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
46
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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.

?

13
Pump
1 week
Yes
Action time
Insulin Tail
Hypoglycaemia

We switched from Humalog to Fiasp. After reading the publications about Fiasp I did not expect very much. However our experience has been a very positive one!

It is now much easier to bolus for a carb-rich breakfast. If the starting BG is good, it is enough to bolus parts of the total insulin needed as we lay the table and the rest while we eat. The spikes are much lower, but also the drop later on is much softer. This causes much less temptation to overcorrect and we have had fewer hypos after bolusing for a large meal.

On the negative side, the tail is notably longer than with Humalog. But since the drop is softer, it is very easy to handle. We now turn off basal completely for 2 hours after bolusing for a larger meal. I imagine the longer tail may become a challenge with many smaller meals throughout the day, but we have not tried that yet.

We did not have to make significant changes to basals or carb ratios coming from Humalog.

Nothing, the change was not a problem at all

14
Pump
8 weeks
Yes
Action time
Insulin Tail
Unexpected results after bolusing
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)

The action time is noticeably faster than with Novorapid, so there is no room for delays between bolusing and eating.
The tail is similar to that with Novorapid, on AGP or CGM it looks like BMs are stable but I'm still experiencing unexpected lows up to 4 hours after bolusing appropriately. I have increased my basal rates on the pump by 0.05 each hour as I was experiencing higher than normal BMs from 01:00-14:00hrs and have reduced the basal by 0.05 from 15:00-21:00 in view of the lows. My carb ratios have also been adjusted from 1unit:10grams to 1unit:12-15grs depending on time of day.
So far I haven't had any illness to confound results but with menses glycaemic control has been easier to maintain.

I'm still using it and will be for the foreseeable future. It would have been useful if my hospital consultant had known as much about it as I did as I spent much of the appointment discussing potential benefits of FIASP over Novorapid and it wasn't so much a consultation as a teaching session...

15
Pump
6 weeks
Yes
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)

Stability overnight has deteriorated. Gone from flat lines overnight to unpredictable substantial falls in glucose overnight which persist despite alterations in basal rate. I:C ratio during the day also adjusted to make ratio slightly more aggressive. Onset time is better and offsets pp peaks but not sure this trade off is worth the less stable basal overnight.. .

If on a pump it make take over a month to stabilise insulin settings and it may make basal insulin and glucose overnight less predictable but this is based on n=1.

16
MDI
6 weeks
Sometimes
Action time
Insulin Tail
Hypoglycaemia

Helped reduce number of post prandial spikes. I did find an increased incidence of hypos but i feel the overall better control was worth it. Didn't find i beeded to change carb ratios.

Stock up on your hypo treatments!

17
Pump
4months
Sometimes
Action time
Unexpected results after bolusing
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)

I found the first week things were really stable without any changes to pump hand outs then all of a sudden I started to have lots of lows and had to back off my basal rate at night while lowering my carb ratio at meals.
I have been using 3 hours as the insulin action time and it seems pretty good.
I do not eat a lot a sweets but have found that bolusing right before or during the beginning of a meal works really well in regards to post meal BG excursions. but I find if I bolus after eating it doesn't work as well and this was not tested simple carbs rather a well rounded meal.

That setting may change over time and its not quite as fast as the claims are but better than the other insulin out there. Mind you I have only used Humalog
Rates on a pump may have to drop.

Interested in hearing if others have more bubbles in there pump tubing with FIASP?

18
Pump
week
Yes
Action time
Hypoglycaemia
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)

Changed from animal insulin so trial and plenty of error has been the name of the game.
So far taken 10.2 units off of my basal carb ratio has changed from 1-10 to 1 - 13 and profile much smoother.
Very frustrating to use because as soon a one section fixed another needs adjusting.
May I apply for sainthood?

Nothing really as I had read plenty of blogs/reports from other people before I started.

19
Pump
3 months
Yes
Insulin Tail
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)
Other things worth considering

1.Not as much tail as novo rapid. It does kick in more quickly, bringing a high down faster.
2. Required more fiasp in both basal and bolus, I:C, ISF than when we used Apidra.
3. Over the 3 months, increasing irritation at the site for pump inset. At first just red irritation that was a small spot, then noticed skin where site had been located (only for 3 days) remained red, irritated for a long time after site was changed. Finally quit using Fiasp when started to get a large red, swollen area around the site after 2-3 use in that spot.
4. Over the 3 months, started to get spikes in high BG, which we wondered might be attributable to less absorption when by day 2 of a new site skin was becoming irritated.
5. Was very disappointed as had hoped we could use it.
6. Went back to Apidra, which also lacks the long tail of novorapid.

We will not, due to skin irritation.

20
Hybrid Closed Loop
3 months 
Yes
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)

Badal rates neeeded to be upped pretty much across the board. Carb ratios increased (less insulin). Much quicker to
Come down from highs- DO NOT STACK THIS INSULIN or you will crash!

Using in a 6 year
Old for what it's worth!

Check check
Check all settings!

21
Hybrid Closed Loop
1 month
Yes
Action time
Hypoglycaemia
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)
Other things worth considering

Prebolus time is best at 0-8 minutes for me. 10-15 is to long, resulting in lows during or right after the meal.
Basal rates have needed slight increase. (Avg 15%)
Must change pump sites more often. Sure-Ts every 1.5-2 days, Mios every 2.5-3 days.
Skin can become irritated quickly if I wait too long to change site, and insulin absorption gets way slower if I don't change promptly.
I have found that I need to change my reservoir out every 3-3.5 days.
I've been experiencing light headedness and feeling faint and dizzy when moving to standing position. So I've been checking my blood pressure at least once a day for a week. I normally have blood pressure in the 100s/60s range, but this week it's been in the 90s/50s range. I even had one reading of 89/56. This is pretty low, and I definitely feel it. I think it could be caused by the Vit.B3 in the Fiasp (since it's related to niacin). Nothing else has changed in my life or health to explain the lower blood pressure. I plan to discuss it with my endo and request a lipid panel as well, since my cholesterol and triglycerides are usually pretty low too, and B3 can lower those as well.

The faster onset sometimes means that you don't have enough insulin left to cover slower digesting meals. This has been more of a challenge than I expected.
Be aware of any blood pressure changes you may experience (esp. for children).

22
MDI
1week
No
Action time
Insulin Tail

Action time appears faster than humalog that I was using. Tails off quicker so adjustments for slow absorption required.

.

23
Pump
4 days
Sometimes
Action time
Insulin Tail

I have previously used APIDRA and couldn't get spikes after eating under control, even if I injected half an hour before meals.
I have found since using FIASP that I can generally get post-prandial CBG's less than 10mmol/L but on occasions have had hypos shortly after eating.
I am now injecting no more than 10 minutes before eating and so far so good.
It's still very early days so I haven't made any adjustments to basal rates, ISF, or carb ratios yet.

Anecdotal evidence is always useful but in true diabetes fashion the experience appears different for everyone.
I had already done a fair bit of research before switching and so I don't think there is anything I wish I'd known before starting

24
Pump
3 months
Yes
Action time
Insulin Tail
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)
Other things worth considering

I use a Vibe + Dexcom and in May switched from Humalog to Fiasp. From the start, I found it very aggressive with a super-quick action (less need to prebolus and much faster response to corrections) but a shorter tail (need for longer extended boluses). I also had to reduce my I:C ratio from 1:8/1:9 to 1:9/1:10. Unfortunately by the third cartridge, I was starteing to experience SEVERE site issues. Big red bumps were appearing within a few hours of site change and there was painful stinging on bolusing. Also, obvious site absorption issues appeared (CGM showing upward trend overnight and not responding to corrections - not attributable to evening meal). I have always had to change on a 2-day rotation, but with Fiasp it was not possible to make sites work even when changing sets daily.

Because site sensitivity issues have been reported previously and supposedly improve with time, I tried desensitising myself by pumping a premixed "home-brew" of Humalog + Fiasp, starting at a 4:1 ratio. This has worked well and I have now managed to get to a 1:1 ratio with only occasional site issues towards the end of day 2. My impression is that the 1:1 mix shows the same aggressive onset and short tail as does 100% Fiasp. I assume that the Niacin (vitamin B3) added as the accelerant has the same effect on the Humalog in the mix.

I have been able to set my I:C ratios back to the same as for 100% Fiasp. I now almost always extend meal boluses even for fairly high GI meals and extend longer for pizza/pasta etc (50% over 3 hours) which seems to deal with the 4-hour rise. Have had to increase my basals by ~10% particularly on the overnight rates. I don't eat low carb and now suspect that I have perhaps been "covering" part of my basal requirements with the "tail" from my boluses.

It would have been nice to have known about the site issues - I might have started out on a mix from the outset.

25
Pump
3 weeks
No
Action time
Insulin Tail
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)

Novorapid and Apidra both took usually about 45-60 minutes to show any drop if bg sitting fairly level. Testing with a steady starting level of 10 one morning a correction and bolus for 30g carbs with Fiasp showed a 3 mmol drop within 15 minutes, continuing to fall after eating cereal before coming back to a level of 6 after an hour. Previously it would have taken a minimum of 45 minutes to see a starting drop. With pasta and rice dishes I have had to reduce the up front amount and extend the rest for a longer period to maintain steady levels - rice now 8 hours instead of 6 and pasta 3.5 instead of 2.5. Basal levels have increased by about 10% which is actually meaning I'm getting closer to the 50/50 ratio the consultant would prefer to see. On novo and Apidra I would often spike into the teens 2 hours after eating, particularly at lunchtime but would be back to normal and still dropping by 4 hours later without correction. Fiasp is showing levels generally back to starting levels at 2 hours and no drop over the next 2 hours. Hypos have reduced as have levels above my 4-8 target. Past 2 weeks showing 80% results in target, 10% above and 10% hypo which is usually 3.6-3.9 so pretty safe, with average at 6.4, standard deviation 1.7. Previously it usually would have been about 2/3 on target, 10% hypo (wider variation) and about 1/4 above target. Average bg around 7.5 standard deviation a bit over 2.

I read others' experiences before starting so increased basal by 10% and dropped breakfast and lunch boluses by 10%. Trial and error showed I needed to switch boluses back to normal.

26
Pump
1 Month
Yes
Action time
Insulin Tail
Unexpected results after bolusing
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)
Other things worth considering

Fiasp is fast, but effective time is shorter than novorapid. I need to change set more often. basal + 20%.

There need to be done more changes than was expected. Not just bolusing.

27
Hybrid Closed Loop
2 months
Action time
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)

No prebolus required - in fact, now we don't prebolus until he sits down to eat. On Humalog, he would bolus while the meal was being prepared. Doing so now causes an almost immediate low. Corrections are fast. Highs, when they do occur, crest quickly. For a child who wants to eat when he's hungry and often wants seconds this is nothing short of a miracle.

Basal rates increased across the board, probably 20% or more over Humalog. ISF is more aggressive. Modify pump rates <1 hour before you want to see a change.Fiasp plus Open APS has improved my son's life considerably. I plan to drive to Canada every six months to stock up until it is available here.

We started using it following a family vacation to Canada, when we bought 3 vials to experiment, and then came back to an erratic summer schedule. I'd recommend (for a child, at least) working with Fiasp when life is as steady and routine as possible (ha). Also expect to need much more insulin and don't freak out that these are new rates and ratios that would be comical on the previous insulin. Don't make any decisions without using it for at least a month.

28
Pump
5 month
Yes
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)
Other things worth considering

I have 2 children with diabetes type 1 (using 640g and cgm) and have done a data study. I have these findings (without any adjustment):

1) Fiasp have helped on hyperglycaemia - the higest blodsugar values was cut off.
2) Fiasp is best when you are in target before a bolus. In other word if you get out of target then Rapid was better to get you in target.

Adjustment
I have done an ajustment of "insulin active time" from 3 to 2.5 hours and adjusted insulin sensitivity as well. I put it lower so they get more insulin to corrections. It have seemed to helped.

My conclusion is that my children are better of with Fiasp than Rapid after the adjustment.

I have more visual results to be shared.

I don't understand this question. My children continues using Fiasp.

29
Pump
2 months - now stopped
Yes
Action time
Unexpected results after bolusing

Hi Tim,

I used it for a couple of months and gave up. Results were random - random highs, random lows, and generally unpredictable results. I thought it was necessary to change canula more frequently. Overnight was random and I just felt out of control. The tail end was interesting - I often spiked!

The response time was better and it helped prevent spikes. Maybe it would work well to have Fiasp for bolus and something else for basal.

It did help me though - now back on Apidra it has helped focus on the things that are wrong, but for me I don't think I will be going back to Fiasp.

That it is unpredictable, particularly at tail end.

30
Hybrid Closed Loop
7/1/17
Yes
Unexpected results after bolusing

I did very well on Fiasp until I switched to the Loop model that used DCA. Then I seemed to have a lot of problems day & night. I lowered my basal rates and also decreased the number of of my meal bolus, increasing my insulin all around. That seems to have solved the problems at least temporarily. My next step will be to go back on Novolog and see how that works.

Things may change and you may require more insulin as you develop an .immunity" to Fiasp.

31
Hybrid Closed Loop
3 weeks
Yes
Hypoglycaemia
Unexpected results after bolusing
Other things worth considering

I am noticing that anytime I eat and bolus I am rising at a very steady pace, even with precise carb counting. Autotune thinks my rates are correct.

I also have been having a lot of severe bottom out lows when I finally come down from those highs. I also have perfect flat lines overnight and whenver carbs are not involved.

Worth noting that I also take Metformin

How difficult it would be

32
Pump
1.5 month
Yes
No
Action time
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)
Other things worth considering

I use the Freestyle Libre, not CGM.

I suddenly had problems at night with unexpected rises th could not be explained. This didn't occur every night but sometimes so difficult to find a pattern when I needed to change my basal.

I also noticed that the insulin seemed to be working better while at home doing nothing but as soon as I did something else, bg rose and was very hard to lower.

I also had a lot of problems starting up Fiasp where I had to change just about everything, basal, carb ratio, acting time. This evened out after a while and I was at the end back to the same levels as I had with Humalog.

I am now back with Humalog again atleast temporarily because it seemed impossible to get it working as it should again.

That it will require so much timing in. I started at a very bad time for me and I really didn't have the time for all the work it took to start it up, it took a lot of energy and testing to tune it in.

33
Hybrid Closed Loop
2 months
Yes
Action time
Insulin Tail
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)

No more than 5 minutes pre-bolusing required for meals if in range pre-meal. Brings down a carb caused high or a stress caused high nice and fast, but struggles with protein caused highs.

Overall reduced basals but increased boluses compared to humalog. Timings of basal didn't significantly change. DIA changed from 4 with humalog to 5 with fiasp.

Stinging happened on bolusing for the first few weeks but then reduced to nothing.

Get it set up on prescription early as any delays in getting a refill will make you realise how much you value Fiasp when you have to temporarily return to slower insulin!!

34
Pump
8 weeks
Yes
Action time
Hypoglycaemia
Unexpected results after bolusing
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)
Other things worth considering

Initially action time seemed markedly shorter. I needed to adjust well-known dose strategies for food, reducing the time between bolus and eating and using dual wave/combo bolus where I would have expected 'all up front' to work well.

Rather strangely I initially saw greater spikes after food than I would have expected with NovoRapid so had to alter meal ratios.

After about 2-3 weeks I noted a change in insulin sensitivity and needed to adjust basal pattern, meal ratios and correction factors again.

Breakfast was particularly challenging and needed substantially more insulin than identical breakfasts would have with NovoRapid (I always eat the same thing to make things easier).

Between weeks 4-5 I thought I was making progress and seeing some promise. This lasted approximately 10 days, before sensitivity changed again and I was seeing more sustained high blood glucose with little effect of significant correction boluses (2-3u) within 1-2 hours.

Earlier rapid action had also pretty much disappeared by this point. I was needing to pre-bolus in just the same way I would for NovoRapid, I no longer needed the additional dual/square wave boluses to slow the insulin down for some foods and corrections were taking at least 1-1.5 hours to begin to affect CGM trace. Meal doses were also behaving unpredictably such that I felt I could only reliably use Fiasp while wearing CGM (which I can oly afford to fund occasionally) so that I could catch the raging highs from standard meal/bolus pairings that were intermittently failing.

I reverted to NovoRapid and have had significantly fewer hypos and post meal spikes since, with much more reliable action.

How unreliably it would act for me, and how the faster action would disappear after a few weeks alongside increasing insulin resistance. I see no need to try it again.

35
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)

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36
MDI
Five months
Yes
Action time
Other things worth considering

It certainly kicks in faster and harder than Novorapid.

I've found myself with increasing insulin resistance and have had to increase my dose by 30%.

It's not predictably effective when correcting highs. Sometimes it seems to work very quickly and sometimes it takes forever. Novorapid was consistently slow.

That it very quickly made me more resistant to insulin and that it needs a much shorter pre-bolus time. It's not much faster to correct high blood sugar usually.

37
Pump
4 months
Yes
Action time
Insulin Tail
Hypoglycaemia
Unexpected results after bolusing
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)
38
MDI
Pump
Hybrid Closed Loop
Other
10
Sometimes
Action time
Insulin Tail
Hypoglycaemia
Unexpected results after bolusing
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)
Other things worth considering

yes

yes

39
Pump
Of and on for a few weeks
Yes
Action time
Insulin Tail
Hypoglycaemia
Unexpected results after bolusing
Other things worth considering

I found Fiasp to cause pain when it was delivered via my pump.
Insulin action was not as expected. The first day was great every time I switched back to Fiasp. After that, I seemed to develop resistance towards it. It wouldn't seem to kick in as fast, I seemed to need much more to cover carbs and do corrections, and then hours later my bgs would suddenly crash. Caused much more of a roller coaster in blood sugar levels than novarapid does.
I was excited about trying Fiasp, and I'm glad I did, but I'm sticking with novarapid for now.

?

40
Pump
Of and on for a few weeks
Yes
Action time
Insulin Tail
Hypoglycaemia
Unexpected results after bolusing
Other things worth considering

I found Fiasp to cause pain when it was delivered via my pump.
Insulin action was not as expected. The first day was great every time I switched back to Fiasp. After that, I seemed to develop resistance towards it. It wouldn't seem to kick in as fast, I seemed to need much more to cover carbs and do corrections, and then hours later my bgs would suddenly crash. Caused much more of a roller coaster in blood sugar levels than novarapid does.
I was excited about trying Fiasp, and I'm glad I did, but I'm sticking with novarapid for now.

?

41
Pump
did 9-10 weeks
Yes
Action time
Insulin Tail
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)
Other things worth considering

I used FIAsp for around 10 weeks.

Initial responses : predicted fast action didn't really happen only some slight drop, up to 1 mmol, occasionally.
Time of action was unpredicatable, was using HAPP and thought it was the shape of the insulin curve.
Started using AAPS in order to use the FIAsp prediction - this was definitely better but seemed often to end too soon.
Irritation at site.
It did bring bloods down significantly more quickly than humalogue.
Within the first week I found my pod was running out of insulin before the expected 3 days.
Soreness/irritation at site.

My general health is often not good but in the summer sun usually ok, Tiredness can be a major problem.
Asthma gradually became a bigger problem and found I needed to take a few days of prednisolone to bring it back under control and then was ok. This cycle repeated twice. This is not usual. The normal pattern is infection causes the need for this medication and for a longer period of time. At this time of year I am generally pretty good.

Symptoms of other diseases have become worse/developed. Whether this would have happened anyway I don't know, it is unlikely. Asthma remains difficult.

Realised around 6 weeks in that it may well be that FIAsp was not ok for me but didn't want it to be; I ignored it and ploughed on.

Site sore, 3 or 4 red marks still on my arm caused by irritation.
In the final couple of weeks I found FIAsp did not produce much response in bringing post prandial bloods down. Eventually I used 2 or 3 times as much insulin to get my bloods down. It is difficult to be precise as other medications impact my BG. Overnight basals would always gradually settle back to normal. At this point, 8 days ago, I switched back to humalogue.

Prior to using FIAsp I had no problems with attaching or removing pods. Post FIAsp the first pod I used caused several layers of skin to come off with the adhesive, this was very sore, left two dark red shiny patches. These are still slowly regrowing skin and a litlle sore. This has never happened before.

As yet I have not discussed this with my GP or clinic.
For many years I had an excellent consultant, I am grateful to him for my CGM.
My current consultant is reputedly an excellent. I find him to be a poor listener and appears to assume that anyone who says anything other than the required response is either lying or really rather stupid. It is doubtful if I will discuss these difficulties with him.
I will be discussing it with my GP, who does listen and who will admit to not know everything.

T1D, asthma + unspecified autoimmune disease(s)

That allergy and insulin resistance are likely to occur.

42
Pump
3 months 
Sometimes
Action time
Insulin Tail

No need to pre-bolus, and require less insulin for carbohydrates eaten as the insulin seems to act more effectively.

Did my research, but I’d advise not trying to change anything too quickly. Only change one thing at a time and give yourself a few days to adjust to changes before considering changing anything else.

43
Hybrid Closed Loop
2 months
Yes
Action time
Unexpected results after bolusing

In short, I often have to "chase" his, my basal rates are higher than Humalog, and, in general, resistance seems to not be getting better after 2 months.

I began openaps using Fiasp. I wish I had started with Humalog so that I could compare.

44
Pump
5 months
Yes
Action time
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)
Other things worth considering

First experiences of Fiasp were very positive, fast action so cut out spikes with high GI carbs. Shorter DIA and better ISF (less insulin for bolus). HOWEVER, by 3rd reservoir, MAJOR site problems started. Big red bumps, significant stinging on blousing. Poor insulin absorption from inflamed sites. Problem got worse so inflammation and pain within 4-6 hours of putting in a new set. Decided to try to acclimate myself to the Vitamin B3 by mixing Fiasp with Humalog. Started with 1:4 which alleviated site problems and seemed to work almost as quick as pure Fiasp. Now using 1:1 Fiap:Humalog. Still some site inflammation on day 2 of site and some stinging but absorption usually OK. Sites sometimes degrade a bit on 2nd night.

About site problems.

45
Pump
2 weeks
Yes
Other things worth considering

Painful, I could not take it 🙁
Onset not widely different to humalog above 9mmol anyway, for me.

As above.

46
Hybrid Closed Loop
1 week
Yes
Action time
Changes required on pump (e.g. basal rates, ISF, DIA, I:C Ratio)

After 1 week I've learned that it hurts with bigger boluses sometimes. After one week we have noticed higher insulin resistence on sixth and seventh day.

Have not stopped yet



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