I know this is an old thread but my comments are directly related to this quote, and I was wondering if anyone else has a similar experience …
I have been using Fiasp for about 4 months or so. I mainly switched to it from Humalog because of the skin irritation Humalog was causing with OmniPods. Fiasp has helped with this. The skin irritation is not as severe using Fiasp.
However, insulin needs seem to have increased greatly. I notice this especially on days that i do NOT run, of course. But on these days, it can be as high as 3 times what I used to need. For example, this morning to keep TiR I have eventually taken 3+U for just coffee, no food. Normally I would take 2U for 30g carb + coffee and stay in range.
The other thing I’ve changed is added a B complex supplement. I sort of doubt this would have such a huge effect on insulin sensitivity but maybe? I plan to stop taking it and monitor to see if I return to normal. I may switch back to Humalog to see if that makes a difference but I don’t look forward to the skin problems!
I’ve also been using the AB branch of Loop for a week or so which does a good job keeping me in range. I don’t think it is the cause of my noticeably increased insulin though, as I already had good TiR using the the temp basal mode.
Has anyone else noticed significant increase in insulin from Fiasp? It could be coincidental. I admit, I have not been monitoring insulin intake in detail until recently so I will do more monitoring over the next few weeks.
Thanks, Jen. Maybe my insulin resistance is not due to Fiasp then. I’m going to continue to monitor and will update here when I have data from more days!
Not yet; I’m at about 90 days so far and therefore my PDM can give me an overall figure for my average daily bolus (17.3IU) and basal (15.5IU), total 32.8IU/day. Those numbers aren’t significantly off what I assume my baseline is if I stick to the diet - 12+12. I don’t stick to the diet so I have to do corrections and temp basals (for the nuts). My average reported carb intake per day is 92.1g, but I underreport; that bolus corresponds to 138g/day carbs.
What I have done that maybe different is that I’m periodically swapping back to Humalog to use up my stash (damned diabetic squirrels), but I haven’t done that to a significant extent over the 90 days.
I’ve also noticed the skin irritation thing. It is not predictable; the pod I have on at the moment is causing irritation every time I bolus, a stinging sensation. My guess is that the canula orifice is right next to some sensitive nerve cell.
Thanks, @jbowler, for this. I’m afraid I’m guilty of this, too! Tonight I had 30g for dinner, and instead of the usual 2U, I eventually had 5+U. I’m mostly staying in range, but the extra insulin concerns me. I will monitor more over the next week, and try to concentrate/eliminate one thing at a time. I’m now thinking the insulin resistance may not be Fiasp related after all. I will update here once/if I identify what it is!!
I also haven’t noticed an increase in insulin resistance over my time using Fiasp (looking at TDD mainly). Of course there’s a lot of factors at play but just generally haven’t seen any spikes in TDD or any needs for higher than my usual boluses like you were describing. However, I’m planning on going back to novolog for maybe a month this summer to see if there’s any differences in sensitivity! But please do let us know if you find the culprit to your insulin resistance!
Thanks, Larissa, for your feedback. I appreciate it! It seems no one else is experiencing a reduction in insulin sensitivity due to Fiasp! This is good, of course! I’m still experiencing it though and continue to slowly eliminate possible causes. Nothing uncovered yet. It could just be a phase I happen to be going through, maybe weather, … I’ll update here if I’m able to pinpoint anything.
I know this might be an old topic - but I’m seeing the same thing and looking around. My ratios have changed significantly since moving to Fiasp. It used to be 1 to 1 for Fiasp vs Novorapid. Now it feels like 50% extra insulin for the same meals.
@rish Yes, FIASP ended up being like injecting saline water for me! I think others do experience this as well. Needless to say, I know longer use Fiasp! Good luck!
I think if you are pumping that if you are experiencing more resistance, try and change your basals before just hitting it with larger boluses.
I know I adjusted my basals some to account for a few things, and that I can be more aggressive with my basals with Fiasp is also a bonus.
I know that I definitely used more insulin on the average day than I did with Novolog. But, I could have been eating more carbs as well because Fiasp worked well for me.
I have went on/off/on Fiasp a couple times over the years, and I still get a honeymoon phase where it reacts faster, but I don’t feel it was ever the same as the first time I tried it.
I am now using Lyumjev (LoomJev for the sake of pronunciation.) I kept the same profile as Fiasp, and find that it also does a good job, and works very well with Tandem’s Control IQ version of mild looping.
I ended up having issues with Fiasp giving me occlusions. This was only this last year though, so something, somewhere must have changed. No occlusions with LoomJev other than one with my site/cannula.
It tends to sting some, similar to Fiasp, but I am not having site issues. (I did have some initial reactions, but my body adjusted.)
This is interesting becuase I’ve been having a ridiculous number of occlusions ever since switching to the YpsoPump (which uses the Orbit infusion sets). I blamed it on the pump in combination with longstanding infusion site reaction issues I’ve had for years, but when I talked to my endocrinoloist, he suggested it could be Fiasp. I’ve also experienced ever-increasing doses with Fiasp, so it might be time (after years) to give it a break. But we don’t have the Lily equivilent here, and I dread going back to a slower insulin. Maybe I’ll give it a try for just a month to start and see how things go…
Yeah, not sure what you can get in regards to LoomJev. I know it is still pretty new here. Released last summer, but it seems like hardly anyone even knows about it.
My endo knows I am pretty good at keeping track of and paying attention to how I interact with my insulins, carbs, timelines, etc. She thought it would be great for me to try it out.
I have been on it a couple months now.
Get this, they offer their own discounts for people without insurance, and others with insurance that won’t cover it.
I got 3 months supply for $35!!! This is an amazing price! Not sure if this was an error or not, but darn if I am not complaining about getting a BIG win on saving some money FOR ONCE!
I returned to Humalog, and yes, I immediately rebounded to my previous ratios prior to using Fiasp. I was only on Fiasp for a few months before I gave up on it. I was using it in OmniPod, and I’ve heard some say that it doesn’t work well in the pod.
I am on Novolog now. I’ve been switching back and forth between Humalog and Novolog the last several months. It seems like I become insulin insensitive so I switch to the other and it seems to help. Today I was at a BG of 200 all morning despite eating nothing and taking lots of corrections and increasing basal 100%. I finally went running at noon, and I dropped like a rock from 200 down to 128 in the first couple of miles, then down to 60 in another mile. I had to ingest 30 carbs to keep dropping into the 40s. I will switch to Humalog on my next pod change to see if that helps.
Yeah, that is what I hate about Novolog, you can have downward runs of BG that go like a freighttrain and are very hard to stop without going on the roller coaster.
I have much less of a roller coaster affect on Fiasp/LoomJev though.
One Question, on your resistance. Are you doing many larger boluses? I find that on most insulins I have tried, if I give too many larger boluses, I will fall off my normal graph of how I react, and how much I need, of different insulins.
Before going on Control-IQ, I would prefer to go on a much higher temp basal, and do smaller boluses. This worked a lot better for me, and was easier to keep better control of.
Now with C-IQ, I just superbolus when needed and let the pump figure out the aftermath
No, my bolus corrections are generally small using “fake carbs” of 5g or 10g, so usually less than 0.5U at a time. I’m on DIY Loop Autobolus branch though, so it, too, will give me small corrections, generally 0.05U-0.5U. I had 4+U IOB by the time I started my run today, so I knew I could potentially drop, that’s why I had lots of carbs on me. But I didn’t want to just sit at a 200 BG all day! I usually start my run with 0U IOB!
Yes, I too usually can just let Loop figure out the math but not today, my body just did not respond to the insulin Loop was programmatically giving, at least not until I ran!
Hmm, those smaller boluses don’t usually cause issues like that with me, but I know the bigger ones do.
I think it is almost like over-saturation of a site that causes this.
Good test, either way, give an actual injection in another location. This will tell you whether it is the insulin itself, or your specific site location. Don’t do IM, as these shots are always more effective.
Unfortunately, I’m just starting to run into that, after a couple of months on Novolog in the pump. Lows that go on for hours and then ZOOM up to 160-180 to hang out there for hours. Starting to wonder if I might be better off switching back to Humalog.
