New Lilly Ultra-Rapid acting Humalog

https://diabetes.diabetesjournals.org/content/diabetes/68/Supplement_1/1112-P/F1.large.jpg?width=800&height=600&carousel=1

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Wow, that’s pretty impressive. I’ve been using Fiasp for a while now but I wonder…

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I wonder if Lilly combined some niacinamide with the old Humalog to mimic FiASP

I look forward to trying URLi when it’s approved in Canada one day

It has 2 additives, but not the same ones as Fiasp. I think I posted them previously. I’ll see if I can find it again.

Treprostinil and citrate

Treprostinil is already a drug (Remodulin®) used to treat pulmonary hypertension. It’s apparently a vasodilator.

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Even better. I was diagnosed with PH a year ago and need all the vasodilation I can get

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This looks very impressive.

How do you like Fiasp? Have you already opined elsewhere in the forum?

I find it works really well. I have weighed in on various discussions of it, but the two big benefits for me are that I was having to pre-bolus like an hour ahead of time with Novolog where Fiasp kicks in pretty reliably after 20 minutes, and the tail is shorter and cleaner which really helps with setting temp basals for exercise. I can set one an hour ahead of time and it works effectively to keep me from running too low, whereas Novolog seems to have a way of kinda hiding out in my system and adding an extra, unwanted boost to the exercise effect, so I’d have to do the temp two hours ahead and let my BG run up to 150 or thereabouts to avoid the effect.

Only downside I’ve hit is that with a high-fat meal (yes, pizza) I’ve had it come on too fast before the delayed carbs have kicked in. Had one pretty bad hypo from that. But it’s just something to be aware of.

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Very good info. All the benefit on the front end is appealing, however, what do you do differently on the tail end? I’m thinking of things like pizza. You’ve mentioned the impact at the time of eating, how have you changed things to handle the delayed carbs?

Sorry to hear about the hypo.

Setting a dual wave bolus works pretty well, though I’ve never felt real confident about doing those, so I kind of do a combined thing by keeping an eye on my CGM (I use Sugarmate on my desktop/laptop computers, so my BG is always right there in my status bar). What my CGM usually shows me is that I’ll get a bit of a rise, 30 points or so, about the usual time, like an hour or so after eating, and it will seem to level off, yay, all seems good, but then a while later it will really shoot up again as the fat delay fades out. Sometimes it seems like the dual wave is enough, but a lot of times it seems to need a little more oomph, so I’ll watch for the first signs of that second rise and if it looks abrupt enough I’ll give myself a couple more units to keep it reined in. With Novolog this wouldn’t work—it would be way too far behind the curve once it’s already showing up in my CGM—but Fiasp is quick enough that it can rein in at like 170 when normally it wants to shoot up into the 200s. I’m pretty habitual in my week-to-week lunchtime meals, which is usually when I have the most carbs (just really hard to avoid if you buy your lunch), so I usually have a pattern I can rely on in terms of that.

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While Fiasp had truly made a big difference for me, I always feel that competition is a good thing!
And having a slightly different formulation means that there will be odds that where Fiasp doesn’t work for someone, the URLi will work great for them.
Any and all advancement in getting injected insulin to closely resemble a more realistic action to our body makes a big difference to our control, and a huge difference in how you can use a pump, and programming, to ease more of the burden we go through as diabetics.

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Does anyone know the current (Feb 2020) status of ultra-rapid Humalog with respect to coming on the market?

Do you mean Biochaperone?

its hard to know for sure. They finished 3 Phase 3 clinical trials last year and are recruiting for another. If they’re waiting for the results of the just-starting trial before filing with the FDA, my guess is 2021 or 2022. Maybe earlier outside the US?

Even though I am on Fiasp, and will NOT go back to Novolog if humanly possible, I do wonder how well this new ultra fast will work.
Also, with a different formulation, it will help people that cannot use fiasp for long without it loosing some or all affect.
I know I would try it. Fiasp lost the initial potency with me (still far better than Novolog though.)