Post fiasp resistance.

[Vamppir8]

12 weeks back on novorapid and pleased to say almost back to normal.

Fiasp breakfast 5 to 10
Lunch 3 to 10
Tea 2 to 10

Novorapid breakfast 2 to 10 (including foot on floor)
Lunch and tea 1 to 10.

Was scary time, nhs useless, thought I had copped it, but relax, chill, it does come back eventually. Wish I had never bothered. Nhs denied there was a problem, half an hour google, its a big problem. Only went on it because spike in morning, foot on floor, sorted with 2 glasses of water the minute you wake, down it goes. Jabbing 34 units for breakfast 70gms was scary, where does it stop?

 

[helli]

@Vamppir8 can you explain this a bit more?
What is post Fiasp resistance?
I have been using Fiasp for the last 3 years. It was certainly challenging when I started but I think I have worked it out now.
However, if there is a potential problem with it, I would like to know what I am looking out for.

 

[Robin]

@Vamppir8 can you explain this a bit more?
What is post Fiasp resistance?
I have been using Fiasp for the last 3 years. It was certainly challenging when I started but I think I have worked it out now.
However, if there is a potential problem with it, I would like to know what I am looking out for.

I read when Fiasp first came out, that some people suffered from insulin resistance after they’d been on it a few weeks, it’s something to do with the Vitamin B3 used in the formulation of it. As I’m not using it, I’m afraid I didn’t take in the detail, but just noted it in passing.
There's an interesting article on it here.

Further Fiasp insight | Diabettech - Diabetes and Technology

Reduced insulin sensitivity and more insulin needed. A hypothesis on the changes with Fiasp.

www.diabettech.com

 

[Vamppir8]

Became resistant overnight after about 6 months. Feb 8th, breakfast 7 units, 9th, 34 units! Changed pens, changed batches, told to keep going.... googled it "like injecting water" is a common quote. Consultant, you cannot become resistant overnight, nurse you can become resistant overnight... switched back to novorapid no better in short term, but over the weeks needed less and less. Almost back to normal. My new diabetes nurse admitted she has a few in her 100 patient care having same problem.

 

[helli]

Interesting.
I find it is like injecting water if my levels are high. But I don’t experience anything long term.
In contrast, I can hypo in 5 minutes if I bolus with Fiasp when my levels are in the 4s.

 

[counsellorneil]

Interesting.
I find it is like injecting water if my levels are high. But I don’t experience anything long term.
In contrast, I can hypo in 5 minutes if I bolus with Fiasp when my levels are in the 4s.

I find this too. When my glucose level is between 5 - 9, Fiasp seems to respond/react quickly. When 10 or higher it can take a lot before it starts to do anything. But overall it works well for me.

 

[Lucyr]

Became resistant overnight after about 6 months. Feb 8th, breakfast 7 units, 9th, 34 units!

Why did you increase your dose so much in one day. It’s best advised to adjust your dose gradually, taking too much insulin is really dangerous, so would have been better to increase by 0.5-1.0u at a time, you could accidentally kill yourself if you’re making adjustments like 7u one day 34 the next for the same meal.

 

[Amity Island]

I read when Fiasp first came out, that some people suffered from insulin resistance after they’d been on it a few weeks, it’s something to do with the Vitamin B3 used in the formulation of it. As I’m not using it, I’m afraid I didn’t take in the detail, but just noted it in passing.
There's an interesting article on it here.

Further Fiasp insight | Diabettech - Diabetes and Technology

Reduced insulin sensitivity and more insulin needed. A hypothesis on the changes with Fiasp.

www.diabettech.com

As I understand it -- I was offered it but declined after some cursory research a few years ago - turned out the B3 is added to speed up absorption, but it fails to have any effect after a very short time. So pleased I didn't accept this wonderful advancement in insulin.

 

[everydayupsanddowns]

I read when Fiasp first came out, that some people suffered from insulin resistance after they’d been on it a few weeks, it’s something to do with the Vitamin B3 used in the formulation of it. As I’m not using it, I’m afraid I didn’t take in the detail, but just noted it in passing.
There's an interesting article on it here.

Further Fiasp insight | Diabettech - Diabetes and Technology

Reduced insulin sensitivity and more insulin needed. A hypothesis on the changes with Fiasp.

www.diabettech.com

I had some experience of this when I tried Fiasp. I seemed to need to ramp up the doses as the weeks went on, and then sometimes they would work and sometimes they wouldn’t. At the same time it’s rapid action had more or less evaporated and the sting/itch at infusion sites was making it pretty uncomfy to use as well as unreliable, and no quicker than NR.

I was more than happy to swap back to NovoNotVeryRapid. Which is pretty sluggish, but at least I have workarounds.

I think @Pumper_Sue has found that changing sites every 2 days really helps.

I’m glad it works brilliantly for lots of people, but i’m not in a hurry to try again 😛

 

[nonethewiser]

I find this too. When my glucose level is between 5 - 9, Fiasp seems to respond/react quickly. When 10 or higher it can take a lot before it starts to do anything. But overall it works well for me.

That's no different to novorapid, used it before fiasp & it was less effective in double figures - so required more than when bg is in single figures.

Been using fiasp for last 3 years maybe 4 now, like it as find it works slightly faster & doesn't hang around to long unlike novo..

 

[rebrascora]

I definitely found the transition to Fiasp challenging as it took me 2 trials of 3 months with a year in between to get to grips with it) and I definitely use more Fiasp than I did with Novo(not so)Rapid, but it is a stable situation ie not getting worse and I don't feel that it is related to resistance but just the "action" of the insulin. I say this because, like @helli it works quickly when my BG levels are low but much slower when my levels get above 8 and above 10 I can be waiting longer than NR and need much more than I would NR. If I can keep my levels under 8 most of the time I get on well with it but I have to be very proactive about corrections and I will sometimes inject a correction below 8.
My high alarm is set at 9.2 and if my levels continue to rise after a correction, I will inject another stacked correction within half an hour and it is not unknown for me to inject 3 small stacked corrections even with levels below 10 to keep a lid on things. Without Libre or other CGM I don't think I would manage very well with Fiasp but if I can actively keep on top of my management and keep under 8 with regular scans and corrections as needed it works better for me than NR but I still think I need more of it and if I went back to NR now, I would probably hypo quite a lot re transitioning from the strategies I now use with Fiasp.
It may look like resistance because I need more of it than I would with NR, but I am not so sure that is a reasonable conclusion. Maybe the additives to make it faster, chemically react with the insulin at higher BG levels to block it. To me insulin resistance is a change within my body and it's responsiveness whereas I think this is a change in the insulin's effectiveness, not a change in my body. Not sure if that makes sense. I don't feel that Fiasp is changing my body, it just works differently itself.
I will also add that whilst I don't love Fiasp (like I do Levemir), it is better for me than NR, now that I have learned how to make it work for me, but it has taken a long time to build up that experience to make it work and I have to be very confident (maybe overly confident) to the point of being heavy handed sometimes to get good results.

I am curious to know if the mechanism of other "fast" insulins like Lyumjev is the same as Fiasp ie. the Vitamin B3 additive. I would be extremely reluctant to change again now that I have strategies with Fiasp which work for me.

I find it interesting that the OP ditched it after 12 weeks as that was my breaking point (total frustration 😱 ) when I first trialed it and I would have thrown in the towel after the same period of the second trial if I had not committed myself to giving it a full year the second time. It was about 16 weeks when I suddenly seemed to make progress with it.