Fiasp in pregnancy

Hi all,

Just wondering whether anyone has been using fiasp while pregnant? I have always used novo rapid and recently changed to apidra as I was advised it was slightly faster acting than novo and it does seem to be a little faster for me. I have asked my consultant if I could start fiasp before trying for a baby and I can now do so however I've since read a few posts and blogs where the initial benefits of its immediate effect wear off over time or where it seems to have an effect on the body's insulin resistance. I'm just trying to decide whether I'm better sticking with apidra (which I think I probably am until someone develops a fast acting insulin without the teething problems that novo seem to be experiencing with fiasp) but thought I'd ask if anyone had been using it and how they've found it...thanks

Catherine4188 said:

Hello,

I am currently having to inject novorapid 40-50 minutes before eating to stop spikes. I'm 8 weeks pregnant. It's becoming impossible to keep up with work hours and nausea. I was going to ask my DSN about a faster acting insulin tomorrow. This question will be helpful to me too, so thank you.

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Hi @Catherine4188

Pregnancy is hard work with diabetes! I managed fine with novorapid during my first pregnancy but I just seem to have been having problems with it lately and it not kicking in on time even with low carb meals so thought I'd better look into it before trying again. I changed to apidra and it does seem to have helped so far. The more I read about fiasp the less likely I am to try it especially during a potential pregnancy. Also with being pregnant already fiasp may be too risky due to hypos so I would bear that in mind too as pregnancy is so unpredictable as it is! Are you able to have a mix of food groups to see if that helps with the spikes like scrambled egg and toast in the morning to slow the carb digestion down? Although I know I wouldn't have time to make something like that but if you did that might help. Just keep testing so that if you are spiking you're picking it up early. I was testing 15 times a day and probably more than that while pregnant and it does help. Congratulations on your pregnancy, very hard work but very rewarding in the end

tim2000s said:

Hi @Kateyo, whilst I can't speak for use of Fiasp while pregnant, I have been using it since March, and have finally gotten to a place where I'm fairly confident that my levels are right. It took about a month of fiddling and seeing weird things happening, but I've now got everything running in a way that's turning out to be very stable.

I won't beat about the bush, I do need more of it than I did of Novorapid, but once you get yourself readjusted, it seems to work okay. The key things to be aware of if you do look at changing is that pump sites tend to go off far more quickly than on the other insulins, so I'm changing them pretty much every two days now.

I guess it's really up to you. The faster action really does help in reducing spikes, but it's a question of whether you want to take the time to work out what adjustments you need to make it work for you whilst pregnant (as with changing to any other insulin).

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Thanks @tim2000s I think I've been following your blog on fiasp actually, it's been great to read about others experience of it! My a1c is good (5.4 in old money) and what I'm really trying to work on is those spikes. I can spike to 8 sometimes especially after breakfast no matter what I do and I'm relatively low carb too so I did want to give fiasp a go to see could I work with it to eliminate those spikes or most of them anyway, unfortunately as much as I'd love it to fiasp won't cure me of spikes lol! Would you say your TDD has increased by much? Would you agree that taking the dose as you eat is agreeable? Does your insulin needs drop in the first instance before the resistance from B12 kicks in? Sorry for all the questions, it's just nice to speak to people who have been there done it so I know what to expect and what may happen. My dr has agreed to prescribe it, I just need to make my mind up now.

tim2000s said:

My TDD is up, but it's not by an enormous amount. I'd say 10%-20% overall. Taking the dose as you eat or after you eat is great, as it makes managing eating far easier.

I'm not sure why people think it might reduce insulin need. It's the same underlying insulin as NovoRapid, so in that sense, I was using exactly the same amount as NovoRapid prior to all the adjustments.

I'd also add that quite a few people haven't noticed any issues with needing to use more, and the reality is that each of us seems to be different in this case.

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For some reason I had been finding that I was having to up my basal and ratios on novorapid more and more in recent times with no real reason for it, that I know of anyway. I've also found that my cannulas need changed more regularly, this doesn't seem to be the case with apidra so far but I think these are issues I would more than likely experience with fiasp too! Very frustrating but if you found it eventually levelled off maybe I can hope for the same! I think the reduction question is more than likely coming from their team of HCPs, thats where mine came from anyway. Did I read that fiasp doesn't last as long either before tailing off? I think I'm going to have to just give it a go and can always go back to apidra if I find it's not as helpful as I hoped! Wish me luck, I'm sure I will be on with more questions once I start