems to be about right.

    Stacking is very rare because of its short action. (As long as you pay attention to the wizard!)

    I seem to spend long periods at a level 10mmol/l. I've checked my basal and I don't think it's that so I think I need some bolus adjustment. I think I can probably be more aggressive with my bolus dose because it's much shorter in onset and offset.

    Longer acting foods such as pizza or last night pie crust are going to talk more though. I've turned on dual bolus for the first time.

    All in all I think it's a much better tool mainly due to the fast offset.

    I hope it's good for you too.
     
  20. Scott-C

    Scott-C Type 1 · Well-Known Member

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    Small question, CJ, if I may.

    I tend to adjust pre-bolus timing depending on a guestimate of the GI of the meal, shorter pre-bolus for lower gi like pulses, otherwise I'll slide down before the food gets broken down

    With the faster action of fiasp, are we maybe getting into the territory of bolusing after a low gi meal?
     
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