Different Sites used with Fiasp in Pumps

I’ve had t1d for almost 10 years, been various pumps for 9 years. Right now I am on the x2 and just started Fiasp about 2 weeks ago in the pump. I’ve found amazing results but after 48 hrs my numbers spike at night and are consistently in the 200s after 2 days of a site change. From what I’ve read others have experienced this too-- but I was wondering if people have found different sites working better with Fiasp? I am using the Autosoft 90 right now with tslim supplies, a 90-degree cannula insertion but have used 30-degree insertions before too. Has anyone found fewer site failures using different infusion sets? Thanks!

Hi @Leah1 and welcome to the site.

Any number of us pump with FiASP and it’s interesting to read all the different remarks. Some have no problems, some feel a slight burning at site when infusing, some - like you - have sites that go bad after a 1 or 2 days. There are others who encounter cannula occlusions, and some even develop lumps (similar to but not necessarily lipohypertrophy).

Perhaps many of us at some point have some type of allergic reaction to FiASP?

For me, many of the above happened early in the 3 or 4 months I’ve pumped FiASP, but I now have absolutely no ill effects or early occlusions with it.

I do change infusion sites every 72 hours like clockwork (helps eliminate any longer term scarring). I continue to use the Contact Detach 90 6mm steel sets.

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I did not have any luck with 30 degree sets past 2 days.
Same with 90 sets that were 6mm.
With 90 degree 9mm sets, I run the 3 to 4 days without issues.

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I use Contact-Detach sets with Fiasp, and I’m 99% sure that the package insert says to change these sets every 24-48 hours rather than 72 hours, although most people I read about who use them seem to change them at 72 hours like plastic sets. I wear mine for a maximum of 48 hours when I can (I often have to change at 12-24 hours due to reactions). However, I do reuse the sets when I can, so that reduces the speed at which I go through them.

I use less insulin than most people, hence my infusion sites usually don’t fail due to overuse (20-24 Units TDD). I’ve never read the package insert, nor am I inclined to change my ways :stuck_out_tongue:

@Jen I needed to open an new box of Contact-Detach sets today and took a moment to read the insert. Sure enough it did say “change you sets every 24-48 hours, or as recommended by your doctor”.

It also says do not reuse infusion sets as the risk of site infection is high.

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I had similar problems but it was correlated with how much Fiasp was left in the X2 cartridge. When it fell to 50 units, sometimes as low as 20 units, the Fiasp seemed to stop working. Any size correction or mealtime bolus did nothing.
A Tandem TS rep couldn’t offer any concrete suggestions because the X2 is only qualified for use with Novolog or Humalog. But she did say other people were reporting issues.

I finally got things working for me by making an 80/20 Fiasp/Humalog mixture. Recently I ordered Humalog diluent from Lilly and prepared the mixture using it in place of Humalog so only one type of insulin was in the cartridge. That’s also working well.

But as @Jim_in_Calgary said, the issues reported here about Fiasp in the X2 run the gambit from ‘no problem at all’ to ‘I’ve given up’.

Right now, Fiasp isn’t approved for pump use (any pump), but Novo has an application in with the FDA for approval (supposedly right around the corner). If approved maybe that will shed some light on the issues and offer remedies by way of product use guidance.

Lilly supposedly has a fast-acting insulin in the approval process at the FDA. I’m anxious to see the specs on it, and if it’s approved, trying it.

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Since I use alcohol before inserting any site, I figure any risk of infection is fairly low. At most I might be transferring bacteria from one place to another. Also, since I’m only leaving sets in for one or two days, I don’t think it’s as high as if I were leaving them in for a week. I often have to change sets after only 12-24 hours, so I wouldn’t have enough sets to use unless I paid extra out of pocket on top of what the government covers if I didn’t reuse them (I’d need them prescribed for more than once a day!). :slight_smile: