Fiasp: my experience

[gorman100]

I posted a while ago about having very high sugars after mealtimes. I was really struggling with pre-bolusing and started to research Fiasp insulin. This coincided with my yearly consultant review, and having read the reviews I was very pleased with my consultant approved a change to Fiasp....

Well, I'm equally disappointed to say that it just doesn't work for me at all!

I moved over from Novorapid. This was effective, and if nothing else predictable. It also should not be marketed as "Rapid" in any sense of the word! Interestingly, my hospital clinic (and the whole BERTIE/DAFNE course) advises that you should inject and eat immediately. This is the biggest misconception they teach diabetics: it just does not work. To effectively use Novorapid, you've got to time it. In my case, I can inject and wait 30-45 mins before I get a drop in blood sugar. Some foods need an even longer wait...

So, I thought Fiasp would be ideal for me. In reality, it doesn't seem to drop my sugars very quickly at all. I still need a long pre-bolus (30 minutes in the morning), I actually need more of it, and it is also very unpredictable. With Novorapid, I could time the 4 hours it took to get out of my system. With Fiasp, it generally leaves at about 3 hours, but every now and again I'll get a sudden drop at 4 hours. Like yesterday: 30 minute lead at lunch, taken at 1 pm, flatline 6 all the way until 4.30 pm: sudden rise to 10... Sudden drop to 4.2 by 5.30... No food or other insulin involved!

Additionally, sometimes Fiasp seems to work really well at reducing blood sugar spikes (say, to take the edge of a 10 and rising). Other times, it just seems to do nothing. I'm a little bit mystified, to be honest! I really thought this was the answer to my problems, but I'm really struggling with it. Any tips appreciated!

I've been a T1 now for 18 years, and I always rotate injection sites. Nothing obviously wrong with those, or any explanation as to why this would influence my levels. I use Livermir, which I have for about 10 years: that's well adjusted, and I can get a flat 6 overnight, for instance. I don't low carb, as such, but I probably eat about 30-50 g of carb a day; I know I could reduce this, but I struggle without some carbs in my diet...

I'm sticking with Fiasp for now, and hoping that it will all come together. I'd even started to think this could be a dud batch of insulin, but the fact that it sometimes does work perplexes me!

 

[Circuspony]

That's disappointing - I was planning on asking my consultant about if because I also struggle with novorapid not being 'rapid'!

 

[gorman100]

That's disappointing - I was planning on asking my consultant about if because I also struggle with novorapid not being 'rapid'!

I'd hoped that it would solve this completely, but it sadly is very much like Novorrapid but far less predictable...

But we're all different: maybe you'll have a better experience!

 

[pinewood]

Thanks for sharing your experience. I also find that NovoRapid takes at least 30-45 mins to work and therefore pre-bolus accordingly; especially for low-fat/high-carb foods. I was excited about trying Fiasp but keep getting told it is still being approved in my area (even though I am in central London!). For me, the biggest appeal of Fiasp is to nip spikes in the bud quickly - my biggest frustration with NovoRapid is not having to pre-bolus in advance but having to wait over an hour for a correction dose for a high blood sugar level to take effect.

Hope it works out better for you as you experiment with it some more.

 

[slip]

Wow I'd be on the floor pre-bolusing novorapid that early. I was thinking about asking about fiasp at my next appointment, now I'm not so sure.

 

[porl69]

I moved from Novosluggish to Fiasp about 4 weeks ago and so far am really impressed with it. I bolus just as I start to eat ( I eat a lot as well )and get a very slight spike after my meal but nothing problematic. I guess we are all VERY different in how our bodies work. Sorry to hear you are having problems with it

 

[gorman100]

I moved from Novosluggish to Fiasp about 4 weeks ago and so far am really impressed with it. I bolus just as I start to eat ( I eat a lot as well )and get a very slight spike after my meal but nothing problematic. I guess we are all VERY different in how our bodies work. Sorry to hear you are having problems with it

Glad to hear it's working well for you. I really thought this was how I could use it too!

If I inject then immediately eat, I get the "Novorapid" effect: I go from say 5 to 13-14, sit there for an hour, then crash down to 3 as the insulin hits... That off the back of a 20 g carb meal.

Ah, isn't being diabetic fun sometimes???

 

[karen8967]

i changed from apidra to fiasp about 7 weeks ago i do find it quicker than the apidra for the spikes but somedays doesnt seem to kick in for about an hour and sometimes i still get the spike then drop like a balloon but will stick with it

 

[porl69]

Glad to hear it's working well for you. I really thought this was how I could use it too!

If I inject then immediately eat, I get the "Novorapid" effect: I go from say 5 to 13-14, sit there for an hour, then crash down to 3 as the insulin hits... That off the back of a 20 g carb meal.

Ah, isn't being diabetic fun sometimes???

Oh dear, not good at all
Diabetic and fun in the same sentence NEVER happens lol

 

[LooperCat]

Hmmm, I was hoping to switch to FIASP soon, mainly for faster corrections - good old NovoSluggish just takes too long to act. But I agree they shouldn’t be telling people to inject as soon as you eat, it’s nowhere near quick enough to avoid a ride on the glucoaster...

 

[porl69]

Hmmm, I was hoping to switch to FIASP soon, mainly for faster corrections - good old NovoSluggish just takes too long to act. But I agree they shouldn’t be telling people to inject as soon as you eat, it’s nowhere near quick enough to avoid a ride on the glucoaster...

I find it acts around 15 - 20 mins after injecting.....I notice a slight drop in my blood sugars (thank you Libre) in that 15 mins

 

[slip]

I find it acts around 15 - 20 mins after injecting.....I notice a slight drop in my blood sugars (thank you Libre) in that 15 mins

Is this with novorapid or fiasp? (just for clarification!)

 

[becca59]

Interesting. I bolus with Humalog an hour before breakfast. 40 minutes before lunch. And if I eat in the evening which I rarely do. Just before or sometimes after I eat. Thought Fiasp might help me, though my consultant said when I brought it up that the jury was still out on its effectiveness. He may be right!

 

[gorman100]

Yeah, injecting and waiting is the biggest trick to good diabetic control I think. It's a shame that it's difficult to master without a CGM (Libre or the like): "waiting for the bend" is hard to judge without one!

 

[scotteric]

Ive tried it in a pump and on MDI. I find a more noticeable difference in speed using it in a pump. However, there are issues pumping it many people have experienced. I find at times it is slightly faster and other times I don't see any difference between it and NovoRapid when injecting. What is noticeable is that I need much more of it for the same amount of carbs and it doesn't last as long. While this may be a benefit for some people to prevent lows, I find NovoRapid more useful for preventing post-meal spikes .

 

[Brendon.Dean]

I had the same experience as you did when I tried it (sedentary lifestyle). It was unpredictable, after 3 hours random lows, high post bolus blood sugar 9x out of 10. I switched back to NovaRapid and now have an active lifestyle and my diabetes is way better, oh and I use the pump now too.

 

[tim2000s]

Fiasp worked well for me initially, then worsened in steps until, around October/November last year it became totally unpredictable and I ended up switching to Humalog.

I've found that Humalog works nicely, where Fiasp I've had to totally give up on. Roll on the next faster insulin...

It's all documented at http://www.diabettech.com/fiasp

 

[EllsKBells]

I haven't used Fiasp personally, but this does tie in with a conversation I had with my DSN a while back. She said that they weren't changing any humalog patients over to Fiasp, because they weren't convinced it was actually going to give any benefit, and taking those on novorapid on a case by case basis, because those that had switched were having very mixed results.

 

[scotteric]

I haven't used Fiasp personally, but this does tie in with a conversation I had with my DSN a while back. She said that they weren't changing any humalog patients over to Fiasp, because they weren't convinced it was actually going to give any benefit, and taking those on novorapid on a case by case basis, because those that had switched were having very mixed results.

This doesn't make sense to me though because Humalog shouldn't be any faster than NovoRapid.

 

[gorman100]

I had the same experience as you did when I tried it (sedentary lifestyle). It was unpredictable, after 3 hours random lows, high post bolus blood sugar 9x out of 10. I switched back to NovaRapid and now have an active lifestyle and my diabetes is way better, oh and I use the pump now too.

I agree exercise definitely helps. I also think I need a pump (or, at least, I'd like one!) but my consultant suggested we try Fiasp first... I'm giving it another few days, then I think I'll go back to Novorapid.