User experiences of Fiasp

The below table shows the details from various users of Fiasp that have shared their experiences of the new insulin to make it easier for those who are about to start using it to understand it in the real world.

Experiences with Fiasp
Entries
12
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# How is your insulin delivered? How long have you been using Faster Insulin Aspart? Are you using CGM while using Fiasp? Please select what your FIasp experience relates to? (You can select multiple responses) Please provide your experience with Fiasp. Provide as much detail as you can so that those coming along later can understand what happened, what you changed and what to watch out for. If you were to start using Fiasp again, what do you wish you'd known before starting?
1
Hybrid Closed Loop
1.5 weeks
Yes
Action time
Insulin Tail
Hypoglycaemia
Unexpected results after bolusing
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)

Fiasp takes effect for me within 20mins of bolusing.

It seems to have a shorter effective tail.

My hypo symptoms seem to be starting earlier, but this may be temporary.

I've noticed that insulin stacking can create extra sensitivity.

I adjusted my DIA to two hours due to the changes in action, but other settings are the same.

The main thing to watch out for is the speed of action. I've noticed that it is very consistent in taking effect after 20 mins, so given the time it takes for food absorption to start, I rarely bolus more than ten minutes prior to eating .

I wish that I'd known that the effective tail is quite short.

2
Hybrid Closed Loop
1 week
Yes
Action time

Great experience. Starts fast. Do not prebolus under any condition.

Pretty straightforward.

3
Hybrid Closed Loop
8 days
Yes
Action time
Insulin Tail
Hypoglycaemia
Unexpected results after bolusing
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)

I've noticed the quicker action (which is expected). I did have one meal where food did not absorb quickly enough and was seriously considering giving glucagon since my blood sugars dropped below 1.1mmol/L. Because I have gastroparesis, I now wait until my blood sugars start to rise a bit after eating and then bolus, and because Fiasp is so quick, I still don't peak at a crazy high blood sugar (which is kind of nice).
I've had to drop back my DIA with the Fiasp compared to Novorapid. Novorapid I had at 4.5hrs and I tried Fiasp at 4, but have just dropped it again to 3.5hrs.

I wish I'd known how aggressively it works up front.

4
Pump
4 days 
Yes
Action time
Other things worth considering

Works faster, works more effectively at high bg levels (less insulin resistance at higher bg levels).

Less insulin resistance at higher levels.

5
Hybrid Closed Loop
8 days
Yes
Action time
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)
Other things worth considering

We use Fiasp with Loop with our 11 year old son. We adjusted our bolus time to 0-8 minutes before a meal (novorapid was 10-20 minutes pre-meal), depending on current BG, trend, and meal. We have also done minor adjustments to ISF. We have found a significant reduction in post meal spikes and also a nice response to Loop's high temp basals (due to the faster action time of Fiasp). We continue to monitor and make adjustments as necessary. We did not have issues with lows because we anticipated the faster action time and adjusted for it. It's certainly a new, very useful tool to have in the diabetes tool box and like any diabetes tool requires careful monitoring and caution while learning how it works for you.

I had researched and done plenty of reading on Fiasp so felt prepared, and had no surprises, so nothing really.

6
Pump
A week
Yes
Action time
Hypoglycaemia
Unexpected results after bolusing
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)

Have shortened action time to 2 hours but need to do proper ISF test. Think might need to change I/C ratio from roughly 1/4 units to 1/5 or 6. Am using extended bolus's much more. Have had a couple of unrecognised bad lows, symptoms slightly different. My targets = 3.9 to 7.5 of which I usually achieve around 50%, this week's has been 63% which is better, less highs but more lows. Work to be done!

Reduce bolus units by 10% to start, increase basal for dawn phenomenon. Check ISF, I/ C ratios fairly soon after starting. Carry fast acting fudge, juice for those hypos.

7
Pump
3.5 weeks
Yes
Action time
Insulin Tail
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)
Other things worth considering

Action time is brilliant. But does not help in morning after breakfast - well, it did a bit, but I only tried on one occasion. I dealt with it by giving myself a correction bolus on waking and a third of my dose for b/fast, then showering, then doing the rest of the dose just before breakfast. That works.

I have come to the conclusion that if your blood sugar is very high - it does not like it. And does not work particularly effectively.

Moreover, after removing the cannula after 3 days (I always do 3 days as micro-scarring occurs after 24 hours, not visible, but there, so don't take chances, been diabetic for 46 years so have to be careful of sites) the place was sore, a little red lump.

I have had to change every 48 hours - the sites are still red and a little sore and still a lump. The sites are still visible, every single one I have used though the lumps do go down. That worries me.

I am continuing use as it is fabulous for control as long as blood sugars are kept under control.

Not sure what to think, to be honest.

I am still using it.

8
Hybrid Closed Loop
3-4 weeks
Yes
Unexpected results after bolusing

Over the last week of use i have been eating and bolusing as normal for breakfast. It appears that FIAsp doesn't appear to work and my sugar levels spike (typically would be increase from 5.0 to 9.5) - am seeing the insulin having almost no effect and peaking over 15.0 before it appears to work. Significant enough effect to consider changing back to Humalog.

Nothing to add

9
Hybrid Closed Loop
2 weeks
Yes
Action time
Insulin Tail
Hypoglycaemia
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)
Other things worth considering

Action time is ~15mins faster than Humalog, great for bolusing during/end of meal. Really cuts down on post meal spikes.

Using Loop Hybrid closed loop with medtronic pump. Tried setting shorter DIA of 3.5 and 3.75 (from 4hrs with humalog) but kept going Hypoglycemic from insulin stacking.

From what I can tell DIA is similar to humalog at 4hrs but insulin starts working quicker. Will try again once Loop is updated with better/multiple insulin DIA curves which include FIASP.

Expect total DIA to be similar to current fast acting insulin, only with a quicker onset. Expect more Hypo's. Did not use long enough to encounter medium/long term effects.

10
MDI
14 Days
Yes
Action time
Insulin Tail
Hypoglycaemia

Works much better than Lispro. Less Insulin Doses (ca. 3/4). Shorter "Injekt-Eat-Distance" (20 to 45 minutes). Shorter Duration of Action (ca. 4 instad 5 hrs.). Since using Fiasp no numbers obove 11 and under 3 mg/dl. So far no problems or abnormalities.

All fine, nothing 🙂

11
Pump
5 days
Yes
Action time
Insulin Tail

Overall I’m impressed with Fiasp and think it’s a great step forward from Humalog.
Post meal highs are much lower and general BG profile flatter.
Mentally its taking some getting used to - being a 7 an hour after a meal with 6 units of insulin on board screams impending hypo to me. But it just flatlines then returns to around 6 (when I get it right!).
I bolus as I eat and that seems to work quickly enough to avoid any post meal high.
I’ve reduced active insulin time to 2.5 hours and that seems to be working – the tail is noticeably shorter than Humalog.
Breakfast is an issue. It seems much less effective then. I’ve increased my carb/insulin ratio in a morning which has helped and am also taking a super-bolus with breakfast (bolus the following hour’s basal rate with the meal, then run a 0% temp basal for an hour). That is really helping.
I’ve experienced no irritation at the site after 3 days of use, although for the first time ever I can feel a bolus going in- its a very mild itching sensation that stops as soon as the bolus ends.

Reduce active insulin to around 2.5 hours.
You might need to tweak your approach for breakfast - it seems less effective then.

12
Pump
3 weeks
Yes
Action time
Insulin Tail
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)

need 20% more insulin. acts fast. less of a tail. still fair enough.

?



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