I’m curious if you can give some details on the occlusions you had with Fiasp? I had yet another occlusion today, less than 24 hours into my infusion set. It was a real occlusion in that in addition to the alarm my blood sugar was skyrocketing for no reason. When I’ve investigated the source of the occlusion in the past (didn’t bother today as it was clear I wasn’t getting insulin), it always seems to be at the infusion set (not the tubing or site), becuase if I remove the needle and try to bolus through it, no insulin comes out. They are really thin 31 gauge needles, so I wonder if Fiasp just clogs them up, and if so, which alternative insulin might be better (I’ve only used Humalog and Apidra in the past, and sadly my endocrinologist said the new Lilly equivilent to Fiasp isn’t available here yet). I really hate the thought of going back to a slower insulin, but I also think these repeated spikes I have from occlusions are really detremental to my control.
I went through a number of them actually.
It usually was around day two, and it could be tubing or site. I did have one or two that would be considered in the cartridge itself.
Towards the end I would be getting them to start pretty close to the end of day one.
When I started on Fiasp, I would get them, just restart insulin and ignore it. It rarely happened, and were false alarms.
I had a long stretch of very good results while using Fiasp. I started using it as soon as I could (not long after being approved I think.)
Like I said, something changed.
I still really like Fiasp. And I recommend people to TRY IT! It isn’t for everyone, and for some, the added benefits go away after a while.
Have you noticed if this happens after a time of zero basal? Like when basal is continuously flowing, it does not occlude. But when basal is turned off for a time, it clogs the needle?
@Eric - how many ALA capsules do you take daily? I take just one and don’t think it’s helped my insulin sensitivity. Need to look at the container to see what’s actually recommended. How significantly do you think it’s helped you? Thanks! Jessica
Hi @JessicaD,
I take 600mg every day. That is the recommended dose on the bottle I have, but some studies had doses between 600-1800mg daily.
ALA does a lot of stuff. It’s in all our cells. It converts glucose into energy. It’s an antioxidant so it helps prevent cell damage. It also helps stabilize other antioxidants and is thought to enhance calorie burning.
I really do not know how much it helps my insulin sensitivity. There is no single silver bullet, it’s everything combined, like exercise and all of that stuff works together. But since there is no down-side to taking it, I add it to the mix.
If we all ate perfectly balanced meals, most of us would not need a single supplement. But how many of us can claim to eat perfectly every day?
I take 600mg ALA capsule once a day, too. I noticed a big improvement in insulin sensitivity when I first started taking it, but that could have been attributed to other factors as well. As Eric says, so many things effect our insulin sensitivity. I’m currently in a phases where my sensitivity is lower than usual, but I still take ALA and believe it does help as part of the mix.
Nope, lately I have not suspended my pump much. In the past I’ve gone through periods where I suspend for 30 minutes to try to prevent lows and suspend for 60 minutes or so for exercise. But I haven’t been doing either of those lately. When I disconnect my pump, I just leave the basal running.
I’ve also been noticing infusion set irritation issues that my endocrinologist said could also be due to Fiasp. Just really hoping I can hold out for the Lilly equivilent. Fiasp has had such an enormously positive impact on my daily diabetes management, I hate to give it up unless absolutely necessary.
@Jen Lyumjev causes horrible site pain as well. It’s not like a stinging sensation but rather a blunt force trauma that constantly irritates the area. I did not find that it works any faster than Novolog. I gave up on Fiasp long ago because of all the quirkiness associated with it, the most annoying being that it just stops being effective after a few months and I have to stop using it for 3 months. Be warned, the additive Lily uses to fuse the insulin molecule to quickly move through the cells causes migraines in most patients that are using lyumjev
So what happened when you stopped using fiasp? Assuming you went back to novolog?
@Sam Once I notice the Fiasp isn’t working anymore, I move back to Novolog. I usually have to wait a few months before the Fiasp is effective again. From research I’ve done across the net, I’m not even close to the only one this happens to. About a year ago, I made the decision to stick with Novolog, which I like very much. It starts to work in about 15 minutes and gives me a very smooth BG line with CIQ.
I guess what I’m asking is… when you switched back to novolog did it start working the way you hoped immediately? Or did the frustrations you had with fiasp linger for some period or time? Or some indefinitely?
@Sam Sorry, I misunderstood you. Yes, the Novolog worked as expected without issue. My apologies
No apologies necessary
It’s just been a concern all along how much bolus I take compared to basal (I’m on mdi) and it seems like fiasp has even increased that already off balance situation.
It’s reaching a point of absurdity how much bolus I’m taking with fiasp…it seems like pumpers don’t always break it down that way since they’re taking a total amount of the same insulin and whether we call it basal or bolus is basically semantics from a chemistry standpoint… but it’s starting to concern me as a shooter
@Sam Ive raised this concern to my Endo and he thinks I’m nuts. He says Fiasp is insulin, and it will work no matter what. However, a psychiatrist friend of my mine told me the additive Novo Nordisk uses in Fiasp actually causes insulin resistance. I’m not a chemist or biologist, all I can do is repeat what I’ve been told and what I’ve experienced. So far, I’m not impressed with Fiasp or lyumjev
It certainly appears that the way they’ve modified it somehow affects how at least some people absorb and metabolize it… whether that’s supported in their laboratory experiments and trials or not
I would trust your words in this matter over anyone else’s
Pretty old thread, but I’m using Fiasp and have been struggling a lot lately. Used it for years with no issue, but all of a sudden my sugar spikes like crazy after meals and isn’t going down until 2-4 hours later. It used to be so fast for me that I had to take it after the meal sometimes, so something really drastic has happened here. I’ve talked to a few doctors and nurses at the clinic I go to about it but none of them seem to be taking me seriously, and some even make it sound like I’m lying. Really at my wit’s end here. I’ve had type-1 diabetes for 15 years and it has always worked fine with A1Cs in the 50s, and now this. Should I ask for another rapid-acting insulin or is the change so drastic that it might be because of some other issue with my body? Hard to say, I know - but any advice would be greatly appreciated.
@Erki, there are apparently many different responses to Fiasp. I had a rash and stopped using it. Other users say it worked very well. Others say it worked for awhile, and then it was not working fast. I have not heard about spiking after using Fiasp. Is your Fiasp expired? Maybe try a new vial.
There are a lot of possible reasons that things like this can happen, but perhaps the most likely causes are one of these:
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A bad vial, as @Richard157 suggested. Swap it out.
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Bad injection or infusion sites. Like if you are using the same site over and over, they can become less effective. Try a different site.
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Changes to your overall diet. Have you changed anything recently?
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Changes to your timing of meals and dosing. Has anything changed with that lately?
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Any increase to overall stress levels or less activity than normal?
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Changes to your insulin needs. If none of the first 5 things in the list are the cause, perhaps you just need more insulin. Start adjusting your dose a little bit at a time.
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Some other medical issue that makes you need more insulin. Having an exam and bloodwork done can help identify if there is some underlying issue you have that is contributing to higher BG.
How long as this change been going on? Hours, days, weeks?
Same infusion/injection site, or something different?
The only other FAST insulin is Lyumjev.
I use both Fiasp and Lyumjev. Both have advantages and disadvantages.
I found that most issues I have with Fiasp are solved by a time using a different insulin. But my issues always end up coming back. Mainly occlusions. But effectiveness changes.
Lyumjev tends to bleed out, and can actually be painful on some boluses. Fiasp would sting, Lyumjev can hurt. Obviously this is how I react, not everyone else.