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Fiasp v novorapid

Discussion in 'Insulin' started by sjm1308, May 1, 2019.

  1. sjm1308

    sjm1308 Type 1 · Well-Known Member

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    Hi all! I was previously on novorapid for 10 years then I was changed to fiasp as I was very insulin resistant in the morning. I was needing to take my novorapid 45-60mins before breakfast so we thought fiasp might be an alternative.

    My bgs have been like a rollercoaster since the change and tbh I still have to take it 30mins before breakfast. I actually feel im more insulin resistant with fiasp. I've gained weight since starting it am not sure if that's related.

    Well I stupidly ran out of fiasp at the weekend but had a spare novorapid pen and have been using it. My bgs are much more stable and in some ways I feel better.

    Is this common or just in my mind? Am thinking of asking my dns to change me back at my next app.
     
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  2. Muneeb

    Muneeb Type 1 · Well-Known Member

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    I know there has been varied opinions on FIASP. But there's a whole load of reasons for that, in general when people switch to FIASP they have done their own research so are probably looking into diabetes management more, so they have a keener eye. On top of this many people now use CGM's that allow you to see how BS levels are affected, so people can make more informed decisions.

    I personally changed to FIASP and it works a treat, is it much faster than novorapid? I'm not sure because I have CGM data for FIASP since I started using it but not when I was on novo.

    One thing I found is that FIASP seems to go off a lot quicker, in general after 2 weeks it will stop working. If exposed to elevated temperatures for a short period of time it seems to go off quick as well. I use a FRIO wallet for my pen all the time now.

    Also my BS levels are much better now, but again this could be a combination of understanding the effects from a CGM, eating healthier and focusing a lot more on exercise.

    I found that if my basal insulin is not correct or even slightly out, I require a significantly higher amount of FIASP, especially when I'm ill and in general I require more insulin on the morning.

    Also a key point to take not of is your injection sites. I found injecting in the leg for example takes SIGNIFACNTLY longer to absorb and lower BS than injecting in the abdomen (however you can use this in your benefit, e.g. higher fat/protein, inject in leg rather than abdomen). Also make sure your sites are not affected by lipohypertrophy (Fat deposits) as this will affect insulin absorption.
     
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  3. db89

    db89 Type 1 · Well-Known Member

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    Hi @sjm1308 - I've been on Fiasp coming up on 2 years now. I did use some Novorapid penfills I had left over the course of the first year and the only difference I seemed to notice was in the timings. My ratios did come down a little bit on Fiasp, but not to any extreme.

    One of the main differences I have found with Fiasp is that timing is important. Like you, I still need a good pre-bolus in the morning for breakfast (I was similar to you in needing 45+ minutes to cope with porridge for example). I find myself split bolusing and even splitting the same injection between multiple sites for slower absorption but I am happy to manage it this way and I've never wanted to go back to Novorapid. I also find it only seems to last about 3 hours as opposed to 4-5 with Novorapid and there is much less of a tail.
     
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  4. helensaramay

    helensaramay Type 1 · Expert

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    I switched from NovoRapid to Fiasp in November last year.
    Like you, I found my BG went on a roller coaster ride. There were times when it seemed as if the Fiasp was doing nothing. As I use a pump, I rely on fast acting insulin for all my insulin needs including basal. As a result, there were times my BG was much higher than I had seen for years. Other times, the Fiasp was brilliant working quicker than NovoRapid.
    I spoke to my diabetes team and they said they had heard of Fiasp being "unstable" so provided some Humalog to try. It is not as fast as Fiasp but it is different to NovoRapid so my body may suit it better.
    However, as I had a bit of a Fiasp stash and I don't like throwing things away, I have persevered with Fiasp but not kept it out of the fridge for as long. As a result, Fiasp has behaved itself in the last couple of months.
    So, for me, as long as I don't expect the Fiasp to last longer than 2 weeks out of the fridge, I am fine.

    I have not tried keeping the unfridgerated Fiasp in Frio bags as suggested above, It could be worth trying - thanks for the tip @Muneeb
     
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  5. Muneeb

    Muneeb Type 1 · Well-Known Member

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    You're welcome. They do a range of sizes and they are very easy to use.
     
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  6. helensaramay

    helensaramay Type 1 · Expert

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    I have had Frio bags for my pens for most of my diabetes life. I use them whenever I go on holiday. They are especially useful when walking and camping in hot climates.
    I have never thought about using them in the UK because I don't think it gets hot enough.

    I would struggle to keep my pump in a Frio bag but Fiasp seems to cope for 3 days (the time between set changes) without refrigeration.
    I have to keep my insulin vial out of the fridge because I would get bubbles when using it in the pump straight out of the fridge and I carry the vial around with me to use with a syringe if the pump fails. I will look to keep this vial in a Frio bag. The bag will be a bit large because it is the 2 pen one. I can get a smaller one if it works.
     
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  7. slip

    slip Type 1 · Well-Known Member

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    Helen, just a quick question about your change to fiasp, the rollercoaster affect and then egtting it to work - have you made changes to the way you bolus or tweaked your basal rates to compensate for fiasp? I just thought it might be worth mentioning (for the OP) what you did if anything to tame the fiasp?
     
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  8. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Just to play devil's advocate @sjm1308,
    Is it fair to say you were using Novorapid and now Fiasp to manage BSLs after a meal?
    That is, trying to 'catch' and control' BSLs from what you eat with use of insulin, including delaying
    food intake after the injection of insulin.
    Have you thought about eating food whose BSL rise and effect better matches the insulin's action ?
     
  9. helensaramay

    helensaramay Type 1 · Expert

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    Good question.
    I was told by my DSN to make no changes to my insulin doses on my pump but I was sceptical so I made a copy of my standard basal profile and tweaked it. At first there was a lot of tweaking to try to smooth out the rollercoaster before I realised it was the instability issues. In the end the NovoRapid profile and the Fiasp profile ended up the same with a 30 minute offset. Because the Fiasp reacts quicker, any change in my profile dose was moved 30 minutes earlier. But the dose remained the same,
    Likewise with bolus - the dose remained the same but I didn't have to pre-bolus 40 minutes before I ate.
     
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