Any MDI fiasp users here yet? I have a sample pen but haven’t put it to use yet. I’m curious if any real perceived benefits are seen over other injected analogs?
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My experience with it is that it does work faster up front, but the downside is this means more injections later on or greater reliance on regular insulin with almost every single meal to avoid spikes an hour or two later. I think it is amazing for fruit and very fast-acting carbs that digest quickly, but not for anything that stays in your system a bit longer.
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That’s kinda what I was envisioning… maybe great for corrections but less than stellar for mealtime bolus… seems like more and more even with novolog I’m getting spikes after it wears off if there’s significant protein/ fat involved…
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Same! I wish there was an insulin that kicked in as quickly as Fiasp but lasted as long as Regular.
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Regular is some good stuff in a lot of cases… there is no perfect insulin… it’s like trying to play golf all day every day with only one club
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I’m a Fiasp user after switching from Humalog. I agree that 2-3 hour peaks after a fat/protein rich meal can be worse with Fiasp than Humalog, due to the relatively fast in-out of Fiasp. However that is the only downside I have discovered. I have used a lot of after meal correction Fiasp; by the way, corrections seem quite reliable and predictable with Fiasp as long as you catch a high before it gets too extreme.
Try adjusting your pre bolus with your sample Fiasp based on the meal type. This works well for me…for some meals such as steak and vegetables I don’t pre-bolus at all, I bolus when I take the meat off the grill. I have found that if I am attentive to the CGM trend during that 1-2 hour time frame after eating, I can pre-emptively catch an impending high after almost any meal. That is my favorite thing about Fiasp.
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Seems to work a bit faster than novolog. Not sue if matching sharp peaked insulin with fast jumping sugars is optimal though. Strangely I just got back from the CVS over a Fiasp prescription… I used 1 pen and after a week the fiasp pen looked cloudy. I went back to CVS and said i wanted to return the 3 boxes, the other pens looked clear or quasi clear. He only wanted to take the 1 pen back, but i said your taking all this back not sure how they stored it, he wasn’t happy but $1500 for 3 boxes it better not look like a milk shake. I’ll have to see what happens, he’ll likely say come pick up the insulin you left, in which case i’ll reach out to the ca pharmacy board, insurance company, gov’t overlords if its not made right… I cant’ even understand why a prescription is needed for some insulin’s and not others. Why also do we only see these new drugs when their last patent runs out, ah 18 years later and the 6B a year made to cover their big R&D and we get the same old Novolog that was released in 2000 with a b vitamin crazy glued on, … They wonder why people view drug companies as vampires, pharmacist a organization that should be replaced with automation and Endo’s, an entitled self righteous bunch who collect $220 for 5 min to just give you a hard time. After so many years i go out of my way to find the dumbest doctor who is a walking script pad, they’re good for nothing else. Lab’s and the result boundaries are all online. Anyway for Fiasp, i would say Novolog pre 15 min meal is better than Fiasp, Fiasp for other cases, Fiasp for corrections, sure afrezza is better though, and from what i’ve read avoid fiasp if your on pump because it clogs quickly.
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It’s a bit of a paradox. I found Fiasp more useful when pumping vs. MDI, as NovoRapid works way slower for me in a pump. At the same time, pump sites degrade faster and I found it would lead to more spikes after exercise and waking up due to its shorter duration.
I have been used Fiasp in an omnipod for about
1.5 years and have had no issues with pump clogging.
Fiasp is not some sort of magical insulin, but I like it quite a bit better than humalog as it starts working quicker.
For high protien/Fat meals I just do extended boluses. Unfortunately that is not a thing on MDI but when I did MDI with humalog I still had to do a second bolus for high fat/protien meals.
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I don’t disagree with anything your saying, that’s why i started using Fiasp about a month ago. Fiasp to me is better just not vastly better than novolog. Everyone should try as many things as possible and see what works. It was only after trying to save 5k in expenses and changing back from a pump after 18 years to MDI that i was like wow this is better than a pump. Tresiba+Fiasp+Dex5+iwatch, its never been so good. The problem with the pump for me and not mentioned enough, is the poor absorption rates at said location over time. It could that having used pumps for 18 years i had built up excess scar tissue. It could also have been that i wanted to save supplies and should have pulled the site after 1 day instead of waiting 3 or sometimes 4 days. Yeah if resources were unlimited i would try as much stuff as possible and stockpile as much of the good stuff as i could. only exception is i was once locked into a Tandem pump for 4 years, i was suckered by the apple like color display. After 4 years having to hit 15 buttons to give insulin, always having to charge it, and the horrible reservoir refill process and i couldn’t wait to go back to minimed. I remember once going to Japan and finding all 10 of the reservoirs i brought, the pump said were bad, that’s when your stomach sinks.
Yeah I go back and forth between MDI and pumping now due to site issues and I’m just as proficient at both. Do you find Fiasp much quicker on MDI though? On a pump I find a huge difference, with pens I don’t really find it that much faster and Novolog lasts longer which is better for me. Regular insulin is the real secret to MDI in my opinion, doing MDI without it is like using a pump that has no extended bolus options. Tresiba doesn’t work for me but a split dose of Levemir sure does. I think many people hate MDI because they are taught just to use a single dose of Lantus which doesn’t meet the basal needs of many people and has its own problems unique to Lantus.
Maybe that’s the issue, most doctors want to write prescriptions for 1 bolus and 1 basal insulin. What should really be the case with MDI is giving say 4-5 different insulin’s, and this is after trying each and seeing if it agrees to diet etc. If you have a meal of rice, you whip out say Fiasp, if a ham sandwich maybe you go for Novolog, a wedding and you eat all night maybe a shot of R. I think many people on pumps could improve blood sugars by having their basal set correctly, sometimes people fight highs all day. I’ve read studies where the ideal basal was worked out to be 48.5% of TDD. When i used the pump i had some decent control by looking at the past 3-7 day TDD and then plugging into excel my current basals and multiplying by a factor to get it to say that 48.5% of the TDD. A pump and excel are best friends. Strangely i also found it interesting people have to go thru the 2-3 days of issues when using Tresiba. The half life of tresiba is 25hours which is basically 1 day. If they used excel the pain of getting fully titrated would be less, shot 1 is say 20u, day2 that shot is 10u, day 3 that shot on day 1 is 5u. In fact with excel you could write it out so the first 3 days would be closer to the fully titrated amount.
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Yep, but at least with R you can buy it cheap over the counter without a prescription. I agree Tresiba is wonky the first 3 days, but I think my problem with it was likely that 1 dose for 24 hours just didn’t suit me. I would have to lower my dose to keep from going extremely low during the night to a point where my dose was so low it wouldn’t last 24 hours. I’ve read plenty of other people have this problem. I also don’t like that it can’t be adjusted as needed like Levemir can every 12 hours (so I can take less on weekends for example or more at night to help with a high fat/protein meal). What was strange with Tresiba though was after about 14-16 hours it would “shut off” as if I had no basal in me at all and if I ate even the tiniest amount I’d get the biggest spikes I’ve ever seen. Even when Levemir has run out before I’ve taken my next shot it still seems to have some effect and I haven’t experienced such dramatic highs.
I know what you mean to some extent… with Lantus id have to snack a little to feed it wheras with tresiba I will invariably rise if I eat virtually anything. This took a while for me to get used to but now I think of it as tresiba working as more of a ~pure~ basal… it has little benefit to cover food but for me works excellent to steadily cover my natural tendency to rise even without food
That can be true, especially if I’ve taken slightly too much Levemir, but I mean when I would bolus for food after ~14-16 hours of taking Tresiba I would get enormous spikes. I forgot to take my morning dose of Levemir a couple of weeks ago and definitely got a larger spike from DP on the way to work than I normally would, but when I injected it took care of it and then it was fine all day as long as I kept taking Regular every couple hours. On Tresiba I’d spoke to 16 and it would be impossible to bring down for hours no matter how many times I injected, not sure why.
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We [very] recently switched to Fiasp in a Tandem.
So far it does seem like magic.
Having trouble believing how effective it is.
Please elaborate
@Thomas Great to see you post! What happened to the little marsupial?
Critter got tired.
Need to test this out for a longer period to make sure it is not a fluke.
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