Category Archives: insulin injections

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

 

Bravery

“One. Two.  Three. Four. Five. Six”  SNAP! The infusion set is inserted into my son’s stomach. He writhes in pain, rubbing his stomach. His eyes are closed as he tries to compose himself.

I usually tell him to “suck it up!”  I tease him about being a wimp and he gives me a lecture on the varying levels of pain a site causes depending on location and insertion method. This time I said nothing.  I paused for a minute and watched him in awe.

We will soon have been at this game called diabetes for thirteen years.  That is 87% of his life spent living with diabetes.  As of today that is at least 37,776 times that he has had his fingers lanced to make them bleed so that I could know his blood glucose level or ketone level in his blood.  He has been poked by a syringe to inject life saving insulin into his body a minimum of 5500 times.  He has been stabbed by an insulin infusion set injector at least 1300 times.  I don’t think he has ever cried.  I don’t remember ever having to chase him to lance or inject him.

He puts off changing his sites. He forgets to test. He will do anything rather than endure another injection or have blood work done.  I will give him a hard time.  I will tell him to deal with it.  Why? Because in my head, I still see that lifeless little boy that I willed to live all those years ago.  I vividly remember what life without insulin looked like.  There is no option but this one. 

Despite that hard line; despite “knowing” that there is no alternative, last night I allowed myself a moment to recognize how brave and strong he really is.  I HATE lancing my finger. I squirm and cringe.  I jump and do anything rather than voluntarily stab myself.  I hate getting blood work done and will not watch and the needle enters my veins.  The needle that I stuck into my son’s stomach is bigger and longer than most needles I have experienced.  I had an IV put in my hand about a year ago and after the nurse was done messing about, turning it, and twisting, I was almost sick to my stomach and fought to stay upright. 

If I had to have infusion sets stuck in me on a regular basis, I would be an Emla addict and I would still cringe and squirm.  My son used Emla for a few years, but then he decided not to bother with it any more. 

I still believe that injections, insertions and lancing is a FAR better alternative to life without insulin but I also remain amazed at the pain that a person with diabetes goes through to stay alive on a daily basis.  I am amazed at all that my son has gone through and he still simply takes it all in stride each day.

Little bruises

We have spent a lot of our time this summer traveling. It has been an amazing summer with lots of lovely warm days. Its not surprising then to see so many people–young and old in shorts and lights shirts. 

Sitting in Tim Horton’s recently, I saw a little girl happily playing with her grandfather. She carried a small lunch bag.  She was wearing shorts and a tank top. Her bare arms and legs visible and full of energy. The bare limbs and lunch bag sent my mind reeling back in time. 

I remembered when my youngest son was her age–around five perhaps.  I remembered his small legs.  The tops of which were often marked by small little bruises.  I remembered the tank tops he would wear and the dots that could be seen on these little limbs as well. 

At the time I thought of them as the price paid to keep my son alive. It was an invitation for people to talk and learn about diabetes.  Now, as I watched this young girl, I wondered what people really thought.  Did they ask themselves if I was abusing him? Did they mistake life saving injections for some sort of injuries? If I didn’t know the difference I might have asked myself if that child was accident prone or was there something more going on. 

I looked at the little girl again.  She was full of life–full of innocence.  Her body unmarked and perfect.  I saw my son the same way.  Like his older brother, he was perfect and full of life.  He had lost some of his innocence by that age however.  He had already spent years having his body violated by needles.  He had already cheated death and we would make every second of life count.