FIASP for Insulin Pumps

#242

Time to get a better informed endo?

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#243

I have been using Fiasp in my 670G since late November. I have reduced my A1c from 7.8 to 7.2. Not sure if it was the Fiasp or my 670G getting to know me better. Probably a combination of the two.

In any case, My Endo called me last night to congratulate me on the improvement.

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#244

No kidding. The only issue is that endos are few and far between around here, and I already drive 1 hour to see this one. My experience is that most endos are also kinda rude and hard to get along with. I also am not feeling like I get much benefit from going to an endo.

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#245

Try and find an Endo that is a diabetic as well. That has made a WORLD of difference for me! I drive almost an hour to see her, and I don’t care. She is worth it a thousand times over!

#246

Are you sure about that?

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#247

You have my sympathy. I hope I"m more fortunate when I move back to Ohio and become captive to an endo in the Medical Center at Wright-Patterson AFB.

I had mixed results with Internal Medicine docs when I was still misdiagnosed as T2. The IM docs would see T2 patients, but T1s had to see an Endo. IM docs seem to have at least a little training for diabetes.

#248

Two hours for us assuming no traffic. Well worth it.

#249

As an update, I’m no longer having trouble getting FIASP through Medicare Part B for my pump. I still have to fill my Tandem t:Flex with only 300 units instead of the full load of 480.

Using the DexCom G5, and doing a whole lot of analysis, I’m seeing that my insulin duration is at least 5 hours and the lag between bolus and the effect from it is about 1:15. Novolog had a lag of about 2 hours. I’m not sure about the Novolog duration.

As a side note, my endo was shocked and pretty disapproving about a duration of 5 hours. He says that 3-1/2 hours is more typical of his patients.

I’m hoping to get an Apple Watch soon to see my DexCom numbers, but have a significant and growing number of health problems (cancer & coronary atery disease) to keep my mind busy instead of my diabetes analysis.

#250

Rob, which company or pharmacy do you use for your insulin?

#251

I’m using Walgreens. They always have to order the FIASP but it always arrives the next day. Getting them to properly run it through Medicare Part B instead of Part D is usually a challenge adding an extra day to the process. So I have to make sure I don’t go there on a weekend.

#252

I Bolus for breakfast at about 9:00 am using Fiasp. My normal pattern is that I spike up to approx 175 around 11:30 am and then slowly go down until I get a low alarm (70) around 4:00 pm. I then snack on low fat Dannen Greek yogurt (6 gr. Of carbs) which returns me to 80 by 5:15

Not sure if it’s the duration of Fiasp or the basal rate on my pump which results in the low. In any case, I enjoy eating the yogurt so it’s not an issue for me.

#253

how many carbs, and how long before eating do you prebolus?

#254

That is odd that they would be disapproving of a shorter duration. A shorter duration gives easier control as you have less stacking of insulin on board. Your basal rate takes care of baseline requirements, and if you need to have the bolus cover a longer period of time for some foods you can do an extended bolus.

#255

Rob,

I’m two years from Medicare. Is any type of advance paperwork or pre-approval required for insulin for a pump to be billed to Part B? Or is it as simple as having my endo write insulin for insulin pump and getting the pharmacy to bill correctly?

#256

Well. Things have been going well for the most part with Fiasp, but I have noticed I have much higher occurrences of bleeding infusion sites. Sometimes they start bleeding or leaking minutes after insertion. I am not sure what the cause is though. I experience much less site irritation and have better absorption for longer than Humalog, so I really want this to work out.

Anyone had the infusion site bleeding/leaking issues?

#257

I only purchased my first vial of FiASP a week ago and so far no problems with pumping it or infusion sites. Changing sites every 3rd day as I did with Humalog, I use 90 degree steel cannulas with no bleeding.

Onset is amazingly fast (15 minutes tops). This compares to up to 120 minutes for Humalog.

Duration is likely a slightly longer tail than Humalog, however it seems shorter (3 hrs) as 90-95% of the glucose lowering punch is gone after 3 hrs (hope that makes sense).

Using more insulin however it’s far easier for me to control spikes after protein / fat meals (I’m virtually carb free so that’s not been an issue).

According to Sugarmate app, my estimated A1C over past 7 days is 4.2 mmol/L (76 mg/dl) with a Std Deviation of 1.0 mmol/L (18 mg/dl).

I give FiASP a gold star :star2:

#258

It seems that most people have an initial BIG improvement, then it settles down some.
I know when I first started, the response was phenomenal! After a while it wasn’t as pronounced, but still FAR better than anything else for me.
The VA still doesn’t provide Fiasp, so I am still buying it from Canada out of pocket.

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#259

This has been my experience. I’ve actually been switching back and forth now between FIASP And Novolog just to see how they’re different overall. Biggest overall difference for me has been, I will crash alot quicker and harder with FIASP even when I temp basal for exercise.

#260

all of this is shocking to me because I started on the pump about 8 months ago, did alot of research about which insulin is most reactive, especially for athletes, and have used FIASP since I got my pump. I have had no issues at all, although now I’m starting to wonder if I could improve on consistency. But since I didn’t have any other pump experiences, the FIASP seems fine to me. I went on the pump because Novolog and Tresiba caused fat pocket/storage (totally better with FIASP, no question). The only thing that I think was difficult to understand was that FIASP is not what you would expect as “fast acting;” in other words it takes about an hour to fully take affect.

#261

Yes. Similar here.

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