FIASP for Insulin Pumps


#142

Where were you able to buy it without a Rx?


#143

All insulins can be purchased over the counter in Canada.


#144

I bought at a 24 hour Shoppers Drug Mart. FIASP was a special order needing about 3 days advance notice to bring in from central stock, which was easily arranged via email. And the pharmacy alerted their personnel of the special order so the evening person knew exactly where the order was.


#145

I had seen one online pharmacy in Canada that shipped to the US, but they required an Rx. I didn’t look that hard to find one that didn’t, but maybe I should. I would love to try it.


#146

Online might be a different story, the online pharmacies I’ve seen that sell to Americans sell at higher prices than we pay over the counter here and probably have stricter rules. If you go to www.diabetesexpress.ca you can at least see what we pay for insulin to determine if you’re getting gouged by the other online pharmacies or not. I don’t think they will ship outside of Canada though.


#147

I crossed over into Ontario and picked mine up in person and so didn’t need an Rx.


#148

For you that have been on FIASP for a while, are you starting to notice any change in how long it takes to work? I ask, because I remember when I first went on Humalog (mid-90’s, if I recall correctly, still on MDI – I’d been waiting for faster-acting to come out before I started pumping), I was amazed at how quickly it worked. I could bolus for a bowl of cheerios and milk (imagine eating such a high carb breakfast!) and not have much of a spike, at least none caught with non-continuous monitoring .

Within probably a year, the speed that the Humalog worked had been much reduced, and changing to Novolog worked about the same. It being still pre-CGM, I didn’t have a really good idea of the tail, but I certainly have something of a tail at 6-7 hours after a large bolus, maybe longer, sometimes. (I still use a 4 hours on my MM530, because that gives me an appropriate estimate for most of my boluses, with their formula, just try to remember and adapt if I’ve taken a large bolus). Apidra worked slightly quicker, at first, and I did use it to bring down highs for a while, by injection, while still pumping with Humalog.

I’ve been on insulin over 63 years, and did, about 20 years ago, have what were diagnosed as allergic reactions to it, for awhile – perhaps this tendency is involved in the above reaction. But, I wondered if others had once reacted this way to Humalog and Novolog, and whether those people will find the same reaction with Fiasp eventually. Or, not <gr.>, I hope.


#149

Ah OK makes sense. I thought people were talking about the online places. I do know that they will ship it, but I think you have to have a prescription to have it shipped so that the US government doesn’t get mad, and so the pharmaceutical companies don’t get mad because you cheap butt is trying to cut into their profits.


#150

I’ve been on FIASP now for a month on my 670g and still love it. I did two previous week long trials. Last week I was ‘in range’ at 90% of the time, I was usually around 78-%80 on Humolog and Novolog. I’ve also dedicated 30-45 minutes a day the last month to cardio, and using temp target 30-45 minutes in advance of workout. I’ve also been more conscious of carb choices, basic common sense stuff. Anyhow I really like this insulin so far, it’s not perfect and some days are confusing as heck, but overall I’m satisfied!


#151

I have taken an injection of Novolog for a meal and then let auto mode (using FIASP) correct several times. Usually a higher fat meal. So far it has worked out very well.


#152

You may know by now there’s citric acid in Fiasp to help reduce the bump that develops over time under the infusion site. That’s why it stings a little during a bolus.


#153

So I’ve been pumping Fiasp for about 4 months, and one thing I’m noticing is that I’m having a much harder time burning off the winter weight gain I usually experience. Fiasp is making it much easier to manage exercise (biking) without dropping low, but I usually manage to take off the 10-15 lbs I put on over the period of bad-biking weather by end of spring/early summer. This year it just doesn’t want to budge at all, and the weather’s been such that, if anything, I’m getting out a lot more often than I usually do.

I’m wondering if anyone else has experience around Fiasp and weight loss/gain they could share?


#154

Thanks, I didn’t know that!


#155

My guess would be maybe better control is making it harder to lose weight becaue you’re not “wasting” so many calories with high blood sugar? If your control is tighter, that is.

My weight situation is complicated because I’ve always found it incredibly difficult to lose weight. Over the past year I’ve found it easier to lose than I ever have in the past, but it’s hard to tell whether that’s Fiasp or metformin. I’ve cleared my schedule completely for the next year so that I can focus on weight loss (I’m overweight), so hopefully Fiasp won’t interfere with that.


#156

I’ve been using Fiasp for a year now and had no weight gain or loss :slight_smile:


#157

Novo Nordisk does add some ingredients to insulin aspart (Novolog, Novorapid) to help it act faster. Since I didn’t remember citric acid being mentioned anywhere else I’ve read about this issue, I went and checked. Here’s the list taken from a Novo Nordisk source.

05%20AM

I’ve read others mention that the arginine and niacinamide (Vitamin B3) are the additives that speed up insulin aspart’s action.

It’s mentioned elsewhere in this document that the hydrochloric acid is used to balance the ph of the final solution. I didn’t check the ph of the final solution; perhaps it’s designed to be acidic to help deliver its promised action.

On a related topic, I am allergic to insulin aspart. I used Novolog for a few years and slowly started to develop red raised inflammation at every infusion site. I had to stop taking Novolog for this reason. Since then I’ve found that I was not alone in this reaction. I read accounts from many others who have had the same reaction.

Since Fiasp has come on the scene, I’ve also noted several reports of this happening to others. I don’t know what the incidence is, however. I have not had the opportunity to try Fiasp and I think I’d have the same “pump bump” reactions I had with Novolog, if I used it in a pump. I am curious to try Fiasp as a stand alone correction insulin using a syringe.


#158

Aaron J. Kowalski, Ph.D., JDRF Chief Mission Officer and Internationally Recognized T1D Expert, mentioned “citric acid” when I asked him the other day about the “sting” when I had an opportunity to hear him speak the other day. I also should mention I adjusted my insulin pump’s (670G) “active insulin time” down 30 minutes to 2 hours for me. I did immediately notice Fiasp is faster acting but not sure it has a shorter active time. The active insulin time, as I understand it, just has to do with the bolus wizard and not the Auto Mode bolus’s but I could be wrong.


#159

@Hammer and @SLYDoggie I too have the t:slim X2 and my doctor recently switched me from Humalog to Fiasp. I was excited to try Fiasp especially since my doctor raved about it. The first week I was on Fiasp, my blood sugars were like night and day - it was amazing (in a good way). My blood sugar was stable and I had very few spikes. I thought it was a game changer and said goodbye to Humalog! Then after that first week, I had the complete opposite experience. My blood sugars were constantly high to the point where it didn’t seem like I was getting anything and no matter how much I gave myself insulin through my pump it never brought it down. I even tried switching my infusion set a few times and that didn’t make a difference. I thought I read on here that you need a certain infusion set for it to work? I called Tandem and they said they haven’t done any testing with Fiasp, only with Humalog and Novalog, so she couldn’t recommend anything to me. Can I ask what infusion sets you use where you have had success with Fiasp, because I would love to go back to it!


#160

I used the T30 and the T90. The T30 didn’t work well for me at all.
The T90 with 6mm ended up being too short and didn’t work.
The T90 with 9mm works best for me.

Also, have you changed your basal? I didn’t touch mine for a while, but ended up having to increase my nighttime by a bit, but ended up slightly less in the day.
I find that it doesn’t last as long in the pump, especially if it gets hot.

I also find that larger doses, or super boluses make a much bigger impact with Fiasp than with Novolog.
The steel canula also worked well for me, but I don’t like the extra attachment point.


#161

I have had very similar experiences to you. For some reason, the infusion site just stops working. It seems as if this can happen at any time. I was at the point where I was changing my infusion site every 2 days but was still having issues at times. I switched to the TruSteel Infusion sets and it has been better although I have still had the issue.

I’m a little frustrated at this point because, when it works it is amazing. When it doesn’t work, the only alternative is to switch sites or give myself a shot. According to my doctor, the “addition” they made to Fiasp to get it to work so quickly causes an increase in the sites resistance to absorbing the insulin. His theory is that the “Teflon” in the plastic canula (to aid in insertion) may add to the issue. The TruSteel infusion set has a metal needle rather than a plastic canula. The design of the TruSteel is also very different in that there are 2 “patches” you attach to yourself. The first is an “anchor” patch which leads to the pump and it then has a short tube that leads to the patch with the needle. The thought is that you don’t need the pump and pump tubing tugging on the metal needle sight. I had to get longer tubing to make this work even though I’m not overweight.

I’m still on the fence with Fiasp. For shots it is amazing but I’m sure this issue is why they haven’t received FDA approval for pump usage.

Regards, Steve Yarbrough