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

 

Choice. YDMV

Choice.

Your Diabetes May Vary.

Everyone is different.

What works for me, may not work for you.

These phrases are very important in the world of diabetes and specifically in the world of Type 1 diabetes.

I have always been vehement about people’s right to choose. I believe that individuals have to do what is right for them.  What is right for you may be not right for me but does that mean that I should stop you from doing it, right?

I have been equally as dedicated to the right to choose since entering the world of diabetes. I believe that people should be able to go on an insulin pump at diagnosis and not wait for a specific period of time…if they so choose.

I believe that everyone should have access to a Continuous Glucose Monitor. Access should not be restricted by income level or insurance plan…if they wish to use one.

Most importantly I believe in the right to education.  Education allows people to make informed choices.  Just because an insulin pump has been the best treatment option for my son, doesn’t make the best option for you.  Every person is different. Every body reacts differently. Each person should have the right and be educated to make the choices that fit their lifestyle regardless of budget.  That is my point.

I know of adults who have pumped and hated it. They did not want to be tethered to something. They felt that they had better control with injections.  That was their choice and they made it armed with information about themselves and the alternatives.  Everyone is different.

I have met parents who have seen great success using NPH on their children. I was able to learn how to use NPH and a rapid acting insulin in such a way that my son rarely did without at birthday parties or other food related events. We were educated.  We could make choices that worked for our families.  What worked for us does not always work for someone else.

If someone chooses to use an insulin pump, they have to choose the pump that works for them.  Some people don’t like tubing. Some people want a pump that is water-proof. Some people require larger reservoirs or a sensor augmented pump. It is vital that they be allowed to learn about their options and then make the choice that fits their lifestyle.

We all have seen how amazing Continuous Glucose Monitors are…but some people still don’t want them. My son is one of those not sold on the benefits of wearing yet another device. They have a right to make that choice but that choice should not be driven by money.  It should be made based on their own desires and knowledge of their diabetes care.

No one should have to choose insulin or bread, pump supplies or car payment, insulin pump or house down payment, a cab ride home after a night out or a sensor for their CGM.

No one should be forced to use an insulin regimen because they are ignorant of the options.

No one should be stuck in one treatment form or the other because it might take a bit more time to educate them.

Options should be given to everyone regardless of age or income.

People with diabetes should be shown all of the insulin options–do you want to go with limited injections? Do you want to use a basal/bolus regimen? Do you want to use an insulin pump? What features are important to you? Do you want to have a pump with tubing or without? A pump with CGM compatibility or without? Do you want to try a CGM? What works best for you and your lifestyle? What will give you the best quality of life?  Yes it can be overwhelming but knowledge is power.

One treatment option does not work for everyone. I have come across people who have created their own insulin cocktails to maintain great control on injections. I have known people who only used their pumps to cover meals and used an injection to deliver their background insulin.  I am hearing of people looking to add in the use of inhaled insulin for very specific needs.

Everyone is different but everyone deserves the right to make their own informed choices.  Those same people who make informed  choices then deserve our respect because what works for them may not necessarily work for everyone else.

Thank you DiabetesInsight.ie
Thank you DiabetesInsight.ie