Fiasp

[RD02]

Hi I’ve been offered a trail of Fiasp,

I’m currently using NovoRapid which works extremely well for me when I get the timing right, but as always it’s not so convenient when eating out.

I’m just after some fellow Type 1’s experience with it.

 

[Zhnyaka]

fiasp acts faster than novorapid, it can be injected after eating. Otherwise, these insulins are identical. Although some people say they are allergic to fiasp.

 

[Nicola M]

I’m on Lyumjev which is basically the same as Fiasp and works just as quickly.

The only thing I’d say to look out for is you’re at risk of worse hypos due to how quickly the insulin can start working, I’ve had a few bad ones, I was still awake and could treat them myself though but we are talking 2.0mmol and below.

Fiasp can cause stinging/soreness at the site when you are injecting it, it doesn’t happen for everyone but some people find they don’t get on with it. I get it with Lyumjev and just put up with it as the benefits outweigh the drawback of stinging.

 

[SherwoodT1]

I did the switch a good few months ago. It definitely helps with pre-bolusing. I found while it's not instantaneous, it can be very forgiving if you can't pre-bolus in adequate time. With the extra time, I've managed to eat meals and stay under 10.0 mmol/l, despite carbs featuring as a significant component in meals.

Corrections are the sticking point for me. If you misjudge the need for a correction dose, boy do you need glucose to hand! But overall, I've found fiasp to really help me with control. I hope it goes well for you.

 

[In Response]

fiasp acts faster than novorapid, it can be injected after eating. Otherwise, these insulins are identical. Although some people say they are allergic to fiasp.

I have been using Fiasp for a couple of years. It takes some time to get used to as it does NOT behave the same as NovoRapid (but faster) for me.
The key difference is the speed that it works is VERY dependent on my current BG.
- If my levels are high (over 10) Fiasp can take an hour to kick in. This means that it can be a pain to use for corrections
- if my levels are in the 4s and low 5s, it will work immediately - faster than I can eat. So, I have to bolus AFTER eating otherwise I hypo. This is the biggest risk for me and something that I have to pay close attention to.
- if my levels are in between, I can bolus just before starting to eat.

The other thing I have noticed is that Fiasp does not last as long out of the fridge as NovoRapid. My doses are relatively small even though I also use Fiasp as my basal in my insulin pump. I find Fiasp loses its potency when it has been out of the fridge for more than 2 weeks.

I would recommend it but it needs more management - I keep a closer eye on my BG (thanks CGM) so I can avoid those highs.

 

[CheeseSeaker]

Fiasp is essentially NovoRapid with added nicotinamide/B3

Where Novorapid (was using this for 20+ years - the time flies) takes at least an hour to kick in (in normal situations) Fiasp can do it in 15-20 mins, so much easier to avoid the post-prandial (after eating) highs.

Lyumjev is Humalog with vasal dilator (Treprostinil) added to speed up absorbtion

I found both of these caused me issues (worked great for a while - say 3 weeks) then I got absorption problems with Fiasp, long story but needed an ultrafast (fiasp or lyumjev) for looping.

Ended up mixing Novorapid and Fiasp - this worked much better for a good 4 months - then I got insulin resistance again.

Switched to Lyumjev - same resistance - so tried Fiasp and Lyumjev mix - much better (oddly), and now on 80% Lyumjev, 20% Fiasp, heading slowly for 100% Lyumjev

Means my Insulin loop works properly and slow introduction reduces the issues with Lyumjev (treprostinil takes some of us a while for the body to accept)

Mixing insulin is not recommended by any manufacturer - so personal risk, but it worked well for me.

Fiasp may work well for you (hope it does) and an ultrafast works much better once you learn to control it - I'd recommend you try it, but keep some Novorapid in case it causes resistance and you need a backout plan (either back to Novorapid or mixing)

 

[RD02]

Thx for all the info will go ahead with trying this out

 

[ArtemisBow]

This is only my personal experience, but Fiasp was a disaster for me. I was having issues with spikes after meals and thought it would help (pre bolusing was not always possible) so trialled it.

In my case the absorption was entirely inconsistent, often taking longer to react than Novorapid had. And then suddenly it would all come through at once. So I switched back after a month because while a bit slow at least Novorapid acted the same each time.

Good luck with whatever you choose to do!

 

[In Response]

In my case the absorption was entirely inconsistent, often taking longer to react than Novorapid had. And then suddenly it would all come through at once. So I switched back after a month because while a bit slow at least Novorapid acted the same each time.

This was my experience until I realised my BG affected the rate at which it started working and the absorption was not inconsistent.
Once I had sussed this out, it all made sense. Sadly, there was no one to warn me beforehand so I had to work it out alone. Now I see I am not unique with this experience.

 

[ArtemisBow]

Actually now that you’ve said about the BG level making the difference in absorption, that does seem to explain some of it. I remember eating the same meal twice, once with a correction for high BG preprandial and once at normal levels, and getting very different results - at the time I thought the corrections just weren’t working but perhaps it was the high BG making it slower. Unfortunately those are the times when I wanted it to work quickly!

 

[RD02]

Not sure if anyone is still following this but have been on Fiasp for a week now. I’ve found I’ve had to reduce my carb to insulin ratio from 1unit to 10 grams down to 0.75 units to 10 grams of carbs. I’ve not spiked on my usual porridge/ blueberry, walnuts breakfast to above 9mmol and it’s back down within 45 mins to it’s original start point before eating. So far positives all the way round. Next is exercise. This I’m anticipating to be a challenge as already with NovoRapid found the need for constantly drip feeding in some carbs.

 

[YogiBear76]

This is only my personal experience, but Fiasp was a disaster for me. I was having issues with spikes after meals and thought it would help (pre bolusing was not always possible) so trialled it.

In my case the absorption was entirely inconsistent, often taking longer to react than Novorapid had. And then suddenly it would all come through at once. So I switched back after a month because while a bit slow at least Novorapid acted the same each time.

Good luck with whatever you choose to do!

I'm going through this at the moment.

 

[In Response]

How high is your BG wen you experience this?
As said previously, this is usual for Fiasp if your BG is in double figures.

Fiasp is not as easy to manage as NovoRapid - but can give better results if you understand how it works for your body and minimise the highs.

 

[Shaggy_dog]

Fiasp is essentially NovoRapid with added nicotinamide/B3

Where Novorapid (was using this for 20+ years - the time flies) takes at least an hour to kick in (in normal situations) Fiasp can do it in 15-20 mins, so much easier to avoid the post-prandial (after eating) highs.

Lyumjev is Humalog with vasal dilator (Treprostinil) added to speed up absorbtion

I found both of these caused me issues (worked great for a while - say 3 weeks) then I got absorption problems with Fiasp, long story but needed an ultrafast (fiasp or lyumjev) for looping.

Ended up mixing Novorapid and Fiasp - this worked much better for a good 4 months - then I got insulin resistance again.

Switched to Lyumjev - same resistance - so tried Fiasp and Lyumjev mix - much better (oddly), and now on 80% Lyumjev, 20% Fiasp, heading slowly for 100% Lyumjev

Means my Insulin loop works properly and slow introduction reduces the issues with Lyumjev (treprostinil takes some of us a while for the body to accept)

Mixing insulin is not recommended by any manufacturer - so personal risk, but it worked well for me.

Fiasp may work well for you (hope it does) and an ultrafast works much better once you learn to control it - I'd recommend you try it, but keep some Novorapid in case it causes resistance and you need a backout plan (either back to Novorapid or mixing)

I know that this is an old post, but I wonder how long you used the Fiasp/Lyumjev mix, and if you are still using it what ratio you are on?

 

[CheeseSeaker]

I know that this is an old post, but I wonder how long you used the Fiasp/Lyumjev mix, and if you are still using it what ratio you are on?

I think I used it for 3-4 months or so (30% Fiasp and 70% Lyumjev), it appeared to help with a more constant BG and absorption of insulin, then eventually I had a a few weeks of unexplained highs and crashing lows (as my Loop threw more insulin in to get my BG to drop).

In the end I went back to trying 100% Lyumjev, which worked well for a few cannula changes, then I got highs again.

Finally worked out it was critical with Lyumjev (and potentially Fiasp) to do very frequent site changes, ensuring I was using areas of the body that hadn't seen insulin in a long time - side effect seems to be I don't get any pain/discomfort from the insulins now

That seems to have fixed my Insulin resistance problems and I'm happily running a Fully Closed Loop using 100% Fiasp - it kicks in quickly and handles the unannounced carbs without a problem - issues are exercise (helps a lot if I set a temp target an hour before, or eat when walking the dog etc), and tuning the loop so I don't go too low (less insulin allowed for the Dynamic ISF part of the loop)

Last few days was 90% TIR - 2% low, 8% high with no time in very low - getting there slowly with the right insulin and understanding my body absorption

 

[Shaggy_dog]

I think I used it for 3-4 months or so (30% Fiasp and 70% Lyumjev), it appeared to help with a more constant BG and absorption of insulin, then eventually I had a a few weeks of unexplained highs and crashing lows (as my Loop threw more insulin in to get my BG to drop).

In the end I went back to trying 100% Lyumjev, which worked well for a few cannula changes, then I got highs again.

Finally worked out it was critical with Lyumjev (and potentially Fiasp) to do very frequent site changes, ensuring I was using areas of the body that hadn't seen insulin in a long time - side effect seems to be I don't get any pain/discomfort from the insulins now

That seems to have fixed my Insulin resistance problems and I'm happily running a Fully Closed Loop using 100% Fiasp - it kicks in quickly and handles the unannounced carbs without a problem - issues are exercise (helps a lot if I set a temp target an hour before, or eat when walking the dog etc), and tuning the loop so I don't go too low (less insulin allowed for the Dynamic ISF part of the loop)

Last few days was 90% TIR - 2% low, 8% high with no time in very low - getting there slowly with the right insulin and understanding my body absorption

Thanks for that. I've been using Fiasp for a while using the Boost version of AAPS, but went back to Lyumjev to see if using other areas would make a difference to reactions, as Fiasp seems to be slowing down! I find Lyumjev will work fine for 36 hours and then, sometime over the following 36 hours will become slower than Novorapid! I don't fancy changing cannulas every day and half, so I'll give the mix a go and see what happens with that. I'm usually around 85% in range, but there is a big variation in that due to the sudden site issues! Thanks for the quick response!

 

[CheeseSeaker]

Thanks for that. I've been using Fiasp for a while using the Boost version of AAPS, but went back to Lyumjev to see if using other areas would make a difference to reactions, as Fiasp seems to be slowing down! I find Lyumjev will work fine for 36 hours and then, sometime over the following 36 hours will become slower than Novorapid! I don't fancy changing cannulas every day and half, so I'll give the mix a go and see what happens with that. I'm usually around 85% in range, but there is a big variation in that due to the sudden site issues! Thanks for the quick response!

No problems - As I mentioned, try a 'new to insulin' site on your body with Lyumjev (I use chest or love handles as somewhere not used). If you get a 3 day good result, thats probably the issue.

Fiasp / Lyumjev should work ok (I started on 50% then dropped to 30% and didn't notice a difference) but its what the Diabetes team call 'Off Book' and aren't very happy about it - its personal risk (but worked fine for me)