As I’ve mentioned plenty of times, I’ve been using Fiasp in a Closed Loop for some time, and the last week or so has really seen it coming into it’s own in terms of the distribution of my glucose levels. This last week is a case in point, and I’m of the opinion that this stuff works extremely well in a closed loop system.
But I’m not the only one that’s using this stuff. There are plenty of others. And their voices are also worth hearing. Using data from those who have filled this form in, providing this data set, plus feedback from diabetes.co.uk/forum and facebook groups, we see the following
- It acts faster than both NovoRapid and Lispro. For those for whom it works, the time before a meal that is required for pre-bolusing is dropped, in most cases to between zero and ten minutes. For me personally, bolusing with food works very well, so it’s good to see this result from others.
- It IS being seen to be faster than Humalog for some. We hear from some HCPs that they are only going to change those who are on NovoRapid, however, the feedback from the small sample set that is given suggests that many humalog users would benefit:
- “I’m impressed with Fiasp and think it’s a great step forward from Humalog.”
- “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.).”
- “Action time is ~15mins faster than Humalog, great for bolusing during/end of meal. Really cuts down on post meal spikes.”
- There is a lack of clarity as to how to handle the tail – whilst it is not that different in theory to NovoRapid, people are getting different experiences of it. Some are using the same period as Novorapid/Humalog whilst others have shortened their DIA.
- Careful monitoring after changing is really important.
- Some people see increased resistance to Fiasp around breakfast time, in line with Dawn Phenomenon issues.
- Localised red bumps have been seen at some cannula sites, raising some concerns about micro scarring, and a couple of people have reduced their cannula life as a result.
- Whilst most users are happy with the faster onset, some have not seen this effect and still get results that are in line with Novorapid, but see the peak occurring with more impact.
- There are a few for whom it simply doesn’t seem to have an effect, and who have given up.
To quote a participant on diabetes.co.uk,
Well FIASP is a god send for spontaneous eating, I kinda of winged it today at the street food event. Got there for 11am, mentally prepared my self to not get stressed at a double digit. From 11am til 2:30 I ate:
Fried Chicken and Fries, Soft Tacos, Fish and Rice, Half a Pizza and a ended with a creme brulee. And to drink two beers. I set a high basal to cover my beers, and I guessed bolused everything. Attached is my Dexcom from the day. No correction needed.
I think that’s the biggest benefit with Fiasp for me. It allows you to regain some spontaneity. There is no longer a need to dose 20-40m mins before eating to avoid a post prandial high. I and others are getting the same kind of reaction, bolusing with food.
Why is this a big deal? Well you are bolusing for what you see, not what you might see and that reduces the risk of both lows and highs. You can even dose post eating (although I wouldn’t recommend it) and still reduce post-prandial highs.
In other words, while there may or may not be a significant clinical difference in Hba1C as a result of using Fiasp (and we’ll see that in the not too distant future with the results of the ONSET 3 or 4 trials), I’d say there’s a very clear lifestyle and quality of life benefit.
What is it? It’s that faster insulins make living with Type 1 easier, and in this context, Fiasp = greater Freedom.
To quote Peter Fonda in The Wild Angels:
We wanna be free.
We wanna be free to do what we wanna do.
And we wanna get loaded.
And we wanna have a good time.
That’s what we’re gonna do.