Category Archives: diabetes control

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

 

Confessions of a Control Freak who has fought Diabetes

I have been lucky enough to get a copy of Leighann Calentine’s new book “Kids First, Diabetes Second“.  I am almost through reading the book and so far am very impressed but I will tell you all about it later. What sent me off to my computer was a line in which she said that for her, she learned to cope with diabetes by taking back control. 

When I finished reading the section in question, I agreed with her whole heartedly but being me, my mind immediately moved off onto another tangent with those few words.  I have always said that diabetes taught me how much control I don’t have.

I am one of those people who likes to plan ahead. Prior to diabetes, I could give you our ten year financial plan, our plan for our next five summer vacations and more.  It was all about the planning and controlling the world around me.  Larry would argue that I am still like that and in some ways I am but in a lot more ways, I am not.

Diabetes has taught me that despite my best efforts, things do not always go as I want them to. There have been the active days that I swore would result in lows so I reduced his night time basal rate only to be chasing highs for the rest of the night. Why? Because the diabetes gods made it so! Okay or more likely there was air in his tubing, a site that was going bad, a bolus calculating error…well you get the idea. 

I have planned to enjoy a good night’s rest only to find my son’s tubing was dislodged during the night and he is up vomiting with ketones.  I have equally planned on enjoying a night’s sleep only to be kept up with a low that we never saw coming.

We have planned for sleepovers that have ended because of highs that he could not get rid of on his own.  There have been celebratory meals at McDonald’s at the end of swimming lessons that left us all exhausted because my son had such a bad low that it took us every low food in my bag and half of someone else’s pop to bring back up.

There have been days when I have been prepared for diabetes to send me its worst…only to have a wonderful day. 

Diabetes keeps me on my toes.  As Leighnann says, for the first year, my life was about trying to gain some sort of control of our lives. Our world became very regimented. I functioned. I kept my son alive.  Meals were set.  There was no variation but over time, I took some of that control back.  I baked again.  I allowed him different foods at snack times. We ventured out of our safe zone.  Diabetes still kept us (and keeps us) on our toes but it has taught me a lot about what I can control and what I can’t.  It has also taught me what is important to control versus what is better left to happen when it happens.

My version what the Diabetes looks like!

Does diabetes control our lives now? No. Do I control our lives now? Heck no! I am now the mother of two teen aged sons, one who is heading off into the adult world in a matter of weeks…all my carefully guarded control is flying out of the window faster than I can hold on. Its not a bad thing…it just is.  We all cringe when someone asks if your diabetes is “under control” but we also recognize that we do have to take back some control of our lives and work to live with diabetes rather than living all about diabetes.