Six things not to say to parents of children with diabetes

things you dont say to a parent of a child with diabetesPeople generally mean well but sadly many just don’t think before they open their mouths.  I therefore thought that it might be a good idea to create a little list for them of thing that you really should NOT ever NEVER say to parents of children with diabetes. Consider it a personal service announcement if you will…

My cat had diabetes

Really? Seriously? Because we know that you injecting your cat’s fur with insulin is really identical to chasing a toddler around the room with a syringe,  pinning them down and explaining that you are stabbing them for the fourth time today because you love them.  Yes, I am sure they are exactly the same.

Yes, there was an eye roll here.

My great-aunt Thelma died of diabetes

Thank you.  I needed to hear that.  I have guilt on top of guilt about not protecting my child from this disease and you tell me that your 90 year old aunt died because of diabetes?

Odds are that she had Type 2 diabetes and at 90…well her odds weren’t the greatest for lasting long anyway but yeah, I can see where I needed to know this.

This is why parents of children with diabetes have bruises on their heads. They spend a lot of time banging it against a wall in frustration. .

Don’t worry. I am sure that your child will grow out of it.

The odds of my child outgrowing their diabetes are lot  less likely than as you overcoming your ignorance of what type 1 diabetes really is.

Nope, growing out of diabetes is not an option.  My child’s pancreas is just no longer doing its job.  We have tried everything we could to revive it but its dead. Gone. No functioning beta cells to produce insulin.  No hope.

On the upside, I would really encourage you to do a bit of Googling or even ask some questions of me and then listen.  Truly listen to what I will tell you and you might be surprised at what you can learn. Your ignorance can be cured!

Perhaps if you hadn’t given your child so much sugar, then he/she wouldn’t have gotten diabetes.

Perhaps if you had not thought that they said “trains” when they were handing out “brains” and decided that you didn’t want to go for a ride, you would have a bit more of a clue.

Having a child with diabetes brings enough guilt.  I fret over what I could have done. I berate my faulty gene pool for allowing this to happen to my baby. Despite these things, I did not cause my child to develop diabetes. What my child ate had nothing to do with his diagnosis.  Really.

Would she prefer a diabetic chocolate?

Eeeekkkk!! Run! Fast! Actually if you eat many of those chocolates you will have to run fast–to the washroom.  Many diabetic candies are filled with sugar alcohols that can cause diarrhea.

Thankfully, my child is able to balance insulin injections with food intake so regular candy is just fine.  We do appreciate you trying though.

Perhaps you may want to relook at how many of those candies you have as well.  I kid you not.  They are nasty!

Is their diabetes under control?

Control? What is that???  A parent of a child with type 1 diabetes is trying to keep a blood sugar fluctuation of .54grams per liter on a constant basis despite over 25 influencing factors trying to mess with things.   Imagine that…trying to maintain a balance of less than one gram of sugar with the influence of stress, food, exercise and 20+ other things!  Can you see why  as parents we simply celebrate when they get even two readings in range?

It’s a big deal.  Diabetes is a really complicated disease.  Most parents of children with diabetes are doing their very best to balance allowing their child to be a normal kid and trying desperately to manage blood sugar levels so that their children feel healthy.  It is a huge challenge.

Parents of children with diabetes appreciate when you care.  Really we do, but please, please, please, think before you speak!

There are certain things that you really truly should not say to parents of children with diabetes.  Offer them a smile, a sympathetic ear, a kind word even.  Honestly, they are much more appreciated.

How to Fight for the Disability Tax Credit with Type 1 Diabetes

How to fight for the DTC with T1DDiabetes Canada recently released a statement claiming that the Canadian Revenue Agency (CRA) is now declining 80% of applications for the Disability Tax Credit (DTC) submitted by people living with type 1 diabetes.  I cannot confirm or deny these figures. I can state that I am seeing a significant increase in the number of people contacting. They are reaching out because they  or  their clients have been declined for the DTC.

What is going on with the DTC?

No one seems to know.  CRA claims that there has been no change in policy.  Public concern seems to suggest otherwise.

For years, people with diabetes have often received a follow-up letter when they have made their application asking for more details from their doctor.  In the past, that letter was filled out in a similar manner to the initial application and the claim was approved.  This seems to be happening with less frequency now.

People living with diabetes are often receiving a letter stating that “an adult who independently manages insulin therapy on a regular basis generally does not meet the 14 hours per week requirement unless there are exceptional circumstances.”.  In some cases this is followed by a request for more information but in other cases it is part of the denial for their claim.

Does this mean that I should not apply?

No.  People living with diabetes usually spend over 14 hours per week to intensively manage their diabetes.  Granted this does not include all people living with diabetes but does include a large majority.

You should continue to send in your detailed applications. Make sure that you are adding tasks that are approved and that your total is over 14 hours.

What happens after I apply for the DTC?

Once you and your doctor have completed your forms and returned your application, there will be some time before you hear back from CRA.

Odds are high that your doctor will be contacted and asked for more information.  Again, make sure that the follow up letter is detailed. Take care to  clearly show that you spend over 14 hours per week on your diabetes care.

What if I am rejected?

If you are turned down for the Disability Tax Credit, you have a few options.

First you can ask that your file be reassessed by another officer.  Sometimes fresh eyes will give a fresh perspective and the ruling can be changed.

Second, you can formally appeal their decision within the first 90 days of your rejection letter.  This is a detailed process but does not necessarily require a lawyer.  If you choose to go this route (and I would encourage everyone to do so), be sure to keep careful and detailed records. You must also contact CRA for a copy of your file under the Access to Information Act to better understand what you are fighting against.

Write your Member of Parliament

Finally, at any stage of the process, I would encourage you to ask for the assistance of your MP.  Whether you are thinking of applying, have applied or have been rejected, it is important for Members of Parliament to be aware of this situation.  Diabetes Canada has written a great template for people to send to their MP.  Download the letter. Be sure to personalize it to your situation and forward it on.  Remember that letters sent to a Member of Parliament in Ottawa do not require postage.

The more MPs that contact the Finance Department and ask them what is going on, the stronger the case for change and fairness.

Together we were able to get access to this credit for some people living with diabetes over 10 years ago.  Working together again, we will create change for even more individuals!

Animas, We are Heartbroken

Animas insulin pumpers heartbrokenJohnson and Johnson announced on September 5th of 2017  that they were closing the doors on their insulin pump division in Canada and the US.  Animas Insulin Pumps would be no more. Animas insulin pumpers in North America were heartbroken.

While some saw it coming in the corporate rumour mill, others were blindsided.

Animas had done something that many companies in many industries are striving to do…they had  created a feeling that you were family.  Whether you were an Animas insulin pumper or you used another brand, you had probably attended an Animas event and were treated royally.

The employees with Animas all seemed to genuinely care about you.  They checked in on you and took the time to know your family.  I had the pleasure to work closely with many members of the Animas family over the years.  They will be huge assets for the next company that employs them. I am sure that many of them are just as saddened as we are.

This is not the first time that an insulin pump company has closed its doors.  We have been here before…twice.

Cozmo (personally a pump like no other) closed its doors in 2009.  We still have two in my son’s closet.  I have friends who still wear this as their pump of choice.  It is doable even 8 years later.

Most recently, Asante, a pump revered by many who tried it,  was also forced to step away from the insulin pump market.  Their users were devastated.  They were heartbroken and felt lost–just like Animas insulin pumpers are feeling today.

How did they go forward?

One step at a time.  The great thing about insulin pumps is that, while some have quirks, many are pretty sturdy and last.  If you have more than one pump in your house–usually because one was out of warranty and you  purchased a new one right away “just in case”, relax.  If for some reason, you current pump stops functioning, go back on your old one while you decide which pump to try next! Just make sure to write down those settings and keep them in a safe place.

What do I do now?

You don’t have  to stockpile supplies   You don’t have to run out and buy a new insulin pump tomorrow.  The Animas press release stated that warranties will continue to be honoured until September 2019. Cartridges will be be available until that date as well.

Statements from both Animas and Medtronic note that supplies will still be able to be ordered in the same way as before. Nothing changes, except when your Animas pump stops working, you will not be able to purchase a new one.

Thank you…

So while we take a breath and rethink our next steps…our next pump…our next option, I want to take a moment and say thank you.  Thank you to the men and women who worked so hard to make Animas a different company.  I truly appreciated getting to know so many of you.  You brought us a new experience in caring.  I hope that we meet again soon, with a new company perhaps bringing new options in diabetes care.

Options are the most important thing.  Make sure to always know your options and always choose the option that works best for you and your lifestyle.

 

9/11 and Diabetes Created New Concerns

Remember 9/11This post was originally written in 2012.  The sentiments remain the same. 9/11 was horrible.  When you live with diabetes, 9/11 brought out fears and concerns that you would never previously have considered…

September 11, 2001.  Is there any adult in North America who does not remember where they were on that fateful morning?

I  had left my house early to drive to the airport 2.5 hours away to pick up my grandmother who was coming to visit from the other side of the country.  My oldest son was in school and my youngest was with me for the ride.

I stopped to do a bit of shopping and was looking at paper towels when my cell phone rang. I was told  “A plane has hit one of the towers in New York. There has been a terrorist attack.”   It made no sense to me and I didn’t believe it.  There had to be a mistake so I continued my shopping  before the next leg of my trip.

A few minutes later my phone rang a second time.  This time it was a woman from Air Canada who said,  “We have your grandmother here.  The plane can’t fly her  because all air traffic has been grounded.  We will be putting her on a boat and you can meet her tomorrow morning.”

What? The terrorist attack was real? Planes grounded?  I was shocked to the core as  I spoke to my grandmother who was in great spirits and excited to experience an Atlantic Ocean ferry boat crossing.  We  headed home and like many others, I alternated between being glued to the tv and checking my computer for updates from friends and family.

I had recently found an online support group  for parents of children with diabetes. The people there had not only become my lifeline, but also my family.  We were frantic to hear from people that we “knew” living and working near the towers in New York.

I had a cousin who was an NYC police officer. I had to find out if he was working that day or safe with his family on Long Island. Another cousin was due to go to traffic court that day in one of the Towers and I wondered if he went before the collapse? It was a day of chaos, fear and some relief.

By the end of the day, everyone was accounted for.  There were a lot of prayers for those lost as well as those who made it out alive.  As the dust settled–figuratively and literally, a new fear began to permeate.  I live on an island in the middle of the Atlantic Ocean and can easily be cut off from the rest of the world–the rest of my family.

More importantly, if we were cut off how would I get insulin or diabetes supplies? My youngest son relies on insulin to live.  What if we couldn’t get it as easily any more? How would I keep him alive?  What if the terrorist attacks continued? Would they target pharmaceutical factories? Could I feed him no or low carb foods? Would he be okay? I could feel the panic welling.

I wasn’t alone in my concerns.   Other friends with children with diabetes were thinking similar thoughts but some were  much more resourceful than me.  One friend investigated getting insulin from rabbits to use for her child.

Thankfully we never had to be concerned with any of those fears coming to pass.   My grandmother is now passed on.  Each year, we all continue to  remember exactly where we  were on that day and we say an extra prayer.

For those of us living with diabetes, we give an extra pause.  We remain grateful for access to the supplies that keep our loved ones alive.  It is oddly funny however that once diabetes enters your life, it permeates everything–even memories of disasters.

Preparing for Disasters with Type 1 Diabetes

diabetes emergency listThis year we have seen many mandatory evacuations because of both hurricanes and fires.  When you live with diabetes in your home, how do you prepare for disasters? Do you have a list of evacuation supplies checked off and ready to go?

People in the hurricane states, often have a emergency tote or bag that they can grab on the way out of the door but remembering everything that you could need can be a challenge.  Over the years, we have come up with a detailed list of evacuation supplies for people with diabetes on the Diabetes Advocacy website.  In lieu of recent events, I thought that it might be a good time to go over some of the items with you.

Keep a container near the door

As I mentioned, it is important to have all of your supplies in a quick, easy to grab container.  Evacuations can be planned, but sometimes you are only given minutes to have all of your valuables ready to leave.  Make sure your diabetes bag is always in the same place so that you won’t waste valuable time trying to find it.

Packing Basics

Make sure that you have some of the basics like a Frio pack if you live in a warm climate.  You will also want a flashlight and spare batteries in case your area loses power.  Candles and wooden matches can also provide light and heat if need be.

A first aid kit should also be in your emergency container. While you may have a lot of diabetes supplies, other medical emergencies can happen and basic first aid is a must.  Don’t forget to add anti-diarrhea and anti-nausea medication to your kit.  You should also have copies of all prescriptions in case you are away from your home pharmacy and need to access your medication refills.

Food and drink

We have all seen the images of people stocking up on cases of water and in an emergency it is vital.  If you have drinkable tap water, fill up milk jugs, juice jugs and other items with water to take with you.  Also pack juice packs, tinned food as well as cheese and cracker snacks. If you pack tinned items, don’t forget a hand can-opener as well.

Diabetes Supplies

It is recommended that you pack two weeks worth of diabetes supplies with you during an evacuation.  Consider bring a spare meter, spare batteries, alcohol wipes, pump supplies, insulin, syringes, ketone strips, and medical tape.

Other items to remember

Don’t forget to bring spare blankets, cash in case bank machines are down, and pet food for your furry family members.

I am sure that I have forgotten a few things but I would suggest that you view the Diabetes Advocacy Emergency page and print off a copy of the emergency supplies checklist.  This will help you feel a bit more prepared should a disaster hit your community.

Back to school with diabetes

Back to school with diabetes

Heading back to school can be stressful.  There are new books to buy.  Every child seems to need classroom shoes, gym shoes, walking to school shoes and then there are the gym clothes, jeans and more! The list is endless but when you are a parent of a child with diabetes, there list is longer.  Thankfully there are a few basics to remember when sending your child with diabetes back to school.

Meet with staff

No matter where you live, you should always make sure that you have a meeting with school staff before your child heads back to school.  If you live in an area that has 501 plans or any sort of diabetes care plans in place, this meeting can be where details are finalized.  If you don’t have any sort of official plans in your district, a meeting with staff is still important.

You want to meet with staff to discuss what they can expect when they have a child with diabetes in their school.  While your child may not be their first child with diabetes, each child’s care needs are different. It is important that they understand your child’s individual treatment plan.

At this meeting you will work together to establish roles.  Carefully outline what do you expect from the teacher and the support staff. Make sure that they understand what they can expect from you.  Finally,  ensure that everyone knows what tasks your child can do on their own.

You should also discuss things like, how will exams be handled?  It is important that school staff understand that  diabetes can cause cognitive impairment when the child is out of range.

You also want to establish a method of communication. The school  should understand that they can contact you and that you would like to be able to stay in touch with them.  Working together will make the year go smoother for everyone.

Click here for a few more ideas of what to take to this meeting.

Gather diabetes supplies.

 

 

Depending on the age of the child, the list of supplies that you require can be different.  A small child will require a change of clothes just in case he/she is high and has an accident in school.  An older child may require access to a phone or cell phone to ask you questions about their care.

Here are a few basic items that can be left in a backpack or put in a safe place at school.

  • juice boxes or glucose tablets
  • granola bars or other carb rich  and carb free snacks
  • spare test strips
  • meter batteries
  • pump batteries
  • a spare glucometer
  • extra needles or pen tips
  • spare insulin vial (to be kept in a fridge)
  • ketone meter and strips
  • spare infusion set
  • spare insulin reservoir
  • alcohol swabs
  • hand wash
  • water bottle
  • sharps disposal container
Other things to remember

If your schedule allows, volunteer to be a part of activities at school.  This will give you a chance to get to know school staff and they will learn a bit more about you.  It will also allow you to discreetly keep an eye on your child’s care without them feeling different.

For younger children, check to see if supports or nurses are available through your district.  The school may be entitled to extra funding that would allow them to have one on one care for your child for all or part of the day.

Make the year fun! Your child is a child first.  Plan ahead with staff regarding things like parties, extra curricular activities, outings and exams so that your child gets the most out of their school year.

For a guide to care policies in many Canadian schools please check out this link.

 

The Disability Tax Credit for Adults…What you need to know

Disability Tax Credit tipsThe Disability Tax Credit is a non-refundable tax credit available to Canadians who meet a very strict criteria set out by the Canadian Revenue Agency.  One of the criteria is that you must take over 14 hours per week to perform life-sustaining therapy.  This is the section that many people living with diabetes qualify under.  Before you apply there are a few things that you need to know.

Having diabetes doesn’t mean that you qualify.

Not everyone with diabetes will qualify for the Disability Tax Credit (DTC).  The criteria states that children with Type 1 diabetes qualify . Adults (anyone over 18 years of age) however, must show that they spend over 14 hours per week on their care.

Why do children get the DTC so easily?

The reason that children qualify  for the Disability Tax Credit is because CRA feels that the time that they spend on their care AND the time that their parents spend on their care, together is equal to more than 14 hours per week.  Adults do not require the help of others for the most part. Therefore must prove that they, themselves spend over 14 hours per week on therapy to keeping themselves alive.

Do I really spend 14 hours per week keeping myself alive?

That is a question that only you can answer.  I will say that if you are intensively managing your diabetes, then more than likely, you do take an inordinate amount of time out of your day to manage your diabetes care.

A person who is not reliant on an external source of insulin to live does not have to be concerned about blood glucose readings, anticipated activity levels, impending illness,  or fat contents of meals when planning their day to day activities.  The average person does not have to draw up a syringe, put in an infusion set or calibrate a continuous glucose monitoring sensor.  A person without diabetes does not have to keep track of their insulin requirements, blood glucose levels or activity levels in a journal.

These tasks, while commonplace for a person with diabetes, are all tasks that are recognized by CRA and count towards the 14 hour total required to be certified for the Disability Tax Credit as requiring life sustaining therapy.

I hear that adults no longer qualify so why should I try?

Some adults are experiencing a harder time getting the tax credit.  There can be many reasons for your application being denied.  You may be including tasks that are not recognized by CRA as being an allowable part of therapy.  Things like grocery shopping, doctors appointments and trips to the pharmacy are not allowed to be included in your total.

Another reason that adults are being turned down is because they are not providing details on their own specific care.  Often people are turning to internet groups that have sample forms filled out. They then simply copy and paste the details that they have found. You should be  using that information as a guide and filling out the application in your own words with your own specific care details.  CRA is noticing a pattern of applications and is now beginning to question their authenticity.

What does that mean?

It means that you need to make your application your own.  Spend one week detailing what you do each day.  It will take you a lot of time to stop and write everything down.  Time each task.  Note how often you perform it.

Take this week’s worth of information and then compare it to your online resources.  Eliminate the tasks that CRA won’t approve.  Add in the tasks that you did but forgot to add in your personal list.  Now total your time spent.  Most likely, you will find that you spend more than 14 hours per week on your care.  This data can also be shared with your doctor at your appointment. It will help he/she understand who much time you do put into your care.  This will further be of use if he/she if they receive a follow up letter from CRA asking for more details on your care.

Adults with insulin dependent diabetes who test regularly (6+ times per week), who inject insulin multiple times per day through injections or an insulin pump, and make their own adjustments to their insulin regimen should apply for the Disability Tax Credit.  If you are turned down, you have the right to ask for your application to be approved by another CRA staff member. Sometimes the second review still does not turn out in your favour but don’t despair. At that point,  you have the right to see all correspondence used in your file and begin a formal appeal process.

If you are unsure of how to fill in your application or you just want someone to review your totals, I can assist you. Email me or check out the Disability Tax Credit page for more details on receiving assistance.

 

Diabetes is hard! Some days you’re the windshield…some days you’re the bug

This post was originally written in 2009.  My son now manages his own diabetes care .  He wakes for his lows.  He treats his highs but one thing remains the same–diabetes is hard no matter who is responsible for care for the daily tasks. 

Diabetes is hard

“Some days you’re the windshield, some days you’re the bug.” Today I am definitely feeling like the bug!

It was after midnight and of course I was dying to get to sleep. I had set my alarm for early the next morning.  It would be my son’s last day of school.

I found a meter and a strip. I grabbed a lancet, waded through all of the junk that the boys had left on the stairs rather than putting away and was off to test my son’s blood sugar level. I hope it would be the last check for a few hours. One check and I could sleep!

We had been out for pizza earlier that day to celebrate good grades so I was certain that my youngest son would still be high. He had been  16 mmol (288) earlier in the evening  so you know I was certain that I was  going to be able to rest.

Wrong! Diabetes doesn’t work that way.

I took the meter. I lanced his finger  and created a pool of  blood. The strip refused to suck. What the???? Okay, I cleaned the finger. I got more blood. I tried again. The glucometer just barely accepted the blood. I waited for the reading…E5. It was an error reading!! There hadn’t been enough blood to get a blood sugar reading. Oh the lovely four letter words that were on the tip of my tongue as I headed back downstairs to get new equipment.

I found a new meter. I was certain that this one had to be better than the last. A new test strip was in my hand. The same lancing device was being used. Back up the stairs I went.  This time I grumbled and picked up items as I went.

Once again, I lanced my son’s finger. Again, I got a large amount of blood. The strip sucked the blood  this time! I walked towards the stairs not even considering having to correct a high blood glucose reading. That was a good thing because he didn’t need insulin.  He was 3.2 (57). He was low!

I uttered a few more choice words as I shuffled off to get some juice. I filled a glass, found a straw and trudged up the stairs for a third time in less than five minutes.

My son wasn’t keen on drinking. I continued to cajole him until he finally began to  sip. Thankfully he drank it all except the last few drops. Those were sucked up into the straw and somehow flew all over his pillow.  I was not happy.  There was now strawberry juice all over a cream pillow case.  I cleaned it off as best as I could and  waited.

Fifteen minutes can become a lifetime when you are dying for sleep. These are the moments when you just think to yourself…diabetes is hard.  Why us?

Eventually it was time to retest.  He was  5.5 (99) and I was finally off to bed for two hours before it would be time to test again.

Diabetes is hard.  Diabetes care is a challenge.  Some days things seem okay…and other days you feel like you are a bug squished against a windshield.

 

 

Tips for Managing Diabetes in the Summer

diabetes family summer partyIts summer!! I mean it really is finally summer! Some areas have been enjoying great weather for a bit but where I live–well, I kind of wondered if summer was ever going to show up.   Now that it is really here, let’s talk about a few tips for managing diabetes in the summer months.

Keep your insulin and test strips cool.

Summer heat can literally ruin blood glucose test strips and insulin.  If you are on injections, make sure to keep your insulin stored in a cool place. If you are pumping, again, make sure that your pump doesn’t get overheated.  You may even want to consider changing out your cartridges more often to ensure that your insulin is fresh and hasn’t been compromised by the heat.

Test strips also react to extreme temperatures.  Again also make sure that they are stored in a cool place.  If you are traveling to the beach or theme parks, you may want to invest in a FRIO Insulin Cooling Pump Wallet.  They are convenient little cooling packs that will help to keep things chilled.

If you don’t have access to Frio packs, another great suggestion is to use frozen juice packs.  You can keep your supplies cool and are prepared for lows!

Mastistol and Antiperspirant are pumpers’ new best friends.

Summer often means swimming and swimming can mean chlorine. Chlorine can bring extra headaches for people with diabetes using an insulin pump in the summer. Personally,  the only way for us  to keep sites on in chlorine was by making sure that a product  like Fernandale Mastisol Liquid Adhesive was used on the skin prior to set insertion.

For people using an insulin pump and/or a CGM, you may also want to look at using an antiperspirant on the site.  Apply a light coat of antiperspirant (not deodorant) to the insertion site area.  This will help to keep sites in place when your body begins to sweat!

Have snacks everywhere.

Summer heat can bring its own challenges for managing diabetes. It tends to mean more exertion and rapidly dropping blood glucose levels.  Make sure to carry extra snack foods with you wherever you go.  One parent suggests that you stock up on Freezies.  They are perfect treats for lows and also help ward off dehydration.  Other families have suggested fruit and frozen grapes as must have snacks for on the go.

Drink lots of water.

Dehydration is a real problem in the heat.  It is especially important for people living with diabetes to stay hydrated because dehydration will cause blood glucose levels to spike.

Test often.

Heat, exhaustion and the fun of the sun can really mess with blood glucose levels so make sure that you test often to avoid any serious diabetes related emergencies.

Bring extras!

As I have said, infusion sets can fall out.  Blood sugar levels can go crazy.  It is vital that you carry extras of everything–extra snacks, extra water, extra test strips, extra insulin and extra infusion sets just in case.

Wear sunscreen.

I know, everyone is supposed to wear sunscreen so really is this a diabetes issue? Well no…and yes! It turns out that sunburns have been known to really mess with blood glucose levels.  The moral of the story? Stay hydrated and wear sunscreen to help keep blood glucose levels in check.

Have fun!

Finally, in Canada especially, we just don’t seem to see summer for long enough so plan ahead and enjoy all that this summer has to offer you and your family!

*please note that affiliate links have been used in this post.  While these links do not direct to the only places to purchase the highlight products, purchasing from the links does support the work of Diabetes Advocacy

Fiasp Insulin. The New Kid on the Block

Fiasp Insulin the new kid on the blockIt has been a long  time since the diabetes world has seen a new rapid acting insulin brought to market.  The last one that I can remember was  Apidra released back in 2004.  It is  not surprising  then that the release of Fiasp by NovoNordisk is creating a lot of buzz.  Not to be let out, my son recently began using this insulin. Since Fiasp insulin is the new kid on the block, I thought I would give everyone a brief rundown on the highs and lows associated with it.

What is it?

Fiasp insulin was released by NovoNordisk onto the Canadian market in March of 2017.  Many of us scrambled to get a prescription because it promised better blood glucose levels without pre-bolusing for meals! According to the press release, you can dose up to two minutes before a meal and up to 20 minutes after starting a meal without compromising overall glycemic control or safety!*

How is it different?

A Medscape article states that  Fiasp is  absorbed twice as fast as its counterparts.

It does this with the help of  two excipients–Vitamin B3 is responsible for the increase in the speed of absorption and Amino Acid (L-Arginine)  has been added for extra stability.**

What do users think?

All of this science is great but most people are wondering how well it works in real life settings.  From what I have seen, the bulk of users really like it.  I could only find one person out of about a dozen users who had returned to their old insulin aspart.

When I asked my son for his review I was told “I still have highs. I still have lows BUT if I have a heavy carb  loaded meal, Fiasp kicks butt and I don’t have the same crazy swings that I always did before.” For a 19 year old who can definitely binge on carbs, this is huge.

Other users seem to have  had similar results.

Some people with diabetes found that the insulin peaks were no longer as pronounced.  They had some difficulty battling highs with Fiasp however while others found it perfect for corrections. In fact some people are purchasing Fiasp just for corrections.

Other users explained that the faster insulin action allowed them to more quickly respond to rising blood glucose levels.  This in turn meant resulted in much  tighter control.  The quick action has  also left one user to caution about the timing of any  prebolus.

Most seemed to agree that Fiasp insulin resulted in fewer food spikes and more stable blood glucose levels but as I said not everyone loves it.  For some users, their traditional rapid acting insulin seemed to work better.

Final thoughts…

All in all, most people with diabetes who are  trying the new kid on the block seem to be happy with it.  It offers another insulin choice  for those who struggled with post-meal spikes or don’t pre-bolus meals.

It must also be noted however that while Fiasp is not currently approved for use in insulin pumps in Canada, both those on insulin pumps and MDI are using this insulin aspart.

Finally, I was also happy to see that the price of Fiasp insulin was par with NovoRapid.  This meant that there was no need to worry about an increased cost for out of pocket insulin expenses.  My understanding is that Fiasp insulin is not yet on many (or any) provincial formularies.  This most likely will mean that if you decide to use the insulin and are currently using a publicly funded program, you may have to either pay for this insulin out of pocket or speak to your doctor about having special authorization added to your benefits to ensure full coverage.

Please remember to check with your diabetes team before starting any new insulin regimen. 

*http://www.novonordisk.ca/content/dam/Canada/AFFILIATE/www-novonordisk-ca/News/Fiasp_Launch_PR_English.pdf

**http://www.medscape.com/viewarticle/877892

 

All opinions expressed below are the result of years of sleep deprivation and worry caused by Type 1 diabetes