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. 




Recipe Nostalgia…How things have changed!

When Diabetes moves in...

When Diabetes moves in…

I smiled a bit when I turned to this recipe yesterday.  My mom always told me that you could tell if a recipe was good by the amount of food spilt on its pages.  Obviously, this recipe had been used once or twice but that wasn’t what made me smile.

As I looked past the blotches of vanilla that splattered the paper, I noted the influence of diabetes on the page.  The first set of notations showed the days of living with exchanges.

When my son was first diagnosed with type 1 diabetes, his toddler meal plan was as follows:

Breakfast=1 Fruit, 1 Milk, 1 Starch, 1 Protein and 1 Fat

Snack=1 Starch, 1 Fruit

Lunch=1 Fruit, 1 Milk, 2 Starch, 1 Protein

Snack=1 Starch

Supper=1 Fruit, 1 Milk, 2 Starch, 2 Protein, and 1 Fat

Snack=1 Starch, 1 Protein, 1 Milk

It would appear that if he wanted to have a carefully measured bowl of rice pudding, it would have been 1 Milk and 1 Starch…almost good enough for a night-time snack!

I can see how the recipe stayed the same but method of calculating what he could eat changed with time.  The second set of notations simply states “28g=125mL”  This meant that if he ate 1/2c of rice pudding, I would factor in 28g CHO.

I don’t see the carb factor for this recipe.  That is strange but perhaps my son no longer ate rice pudding once we figured out that method of carb counting.  More likely, it was just as easy to grab a 1/2 c measuring cup to scoop out his dessert than it was to grab a scale!

Either way, its interesting to look back and see how far we have come.  Thankfully the days of eating a very regimented meal plan didn’t last very long.  With the help of an amazing group of friends, a fabulous dietitian, and a forward thinking doctor, we were able to learn how to make food work for us rather than fighting to make a 3-year-old eat food that he didn’t want. Today, my son eats anything and everything that he deems proper for his body.  That can mean green tea and tuna or a Grandpa Burger from A&W, an insulin adjustment and he is on his way!

Finding your Diabetes Balance

November is coming up and once again we are facing Diabetes Awareness Month.  I once asked a person with diabetes what they do in November and they looked at me rather strangely.  I was told that every month is Diabetes Awareness month in their world! So very true!! 

Despite that, I still try to give an extra push to politicians and do some added awareness “stuff” during the month.  The month is only a few days away and while there are many great ideas floating in my head, including how to make use the US JDRF’s Diabetes for a Day campaign, I have nothing concrete planned yet. 

I have however come up with something that I am hoping will help some people who are living with diabetes–be it parents or people who struggle with the disease. “Finding your Diabetes Balance” involves four intense diabetes coaching sessions offered by me during the month of November for those who feel overwhelmed by the disease.  There will be no further commitment required besides once a week for the month of November but the sessions will be intense and require your full effort. 

We will begin with looking at how diabetes has impacted various aspects of your life.  We will work together to figure out where it is hurting you the most and allow you to dream about where you would ideally like things to be in the near future.  You will then be given some homework to prepare for the second week’s session.

In week two we will create an action plan.  We will see what has stopped you from reaching your goals in the past and look at the tools and resources you have to be a success this time around. 

By week three we are halfway there!  At this point you will be given an affirmation to help you relearn old habits and provide you with the encouragement to go forward.  Together we will discuss changing your perspective to allow new and more positive thoughts to become part of your frame of reference. 

For our final session, we will create a 90 day plan for you.  You will now have a clear idea of how to move forward and we will work to see that you can succeed.* 

This will bring you into December with clear goals and ready to tackle the holiday season and the new year with renewed enthusiasm! Better still, for the month of November, and for people who have diabetes living with them only, these sessions will be offered at four sessions for the price of three! So you will be able to begin to get things on track and save money for the holidays at the same time! 

Remember that you do not need to go to an office or leave the comfort of your own home for coaching sessions.  They can be done via telephone or through Skype with the same effectiveness. If you are interested in this offer or know someone else who could benefit, please contact me or pass the information along! 

*Please note that Life Coaching sessions usually take place over the course of three months.  This is a brief guide to help you move forward. Should you wish to continue with my services beyond this intense one month introduction, continued pricing will be discussed at that time. 

Phil, the SUPER COOL Animas Penguin

In honor of Wordless Wednesday, meet Phil the SUPER COOL Animas Penguin. He was way too cute not to bring home from this summer’s FFL Canada Conference

(And his belly is made to practice inserting infusion sets) 

The Death of a Calculator

Its been in the making for awhile but today it was official.  Tragedy has once again struck our house.

Our beloved calculator, given to us by our great friend Stacey and used daily for probably five or more years has died.  I was crushed.  This calculator sat by our scale in the kitchen.  It had been calculating carbs for us for years. 

Suddenly I remembered that we had another one just like it!I rushed downstairs and into my office to check the second calculator.  You can understand why the tears began to fall when I pressed the button to turn this one on and once again…it was gone too!

Yes, I can go out and buy another calculator. Yes, because diabetes lives in our house I will have to go and buy another calculator or start using the one on my phone more but that is not the point. These calculators were cool!

If you look closely they have a life preserver and a little floating glucagon kit inside. Where can you get something as cool as that? Only from a friend of a child with diabetes.

The sun still shines.  The calculator on my phone was able to figure out my son’s breakfast carbs but meals will never be the same any more.  The great “fun” factor of our cool little calculator is gone.  Carb counting will now be a little more routine but I guess that is just part of the circle of electronics life.

RIP my calculator pals and thanks Stacey for the years of fun with them while they lasted!

Fantasy Diabetes Device

What would my fantasy diabetes device be? We already have part of it. I love, and my son completely LOVES his Cozmo.  My dream would be to be able to keep all of its amazing technology…with one addition. A cattle prod. You know, an electric shock device.

Vibrations and alarms just do not cut it.  When they go off, my son obliges and turns them off without looking or attending to the issue at hand.  I have always thought that if he received an electric shock, he would be more likely to pay attention to what caused the shock. He might even be proactive and change a site before he was warned. He might put in insulin before the pump is gasping for more. He might even…wait for it….test before the pump tells him too!

Ah yes, a little electrical stimulation could work wonders for his diabetes care! His hair may end up a little curlier than it currently is.  He may develop a bit of a nervous twitch but I am sure it would all be worth it in the end.  Don’t you??

Where has all of the new technology gone?

Is it just me? Have I been in the game too long? Am I no longer in the loop like I once was?

This year brings our 11th anniversary of living with diabetes. Not nearly as much fun as a wedding anniversary but its better than the anniversary of my son’s death.  When we first started down this road I was steadily finding something new.

We started on a “new” rapid acting insulin–Humalog.  Soon after, there was Novolog (or NovoRapid for those of us north of the US border).  After that we saw long lasting, peakless insulins like Lantus and Levemir.  We were the first patients that my son’s doctor ever prescribed Lantus for and he was pumping at the time (Mom wanted to have some “just in case”).

We started on an AccuChek meter that required at least 30 seconds to read and people were grateful for this “speed”.  Soon meters were showing up that required 15 and finally 5 seconds to read.  The blood required was no longer a vial per test but a pinhead sized drop.  It seemed that every week there was a new and better meter to try. 

Insulin pumps were also changing on a daily basis.  Smart pumps were coming on the market and everyone was getting into the game.  There were four companies at least to chose from and everyone wanted your business so they each had features that made you take notice.

Continuous Glucose Monitoring was still something done with hospital equipment and a blinded machine but the GlucoWatch and rumours of more were coming.

Fast forward to 2011–We are still using the same meter we have had for the past three years.  We have the same pump that we started my son out on 8 years ago (it has upgraded slightly) and fear when we have to look at a “new” pump because it will not be as good as the current “Green Machine”. There are three CGM systems available in the US but none of them are within reach of those of us without insurance.

We are fortunate that our province has an insulin pump program and as long as we live here (or until my son turns 25) he will have his pump and supplies covered.  They also will cover his rapid insulin because it is a must for his pump.  CGM systems remain a dream that must somehow become a reality before he heads off to university but that is a few years yet thankfully.

So am I out of the loop? I know that there are OmniPods and talk of micro-pumps have been in the works for well over five years but these things are not new and no longer excite me.

Am I just getting bored or not spending as much time researching as I once did? I looked forward to the advances in technology.  New meters were collected and used with serious scrutiny. There were better insulins and everything seemed to be moving forward at a breakneck pace. 

Today things seem slower.  There is still “cure” talk but I have grown calloused to such chatter. There is work on closing the loop but again, its not now and its not something I can put my hands on.  

I miss new gadgets and things that made me think that I was doing better by my child.