Fiasp

[rebrascora]

As long as I am in the low 5's before a meal 4 mins is all I need to pre-bolus if I leave it any longer than it's a def hypo on the cards.
I have found using Fiasp it is very important to have an accurate basal.

Yes, thinking about this, if I had a pump which was set up to deal with my significant FOTF liver dump, I guess my FIasp would not need quite so long on a morning as part of my 45 mins prebolus time is, without doubt, dealing with that tide of glucose from my liver and since I add extra FIasp to my breakfast bolus to deal with FOTF, that is clearly supplementing my Levemir to cope with the "surge in basal needs" at that time of the morning.
Apart from that, my Levemir doses hold me very steady throughout the rest of the day and night and I check them often, so I guess my normal prebolus time of 15-20 mins is what works for me with Fiasp and it is just the inability to tweak my Levemir to cope with FOTF which means I need so much longer on a morning, so it is unfair to "blame" Fiasp for that situation. If Fiasp didn't work quickly my levels would rise quite quickly when I got up but they usually only rise a few decimal points and then hold steady before eventually dropping, so the Fiasp probably isn't taking as long to work as it appears.

 

[nonethewiser]

I found I have to change the site every two days rather than 3 and this does work very well for me.

Is that due to poor absorption after 2 days or site irritation or something, just curious.

 

[Pumper_Sue]

Is that due to poor absorption after 2 days or site irritation or something, just curious.

It's irritation but only when using the angled cannulas' the straight cannula I have no problem with.

 

[EmmaL76]

@MichelleF78 just been having a read through this thread and I honestly know how hard it can be. My diagnosis came a couple of years ago and I’ve been on and off insulin for the whole time, frequently choosing very low carb instead of the constant battle with insulin trying to get it to work in the same way it does for others. That became unsustainable recently as about a month ago I started to be unable to achieve the same results with this diet. so a couple of weeks ago I started on insulin again. First few days seemed to work really well, but since then there is literally no certainty to how it’s going to work for me. I’m also on novorapid, and my long acting seems to do absolutely nothing. I’m pretty sure I have resistance too as for hours in the morning insulin does nothing and I have no more than 10g carbs before lunch! I’m now down to one call a year from a dietician and have little to no support. My mood and energy are at an all time low and nothing I do seems to work. I feel like I’m in no man’s land what works for others just doesn’t for me, people must think I should have this figured out by now, but I simply do not understand how my body works, or apparently doesn’t work.

I’ve just read this through before posting and realised how many times I’ve used the word work… that’s exactly what this is, work! Lots of it! Too much of it. It takes up my whole brain and leaves no room for anything else and I’m sick of it. I wish I could be more uplifting and I’m sure we will both get there @MichelleF78 but in the meantime just wanted you to know that there are people out there that feel exactly the same frustrations and it’s exhausting.

 

[Pumper_Sue]

I’m pretty sure I have resistance too as for hours in the morning insulin does nothing and I have no more than 10g carbs before lunch! I’m now down to one call a year from a dietician and have little to no support. My mood and energy are at an all time low and nothing I do seems to work.

You need to go right back to basics.
Get your basal right is no1 priority . Once that is sorted it will become easier.
You need as much insulin as you need. There is no set amount/standard dose we are all different.
Same with bolus we are all different there is no standard carb ratio many have different carb ratios for each meal.

Take a deep breath and take small steps, Rome wasn't built in a day and I can assure you diabetes certainly wont be.
Use your meter as your guide and work on a day to day bases, having a bad day then tomorrow will be better.

 

[Spathiphyllum]

@MichelleF78 just been having a read through this thread and I honestly know how hard it can be. My diagnosis came a couple of years ago and I’ve been on and off insulin for the whole time, frequently choosing very low carb instead of the constant battle with insulin trying to get it to work in the same way it does for others. That became unsustainable recently as about a month ago I started to be unable to achieve the same results with this diet. so a couple of weeks ago I started on insulin again. First few days seemed to work really well, but since then there is literally no certainty to how it’s going to work for me. I’m also on novorapid, and my long acting seems to do absolutely nothing. I’m pretty sure I have resistance too as for hours in the morning insulin does nothing and I have no more than 10g carbs before lunch! I’m now down to one call a year from a dietician and have little to no support. My mood and energy are at an all time low and nothing I do seems to work. I feel like I’m in no man’s land what works for others just doesn’t for me, people must think I should have this figured out by now, but I simply do not understand how my body works, or apparently doesn’t work.

I’ve just read this through before posting and realised how many times I’ve used the word work… that’s exactly what this is, work! Lots of it! Too much of it. It takes up my whole brain and leaves no room for anything else and I’m sick of it. I wish I could be more uplifting and I’m sure we will both get there @MichelleF78 but in the meantime just wanted you to know that there are people out there that feel exactly the same frustrations and it’s exhausting.

Emma, and Michelle-- total sympathy. It is "work! Lots of it! Too much of it ... and I’m sick of it." And I was only diagnosed 9 months ago ...

For what it's worth:

1) It is disgraceful that we don't get more support. Even just in cold hard financial terms of NHS spending, it's penny-wise, pound-foolish.

There seems to be a problem especially for adults with T1. I gather that paediatric T1 teams have psychologists as part of the team, as standard, and it's generally much easier to get hold of and get advice from their DSNs. Why are adults with T1 often left with so little support? As things are, is it any wonder that over 90% of us never reach the recommended HbA1c target, and that we have much higher rates of depression and anxiety disorders that the general population? Wouldn't it be cheaper to give us better support in the first place? ...

I wish Diabetes UK, and JDRF, would campaign a lot more about this.

2) Remember that stress and anxiety can make a massive difference to your BG and how much insulin you need. When you're stressed and/or anxious, your body releases cortisol; cortisol triggers your liver to release stored glucose (glycogenolysis) or manufacture glucose from scratch (gluconeogenesis) and pump it into your blood; so your BG goes stubbornly high. And of course our livers don't let us know how much glucose they're pumping out! Very rude of them. ; ) We may only be eating 10g carbs for breakfast-- but our liver might be pumping out another 20, and we only find out about that when we see our glucose readings. And of course the irony, the real kick in the teeth, is that stubbornly high BG makes us more stressed and anxious! ...

So-- when you're having problems with high BG, yes of course use more insulin as needed, but also try a range of different things that might reduce your stress/anxiety and see whether any of them work for you-- both in general and in terms of helping to lower BG.

3) Finally, re Fiasp, which is where we started:

I started on Fiasp, then tried Novorapid, then a couple of months ago went back to Fiasp. As others have noted, the stuff about Fiasp being far faster to take effect than NR is nonsense.

But-- like Barbara and Nonethewiser, I like the fact that Fiasp has a shorter profile than NR. I worry a lot about overcorrecting, so I like the fact that, with Fiasp, I can feel safer sooner in administering a correction if necessary.

Anyway-- very best wishes, and God give us all strength. ; )

 

[EmmaL76]

Thanks both, I really do try and get on top of it but life is really getting in the way. I know stress is probably the biggest hurdle for me to overcome, but without this sounding like a one woman pity party it’s out of my control. I have 4 children, one may need brain surgery! One with heart issues one with extreme hyper mobility and one who’s currently under investigation again for autism. Sometimes it’s just too much, I feel like I’ve fallen from the tree of hard knocks and hit every branch on the way down! It’s so hard to prioritise yourself when I’m stretched so thin but I know I have to so that I can be there for others. Ive been on the nhs waiting list for my mental health for almost 2 years now. I’m trying but with so little in the tank the urge to give up can be overwhelming

 

[helli]

As others have noted, the stuff about Fiasp being far faster to take effect than NR is nonsense.

I don't think this is what all of us have said. Myself and @Pumper_Sue mentioned it works fast if our levels are lower.
It definitely does not work faster than NovoRapid for me if my levels are 8 or over but, if my levels are in the 4s, I have to bolus after eating to avoid a hypo. For levels over 10, it feels as if I am injecting water until an hour later when it will suddenly start working.

 

[Spathiphyllum]

... Ive been on the nhs waiting list for my mental health for almost 2 years now. I’m trying but with so little in the tank the urge to give up can be overwhelming

I know I'm very, very lucky: when I heard how long the NHS waiting list to see a real person was, I found someone privately-- and when it became too much for me to afford, she made adjustments, god bless her.

Is there any way you could get in touch with your diabetes team, emphasise to them how hard things are currently, and see whether they could get you bumped up the NHS mental-health waiting list?? ... Or: any of the teams treating your children, do they have any provision for helping parents to get help? (I mean-- one would have thought that paediatric teams for children with e.g. heart problems would have provisions for parents as standard, or at least good signposting ...)

Oops! There goes my Libre alarm-- overcorrected due to sheer frustration. ; )

 

[Spathiphyllum]

I don't think this is what all of us have said. Myself and @Pumper_Sue mentioned it works fast if our levels are lower.
It definitely does not work faster than NovoRapid for me if my levels are 8 or over but, if my levels are in the 4s, I have to bolus after eating to avoid a hypo. For levels over 10, it feels as if I am injecting water until an hour later when it will suddenly start working.

Yes, but I think some others have said that Fiasp in general is not nearly as much faster than NovoRapid as we were originally told.

 

[Pumper_Sue]

Yes, but I think some others have said that Fiasp in general is not nearly as much faster than NovoRapid as we were originally told.

It is as long as your basal is correct. I'm lucky in that I have a pump and I learnt a long time ago to split my dose at 70/30 if in the 4's or low 5's otherwise I split it 80/20 over a 2 hour period.
Fiasp does take a lot of getting used to but you do have to think ahead before injecting it so you get the right result for you.

No1 rule with diabetes though is never expect perfect numbers, if you do you will become very frustrated

 

[Spathiphyllum]

It is as long as your basal is correct. I'm lucky in that I have a pump and I learnt a long time ago to split my dose at 70/30 if in the 4's or low 5's otherwise I split it 80/20 over a 2 hour period.
Fiasp does take a lot of getting used to but you do have to think ahead before injecting it so you get the right result for you.

No1 rule with diabetes though is never expect perfect numbers, if you do you will become very frustrated

Of course I don't "expect perfect numbers". I do however try to minimise my risk of eventually going blind and getting my feet chopped off. ; )

 

[everydayupsanddowns]

It’s odd the things some clinics say isn’t it.

When I switched to a pump I was using Humalog (my experience was very similar in action time to NR, but just more of a sting in the tail).

They switched me back to NR because they said Humalog can crystallise in pump tubing - though I know some members here who pump with Humalog no problem at all.

I tried Fiasp and didn’t get on with it. I didn’t find it as reliable in action as NR for me, my sites got sore, and the initial ‘rapid action’ stopped working after about a month, so it was only as (un)quick as NR at that stage anyway!

 

[JohnnyRam]

Thanks both, I really do try and get on top of it but life is really getting in the way. I know stress is probably the biggest hurdle for me to overcome, but without this sounding like a one woman pity party it’s out of my control. I have 4 children, one may need brain surgery! One with heart issues one with extreme hyper mobility and one who’s currently under investigation again for autism. Sometimes it’s just too much, I feel like I’ve fallen from the tree of hard knocks and hit every branch on the way down! It’s so hard to prioritise yourself when I’m stretched so thin but I know I have to so that I can be there for others. Ive been on the nhs waiting list for my mental health for almost 2 years now. I’m trying but with so little in the tank the urge to give up can be overwhelming

Sad to read this @EmmaL76. I was just thinking a couple of days ago how utterly fed up I sometimes feel having developed diabetes seemingly randomly and out of the blue and how life-changing in a not-good way it all has been, especially coming some 20 years after becoming asthmatic and managing that. But what you are coping with is incredible, it is no wonder you feel the way you do. I hope you have some support around you with family and friends and are able to draw some strength from that. All best wishes.

 

[helli]

@JohnnyRam why do you think your diagnosis is life changing?
I understand it is challenging for young children - they probably feel their freedom to run around and eat sweets is being curtailed. However, being diagnosed as an adult, I was told diabetes should not stop me doing what I want. Nearly twenty years later and I still feel the same. It has taken some mistakes and a bit more planning but it has never stopped me travelling (including to some unusual places), exercising (including some extreme sports), having a (sometimes stressful but rewarding) career, having a loving relationship and eating what I want.

If you feel diabetes is life changing in a not good way, you may benefit form some mental health support. Feeling that way will not help with managing your diabetes and your full body health.

 

[JohnnyRam]

Mostly I am fine, and I have probably given too negative an impression with the turn of phrase - and I too have not let it stop me in my tracks - but there have been times where the relentlessness of it has made me feel quite down, especially in the early days when it took some time to manage it reasonably well. Less so now, but post my diagnosis before Christmas I felt confused and anxious about it all.

 

[Spathiphyllum]

@JohnnyRam why do you think your diagnosis is life changing?
I understand it is challenging for young children - they probably feel their freedom to run around and eat sweets is being curtailed. However, being diagnosed as an adult, I was told diabetes should not stop me doing what I want. Nearly twenty years later and I still feel the same. It has taken some mistakes and a bit more planning but it has never stopped me travelling (including to some unusual places), exercising (including some extreme sports), having a (sometimes stressful but rewarding) career, having a loving relationship and eating what I want.

If you feel diabetes is life changing in a not good way, you may benefit form some mental health support. Feeling that way will not help with managing your diabetes and your full body health.

Of course being diagnosed with T1D is life-changing and "in a not good way"! Pretending otherwise is absurd and harmful.

Equally of course T1D need not stop us from e.g. travelling, exercising, careers, etc. But life with T1D is much harder than life without it. Recognising this undeniable fact does not in itself mean one needs "mental health support". It just means one is being honest, with oneself and other people; and that is essential for mental health.

 

[helli]

Of course being diagnosed with T1D is life-changing and "in a not good way"! Pretending otherwise is absurd and harmful.

I did not mean to offend but explained how I feel.

Why is not changing my life (apart from planning ahead) and managing my diabetes such that I have no complications after 20 years harmful?

 

[JohnnyRam]

Of course being diagnosed with T1D is life-changing and "in a not good way"! Pretending otherwise is absurd and harmful.

Equally of course T1D need not stop us from e.g. travelling, exercising, careers, etc. But life with T1D is much harder than life without it. Recognising this undeniable fact does not in itself mean one needs "mental health support". It just means one is being honest, with oneself and other people; and that is essential for mental health.

Thanks @Spathiphyllum, you've captured what I was trying to say much more effectively than I did. I meant life-changing in the sense that it has changed my life in an unexpected way, rather than prevents me from doing things I want to do. In fact, I think that like @helli I am probably more determined to keep doing the things I want to do in spite of the diagnosis - I'm sure that is true of many who use this forum.

 

[Spathiphyllum]

I did not mean to offend but explained how I feel.

Why is not changing my life (apart from planning ahead) and managing my diabetes such that I have no complications after 20 years harmful?

Denying that T1D is life-changing and not in a good way is harmful to other people. It can give them the impression that there is something wrong with them when there isn't-- when the feelings they are having are absolutely normal and rational. And it can encourage them not to talk about how they really feel, and that is harmful.

Helli, you may never have felt completely fed up and overwhelmed by the relentlessness of the demands of T1D, in which case congratulations!

But as far as I can tell (and as research indicates) most people with T1D do from time to time feel utterly fed up and overwhelmed by it, and not only soon after diagnosis.

If those feelings get very severe and/or last very long, that's when people need mental health support. Otherwise, the most helpful thing is just to let people know that this is normal and that we empathise.