This is a new insulin like no othe on the market. Therefore, discussing experiences is fantastic. A few of the post are listing info that is giving a false impression of the FDA testing process and the patient experiences. Context has a great deal to do with info from the testing participants, and making assumptions that may lead to false impressions don’t help.
I would love to hear about firsthand experiences, and to have the facts in context. Info on issues needs to include info on pump basal dosages, bolus and carb ratio info.
Some of the experiences sound much like basal adjustment issues or site issues and not the action of Fiasp alone.
Thank you all for the info and experiences with Fiasp!
Hi I have been using Fiasp for 3 months now with the occasional hiccup.
From reading other forums and peoples experience of Fiasp many are making the same very basic mistake… which is treating it as if it’s the same as novolog/rapid.
It’ has a completely different action, so treat it as such.
Reset your basals do extensive basal testing and recheck you carb ratio and correction factor and do remember to split your bolus for meals.
People also seem to be under the impression it only lasts for 3 hours it doesn’t it more like 4 1/2 to 5 hours read your patient leaflet and take note of the info.
Warm weather I change my set every two days and normal every three days with no issues.
I have the occasional itch from the site so have started using a barrier spray which has solved the problem.
Thanks for letting us know. I was going to ask my endo to try it for the fast acting piece because I have to pre-bolus for nearly everything, but I have enough trouble with my infusion site failing early with both Humalog and Novalog, so maybe I won’t bother. I’m on the 670G so I can’t split my bolus or do an extended bolus anymore. Just like Fiasp, the 670g works completely different. Double drat and darn.
@Jane_Vaugh. I suspect that the majority have not had problems with Fiasp. It is just that the numbers that have are clearly a significant minority. I would still be inclined to try it out. You don’t have anything to lose if you get one vial for a trial. Those that have got Fiasp to work certainly love it for the super quick kick in.
As far as the lack of extended bolus on the 670G is concerned. I know that quite a lot of the DIY loopers (Loop/OpenAPS) have had fantastic success with Fiasp. A couple of loopers have posted that you can get away with only the up-front (immediate) part of a combo/dual-wave bolus and the loop program will do the rest. I am sure that the same will be true for the 670G. Someone on the Looped Facebook group posted that their child “forgot” to bolus at all all day and using Fiasp, the program kept him in range.
If you decide to go ahead, you might want to check on the 670G Facebook group. I am sure there are Fiasp users on that.
I was surprised to read the 670 can not do extended or duel wave boluses so checked the user manual and all the info is on page 89 onwards no different to any other pump, so I’m rather confused as to why you can not split your bolus.
Can you explain what you mean as my next pump is meant to be the 670 when available.
In manual mode the 670g works just like a regular Medtronic insulin pump. In Auto mode, you can manually split the bolus, half up front half later but you can’t do a dual wave or square wave bolus (extended bolus). Basically in Auto Mode the pump gives you a super bolus-all the bolus up front and no basal for some length of time - so no insulin on the back end. Look up “super bolus” for the full explanation but essentially on a traditional insulin pump you borrow insulin from your basal and give it up front with your bolus. You then lower your basal for an hour or so on the back end. Some folks have found a super bolus works on problem meals like pizza and bagels. The problem with manually splitting the bolus is the 670 pump delays resuming the basal even longer. I always used extended blouses for higher carb meals and it was quite the learning curve switching to Auto. I had to change carb ratio and active insulin time and let the pump take its time figuring my system out.
Apparently with the new insulin, adjustments need to be made for carb ratios and active insulin time too. So, I’ll talk to my endo and see.
I’ve been using Fiasp in my pump for the past six months and love it. I had some problems with site irritation in the beginning, but they seem to have resolved. One thing I do notice is that the site irritation seems to correlate to the sizes of boluses. So when I’m eating low carb and doing large boluses, my sites tend to get more irritated than when I’m eating low carb and doing small boluses. I’ve also had problems with site irritation in the past, so this isn’t new to Fiasp. Like @Scott_Eric, my endocrinologist (who has T1 himself) said that the studies have been done and have shown that Fiasp is more effective in pumps than with MDI, they just haven’t been published yet (at least as of the time I last saw him).
First sorry for bumping, but my case is exactly the same.
Anyone with similar experiences to the topic starter? Or any updates from the TS?
I have an Omnipod with Novorapid (Humalog), and switched to FIASP (I have a tendency to peak after meals and fall into a hypo 5 hours after meals).
I set up my pump this sunday at 2pm and my my post dinner values spiked to 30mmol (500!!! mg), a value I even never had when I came into the ER and my diabetes was diagnosed. So I thought, ok bad pump. Solved the problem with a pen with humalog. Overall, I pumped over 20 units of fiasp, which were totally “lost”
I switched to a new pump on Sunday, and my night values were perfect, so when getting up I was convinced it had been a bad pump. I prebolused and had breakfast and spiked massively again. Solved with Humalog in a pen again. During my lunch and dinner I used FIASP in a pen directly (to see whether is was FIASP or FIASP in a pump), and it worked wonders, nice smooth curves. My nighttime values were great as well. When I woke up this morning I bolused 10 units with my pump (normally enough for a big meal) and ate nothing. Three hours later, my values rose from 90 to 225.
Conclusions (for my case):
FIASP is fine to provide basal in a pump, I am not rising at all during night etc.
FIASP is horrible as meal insulin in pump
FIASP works perfect in a pen
Anyone who can comment on my case? Similar experiences? Is there a solution? If this will remain the case and FIASP works great in a pen and be horrible in a pump I might even switch back to MDI.
I use fiasp in my pump, and my experience is that the action time is shorter than NovoRapid/NovoLog that I used before. I had to change it from 4 hours to 3 hours on the pump. Basal was the same for me, but I had to take more insulin for meals and corrections. I went from a 2.5 mmol/L (45 mg/dL) drop from one unit of insulin to 2 mmol/L (36 mg/dL). I used to need 1 unit for 16 grams of carbs to 1 unit for 10 grams of carbs. This can give the illusion that it doesn’t work as fast as it should. I thought the same in the beginning, but it really does work faster for me after the adjustments.
I can now eat some faster acting carbs without a spike, like fruits and rye bread.
If the infusion site has been in more than 3 days, I experience local insulin resistence.
I also experience some local irritation after using it for a few days (I get a small lump under the skin) and fiasp can sting when it’s bolused.
I strongly recommend keeping a food diary. Write every BG result you take, weigh all food and calculate carbs as precisely as you can, and write the insulin you take for said meal. Then test 1 hour and 2 hours later and write those results down under the meal so you can see the exact result of the meal and dose. Also, write comments next to the meal, like if you have exercised or been sick or whatever, that can affect your BG before and after eating. After a week or so, you should be able to see a pattern.
I have encountered this (though not with Fiasp). The fact that you have ineffective boluses with two different pods suggests it’s not a pod failure, and the fact that the Fiasp works perfectly when injected suggests it’s not an issue of prebolusing time or dosage or Fiasp itself.
Are you noticing any leakage from the pod when you do a bolus? Is the adhesive at the cannula end damp, or do you smell insulin? You are taking some huge boluses (20 units, you mention), and some people find with pods that the tissue can’t absorb large boluses quickly enough, so the insulin backs up along the cannula. (Search “tunneling” on this forum.)
What worked for me was to do a smaller initial bolus (I cap it around 4.5U but it’ll be different for everyone) and extend the remainder of the total bolus over 30 minutes or an hour – or, as you’ve discovered, do an injection when a bolus is large.
Try that a couple of times. I’ll be interested to see if your post-meal results are better.
With Fiasp you need to learn to use it properly.
Firstly read the patient leaflet and understand how Fiasp works.
Due to the peak (1 - 3 hours) you really need to split your bolus, find out what suits your own personal needs.
When first using Fiasp you need to reset your basal and also go right back o basics as if you are a new pumper so make sure your carb ratio is correct as is your correction and also set your duration correctly.
There is nothing wrong with Fiasp at all it’s just the way people are using it.
Try it, it’s much easier with Fiasp if you can find an injectable basal you like. I’d recommend using Regular insulin for when you would extend boluses on the pump to get good results.
Just for contrast: I started using Fiasp in my (old school, pager-style) Medtronic pump about 2 weeks ago. And I LOVE it. My meal boluses are back to keeping my spikes down to a manageable level, and my between meals #s are running comfortably in the 90-120 range. Running a low temp-basal 2 1/2 hrs before biking actually keeps me from severe post-exercise hypos now—something I was really struggling with—thanks to the shorter tail. I do notice that it starts to fade on the 3rd day of an infusion set, but other than that it’s been absolutely terrific for me.
I find Fiasp in large boluses does not work well. It works much better for me eating a low-carb diet than it does when I try it eat larger amounts of carbs. If I want to bolus more than about 5 units with Fiasp (which I dont’ do often since I eat low-carb), I do so with an injection or an extended bolus. For smaller boluses, temp basal rates, adn regular basal, Fiasp is amazing.
First, I did not bolus the entire 20 in one go, I bolused 6, nothing happened, 6 again, nothing happed, 8 (already in the high 200’s), nothing happened.
A quick follow-up:
On wednesday until 1pm, I did not eat any carbs at all and bolused a total of 20 units (in small doses) as well, and rose from 90 (morning) to 250. So nothing happened at all.
Switched pump again to humalog at 1pm, everything was fine again. BUT, during the night, I appeared to have been in a mild hypo during the entire night (~65). Really weird, this normally never happens, because if I enter a hypo at night, normally my body kicks in and I end up with high values in the morning. And again, last night, I have been on the brink of a hypo (solid 75) but the weird thing was, I went into a hypo at 8AM when I got up, and this is the time I am normally the most insulin resistant. Could this have been the result of lingering 40 units of FIASP or is this total nonsense?
Currently back on my old pumping regime with humalog, and good values again. Unfortunately it has all been a FIASPco for me
If I want a next go with FIASP in a pump, what would be the perfect set-up to make it work and see what is happening? Low carb, small boluses (some delayed), anything else?
Upd: FIASP does seem to work wonders in a pen and in small amounts. I ate a small Mars bar (craving ), dosed 2 units and had a FLAT profile (half hour intervals: 100-120-110-110-100-100). With 2 units of Humalog I would have spiked to 180, only to drop into a hypo afterwards.
well, I guess to prove my own point (NOT on purpose! )
My Tandem rep gave me some of the new XC infusion sets.
Well, these are 6mm, not 9mm. Evidently this makes a pretty big difference to me! I do ‘ok’ for the first day or two, then I suddenly act like I am not getting any insulin at all. Not good after eating a big dinner while out!
Anyways, the canula length never made a difference for me before on a 90 degree set. But it evidently DOES make a difference with fiasp!
Btw, just to test my theory, I swapped to a new 6mm set in the middle of the night, and my numbers are coming back down (not as fast as they should, but I have been over 200 most of the night it seems.)
Ok, update, I am a complete idiot and switched my FIASP with TRESIBA. That explained why:
My basal was ok, since I used a basal insulin
I spiked after meals
I got a hypo during nights, since I had a really high basal because of all the “bolusses”
But, you might ask, how on earth does one mix up the two? Well, the answer is in the color, the one is green and the other is green with a hint of yellow. You can (barely) tell them apart colorwise (let alone when in the blister), but only when they are next to eachother. Really bad color coding, because FIASP+Tresiba is a really viable MDI strategy.
All in all, it was just a perfect storm. I normally have some Lantus as backup when travelling, but the Lantus expired, and they gave me Tresiba and only had penfills. I never used Tresiba so I did not know that the colors were identical to the (also new) FIASP. Then I asked my girlfriend to remove all the cartons and put it in the fridge, and then I just carelesly took out a green penfill when my pump expired.
So one big word of caution: FIASP and TRESIBA look SUPER-SIMILAR! (in Europe at least).
Fiasp is not working for me too. I switched from Humalog (pen) and its just not working. Always having spikes after meal. Its good if I have high blood sugar it brings it down fast but thats it. It may be good just for lower blood sugars but not to use it daily like I was using just Humalog. I feel tired after every meal and always having spikes… I will go back to Humalog and use the Fiasp just when my sugar will be high to lower it.
For example this morning I wake up with 7.2 mmol, I started eating 3 rice cakes and cottage. I injected 4 units of fiasp. Also I had coffe. Hour later my sugar was 12mmol…
), dosed 2 units and had a FLAT profile (half hour intervals: 100-120-110-110-100-100). With 2 units of Humalog I would have spiked to 180, only to drop into a hypo afterwards.