Faster Insulin: The Holy Grail of Type-1 Diabetes
OK, my kids are right. I’m a geek.
Monty Python movies still crack me up… especially Monty Python and The Holy Grail. Love that scene at the “bridge of death” where the creepy guard asks questions that must be answered correctly in order to pass, lest you plunge into the bottomless gorge. Challenging questions like “what is your name, what is your quest, and what is your favorite color.”
In the diabetes world, the answers to get to the desired insulin treasure are a bit intriguing.
What is your name? “Just call me ‘tired of waiting for this so-called-rapid-insulin to work.’ ”
What is your quest? “I seek a faster insulin.”
And what is your favorite color? “Whatever damn color the faster insulin is, that’s my favorite.”
Well, our quest isn’t quite at an end. But we’re getting closer.
Here’s my review of FiASP insulin and how it compares with other fast insulins:
Novo Nordisk’s new FiASP insulin (short for Faster insulin Aspart) has hit the market in various parts of the world, and is awaiting FDA clearance here in the US. The good news is that it IS faster than the rapid insulins we’ve been using for the past 15+ years (aspart, lispro, glulisine – brand names Novolog/Novorapid, Humalog, Apidra). The bad news is that it is just slightly faster, and still nowhere near as fast-acting as the insulin the pancreas produces. It’s also not quite as fast as inhaled insulin (Afrezza) or injections of rapid insulin given into muscle.
But it is an improvement. By adding niacinamide to the formulation, the insulin molecules form monomers (single pieces of insulin) that move through the subcutaneous fat layer faster than before.
How much faster is FiASP as compared to normal insulin?
Its onset of action is about 6 minutes earlier, the peak is 7 minutes earlier, and it works 50% harder during the first 30 minutes compared to traditional aspart.
The result: Better post-meal patterns with a peak that is approximately 40mg/dl (2.2 mmol/l) lower.
What about the duration of action?
Sorry, no difference.
It takes just as long to finish working as the rapid insulins that are currently on the market. Although it starts out faster, FiASP has a long tail of action. However, when used to correct high blood sugar, you will notice a more rapid decline during the first 30-60 minutes.
Will FiASP be approved for use in insulin pumps?
Yes, but beware: The “insulin on board” algorithms will be rendered somewhat inaccurate. Those algorithms are based on the action profile of traditional rapid insulin, so when using FiASP, the pump will over-estimate IOB during the first two to three hours. It may be necessary to set a slightly-shorter duration of insulin action in order to have the pump calculate IOB correctly (for example, setting 3.5 hours rather than 4.0 hours).
Does dosing need to be changed when converting from rapid-acting to FiASP?
Unit-for-unit, FiASP has the same potency as rapid-acting insulin, so it should be a relatively easy conversion, and one that I would recommend to most people on pumps and multiple injection programs. However, don’t fall into the trap of thinking “this stuff is faster… I don’t have to take it ahead of time.” That’s like buying reduced-fat snacks and then eating the entire package because they’re… well… better for you. Users of FiASP will still need to pay attention to the timing of their bolus insulin. In order to see the benefits of the faster onset, it will need to be taken at the same time you take your insulin currently. Taking it later will negate the benefit. And with slowly-digesting meals/snacks, it will be more important than ever to delay the injection (or use a dual/combo bolus) in order to prevent post-meal hypoglycemia.
So at least we’re on the right track. Much faster insulin is going to be necessary if our “hybrid closed loop” systems are ever going to become full closed-loop systems. But for now, an almost Holy Grail is better than no grail at all.
I’ve been on Fiasp for quite sometime. I’ve switched from taki g it when I eat to after I eat. My numbers will get above 200 and I will take up to 10 units and within 5 mins my numbers go down. It works well for me.
I complained to my endocrinologist that, with Humalog, my blood sugars were HIGH (in the 200-350 range) for 2 hours after every meal until the Humalog FINALLY brought my blood sugar back into normal range. (Therefore, this meant that my blood sugars were HIGH for 6 hours per day . . . not good.) So she switched me to the Fiasp pen. Well, this morning it took the Fiasp insulin 4 hours & 40 minutes after taking it to drop my blood sugar below 300! What the hell? I THOUGHT it was supposed to start working in 10-15 minutes! If this experience continues, I will be switching BACK to Humalog. UGH!
HI gregory, there may be additional factors resulting in your aparant delayed insulin action. Feel free to schedule a consultation and we can definitely discuss the issue and help you reduce this.
however I found that humalog takes longer to absorb for me than Novolog, and while fiasp initially was faster, after a few months of use the absorption time began to get longer and longer. not all insulins are equal and our body can sometimes react to them differently. It’s great to have different options to choose from, but nothing is one size fits all.
My doctor changed me from novolog to fiasp last week because novolog was taking a while to work. Fiasp seemed like it did nothing for me. My blood sugars have been over 300 to 400 since then. I have been taking my shots as usual hoping fiasp was the answer for a quicker response to high sugars. Last night I went to bed with a level of 302. 5 hours later my dexcom woke me wth an urgent low alarm. My sugar was 36. It seemed like my fiasp injections that had not worked hit me all ar once. I switched back to novolog today ans will call my doctor in the morning to tell him about this.
Fiasp is definitely not a “Silver bullet” a slight increase in action speed won’t do much for that kind of high, you may also be seeing insulin absorption problems related to scar tissue, reduced circulation, or being under hydrated.
This can lead to big swings form high to low blood sugars
also large doses do not absorb well so you might want to talk to your prescriber about splitting any large injections into multiple smaller injections to get better absorption.
I tried Fiasp. Just tried it again today. It not only doesn’t lower my glucose, let alone dent it, it makes my glucose rise. Why I ever tried it I’ll never know, but it’s an absolute joke. Back to Novo Log for me. If it works for everybody else they way it did for me, it should be pulled. I tried it right after coming to market. It was a joke then and a joke now.
Definitely a product where “individual results may vary” should be part of the packaging. We find that some people have great results with fiasp, and others have issues either right away or over time. But we always support having more options, even if those options are not a fit for everyone.
I’ve been on it for a wk now and I have the same complaints as you. I’m so disappointed bc I honestly was counting on a small miracle. Turns out it’s the opposite. After a long fight w the insurance co and finally getting approved it’s turning into a huge let down. I’ve had T1 x 48 yrs and I’d be interested to know if longevity is a factor in why it works for some and not others.
HI Andi and Mark,
our educators had similar experiences. In clinical practice we see that some people use Fiasp with no issues. Some can use Fiasp in injection therapy with little or no issues. However, using Fiasp when pumping is far more likely to have problems along the way. we are not sure as to the exact cause of the issue, but we suspect it has to do with a response to the vaso-dilators used to speed absorption. We have reported our findings to Novonordisk.
All of our educators found huge initial benefits from Fiasp that then waned, until it became problematic and we returned to our original rapid acting insulins.
I have found FiASP very useful & fast when my BG spikes. I’m on a pump with Novolog but my Dr has given me some pens. But the pens are 300 units and I guess they are only good for a month so if I had to pay for them, costs would go out of control. It would be nice to have 50 unit pens or vials.
I won’t use Fiasp in my pump because it didn’t seem to hold up when I tried it.
FIASP is what I’ve needed for…ever. My dawn effect is strong at around 10 mm/dL (180 mg/dL), rising from 5 overnight to 15 **before** breakfast and 20 shortly thereafter. FIASP on risinghas reduced these peaks by at least 5 (90 mg/dL). I love my bakery carbs and FIASP) matches their uptake very well. I take about 40% LESS than Apridra because a lot of the Apridra was just to get the peak under control. 3 to 5 hours later I was eating to compensate for the excess Apridra (the final 10% of Apridra’s action accurs between 6 and 12 hours v- vhow is that suppost to be a rapid insulin?!?).
The best 4 things since diagnosis in 1970: 1. blood testing 2. Human insulin 3. continuous monitoring 4. FIASP.
Great to hear Fiasp has been so helpful for you!
Thank you for this.
I thought i waa going crazy.
Dr. gave it to me and said it was stronger than my humalog.
I must have taken 3- 2 unit shots spaced out waiting for it to work. I thought maybe it went bad.
The last one i kept the pen in my skin and counted to ten, because it seemed the other ones, I would pull the pen out and the needle would still drip insulin.
To me, it seems slower than humalog.
I can see it on my cgm, the time difference between how fast each one works.
Not a fan
Sticking with what works.
Just wanted to thank you for the posts about fiasp seemingly turning to water in the pump. This was boggling my mind for weeks– On day 3 of my pump change, like clockwork, my sugars would go up to 300 and corrections through the pump with fiasp wouldn’t bring it down. Had no idea this was a problem with the insulin. I kept thinking my pump set/resevoirs despite them looking fine when I change them!
our pleasure Danielle, we recently even did a story about how Fiasp panned out for some users over time because we experienced so many issues. It’s a shame because it was WONDERFUL to use! and some users dont experience any issues at all, so I still say, if you’ve got good controla nd want to take it a step further it’s a great tool to try!
Would you mind providing a link to the story you mention above? I’ve looked all over but have only found the story above from Integrated Diabetes. Thanks!
sorry I’m not able to see what story you’re asking for.
I have been a type one diabetic for 41 years. Recently my high blood sugars seem to be occurring after meals. My doctor recently prescribed flasp and I noticed a tremendous improvement with these I was thrilled. I have just found out, however, that my insurance company will not flasp. Any recommendations? I have United healthcare as my insurance.
my recommendation would be to ask your prescriber to advocate for you and complete a prior authorization or reach out to your insurance company for other alternatives to get it covered.
Fiasp is slightly faster than novolog. i find it necessary to almost double the dose. The Insulin’s do not compare dose per dose they are different. Take more of the fiasp than the nova log.
HI Dan, if you are finding the need for significantly more Fiasp you are likely having physiologic issue with the insulin (That we have seen personally and anecdotally in clients) but it’s not typical to need a dosage increase.
I started taking Fiasp back in early May after taking Novorapid for many years.I thought my sugars were improving but for what ever reason every second day l have a high reading and it’s very frustrating. I’m at my wits end what to do. I walk every day, I’m careful what l eat.
Hi Sue, particularly for those using Fiasp in insulin pumps, we see an impact in insulin absorption that often causes erratic blood sugar outcomes. This may be what you are struggling with. Typically returning to previous rapid acting insulin resolves the issue.
Hi, Glad I found this place, after 40 years of being Type 1 Diabetic and reading all your posts I feel I just graduated from Kindergarden. it looks that my scheme is so primitive, I am only on injections, I never dear to use a pump, just las year I started with Dexcom G6 to monitor my glucose level. I use Novolog for rapid, Levemir for basal, and Victoza to help lower my A1c. I was looking for newest insulins specialy the rapid one and thats why I landed here. And I found a new world here, can someone tell me where to go online to learn a little more how to manage my diabetes, because I never payed to much attention to de basal Insulin, so some times I use more, some times less and i don’t see any difference.
Thank you for your generous words! WE do try to go well above and beyond what most of us are taught. You can explore our website for more information and links to other great informative sites. however i would say the best way to learn more is to work with our educators to tailor your education to your needs. You can call our office to make an appointment with one of our educators (Who also lives with type 1 daily) at 610-642-6055
Try cornerstones4care it has a wealth of information for diabetics all free !
just started on Fiasp and I too find it utterly ineffective actually my sugars go up MORE and take LONGER to come down than when using apidra .. yesterday for example they took 4 hours to go down after injecting and when up IMMEDIATELY after eating and continued to RISE for a couple of hours after eating which is the opposite of the other types I have used. I have to take it EARLIER than the apidra I used before and the sugars go up way higher after eating…….
I am three weeks into using Fiasp instead of Novorapid. I use a Guardian Connect CGM system. I have counted the number of units of Novorapid injected during the three weeks before switching to Fiasp and the number of units of Fiasp injected during the last three weeks. All things cannot be equal, of course, but I have just lived my normal daily life and been following normal daily routines. I have seen an increased consumption by 50% with Fiasp and a lot of highs which did not not really come down even with two hourly injections of between 20 and 30 units. As somone wrote, it was like I injected water.
I will quickly return to Novorapid and wait for the next Holy Grail.
Located in Belgium
I have been on Fiasp for the last month. I am on a pump. It works for about a day and half. Then its like I have no insulin. Consistently getting worse. Last two weeks, sugar levels over 400. Last night I had high ketones. Had to call in middle of night and get a new script for different insulin.On humalog, I had no issues. Unfortunately, I had to change from a really great doctor to a new one. My other dr. is retiring. I have received little or no help. I’m told, to just give us a call if you have any problems. I dont hear from them for 3-4 days. Very frustrated with whole situation. I started Novalog last night. Hoping for better results. Very disappointed with Fiasp.
After time we have heard from more and more patients that Fiasp is not a good fit for everyone, Some patients experience increased occlusions when pumping, others experience reduced efficacy.
Thanks for sharing your experience.
We work very closely with our patients here at IDS. We offer a level of education and support that most clinics and practices simply are not able to provide, because we lived that frustration as well.
Alicia and Gary,
Does your office receive any funding or donations from Afrezza or FIASP or their manufacturers or their subsidiaries? Sorry for the mistrust. I’m type 1. I work in a medical field. Gotta ask.
We pay for our meds and tech just like everyone else. One of our educators may occasionally be asked to share our skills, education, and experience with other educators, and may be compensated for their time, but we don’t promote any specific products or services. Since we all live with type 1 diabetes in our own lives we trust and respect our peers and community too much to compromise our clinical or personal integrity. We do our best to share well rounded unbiased information based on our personal, professional and clinical experience, and/or on statistical data when available.
WE definitely understand your skepticism, we don’t appreciate being “sold” on meds or tech any more than you do!
Is it just me, or has anyone noticed that you can feel it going in moreso than other insulins? It seems to have a bit of a sting. Not really painful or anything, but I can definitely tell something’s entering my body whereas I never felt it with other insulins.
Some users do note a bit of a sting or burn with fiasp use, particularly after time. this appears to be a very individual experience. some users feel a marked discomfort while others feel nothing at all. We hypothesize that this is likely related to a mild reaction to the insulin suspension used. Some users report increases occlusions with fiasp in insulin pumps also associated. Many fiasp users with these issues find that going back to their previous short acting insulin for a time then returning to fiasp reduces or eliminates the issue (rather like hitting the reset button on the reaction)
I have been on Flasp for 2 days now and have had highs for this period of time. I have had highs thru the night although I am bolusing and during the day, same thing.
It’s like i’m taking water! Every unhappy.
I am prone to weight gain – 3 stone with apidra. Doing weightwatchers so not down to my diet. It is listed as a major side effect for fiasp. Has anyone actually experienced weight gain on it please?
The only insulin I have found which does not do this to me is porcine- which I currently use in my pump. My DSN would like me to try it and I am keen to have better control but want to find out more about weight gain.
ANY insulin can cause weight gain, particularly if you are experiencing frequent bouts of hypoglycemia. If your glucose control has tightened, you are simply urinating away fewer calories than you were previously. If you would like to set up a consult with a diabetes specialist who is an expert at helping insulin users to lose weight, feel free to contact our office manager for more details: firstname.lastname@example.org
I have used humalog in my insulin pump and opposed to Fiasp I have seen a big difference in my blood sugars with this faster working insulin.
Has anyone had any experience with Fiasp with 670G and Guardian 3 system? I’ve been on this since early December. Generally doing well but I was hoping to see a better HgbA1C. I was thinking of trying Fiasp to bring down my postpradial highs. I’d be interested in other’s experinces. Also, trying to decide when I try if whether to change my active insulin time from 4 hrs to 3.5.
Multiple educators at IDS have been using Fiasp. The most important take aways are that it is not a replacement for prebolusing, it is a supplement to it. To not prebolus makes fiasp the same as novolog with a prebolus. The second take away has been that the full 4hour action time of Fiasp is the same as the 4 hour action time of novolog. so shortening the DIA tends to increase post correction lows.
I believe it’s a good option. For me though for perfect glycemic control it’s Afrezza everytime. The problem with FIASP is that it hangs around too long. Afrezza clears much faster and flat blood glucose profiles are possible with minimal effort. I love Afrezza.
I have not tried Fiasp but I do use Apidra and I do find it to start much more quickly than any other insulin and importantly to finish working much sooner. The tail of all the other insulins caused me issues. What I find interesting is that most people do not find a difference in the insulins while some people do find Apidra and Fiasp to work more quickly and at least for me with Apidra to have a shorter tail. What would be interesting to research is why? FWIW have been a T1 for almost 50 years so have been on all the different types of insulins for several years, never just a short few days or weeks and also have used all the fast insulin in a pump and with intensive BG testing either fingersticks or CGMS. So again accurate data generation. I do have to adjust my basal rates with the different insulins. I would not switch to Fiasp if it had a longer tail than Apidra in my system.
Since pumps also deliver basals, how does fiasp’s faster action affect basal dosing?
great question. There is no adjustment needed to basal dosing with Fiasp. Since basal dosing with a pump is a series of micro doses over 24 hours, those doses are designed to overlap in action. This is actually why basal insulin dosing works. So the change over to Fiasp requires no change at all to basal dosing or timing.
Unfortunately I’m not noticing much difference. Huge spikes of 14 or so if I take it with a high carb meal, with 2 or 3 extra boluses required over the next 2 hours to fix it all. I’m sad. Nothing has changed…
Getting the right strategies to cover meals can be really frustrating, particularly when you don’t have a guide. Insulin management is all about timing. splitting meals, splitting dosing, prebolusing and use of advanced pump features are all methods that we teach at Integrated Diabetes Solutions to help our clients get the best post meal management they can. Give us a call and we can work with you in this area. 610-642-6055
Alicia Downs, my doctor has given me FIASP to try and I haven’t had good post meal numbers majority of the time. What do you charge to help clients with insulin management?
I recommend giving our office a call. 610-642-6099. One of our office staff can walk you through our services and pricing. WE look forward to working with you!
Afrezza is faster in & out..and it is inhaled..so..no shot
very true, Afrezza is pretty amazing at its speed. But, it’s not for everyone. There many people who can not get the tight dose control needed, or who have respiratory issues. Fiasp gives them a great new option.
Medicare saved me money on my insulin. I use a pump, which makes insulin covered by part B, not Part D, of Medicare. With my Plan G supplement insurance, after I meet my annual deductible of about $166, my insulin has no out-of-pocket costs.
I picked this up in Canada last week. I’m very disappointed. I see almost no difference between Fiasp and the usual suspects . I was so excited to try it but for me it’s been a dud.
Thanks for the review. I have switched but I am only three weeks in.
As suggested post meal spikes are smaller and have become blips on meals of less than 30g CHO. For bigger meals it is a lot less predictable.
It stings when delivered. I tried extending to 15 min but that just prolonged the stinginess.
Cannula sited need changing more often, now diong on his daily rather than every two days
I have reduced the timing before I deliver before meals but reading your review I shall still look at these
It is a lot better when eating out and I need to wait until the food arrives to deliver. It comes down more quickly than before
As said correction work more quickly.
I have decided to give it a proper try and do at least three months. The benefits need to outweigh the stinging in delivery.
My experience of Fiasp is rather different from what you’ve written above. I (and quite a few others) have found that we can take it immediately prior to eating and experience very minimal post prandial rises in blood glucose, indeed, I have tested in with a fairly boring white bread and jam meal, with an immediate pre-prandial dose, and found no rise in glucose levels.A fair number of people have found that bolusing as you would with normal fast acting insulins results in hypos very soon after eating. As always, your diabetes may very, and not everyone sees the same effects.
It seems that the faster onset is not the critical factor in the way this insulin works, but rather the larger availability of insulin in the first 30 mins, which seems to have a major effect. If you’d like more information, I’ve written a lot about it here: http://www.diabettech.com/faster-insulin/
The other thing to note is that the duration is the same as that of Novorapid. Whilst the curve shape is slightly different, i.e. there is less insulin on board between 3 and 6 hours, it’s very much still there, and setting a pump DIA to 3.5 hours will significantly underestimate this factor out at these times.
What niacinamide and what kind of long term effects does that have?
Thanks for the review Gary. Although a little faster action sounds good, I’m sure this insulin will still carry a hefty price. I would be more excited if the rapid acting insulin manufacturers would deliver on better pricing at this point if no new breakthroughs in therapy are emerging. I will be dealing with Medicare very soon and when you hit that donut hole in coverage, it is very scary to make it through to the other side of the donut hole and still be financially solvent!
If you have an insulin pump, Medicare will pay 80% of the cost through part B. It is considered durable equipment. You don’t have to worry about the donut hole. If you do not have a pump, then your drug plan pays. Good luck with that. You will hit donut hole soon. They may not cover it at all if not on their formulary. I did read that it will be the same price as Novolog.
Pat Tennies: Medicare DME won’t pay for Fiasp in the US because it hasn’t been approved for pump use………yet. I’ve been fighting with Medicare, Noridian, and Walgreens for 2 weeks and have lost the battle twice even tho’ my endo put me on it a month ago. I have achieved 50% better control the last month. Guess I’ll just have to go back to using Novolog until Fiasp gets approval for pumps. Hopefully sooner than later.
Some drs will just write a letter of necessity. Use vague wording implying maybe you are using the Fiasp to inject boluses and the pump is your basal.
Thanks for the review. Really interesting to get your opinion on it. I’ve been using Fiasp in an insulin pump for a few weeks now, and I have to say I find the differences of action between Fiasp and NovoRapid to be much more significant than you are suggesting here. It’s quite early days for me, but I have been wearing CGM to observe the differences. I am still gathering data, but early signs are pretty promising. I absolutely agree that it is nothing like instant, but I am able to make adjustments to my approach to various things with the benefit of the significantly shorter onset. Here are some examples:
Meals for which I would have needed 30-45 minute pre-bolus now need only approx 10-15 minutes.
The ‘significantly faster to peak action’ means boluses for more rapid acting carbs (eg white bread) can be taken just before eating and give reduced BG spike post-meal.
Corrections with NovoRapid which often showed little effect for the first 60-90 minutes are now beginning to reduce BG within 30-40 minutes.
Moderate carb load meals (eg basmati rice) which Novorapid ‘matched’ in absorption/action profile now need careful dual wave handling to avoid post-meal hypoglycaemia at 60 minutes.
Duration for me seems to be about 25% shorter than NovoRapid – though of course it is always difficult to spot exactly when the tail is ending.
In short my n=1 is that it the difference is significantly more than 6 minutes/7 minutes earlier action suggested.
I’d be interested to hear how others have been finding it.
great insight. wonder what you mean about the dual wave suggestion (with moderate carb load meals) to avoid hypo at :60. I’m using fiasp currently, and finding that I’m going hypo at that time with exactly that kind of meal,m
I have had a really hard time with Fiasp. It just doesn’t work on me as it is supposed to and I am continually having to check my blood when I use it. It seems to work effectively about 25% of the time and is completely ineffective the rest of the time. I am using it withTresiba and I wonder if they are compatible. I have used about 8 units of Fiasp this morning and am still here with a blood sugar of 13. I have been using it since June 2018 and it just is not doing it’s job. So I guess I will go back to Humalog even though waiting for Humalog to kick in was never great either…
We are hearing reports from patients of varied, or diminishing results with Fiasp. However, others continue to use it with no issue and great results. We hypothesize that some people may see an auto immune response to Fiasp as many users find that returning to novolog or humalog for a period, then going back to Fiasp mitigates issues for a while.
One thing diabetes teaches us is that sometimes, the way the textbook says things should work, and they way they work in our differing bodies just does not quite match up. But it is good to have the option to try.
Sounds like your having a problem with insulin absorption (or resistance). I’ve just been told, by my diabetic nurse, that there are new high concentration insulins designed specifically to address this. Apparently less (but higher concentration) insulin = better absorption. Problems with injection sites may produce the same issue. I don’t remember who is making it (think it may just be, e.g. humalog but more concentrated), but you should look into it. It’s only fo injections though, not pumps at this stage. Good luck.
I am having the same problem, although only on day two of use. It doesn’t seem to have much impact at all on my BG after eating, but I haven’t used it as a corrective dose yet. But it certainly doesn’t seem to work as effectively as my humalog. Does anyone else find that it takes a while for it to settle in once switching over from another insulin type? I will give it a few days, but I’m wondering if I’m one of those it doesn’t work effectively on….
i’d take issue with some of this. i’ve been using it for the last 2 months. It works immediately – and i mean immediately. I had to change the period of action on my pump from 4 hours to 2 and a quarter hours. It tails off much more quickly. It’s fabulous – my after meal highs are GONE. The only meal which this is not true of is breakfast – hormone-induced highs seem impervious, i deal with this by giving myself a correction on waking and a third of my breakfast insulin. Then the rest just before breakfast. This works. NOTHING has ever worked before. You are warned not to take the insulin any more than two minutes before a meal, and i have found longer than 5 is a problem.
For me, it works as fast as i would like it to work – any faster I think would be a problem!
Have you tried it?
Yes everyone here at IDS have personally used Fiasp. none of us found the quick onset that you did. But anytime someone finds themselves outside the norms of insulin action they should adjust their therapy to their needs. Glad you’ve had success with it, and that you are making it work for your needs.
Just started and I agree with Liz
Thanks, that’s good to know as I’m about to start on this insulin with my pump. In terms of your morning highs, two things raise your blood sugar in the night/morning: i. growth hormone (even in adults) is released around 3-4 am which stimulates cortisol production and raises blood sugars; ii. “blue light effect” occurs when you wake and come in contact with sunlight, this again stimulates cortisol production and raises blood sugar. One of the benefits of insulin pumps is that they are designed to solve this problem (though they have to be adjusted over time to tackle it) by varying background/basal insulin to match your body’s circadian rhythm. Injections can only deliver background insulin which is roughly a flat release in comparison. So you should either be on an insulin pump to prevent the morning highs, or if you are on a pump your basal level needs adjusting according to you blood sugar levels.
I am trying to get my insurance to cover this, any recommendations, they said no because it was not approved for use in pumps.
I had to ask my prescriber to write a prescription for “Subcutaneous injection” but not infusion or any mention of use with insulin pump. That was the only way it was covered because in a pump it is a non FDA approved use.
Hmmm… Well, I’m not quite as excited about FIASP as I thought I’d be. Sounds like getting highs down quicker is the best part of it. Should lead to more time in range. More trial & error to come! Thanks for posting the review!