Category Archives: diabetes reality

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

 

Bolus for that!

Our life has been a little chaotic of late. In between boxes, garbage bags, and piles of “things” looking for their proper place diabetes has taken a back seat as much as possible. Maybe that’s why it really hit me the other morning…

I was sitting at the table enjoying my morning coffee. Breakfast had been made for both boys.  Their lunches were packed and waiting for them on the counter.  My youngest had finished his meal.  I gave him his carb count and his insulin had been dosed as he ate.  

He got up from the table and put his dishes in the dishwasher.  On his way out of the kitchen, he noticed the box of Timbits on the counter from the night before.  His hand darted into the box and he popped a little morsel into his mouth.  I yelled out to his back “Don’t forget to bolus for that!”


That is when it hit me…he could not just walk by and grab a snack.  He had to bolus for each piece of food that touched his lips.  I know that this is nothing new.  This has been our lives for over 12 years.  Despite that it still managed to make me stop.  My heart broke a little bit more.  It was such a natural act…and for him so was the grabbing of his pump while grabbing his donut hole. 

What they should know…

What would I like people who don’t have diabetes to know? Ah the list could be long!

I recently went to a diabetes event and there was much talk about the positive parts of diabetes, downplaying the bad and making the best of each day.

I agree with that to an extent. I will never tell my son he can’t do something. I will always promote the best of life with diabetes to him. I try to expose him to people who are positive and doing great things. As with his brother, I remind him that he is smart and the sky is the limit.

This changes when I am dealing with people who have no understanding of diabetes or people who are in an arena of politics that I need to influence.  I want the outside world to understand that while people with diabetes are pilots and hockey players, that they are lawyers and nurses, they are teachers and mechanics BUT they have to take extra precautions.

I want people to know that these people who look so normal on the outside, work hard to maintain their health.  Each night they go to bed wondering if they will wake up.  This is not some abstract or unfounded fear, this is their reality. People do go low and if left undetected, these people can die. 

These people have to measure each morsel of food that enters their mouth and know its nutritional components.  They have to know how much insulin their body will require to properly use that insulin.  If they make a mistake in this math, they will have to pay the consequences.  They will experience blurred vision, head aches, and a poor attitude if they are high.  They will be shaky and not be able to think clearly if they are low.  They will appear drunk or aggressive. They will appear to be very different people from their normal relaxed attitudes.  These are the realities that they face each day.

They carry around a suitcase of supplies–glucometers, test strips, glucose, insulin pumps, syringes, CGMs, and more. They test their blood and inject themselves with insulin numerous times each day.  They stab so many holes themselves, that as Joe Solowiejczyk notes, its amazing that they are not human sprinklers with liquids squirting out all over their bodies! 

These amazing people with diabetes rarely complain.  They do things to their bodies each day that we never think of. They play God in trying to figure out what their body would normally do in each situation like when stressed, when active or when relaxing on the couch. 

They are asked to spend incredible amounts of money to keep themselves alive. Like those living with Alzheimer’s, Parkinson’s, and cancer, the medications and devices that they require each day to stay alive and healthy may or may not be covered by insurance.  The out of pocket costs can reach thousands of dollars each month.  The stresses are incredible.

So what do I want people without diabetes to know about those who live with it? These people with diabetes are REMARKABLE! Their pancreases have quit on them but they have not quit on life.  They work harder than you and I.  They have to think about things that they shouldn’t just to get up each morning but they continue to fight each day.  Be amazed by them.  Be proud of them and most of all support them in every way you can!