Fiasp and Tandem Pumps

Has anyone used Fiasp and Tandem pumps? Apidra started clogging up my sets a month ago after 3 plus months of no issues.

Been using fiasp in my x2 pump for about 4months now I think. Been great. I will get issues if I try and run it past the 3 day mark though.

Thank you. I have used Apidra for maybe 10 years. Used in my Medtronic without issues but I did always have to watch for issues after 2 1/2 days but that has been true for all insulins. I am left with the conclusion that the structure of Apidra is changing and causing clogs all along the tubing as I see diminished amount of insulin flow at the connector point. The main hub point to the cartridge is harder to assess. Why after 3 plus months it started??? Maybe different cartridge and tubing materials, maybe the pump is running hotter all the time as the battery ages??? No idea. So fingers crossed that the Fiasp will go for at least 2 1/2 days.

I have ran fiasp for 4.5 days a couple times.
But the rest of the time I get occlusions around 3.5 days.
I think I have had one time where I was within my 3 day mark and had an issue.
I need to go back to my 3 days ‘on the dot’ timing. I didn’t have any issues with fiasp that way. I just try and get the most out of it when I am paying out of pocket for fiasp.

According to my endo the actual insulin in Fiasp is the same molecule as Apidra. With the added bits in Fiasp maybe it allows it to last longer, but is still prone to occlusions. I tried Apidra and didn’t make it more than a day before my tubing and cartridge were clogged.

Odd timing on this coming up.
This weekend I had pushed my last set to a little over 4 days. I ran my cartridge until empty.
When I was changing it out, I decided to have the pump push out what was left (if you leave the old cartridge in, even empty, it will let you fill the lines.)
When I did this, I removed the long line and only had the 2" line with the connection.
It pushed out a ‘clump’. That is about as good as I can describe it. It was clear, and I didn’t see anything color wise. Just a gel looking substance instead of liquid.
Guess I was fine for sensitivity, it was just NOT WORKING!

I hope my experience will be like yours. I am using fiasp in my medtronic 630 with no issues. I am hoping that will be my case. I really need a mealtime insulin that will help with my spikes after meals. I won’t get the pump until Monday June 22. On the 26th is my training date.

I just tried my first Fiasp in t:slim pump recently. Pump occlusion occurred around 56 hours after use in the early morning. Waked up and changed the steel infusion set and tubing, but the pump couldn’t finish tube filling. Trashed the cartridge and replaced with a new cartridge filled in with Novolog to Fiasp in 20:80 ratio. So far, it works after 3 days. During the filling, notice that Fiasp filling time is less than Novolog, i.e. the insulin may be less viscous with the additives, including more diluent to dissolve additives (B13, etc.). It may be due to the “waste” heat generated in pumping could not be dissipated quickly, resulting in diluent vapor blocking in the pump suction and the pump shutoff. The additives remain in the insulin with less diluent become gel-like substance. BTW, I keep pump in a belt while sleeping. This may also prohibit the dissipation of pump waste heat.

The tslim didn’t work for me as I have basal rates less than the tslim’s lowest basal rate. I am using medtronic’s 770g with automode. I really like it. No more having to skip meals and test basal rates as automode shoots for a 6.7mmol. Sensitivity is also figured out for you. All I have control of is my carb ratio and active insulin time. I have been anticipating the 780. When it becomes available in Canada it will be a free software update through the pump. The zeus sensor is also supposed to make an appearance. Can’t wait!!!:grinning_face_with_smiling_eyes:

Competition is the only thing that keeps us moving forward.
Without it we would still be using sof sensors that were really just random number generators.

I think the real future of cgm is in non invasive cgm that are being developed

So I actually switched endos not too long after this comment because the one I was seeing was not the most helpful (though after my new one moved to another practice to do something else I just go to my primary care as I really don’t need an endo). When I was between endos I had my primary care doc prescribe me Fiasp to try. I have had zero issues with it.

It is interesting to me that this happened. I have never had one occlusion that was directly related to the insulin, only ones related to failing pump sites (actual skin stops absorbing). I’ve been using Fiasp about 2 - 2.5 years now at least.

Fiasp pamphlet shows that insulin degrades after exposing to temperature exceeding 37C(98.6F), which is the same as Novolog. My body temperature is around 98F+/-0.5F. I wear a belt while sleeping with tandem pump inside. Using Novolog, I don’t have any pump occlusion issue. However, Fiasp degrades after 2 nights, resulted in no flow from pump. It may be due to my body heat and pump waste heat accumulated around the pump during sleeping, which is the cause of insulin degradation. If the tandem pump is placed in my pajama cloth pocket outside blanket during sleeping, it lasts more than three days without pump flow being blocked. However, I feel that the strength of Fiasp is decreased after day 3. It would be interesting to know how you carry the tandem pump during day and night, how often do you change cartridge and infusion site. Do you avoid pump be exposed to sunlight, etc.?

I got Fiasp for my latest insulin prescription. I used the 80%Fiasp/20%Novolog ratio. I never had any occlusions but noticed a definite degradation after 3 days in the pump. Or at least I thought I noticed that since it is hard to narrow down all of the variables affecting BG. I don’t think that Fiasp made a huge improvement in Control IQ so I will happily return to Novolog. I normally use my cartridges for 5 days and have no interest in starting to change out insulin every 2 days with no discernible improvement in my BG. That being said I do think that injections by syringe with Fiasp definitely work faster than with Novolog. So if I want to correct a high BG or want to eat cookies and ice cream, I’ll use Fiasp. I look forward to trying Lyumjev someday to see if it works better in my Tandem pump than Fiasp. But I’ve heard it burns and I certainly don’t need that.

1 Like

I carry my pump in my pocket generally, and at night is is either clipped to underwear or to an elastic belt I use when sleeping naked. I do keep the pump out of direct sunlight for the most part too.

I can usually only barely get a site to last the 3 days, and that is with any insulin. Usually by mid to late day on the 3rd day the sites start leaking or just not working. On very rare occasions I can get a 4th day in.