Yep, I think so. The results of one small study concluded that “Pump users should be advised that FIASP may result in the need for additional premature infusion set changes and that more episodes of unexplained hyperglycemia may be expected and should be scrupulously evaluated.”
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I changed my mind and trying Fiasp again. I realized my numbers were still better overall using it, and also realized it lets me eat things I can’t with NovoRapid. I can’t eat peanut butter and banana sandwiches or cereal on NovoRapid without spiking to over 14, but with Fiasp I’m either perfect after or at worst spike to around 9. We’ll see how it goes…
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Are you able to change infusion sets more often? I’ve been having good success with Fiasp, but I already change infusion sets at least once a day (at most two), and every 12 hours at times (such as during allergy season). Basically as soon as a set starts feeling irritated, my blood sugar won’t come down with a couple corrections, or I reach the end of two days, I change sets. I also eat low-carb, so typically don’t use huge boluses, which seem to contribute to irritation issues with Fiasp (unlike other insulins).
I mixed Fiasp with NovoRapid for my last cartridge change because I bought a vial of NovoRapid one day when I forgot to bring extra insulin to work and I want to use it up. It seems to be working exceptionally well, at least as well as Fiasp alone, and maybe even better.
I hope you can find a way to get Fiasp to work for you. I really love it and would not give it up. But I don’t think I’d be able to use it if I were trying to use infusion sets for 2-3 days, or if I were eating high-carb and doing huge boluses.
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Unfortunately it just isn’t economical for me to change my sites too often but I will try every 2 to 2 and a half days. I had a few times where my blood sugar skyrocketed to over 14 and took forever to get it down which frustrated me, but it happened with NovoRapid too so maybe it was just a bad site, under-carb-counting, or a trillion other variables. I realized going back to NovoRapid I really can’t eat fruit or cereal, and I’d hate to give those things up again!
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Do you use the metal sets? If so, it’s easy to re-use them at least once (not sure I’d go beyond that).
I do eat a low-carb diet with Fiasp, and I think that also helps me a lot because I don’t end up bolusing large amounts of insulin. Maybe try using an injection if you’re going to do a larger bolus and see if that helps prolong your sites?
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I tried them and didn’t like them - I found with NovoRapid I couldn’t even get 24 hours out of them without feeling the needle and lots of bleeding! I think you’re right about lower carb/smaller boluses, it’s just so hard sometimes!
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It is hard sometimes. But this is what keeps me motivated:
(I do NOT get limes anywhere near that good when eating higher carb.)
But if you want to eat high carb, I’d try injections for those meals. Might be the best of both worlds. 
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Wow, can’t remember the last time I saw a day like that honestly! I honestly never want to do injections again after my MDI experiment, in fact I think I’ve been too trigger-happy with the bolus button after reconnecting my pump!
I didn’t like MDI, either. I love pumping. But what I mean by using an injection is just doing it for that one large bolus. Not necessarily for every bolus. Just to stop the larger bolus from killing your site (if that’s what’s happening).
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This is what I frequently do now, partly because I can’t bolus more than 5U at a time and I may want all the bolus now, rather than extending over half an hour. As a benefit, I notice my third-day results with pods are much less wacky.
I found Fiasp in the pump to be a real headache, but I appreciated how it (sometimes only slightly) lessened peaks, and I’m considering staying with pumped Humalog for basal and using MDI Fiasp for boluses.
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What issues did you have with Fiasp when you tried it? I’m wondering if the experience in OmniPod is any different. I still have a few unexpired pods, I’m tempted to try one to compare.
@Jen, what a gorgeous track!
We are considering that too. We may start it this weekend and see.
Craziness, primarily. I had no guidance about changing pump settings, and I couldn’t get a handle on what was needed. I changed IC ratios, DIA (of course), correction factors, and basals, and in the end I just ran out of patience, so the “fault” may not be Fiasp’s.
As well, I didn’t find it significantly faster than Humalog (and that was my primary reason for switching) – 10 minutes at best, but when you’re prebolusing at 30 to 45 minutes, that’s kind of negligible. And while it did smooth out peaks right after eating because it’s so aggressive out of the gate, I’d get a steep rise about four hours after a meal, likely because of its shorter tail.
Sites were also consistently irritated, with a raised red bump still visible as much as three weeks after a pod was removed. I’ve never had this with other insulins, and many Fiasp users don’t experience it.
I’m thinking an increased temp basal, started around mealtime, might tackle that four-hours-later rise, regardless whether Fiasp is pumped or injected. (I don’t have any right now, or I would have tried this already.)
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Ok - my quick and dirty review.
Fiasp has been the fastest for me over Humalog, NovoLog, and Apidra. Haven’t used quite long enough to give my opinion on how long of a tail, BUT, it does seem to tail off quicker than NovoLog (which is what I’ve been using for about a year in conjunction with Afrezza and Tresiba).
Going to go full time Fiasp, Afrezza and Tresiba to see if I can control some pesky spikes in the afternoons. Post prandial from lunch needs some fine tuning in first hour and I’m hoping Fiasp can help.
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Hey everyone, as an update, I’ve had Fiasp for just over a week now and I love it! My time-in-range isn’t hugely improved (maybe a bit) but I have noticed that it does kick in FAST and it brings down highs faster, but not as fast as when I’m dosing for food. My post-breakfast spikes (and long tails of being high) are GONE.
One big issue I have is I can’t figure out how to dose for complicated food. For example, I got a chicken tender meal at KFC (swapped the taters for green beans, though, mmm)… the math was about 70 carbs. I dosed at 7:30, ate about 10 minutes later, and then dropped to almost 55 within the next 1-2 hours. I brought it up with glucose tabs and kept it around 120 for awhile but a few hours after going to bed it got up to 250. So, something about these complex meals and the fast-acting insulin is not working right. I am tempted to get R at Walmart and try that as well…
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I would have the same problem with NovoRapid, but it’s definitely worse with Fiasp since the insulin works faster up front and isn’t great at handling delayed fat/protein spikes. I had beer and wings and the same thing happened to me last night actually, I’m thinking a shot of Regular before bed is a good idea!
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I may pick up a bottle tonight, if I am able… that will be a throwback… I don’t remember the last time I used R! Or how to use it! 
I picked up a box of Novolin “Toronto” (as we call it up here) penfill cartridges which are sweet because I can use them in my Echo pen and half dose. Finding a pharmacy that even carried Regular was hard enough, it is not common here since Humalog/Novolog are around the same price over the counter. I’ve never had any experience with it, analogues already existed when I was diagnosed and I went on a pump soon after. I tried bolusing with Fiasp and then taking 1 unit of Toronto for a burger yesterday and it worked out really well. I’m wondering if it can be a real alternative to square waving on a pump if used correctly.
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That’s what I’m hoping for, as well, the square bolus effect. I tried looking up Novolin Toronto… It seems like it is the same as R? Did you take them at the same time? What amount did you take of each, compared to what you normally would have taken? I tried this with pizza the other night and failed spectacularly. (I was near 400 for a few hours, then crashed below 40 about 9 hours after I took it. Probably didn’t help that I took a long walk after I topped out in order to bring it down.)