Fiasp - Faster Insulin Aspart - some first impressions

[tim2000s]

Hi Everyone, I managed to get my hands on Fiasp on Friday and have been trying it out over the last few days. I'm reasonably impressed with what I've seen so far.

On Friday, I gave it a 10 minute pre-bolus trial on a Krispy Kreme donut, and the result was below. For comparison sake, with NovoRapid, I need a 30-40 minute pre-bolus to see similar effects.

I've also undertaken a few "Time to action" tests to see what my ISF looks like with it. So far, on repeat testing, I've seen the below effect, which suggests that 1u is starting to act in accordance with the guidance from Novo, and that due to the early higher absorption rate, although the tail is the same length, the amount of insulin available for the tail is lower so it doesn't have as much of an effect:

There are more details here but so far I'm suitably impressed with the performance I've seen. It does take effect more quickly and the post-prandial rises have been lower than they would have been with NovoRapid at the same timing.

It's not Afrezza, in that it doesn't have an instant hit, but it is noticeably better than NovoRapid for when you are late bolusing.

 

[Northerner]

Sounds really good Tim, thanks for this, I wasn't aware of it. One of the most difficult things to grasp about insulin can be the variable amount of time it takes to peak and tail off, this sounds like it might make things much more predictable 🙂

 

[Matt Cycle]

Interesting stuff. Thanks for the update Tim. I could take issue with Novo over the naming of Actrapid 30 years ago. It was anything but. 😉

 

[Bloden]

That's really interesting. Why the nearly-unpronounceable name tho?!

 

[Amberzak]

I'm going to ask my doctor if I can go on to this. My number one problem is post meal times. I inject after I have eaten (because I'm not always sure how much I want to eat, and I tended to bolus too much when I injected before).

I have a very understanding doctor. And I saw this is available in the U.K. now. So making appointment with her next week.

 

[trophywench]

Interesting stuff. Thanks for the update Tim. I could take issue with Novo over the naming of Actrapid 30 years ago. It was anything but. 😉

Aaah - but it always worked brilliant for me on a sliding scale when I needed one - and it was a LOT more rapid than anything else on the market at the time (hence why it was always used in hospital in scales) - so I don't think I could ever diss it !

 

[m1dnc]

I'm due for a pump clinic review in two weeks and I'm going to see if I can switch. Novorapid is much too slow for me too.

 

[Michael Jones]

Hi all I've just been prescribe Fiasp will let you all know how it goes
Mike T1 since 2001 pumping since 2012 which I love and would never go back

 

[mikeyB]

This could be a godsend to me. Apart from the difficulty I have with variable absorption of Humalog, and the variable absorption of nutrients with the Creon for the pancreatitis. I might be able to get this D much better controlled without the need for a pump.

 

[trophywench]

Oooh Michael - please let us know how it behaves for you in your pump, once you're up and running - I have a friend or two pumping Apidra (as the previous fasting acting one) who have certain problems, so we'll all be interested.

I'm a great fan of Novo Nordisk myself - using Novorapid for donkeys years and also Levemir (which I found utterly brill, as far as MDI could go) whilst I was still on MDI.

 

[Amberzak]

My clinic won't let me go on to it until they've done tests on account of the fact that it's not been tested in a pump yet as far as they are concerned. But the person I saw is rather cautious. I've an appointment with the nurse in July and I'm planning on taking lots of evidence of how it will be good for me, etc.

One issue they said is that because it's far quicker acting, they weren't sure how long it'll be safe to be off the pump for. With novorapid it's about an hour. But as I said to them, the most i will leave the pump off for me is half an hour. So that won't be a problem for me.

For me, it's about the fact that I inject after I've eaten. I always go really high. But it's what I need to do because I'm so changeable in how much I want to eat etc.

 

[everydayupsanddowns]

I'm seeing my GP tomorrow to see if I can swap.

Ironically I've not had massive problems with NovoSluggish in recent months, but I know that at different times it really struggles to keep up for me.

 

[m1dnc]

My clinic won't let me go on to it until they've done tests on account of the fact that it's not been tested in a pump yet as far as they are concerned. But the person I saw is rather cautious. I've an appointment with the nurse in July and I'm planning on taking lots of evidence of how it will be good for me, etc.

One issue they said is that because it's far quicker acting, they weren't sure how long it'll be safe to be off the pump for. With novorapid it's about an hour. But as I said to them, the most i will leave the pump off for me is half an hour. So that won't be a problem for me.

For me, it's about the fact that I inject after I've eaten. I always go really high. But it's what I need to do because I'm so changeable in how much I want to eat etc.

Odd. The first thing I checked was whether it was approved for pump use, and it is. So it must have been properly tested. I also checked the price (as that might inhibit a Dr writing a scrip for it) and it is the same price as Novorapid.

 

[Amberzak]

Odd. The first thing I checked was whether it was approved for pump use, and it is. So it must have been properly tested. I also checked the price (as that might inhibit a Dr writing a scrip for it) and it is the same price as Novorapid.

I think I might just go straight to my gp and ask them to change it.

 

[trophywench]

Hee hee Amberzak - I said I'd discussed it with a DSN when I asked to change insulin the once. Well I had - but we hadn't at that stage reached a decision if you know what I mean. And she wasn't actually my DSN - I'd happened to meet her at a local 'Healthwatch' meeting LOL Not even at my hospital ! So if he asks who's suggested it, just say in a slightly surprised voice Oh - we were discussing it at my last hospital appointment and I'd like to try it ! and don't offer any more - the unspoken bit being 'so I assumed because of that, you'd fall over backwards to make the change for me, immediately' LOL

 

[Amberzak]

Hee hee Amberzak - I said I'd discussed it with a DSN when I asked to change insulin the once. Well I had - but we hadn't at that stage reached a decision if you know what I mean. And she wasn't actually my DSN - I'd happened to meet her at a local 'Healthwatch' meeting LOL Not even at my hospital ! So if he asks who's suggested it, just say in a slightly surprised voice Oh - we were discussing it at my last hospital appointment and I'd like to try it ! and don't offer any more - the unspoken bit being 'so I assumed because of that, you'd fall over backwards to make the change for me, immediately' LOL

Love it. 🙂

 

[Pumper_Sue]

I have just read this report by Tim http://www.diabettech.com/faster-insulin/new-kid-on-the-block/ do read it carefully before you jump ship.

 

[trophywench]

I have just read this report by Tim http://www.diabettech.com/faster-insulin/new-kid-on-the-block/ do read it carefully before you jump ship.

Thanks Sue - seriously @Amberzak - I'd wait and see if I were you rather than as Sue says 'jumping ship'.

Wonder if Tim's got anything further to say after another couple of months?

 

[Robin]

Yes, thank you Sue. I am considering it, but I think I'll wait a bit and see how more people get on.

 

[Phil65]

Hi Everyone, I managed to get my hands on Fiasp on Friday and have been trying it out over the last few days. I'm reasonably impressed with what I've seen so far.

On Friday, I gave it a 10 minute pre-bolus trial on a Krispy Kreme donut, and the result was below. For comparison sake, with NovoRapid, I need a 30-40 minute pre-bolus to see similar effects.

I've also undertaken a few "Time to action" tests to see what my ISF looks like with it. So far, on repeat testing, I've seen the below effect, which suggests that 1u is starting to act in accordance with the guidance from Novo, and that due to the early higher absorption rate, although the tail is the same length, the amount of insulin available for the tail is lower so it doesn't have as much of an effect:

There are more details here but so far I'm suitably impressed with the performance I've seen. It does take effect more quickly and the post-prandial rises have been lower than they would have been with NovoRapid at the same timing.

It's not Afrezza, in that it doesn't have an instant hit, but it is noticeably better than NovoRapid for when you are late bolusing.

Any updates on your FIASP experience?