My T1D daily management, and using Fiasp!

Type 1 and LADA
1

There have been many people asking me about my “diet” and my daily routine. People with T1, or their T1 kids, who are newly diagnosed seem to think my many years with T1D, and no serious complications makes my routine a good example to follow. I try to explain that is generally not true.

There is no set routine that will work for all type 1 people. We are all different. What works for me may not work well for you. Each type 1 diabetic needs to work out a routine by trial and error, until something is working well. Then keeping careful charts or records can help with making changes, as needed.
I eat an average of 140 carbs per day. I am usually using 36 units of fast acting insulin each day in a pump. My insulin:carb ratio is 1:10 (one unit per 10 carbs), but I am less sensitive to insulin in the early morning, so I use a 1:7 ratio for breakfast.

I avoid many foods that have fast acting carbs. I avoid rice, cereal, and most pasta. When I do have pasta or potatoes, I eat small portions.
I am using a 70-170 range on my Dexcom CGM, and I stay in that range more than 90% of the time. My A1C has been in the 5.4-6.4 range for almost 20 years.

There are other T1D’s who are using a 70-150 range, and doing very well with it. There are some who eat less than 50 carbs per day, I refuse to do that. As long as I can avoid serious complications, I do not intend to change my routine. I enjoy my life the way I am doing it now, and I do not intend to change.

This might not work so well for you. I hope you have developed your own routine, and I hope it is working well for you.

I want to also mention that I have started using Fiasp insulin, instead of Humalog. My endo did not approve of my using Fiasp, and I recently posted that on my page. A friend sent me a message saying Fiasp did not work well for her, and she returned to her Novolog. She sent me several vials of Fiasp. I started using it five days ago. It is working very well for me, but it might not work well for you. Fiasp is a faster acting insulin and the acting time for me is three hours, instead of the old four hours I used for Humalog. I do not do any early premeal bolusing now, and I am not having post meal highs. I had 150-190 post meal highs with Humalog, but now I am having 120-150 post meal numbers with Fiasp. My only problem with Fiasp is having some lows in the 50-70 range. I am adjusting my basal rates on my pump to try eliminating those lows. I would like to eventually have a a 70-150 range. Maybe Fiasp will make that possible.

My endo did not want me to use Fiasp, but my friend has enabled me to use it now. I use one vial per month, and I have enough for five months. I will be seeing my Endo on Jan 20. I hope she will be impressed with my better control, and she will finally prescribe Fiasp.

8 Likes
2

So glad to hear Fiasp is working well for you. My experience has been the same as yours. I changed my insulin action time to three hours instead of four, no longer have to pre-bolus for meals, have lower after-meal spikes, and did have to adjust my basal rates somewhat. I hope your doctor is supportive of you continuing to use Fiasp.

I think record keeping and finding what works best for you is the only advice that truly works for everyone with diabetes.

Thanks for all your inspirational posts!

2 Likes
3

Hi @Jen, thanks for your post. Did you have problems eliminating the most troublesome lows?

4

I changed my IOB from 3 to 3:30 and that solved my issues for going low.
Also, Basal-IQ on the Tandem X2 pump works superbly with Fiasp for ME.

1 Like
5

@Hammer, thanks for your reply. I would love to use the Tslim, but I am not eligible to use a new pump for two and a half more years.
I am glad it works well in your Tandem pump.

6

My Endo has hesitated about changing me over to Fiasp insulin also. Does anybody have any idea why some Endos are hesitant to use Fiasp?

1 Like
7

My Endo was concerned about me having very low numbers with Fiasp. She has always wanted me to so everything possible to avoid lows, including my always keeping my A1C in the 6.0-6.5 range. I had previously been in the high 5’s.

8

I have LESS lows with Fiasp!
Riding the Novolog freight train when your BG is plumeting is not fun. Fiasp doesn’t last as long, and has a ‘softer’ tail. For me at least.
I was one Novolog, went on Fiasp for a while, then went back to Novolog for a SHORT period.
I never want to go back to Novolog again!
Fiasp is far easier for me to control.

1 Like
9

@Hammer, thanks for your reply. I am liking Fiasp very much. I agree with what you have said. I am having the same experience.

1 Like
10

Showing your endo the graphs and how they change with less highs and less lows should be a pretty easy sell to get them to prescribe Fiasp for you. Hopefully anyways.

2 Likes
11

@Hammer & @Richard157 - My experience with pumping FiASP, like both of you, has been very positive.

My Endo only knows as much he cares to hear, and he doesn’t seem inclined to believe that BG control with FiASP is measurably different than with Humalog.

He’s entitled to his non-diabetic opinion, which appears to be heavily biased towards “all diabetics should metabolize variants of insulin identically”.

It’s a good thing we don’t need scripts for insulin here in Canada, and I can use what’s best for me.

3 Likes
12

My endo started me on FIASP because Humalog was unpredictable, taking anywhere between 20 minutes and 2 hours to start working. The FIASP worked great, started within minutes. I took 50/50 FIASP and Humalog (2 separate injections) since the FIASP started fast but did not last as long. The 2 together were a perfect match for me. But after a month, the FIASP suddenly stopped working at all - like injecting water, no matter how much I took. So I am back to Humalog. Has anyone run into this problem with FIASP? Any solutions?

2 Likes
13

@Barry2, I have posted this in other groups, and I have read several people saying they had a good start with Fiasp, but it did not last very long. I’m hoping mine will continue working, indefinitely.

1 Like
14

@Barry2 If I had to guess I’d say your body developed antibodies to FiASP, effectively increasing your insulin resistance to this type of insulin.

Try taking a FiASP holiday for 4-6 weeks and then try it again

3 Likes
15

Thanks, Jim

I stopped the FIASP on Dec. 5, but am hoping it will eventually work again. I was thinking if it does start to work again (I’ll try after 4-6 weeks, as you suggest), If it works I plan to use it only when my BG goes too high and I don’t anticipate it with the Humalog. But I’ll be getting a Tandem pump next month, so it will have to be one or the other then.

Thanks again for your response

Barry

2 Likes
16

Good luck with it. I am trying a ‘holiday’ from it and will retry after a month or 2. It was terrific when it worked.
Barry

1 Like
17

I am taking a shot of FIASP and one of Novolog before all meals, and am finding that they work well together. I haven’t noticed more lows this way. If I am testing 80 to 100 then I take my shots immediately before the meal.

Edit. FIASP quit working for me. I am going to take a long break and then try it again.

1 Like
18

It seems to be a common trait among members here: we do not all of accept our endocrinologists’ opinions as a final determinant of our course of action. I applaud this independence! While our doctors benefit from an education we may not share, they, as gluco-normals, do not share our deep experience living with T1D every moment of every day, without pause.

Of course, there are reasonable limits to this independent philosophy but there are also reasonable limits to what any endo knows. Some of my biggest breakthroughs in diabetes treatments that produced better health and just as important, quality of life improvements, followed from ideas sourced from other patients, not doctors.

Interestingly, my endo offered a Fiasp Rx at my visit this last week but I reminded her that I am allergic to pump-delivered Novolog, the same basic formulation as Fiasp but without the added excipients. I told her I might be interested in using Fiasp as an injectable correction tactic and she reminded me that I have Afrezza for that. Good point, but I still think I’d like to try Fisap as an intra-muscular injection correction and observe its performance.

Good luck with your sustained success with Fiasp, @Richard157. I think your willingness to ultimately decide your treatment path, independent from your doc, is a healthy thing. Good for you!

Bravo to my neighbors to the north, where an Rx is not required for insulin. That leaves the choice of insulin up to the patient – an enlightened concept!

3 Likes
19

Thanks @Terry4, I appreciate your post!

I have noticed that many Fiasp users in several online groups have experienced great success in the early stages with Fiasp, but later on things were not so good.
During my first five days I saw much lower BG after meals. I was also using much less insulin, and lowering my basal rates. Then in the most recent two days I have seen higher numbers after meals, I am raising my basal rates, and I am using more insulin. I hope this is only a temporary setback. I have seen many users say they eventually stopped Fiasp, and returned to their Humalog or Novolog.
I agree with your thinking about using Fiasp to correct highs with intra-muscular injections. I have done that with Humalog, but it should be better with Fiasp.

2 Likes
20

I noticed a decrease in performance with Fiasp over time.
I went back to Novolog for a while, for cost reasons.
I couldn’t wait to go back on Fiasp. It was still so much better for me than Novolog that it was worth ordering it out of pocket from Canada.

1 Like